bluuebunny/crossref_metadata_2025 huggingface dataset:
Central neurocytoma—positive and differential diagnosis: An example through a case report
Authors: Andour Hajar , Rostoum Soufiane , Cherraqi Amine , Fikri Meriem , Ech-Cherif El Kettani Najwa , Jiddane Mohamed , Touarsa Firdaous
Published: April 2023

Central neurocytoma is a rare intraventricular tumor, occurring typically in the lateral ventricle of young adults. It is considered as a neuronal-glial benign tumor with favorable prognosis. Imaging is a cornerstone allowing the accurate preoperative diagnosis on the basis of several characteristic features. We report the case of a 31-year-old man who has been complaining of progressive headaches and in whom brain magnetic resonance imaging revealed a central neurocytoma. We remind then, through a literature review, the main criteria to set the diagnosis of this tumor and rule out the other possible diagnoses.
An Exploratory Study of Primary Care Clinicians’ Perspectives on 2021 New and Updated Cancer Screening Guidelines
Authors: Angier Heather , Bonuck Kathryn J. , McCrimmon Sara , Wiser Amy L. , Huguet Nathalie , Carney Patricia A.
Published: April 2023

Background and Objective:

Cancer screening rates remain low in rural, racial and ethnic minority, low-income, and uninsured populations. Prior studies showed that cancer screening recommendations vary based on clinicians’ factors. We conducted an exploratory study on primary care clinicians’ beliefs about new or updated cancer screening guidelines according to clinician demographics.

Methods:

This cross-sectional study involved administering a web-based survey in July and August of 2021 to primary care clinicians practicing in diverse ambulatory settings in the Pacific Northwest belonging to the same health system. The survey assessed clinician demographics, attitudes about the impact of cancer screening on mortality, and how clinicians stay up-to-date with guidelines.

Results:

Of the 191 clinicians, 81 responded (42.4%), after removing 13 incomplete surveys, we analyzed 68 (35.6%). The majority agreed/strongly agreed that breast (76.1%), colorectal (95.5%), and cervical (90.9%) cancer screening, and HPV vaccination (85.1%) prevent early cancer mortality: there were no differences according to clinician gender or years in practice. Female compared to male clinicians were more likely to agree/strongly agree that tobacco smoking cessation (female: 100% vs male: 86.4%, P = .01) prevents early cancer mortality, whereas male compared to female clinicians were more likely to agree/strongly agree that lung cancer screening (male: 86.4% vs female: 57.8%, P = .04) prevents early cancer mortality. One-third (33.3%) of clinicians were unaware of the 2021 update on lung cancer screening and females were more likely than males to say they did not know about this change (females: 43.2% vs males: 13.6%, P = .02).

Conclusions:

This study suggests that clinicians’ attitudes are not likely the primary factor affecting low cancer screening rates in some populations and that few differences exist in beliefs based on gender, and none based on years in practice.
Outcomes of Secondary Arthroscopic Distal Clavicle Resection for Shoulders With Symptomatic Acromioclavicular Joint Arthropathy After Isolated Rotator Cuff Repair With Complete Tendon Healing
Authors: Bismuth Yaniv , Beckers Joris , van Rooij Floris , Saffarini Mo , Godenèche Arnaud
Published: April 2023

Background:

Recent meta-analyses have advised against distal clavicle resection (DCR) as an adjuvant procedure during rotator cuff repair (RCR), whether performed routinely or in shoulders diagnosed with symptomatic acromioclavicular joint (ACJ) arthropathy. However, the efficacy of DCR as a secondary procedure in patients with persistent pain attributed to symptomatic ACJ arthropathy remains unknown.

Purpose:

To evaluate outcomes of secondary DCR in patients with failed nonoperative treatment of symptomatic ACJ arthropathy after isolated RCR with complete tendon healing.

Study Design:

Case series; Level of evidence, 4.

Methods:

Between 2008 and 2018, the senior surgeon performed isolated RCR in 1935 patients, of which 23 (1.2%) presented with ACJ pain and discomfort at ≥12 months after the index RCR, despite complete healing of repaired tendons. Those 23 patients underwent secondary DCR, as ACJ arthropathy was confirmed clinically and radiographically. Clinical assessment before DCR included the Subjective Shoulder Value (SSV) and pain at rest. Clinical assessment at >12 months after DCR included the SSV, pain at rest, Constant-Murley score, range of motion, and satisfaction. Pre- and post-DCR SSV and pain scores were compared.

Results:

Of the initial cohort, 5 patients did not consent to the use of their data, leaving 18 patients aged 53.3 ± 7.6 years (mean ± SD; range, 39-68 years) for outcome assessment. At a mean follow-up of 7.0 ± 3.1 years after DCR, the SSV significantly improved from 58.7 ± 17.2 to 76.1 ± 20.2 ( P < .001), and the pain at rest significantly decreased from 4.7 ± 1.5 to 2.8 ± 1.9 ( P < .001). At final follow-up, the Constant-Murley score was 70.2 ± 21.0. Of 18 patients, 15 had none or mild residual pain (0-2; 83%), while 3 had substantial residual pain (5 or 6; 17%). Only 1 of the 3 patients with substantial residual pain had a poor SSV score (20 points) and was against opting for DCR in retrospect. No patient had infections or gross ACJ instability after DCR.

Conclusion:

Secondary DCR for cases of symptomatic ACJ arthropathy after isolated RCR with complete tendon healing reduced pain in 83% of patients, and 94% were satisfied and would undergo secondary DCR again.
Power Dynamics in Business English as a Lingua Franca Discourse
Authors: Roshid Mohammod Moninoor , Chowdhury Raqib
Published: April 2023

Although power manifests as a form of social behavior through language, how it contributes to business English lingua franca (BELF) discourses remains underresearched. This article problematizes how perceptions of power dynamics manifest through choices of BELF discourses as practiced in the Bangladeshi ready-made garments (RMG) industry. Data for this study were collected from interviews with three levels of business professionals. Findings show that perceived power is embedded in everyday business discourses to both empower and disempower speakers and influence differences in their language use. Specifically, perceived organizational position, business position, linguistic ability, and sociocultural identity impacted language differences.
Gear Pitting Measurement by Multi-Scale Splicing Attention U-Net
Authors: Qin Yi , Xi Dejun , Chen Weiwei , Wang Yi
Published: April 2023

The judgment of gear failure is based on the pitting area ratio of gear. Traditional gear pitting calculation method mainly rely on manual visual inspection. This method is greatly affected by human factors, and is greatly affected by the working experience, training degree and fatigue degree of the detection personnel, so the detection results may be biased. The non-contact computer vision measurement can carry out non-destructive testing and monitoring under the working condition of the machine, and has high detection accuracy. To improve the measurement accuracy of gear pitting, a novel multi-scale splicing attention U-Net (MSSA U-Net) is explored in this study. An image splicing module is first proposed for concatenating the output feature maps of multiple convolutional layers into a splicing feature map with more semantic information. Then, an attention module is applied to select the key features of the splicing feature map. Given that MSSA U-Net adequately uses multi-scale semantic features, it has better segmentation performance on irregular small objects than U-Net and attention U-Net. On the basis of the designed visual detection platform and MSSA U-Net, a methodology for measuring the area ratio of gear pitting is proposed. With three datasets, experimental results show that MSSA U-Net is superior to existing typical image segmentation methods and can accurately segment different levels of pitting due to its strong segmentation ability. Therefore, the proposed methodology can be effectively applied in measuring the pitting area ratio and determining the level of gear pitting.
Evaluating introductory biology student perceptions surrounding the use of integrative cases related to human health for evolution education
Authors: Filice David C. S. , Riedy Joseph J. , Heidemann Merle K. , Smith James J. , White Peter J. T.
Published: April 2023

Background

In introductory biology classrooms, cell and molecular concepts are often taught separate from those related to evolution and ecology, and usually in completely different courses. Furthermore, many examples used to teach introductory concepts are difficult for students to relate to. To address these issues, we developed curricular materials focused on the topic of breast cancer that: (1) aim to teach students how to integrate the various sub-disciplines of biology, with evolution as the unifying theme, and (2) aim to present course materials using relatable examples such as human health and disease. To assess the potential value of these materials, we asked students to complete a pre-unit and post-unit assessment before and after completing the interactive course unit on breast cancer.

Results

We found that after learning about breast cancer, students reported that learning about biology in the context of human health made their learning experience easier, more interesting, and more relatable. After the unit, students also rated evolutionary concepts as being more important for understanding human health and disease.

Conclusions

These results have important implications for developing introductory biology curricula that have more personal appeal to students and may thus translate to better learning outcomes, as well as help students better understand the process of evolution as it occurs in humans.
Hyaluronated nanoparticles deliver raloxifene to CD44-expressed colon cancer cells and regulate lncRNAs/miRNAs epigenetic cascade
Authors: Abd-Rabou Ahmed A. , Abdelaziz Ahmed M. , Shaker Olfat G. , Ayeldeen Ghada
Published: April 2023

Background

Colorectal malignant cells (CRC) are one of the world’s main causes of cancer mortality and morbidity. Notwithstanding the plenty of anti-CRC therapeutics, its prognosis remains not selective owing to cancer resistance to these therapeutics. Raloxifene (RX), a medication firstly used to treat osteoporosis, was recently licenced for the prevention of CRC. Unfortunately, due to medication resistance, many RX-based therapies are likely to become ineffective. Recently, we identified a novel method of administration to lengthen the half-life of RX by mixing it with chitosan (CS) and hyaluronic acid (HA). Thus, the rationale of the current study was to investigate how colon cancer cells were affected by RX-HA-CS nanoparticles (RX NPs) in terms of targetability, cytotoxicity, and epigenetic cascade alteration.

Results

RX NP had an entrapment efficiency (EE%) of 90.0 ± 8.12%. Compared to HCT 116 cells, Caco-2 cells were more susceptible to the cytotoxic effects of RX and its NP as well as they had a higher binding affinity to CD44 receptors compared to normal WI-38 cells. In comparison to the free RX, the RX NP’s cytotoxic fold changes in HCT 116 and Caco-2 cells were 2.16 and 2.52, respectively. Furthermore, the epigenetic cascade of some noncoding RNAs was examined. Moreover, particular protein concentrations were investigated in all tested cells after application of the proposed therapies. Our results showed that the RX NP recorded higher remarkable cytotoxic impact on CRC cells compared to the free RX. Intriguingly, it was hypothesized that RX nanoparticles attacked colon cancerous cells by up-regulating miR-944 and E-cadherin (ECN) expressions, while down-regulating the expressions of PPARγ, YKL-40, VEGF, H-19, LINC00641, HULC, HOTTIP, miR-92a, miR-200, and miR-21.

Conclusions

We may conclude that the RX NP effectively targets CRC cells in vitro via altering lncRNAs and miRNAs epigenetic cascade as well as cellular uptake through CD44-expressed CRC cells.
The effectiveness in preventing frailty of exercise intervention provided by community pharmacists to older persons with chronic conditions: A pragmatic randomized controlled trial
Authors: Hirota Noritake , Okada Hiroshi , Okamura Noboru
Published: April 2023

Background

Once older persons become frail, the risk of falls, bone fractures, and other problems increases. Exercise intervention is a form of prevention that has a high degree of evidence.

Objective

We investigated the effectiveness of frailty prevention consisting of exercise intervention by community pharmacists at 11 pharmacies operated by Osaka Pharma Plan.

Methods

In total, 103 older persons between 70 and 79 years of age (53 males and 50 females) who were suffering from chronic conditions and who visited one of 11 pharmacies between January and March 2021 were enrolled. They were then randomly assigned to either the Intervention group (IG: 6 pharmacies, 61 patients) who were subjected to intervention by a pharmacist, or the Usual Care group (UG: 5 pharmacies, 42 patients) who were not subjected to intervention. At the beginning of the trial and 6 month after, their muscle mass, etc. were measured using a body composition meter, and their Five-Times Sit-To-Stand Test results were also measured. Patients in the IG were provided with information by way of leaflets during the time they were guided regarding taking their medication for a period of one to six months that encouraged exercising at home. Those in the UG were given the standard guidance related to taking their medication.

Results

The amount of change in muscle mass was 1.08 ± 7.83% (95%CI: -1.24-3.41) in IG and − 0.43 ± 2.73% (95%CI:-1.58-0.72) in UG, indicating that there was a trend toward an increase in IG. The percent change in the Five Times Sit-To-Stand Test times at + 6 M was − 0.002 ± 0.24% (95%CI: -0.09-0.05) in IG and − 0.04 ± 0.21% (95%CI:-0.13-0.07) in UG, but in cases in which the second measured time was faster than the first measured time, the results were 65.2% for IG and 29.2% for UG, indicating a significant difference (p = 0.00563).

Conclusion

Despite the fact that the amount of time community pharmacists can devote to providing guidance on taking medications is limited, it has been previously reported that providing information to patients causes a change in patient behavior. The results of the present study are highly significant as they suggest the possibility that this may hold true even when used to prevent frailty, based on the evidence obtained.

Trial registration

This trial was registered at UMIN-CRT on 1st of January, 2021. The registration number is UMIN000042571.
Mycoplasma infection mimicking a malignancy in a waldenstrom macroglobulinemia patient
Authors: Wu Junqing , He Donghua , Yu Fang , Huang Yue , Bian Meiru , Yu Chengxuan , Liu Jiao , Cai Zhen , Zhao Yi
Published: April 2023

Background

Mycoplasma hominis infection is common in urinary tract. 18F-FDG-PET/CT is a valuable tool for tumor and infection diagnosis. Few studies have shown the 18F-FDG-PET/CT images after mycoplasma infection.

Case presentation

Here we described a case of Waldenstrom macroglobulinemia with thickened bladder wall. The 18F-FDG-PET/CT showed the SUVmax up to 36.1 mimicking bladder cancer. The results of histopathological examination and metagenomic sequencing of the blood and urinary revealed the Mycoplasma hominis infection.

Conclusion

The full consideration should be given to the possibility of infection besides tumor in lesions with high SUV value in 18F-FDG-PET/CT, especially in immunodeficiency patients.
Clinical markers of immunotherapy outcomes in advanced sarcoma
Authors: Husain Marium , Quiroga Dionisia , Kim Han Gil , Lenobel Scott , Xu Menglin , Iwenofu Hans , Chen James L. , Verschraegen Claire , Liebner David , Tinoco Gabriel
Published: April 2023

Background

Despite immunotherapy’s promise in oncology, its use for sarcoma remains challenging. There are no sarcoma-specific biomarkers for immune checkpoint inhibitors (ICI). Previously, we reported our institutional experience highlighting ICI activity in 29 patients with sarcoma. In this study, we explore responses to ICI based on ICI regimen and other covariates to identify significant clinical factors in advanced sarcoma outcomes.

Methods

Patients in The Ohio State University Sarcoma Clinics were enrolled in the Sarcoma Retrospective ICI database from January 1, 2015 through November 1, 2021. Data included treatment regimen (single-agent ICI or ICI + combination) along with clinical covariates. ICI + combination was further categorized into ICI + medication, ICI + radiation, ICI + surgery, or ICI + multiple (more than 2 modalities). Statistical analysis included log-rank tests and proportional hazard regression. The primary objective was to evaluate overall survival (OS) and progression-free survival (PFS).

Results

Of the patients in the database, 135 met inclusion criteria. We demonstrated improved OS in patients treated with ICI + combination (p = 0.014, median 64 weeks), but no effect on PFS (p = 0.471, median 31 weeks). Patients with a documented immune-related adverse event (irAE) of dermatitis had improved OS, but only in the ICI + combination cohort (p = 0.021). Patients who received single-agent ICI and whose change in the neutrophil-to-lymphocyte ratio (NLR) was less than 5 had an improved OS (p = 0.002); this was not seen in patients who received ICI + combination therapy (p = 0.441). There were no differences in OS based on age, gender, histology, or subcategories of ICI + combination. This was not the case for PFS; patients who received any ICI regimen and were younger than 70 had a worse PFS (p = 0.036) compared with their older counterparts in this dataset. Patients who developed an irAE, specifically colitis (p = 0.009), hepatitis (p = 0.048), or dermatitis (p = 0.003), had an improved PFS. There were no differences in PFS based on ICI regimen (or subcategories of ICI + combination), gender, histology, change in NLR, or grade of irAE.

Conclusions

This retrospective study demonstrates that ICI + combination therapy can improve OS in some patients with advanced sarcoma. This is consistent with our prior results of ICI in sarcoma.
Evaluation of a new Q-switched Nd:YAG laser on premacular hemorrhage
Authors: Su Zhaoan , Tong Luyao , He Jingliang , Wang Lijuan , Liu Jun , Fang Xiaoyun , Zhang Li
Published: April 2023

Background

Premacular hemorrhage is among the causes of sudden deterioration of visual acuity. This study aimed to investigate the therapeutic outcomes of a new Q-switched Nd:YAG laser on premacular hemorrhage.

Methods

Retrospective, case series study of 16 eyes from 16 patients diagnosed with premacular hemorrhage, including 3 cases of Valsalva retinopathy, 8 cases of retinal macroaneurysm, 3 cases of diabetic retinopathy, 1 case of trauma-related hemorrhage and 1 case with leukemia. A 1064nm Q-switched Nd:YAG laser was performed to puncture the posterior hyaloid and inner limiting membrane to drain the hemorrhage.

Results

The success rate of 16 patients with premacular hemorrhage drainage was 100% in this study. Improved visual acuity was observed in each patient.

Conclusions

In this case series of 16 patients, the new Q-switched Nd:YAG laser was successful in draining premacular hemorrhage with no serious complications.
Comparative evaluation of internal fit and marginal gap of endocrowns using lithium disilicate and polyether ether ketone materials - an in vitro study
Authors: Nagi Nermeen , Fouda Ahmed Mahmoud , Bourauel Christoph
Published: April 2023

Background

The aim of the study was to investigate the effect of material and occlusal preparation design on the internal fit and marginal gap of endocrowns made of Polyether ether ketone (PEEK) and lithium disilicate.

Methods

32 endocrowns were fabricated on prepared mandibular molars and divided into two groups (n = 16) according to the material. Group L: lithium disilicate and Group P: PEEK. Each group was further subdivided into two subgroups (n = 8) according to the occlusal preparation design: full occlusal coverage (LF and PF) and partial occlusal coverage (LP and PP). Samples were analyzed using microcomputed tomography (µCT) with a voxel size of 6 μm to evaluate internal fit, and an optical microscope was used to evaluate the marginal gap. Data were collected, tabulated, and statistically analyzed. Numerical data were described as mean and standard deviation and compared using the ANOVA test. The level of significance was set at α P ≤ 0.05.

Results

All groups’ internal fit and marginal gaps values were within the acceptable clinical range. However, the lithium disilicates group recorded statistically significantly higher mean internal gap values than the PEEK groups. Regardless of the material, the difference between the two occlusal designs was not statistically significant in both internal fit and marginal gap records.

Conclusion

Within the limitations of this study, PEEK endocrown restorations revealed better internal fit and marginal gap than lithium disilicate endocrown restorations. The marginal and internal fit of both lithium disilicate and PEEK endocrown restorations were within the clinically acceptable range. The occlusal preparation design had no influence on the internal fit and marginal gap of the endocrown restoration.
A national analysis of the medical schools of training for merit award-winning laboratory medical doctors working in Britain
Authors: Steele S. , Andrade G.
Published: April 2023

Aims

To inform the discussion regarding the origins of Laboratory Medical Consultant clinical merit award holders (LMC) whether the awards came from the Clinical Excellence Awards (CEA) or Distinction Awards (DA) schemes.

Methods

Setting - CEA is a scheme to financially reward senior doctors in England and Wales who are assessed to be working over and above the standard expected of their role. The DA scheme is the parallel and equivalent scheme in Scotland. Participants - All of the merit award holders in the 2019 round. Design - This involved a secondary analysis of the complete 2019 published dataset of award winners. Statistical analyses were performed with Chi-square tests set at p < 0.05 level for statistical significance.

Results

The top five medical schools (London University, Glasgow, Edinburgh, Aberdeen and Oxford) were responsible for 68.4% of the LMC merit award holders in the 2019 round. 97.9% of the LMC merit award holders were from European medical schools, whereas 90.9% of the non-LMC award holders were from European medical schools. The LMCs with A plus or platinum awards came from only six medical schools: Aberdeen, Edinburgh, London University, Oxford, Sheffield and Southampton. In contrast, the B or silver/bronze LMC award holders came from a more diverse background of 13 medical schools.

Conclusions

The majority of LMC merit award holders originated from only five university medical schools. All the LMCs with A plus or platinum awards came from only six university medical schools. There is an apparent overrepresentation of a small number of medical schools of origin amongst those LMCs that hold national merit awards.
The relationship of online pre-recorded neurology mini-lectures to medical student assessment: a pilot study
Authors: Benamer Hani TS , Stanley Adrian G
Published: April 2023

Introduction

eLearning has become an essential part of medical education. However, there is a lack of published research on student engagement with online pre-recorded mini-lectures and its relation to assessment. The aim of this pilot study is to explore the relationship between newly introduced neurology pre-recorded mini-lectures and undergraduate medical students engagement and assessment. This may encourage the wider use of mini-lectures in undergraduate medical curricula.

Methods

The engagement of medical students with 48 online pre-recorded neurology mini-lectures was assessed through a Learning Management System. To measure engagement, data was stratified according to the number of watched/downloaded mini-lectures. A point system was used (out of 5): − 1 point = watching/downloading 0–10 mini-lectures, 2 points = watching/downloading 11–20 mini-lectures, 3 points = watching/downloading 21–30 mini-lectures, 4 points = watching/downloading 31–40 mini-lectures and, 5 points = watching/downloading 41–48 mini-lectures. The students’ engagement was correlated with their neurology assessments [Objective Structured Clinical Examination (OSCE), and knowledge-based assessment 10 Multiple Choice Questions (MCQs) and one 10-mark Short Answer Question, (SAQ)], internal medicine grade and annual grade point average (GPA) using the Pearson correlation coefficient.

Results

The mean engagement of 34, Year 5, medical students is 3.9/5. There is a significant positive correlation between engagement and internal medicine grade (r = 0.35, p = 0.044). There is a moderate correlation between engagement and neurology OSCE (r = 0.23), annual Year 5 GPA (r = 0.23), neurology knowledge-based score (r = 0.22) and composite neurology knowledge/OSCE (r = 0.27). The knowledge-based assessment included SAQ and MCQs: there was a moderate correlation with SAQ (r = 0.30), but a weak negative correlation with the MCQs (r =-0.11). Sub-groups analysis comparing the top- and low- or non- engaging students made these weaker correlations stronger.

Conclusion

This pilot study indicates a high rate of engagement with an online pre-recorded mini-lectures resource and evidence of moderate correlation between engagement and assessment. Online pre-recorded mini-lectures should be used more in delivering the curriculum contents of the clinical clerkships. Further studies are needed to evaluate the relation and the impact of the mini-lectures on assessment.
Whole sporozoite immunization with Plasmodium falciparum strain NF135 in a randomized trial
Authors: van der Boor Saskia C. , Alkema Manon , van Gemert Geert-Jan , Teelen Karina , van de Vegte-Bolmer Marga , Walk Jona , van Crevel Reinout , de Mast Quirijn , Ockenhouse Christian F. , Sauerwein Robert W. , McCall Matthew B. B.
Published: April 2023

Background

Whole sporozoite immunization under chemoprophylaxis (CPS regime) induces long-lasting sterile homologous protection in the controlled human malaria infection model using Plasmodium falciparum strain NF54. The relative proficiency of liver-stage parasite development may be an important factor determining immunization efficacy. Previous studies show that Plasmodium falciparum strain NF135 produces relatively high numbers of large liver-stage schizonts in vitro. Here, we evaluate this strain for use in CPS immunization regimes.

Methods

In a partially randomized, open-label study conducted at the Radboudumc, Nijmegen, the Netherlands, healthy, malaria-naïve adults were immunized by three rounds of fifteen or five NF135-infected mosquito bites under mefloquine prophylaxis (cohort A) or fifteen NF135-infected mosquito bites and presumptive treatment with artemether/lumefantrine (cohort B). Cohort A participants were exposed to a homologous challenge 19 weeks after immunization. The primary objective of the study was to evaluate the safety and tolerability of CPS immunizations with NF135.

Results

Relatively high liver-to-blood inocula were observed during immunization with NF135 in both cohorts. Eighteen of 30 (60%) high-dose participants and 3/10 (30%) low-dose participants experienced grade 3 adverse events 7 to 21 days following their first immunization. All cohort A participants and two participants in cohort B developed breakthrough blood-stage malaria infections during immunizations requiring rescue treatment. The resulting compromised immunizations induced modest sterile protection against homologous challenge in cohort A (5/17; 29%).

Conclusions

These CPS regimes using NF135 were relatively poorly tolerated and frequently required rescue treatment, thereby compromising immunization efficiency and protective efficacy. Consequently, the full potential of NF135 sporozoites for induction of immune protection remains inconclusive. Nonetheless, the high liver-stage burden achieved by this strain highlights it as an interesting potential candidate for novel whole sporozoite immunization approaches.

Trial registration

The trial was registered at ClinicalTrials.gov under identifier NCT03813108.
Malaria transmission pattern across the Sahelian, humid savanna, highland and forest eco-epidemiological settings in Cameroon
Authors: Chouakeu Nelly Armanda Kala , Tchuinkam Timoléon , Bamou Roland , Bindamu Mabu Maxim , Talipouo Abdou , Kopya Edmond , Awono-Ambene Parfait , Antonio-Nkondjio Christophe
Published: April 2023

Background

Malaria remains a major public health concern in Cameroon. Understanding vector distribution and malaria transmission dynamics is of paramount importance for evaluating the performance of control strategies. This study assesses patterns of malaria transmission in four eco-epidemiological settings in Cameroon.

Methods

Adult mosquitoes were collected using Human Landing Catches (HLC) once every 4 months from August 2019 to November 2021 in Kaélé, Tibati, Santchou and Bertoua. Mosquitoes were sorted by genus and Anopheles gambiae sensu lato (s.l.) species complex were identified using PCR. The presence of Plasmodium falciparum circumsporozoite protein (CSP) was measured by ELISA; the entomological inoculation rates (EIR) was estimated in each locality.

Results

A total of 23,536 mosquitoes were collected. Anophelesgambiae and/or Anophelescoluzzii were the main malaria vectors in all sites. Anophelesarabiensis was recorded in low frequency in Kaélé and Tibati. Other species collected included Anopheles funestus, Anophelespharoensis and Anopheles ziemmani. High anopheline biting rates were recorded outdoor in all sites except in Kaélé. Important differences in species biting dynamics were observed between sites. The sporozoite infection rate varied from 0.36 to 4%. The daily EIR was found to vary from 0.07 in Santchou to 0.26 infected bites/man/night (ib/m/n) in Kaélé).

Conclusion

The study suggests heterogeneous patterns of malaria transmission in different ecoepidemiological settings across the country. The findings stress the need to improve malaria vector control strategies.
Dose escalation in oropharyngeal cancer: a comparison of simultaneous integrated boost and brachytherapy boost
Authors: Embring Anna , Onjukka Eva , Mercke Claes , Lax Ingmar , Berglund Anders , Friesland Signe
Published: April 2023

Background

Local recurrence is the most common pattern of failure in head and neck cancer. It can therefore be hypothesised that some of these patients would benefit from an intensified local treatment, such as radiation dose escalation of the primary tumour. This study compares treatment and toxicity outcomes from two different boost modalities in oropharyngeal cancer: simultaneous integrated boost (SIB) and brachytherapy boost.

Methods

Two hundred and forty-four consecutive patients treated with > 72 Gy for oropharyngeal squamous cell carcinoma between 2011 and 2018 at our institution were retrospectively analysed. Data on side effects were collected from a local quality registry and supplemented with a review of medical records. Patients receiving a brachytherapy boost first had external beam radiotherapy consisting of 68 Gy in 2 Gy fractions to the gross tumour volume (GTV), and elective radiotherapy to the neck bilaterally. The brachytherapy boost was typically given using pulsed dose rate, 15 fractions and 0.56–0.66 Gy per fraction [total dose in EQD2 = 75.4–76.8 Gy (α/β = 10)]. The typical dose escalated radiotherapy with external beam radiotherapy only, was delivered using SIB with 74,8 Gy in 2.2 Gy fractions [EQD2 = 76.0 Gy (α/β = 10)] to the primary tumour, 68 Gy in 2 Gy fractions to GTV + 10 mm margin and elective radiotherapy to the neck bilaterally.

Results

Dose escalation by SIB was given to 111 patients and brachytherapy boost to 134 patients. The most common type of cancer was base of tongue (55%), followed by tonsillar cancer (42%). The majority of patients had T3- or T4-tumours and 84% were HPV-positive. The 5-year OS was 72,4% (95% CI 66.9–78.3) and the median follow-up was 6.1 years. Comparing the two different dose escalation modalities we found no significant differences in OS or PFS and these results remained after a propensity-score matched analysis was performed. The analysis of grade ≥ 3 side effects showed no significant differences between the two different dose escalation techniques.

Conclusions

We found no significant differences in survival or grade ≥ 3 side effects comparing simultaneous integrated boost and brachytherapy boost as alternative dose escalation modalities in the treatment of oropharyngeal cancer.
Venoarterial extracorporeal membrane oxygenation for cardiac support in human immunodeficiency virus-positive patients: a case report and review of a multicentre registry
Authors: Laraghy Matthew , McCullough James , Gerrard John , Stroebel Andrie , Winearls James
Published: April 2023

Background

Human immunodeficiency virus (HIV) is associated with increased risk of heart failure via multiple mechanisms both in patients with and without access to highly active antiretroviral therapy (HAART). Limited information is available on outcomes among this population supported on Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO), a form of temporary mechanical circulatory support.

Methods

We aimed to assess outcomes and complications among patients with HIV supported on VA ECMO reported to a multicentre registry and present a case report of a 32 year old male requiring VA ECMO for cardiogenic shock as a consequence of his untreated HIV and acquired immune deficiency syndrome (AIDS). A retrospective analysis of the Extracorporeal Life Support Organization (ELSO) registry data from 1989 to 2019 was performed in HIV patients supported on VA ECMO.

Results

36 HIV positive patients were reported to the ELSO Database who received VA ECMO during the study period with known outcomes. 15 patients (41%) survived to discharge. No significant differences existed between survivors and non-survivors in demographic variables, duration of VA ECMO support or cardiac parameters. Inotrope and/or vasopressor requirement prior to or during VA ECMO support was associated with increased mortality. Survivors were more likely to develop circuit thrombosis. The patient presented was supported on VA ECMO for 14 days and was discharged from hospital day 85.

Conclusions

A limited number of patients with HIV have been supported with VA ECMO and more data is required to ascertain the indications for ECMO in this population. HIV should not be considered an absolute contraindication to VA ECMO as they may have comparable outcomes to other patient groups requiring VA ECMO support.
Gender differences in symptom structure of adolescent problematic internet use: A network analysis
Authors: Liu Sihan , Zhang Di , Tian Yuxin , Xu Boya , Wu Xinchun
Published: April 2023

Background

Gender differences in problematic Internet use (PIU) have long been discussed. However, whether and how female and male adolescents differ in central symptoms and symptom associations are not fully understood.

Methods

As a national survey in the Chinese mainland, 4884 adolescents (51.6% females; Mage = 13.83 ± 2.41) participated in the present study. This study applies network analysis to identify central symptoms of PIU networks in female and male adolescents and compares whether and how global and local connectivity of PIU networks differ by gender.

Results

Female and male network structures of PIU were different and global strength was stronger in males than females, indicating a higher risk of chronicity of PIU among male adolescents. Specifically, “Reluctant to turn off Internet” exerted the largest effect on both genders. “Increase time online to achieve satisfaction” and “Feel depressed once not online for a while” were particularly critical to female and male adolescents, respectively. Moreover, females scored higher centralities in social withdrawal symptoms and males did so in interpersonal conflicts owing to PIU.

Conclusions

These findings provide novel insights into gender differential risks and features of adolescent PIU. Differences in the core symptoms of PIU suggest that gender-specific interventions focusing on core symptoms might effectively relieve PIU and maximize treatment effects.
The Canadian Healthy Life Trajectories Initiative (HeLTI) Trial: a study protocol for monitoring fidelity of a preconception-lifestyle behaviour intervention
Authors: Dennis Cindy-Lee , Marini Flavia , Prioreschi Alessandra , Dol Justine , Birken Catherine , Bell Rhonda C.
Published: April 2023

Background

In evaluating technology-based behaviour change interventions, it is increasingly important to have a monitoring plan for intervention fidelity. It is important to maintain intervention fidelity to ensure that the theory-based intervention that is being tested is what causes the observed changes, particularly for eHealth behaviour change interventions. In this protocol, we outline the intervention fidelity and monitoring protocol for Healthy Life Trajectory Initiative (HeLTI) Canada, a randomized controlled trial evaluating the effect of a preconception-early childhood technology-based intervention delivered by public health nurses among pregnancy-planning women and their partners to optimize child growth and development.

Methods

The HeLTI Canada fidelity protocol is based on the National Institutes of Health Behaviour Change Consortium (NIH BCC) Treatment Fidelity Framework, outlining the following components of intervention fidelity: study design, provider training, intervention delivery, intervention receipt, and intervention enactment. The intervention fidelity components and associated monitoring strategies were developed to align with the HeLTI Canada approach. Strategies for intervention fidelity monitoring include a pre-post written evaluation of training, standardization of provider training, use and monitoring of activity logs, and intervention session checklists. Possible challenges to intervention fidelity include provider turnover due to the length of the trial and lack of ability to directly monitor participant behaviour change in real-life settings. Details about intervention fidelity monitoring are provided in detail. The study launched in January 2021 and is currently recruiting.

Discussion

Using the NIH BCC Treatment Fidelity Framework, HeLTI Canada has a robust framework for monitoring and reporting intervention fidelity to improve intervention validity, ability to assess intervention effectiveness, and transparency.

Trial registration

ISRCN ISRCTN13308752. Registered on February 29, 2019.
Ultrasonography of the multifidus muscle in student circus artists with and without low back pain: a cross-sectional study
Authors: Rossini Bianca , Anstruther Meagan , Wolfe Daniel , Fortin Maryse
Published: April 2023

Background

Degenerative structural changes and functional deficits of the lumbar multifidus (LM) muscle were observed in athletes with low back pain. While spinal injuries are common in circus artists, there is no information on LM characteristics in this population. The aims of this study were to investigate LM morphology and function and explore the relationship between LM characteristics and low back pain in male and female circus artists.

Methods

31 college circus students were recruited. Participants completed an online survey to acquire demographic data and low back pain history. Body composition was measured using multi-frequency bio-impedance analysis. Ultrasound examinations at the fifth lumbar vertebrae in prone and standing positions were performed to assess LM cross-sectional area, echo-intensity, thickness. Independent and dependent t-test assessed the difference between sex and side, respectively. The relationships between measures were assessed with Pearson’s correlations. The LM characteristics’ difference between artists with and without low back pain (group binary variable) was assessed with Analysis of covariance using lean body mass, height and % body fat as continuous covariates.

Results

Males had significantly larger LM cross-sectional area, lower echo-intensity and greater thickness change from rest to contracted than females. LM cross-sectional area asymmetry in prone was greater in artists reporting low back pain in the previous 4-weeks (p = 0.029) and 3-months (p = 0.009). LM measures were correlated with lean body mass, height, and weight (r = 0.40–0.77, p ≤ 0.05).

Conclusion

This study provided novel insights into LM characteristics in circus artists. Greater LM asymmetry was observed in artists with a history of low back pain. In accordance with previous studies in athletes, LM morphology and function were highly correlated with body composition measurements.
Impact of intrauterine exposure to maternal diabetes on preterm birth: fetal DNA methylation alteration is an important mediator
Authors: Wang Guoying , Xu Richard , Zhang Boyang , Hong Xiumei , Bartell Tami R. , Pearson Colleen , Liang Liming , Wang Xiaobin
Published: April 2023

Background

In utero exposure to diabetes has been shown to contribute to preterm birth, though the underlying biological mechanisms are yet to be fully elucidated. Fetal epigenetic variations established in utero may be a possible pathway. This study aimed to investigate whether in utero exposure to diabetes was associated with a change in newborn DNA methylation, and whether the identified CpG sites mediate the association between diabetes and preterm birth in a racially diverse birth cohort population.

Methods

This study included 954 mother–newborn pairs. Methylation levels in the cord blood were determined using the Illumina Infinium MethylationEPIC BeadChip 850 K array platform. In utero exposure to diabetes was defined by the presence of maternal pregestational or gestational diabetes. Preterm birth was defined as gestational age at birth less than 37 weeks. Linear regression analysis was employed to identify differentially methylated CpG sites. Differentially methylated regions were identified using the DMRcate Package.

Results

126 (13%) newborns were born to mothers with diabetes in pregnancy and 173 (18%) newborns were born preterm, while 41 newborns were born both preterm and to mothers with diabetes in pregnancy. Genomic-wide CpG analysis found that eighteen CpG sites in cord blood were differentially methylated by maternal diabetes status at an FDR threshold of 5%. These significant CpG sites were mapped to 12 known genes, one of which was annotated to gene Major Histocompatibility Complex, Class II, DM Beta (HLA-DMB). Consistently, one of the two identified significant methylated regions overlapped with HLA-DMB. The identified differentially methylated CpG sites mediated the association between diabetes in pregnancy and preterm birth by 61%.

Conclusions

In this US birth cohort, we found that maternal diabetes was associated with altered fetal DNA methylation patterns, which substantially explained the link between diabetes and preterm birth.
The activation of mGluR4 rescues parallel fiber synaptic transmission and LTP, motor learning and social behavior in a mouse model of Fragile X Syndrome
Authors: Martín Ricardo , Suárez-Pinilla Alberto Samuel , García-Font Nuria , Laguna-Luque M. Luisa , López-Ramos Juan C. , Oset-Gasque María Jesús , Gruart Agnes , Delgado-García José M. , Torres Magdalena , Sánchez-Prieto José
Published: April 2023

Background

Fragile X syndrome (FXS), the most common inherited intellectual disability, is caused by the loss of expression of the Fragile X Messenger Ribonucleoprotein (FMRP). FMRP is an RNA-binding protein that negatively regulates the expression of many postsynaptic as well as presynaptic proteins involved in action potential properties, calcium homeostasis and neurotransmitter release. FXS patients and mice lacking FMRP suffer from multiple behavioral alterations, including deficits in motor learning for which there is currently no specific treatment.

Methods

We performed electron microscopy, whole-cell patch-clamp electrophysiology and behavioral experiments to characterise the synaptic mechanisms underlying the motor learning deficits observed in Fmr1KO mice and the therapeutic potential of positive allosteric modulator of mGluR4.

Results

We found that enhanced synaptic vesicle docking of cerebellar parallel fiber to Purkinje cell Fmr1KO synapses was associated with enhanced asynchronous release, which not only prevents further potentiation, but it also compromises presynaptic parallel fiber long-term potentiation (PF-LTP) mediated by β adrenergic receptors. A reduction in extracellular Ca2+ concentration restored the readily releasable pool (RRP) size, basal synaptic transmission, β adrenergic receptor-mediated potentiation, and PF-LTP. Interestingly, VU 0155041, a selective positive allosteric modulator of mGluR4, also restored both the RRP size and PF-LTP in mice of either sex. Moreover, when injected into Fmr1KO male mice, VU 0155041 improved motor learning in skilled reaching, classical eyeblink conditioning and vestibuloocular reflex (VOR) tests, as well as the social behavior alterations of these mice.

Limitations

We cannot rule out that the activation of mGluR4s via systemic administration of VU0155041 can also affect other brain regions. Further studies are needed to stablish the effect of a specific activation of mGluR4 in cerebellar granule cells.

Conclusions

Our study shows that an increase in synaptic vesicles, SV, docking may cause the loss of PF-LTP and motor learning and social deficits of Fmr1KO mice and that the reversal of these changes by pharmacological activation of mGluR4 may offer therapeutic relief for motor learning and social deficits in FXS.
High-grade large cell neuroendocrine carcinoma of the esophagus: a case report and review of the literature
Authors: Awada Hussein , Hajj Ali Adel , Bakhshwin Ahmed , Daw Hamed
Published: April 2023

Background

Neuroendocrine carcinomas are extremely rare in the esophagus as they represent less than 0.04% of all neuroendocrine tumors. To date, only 14 cases of poorly differentiated, high-grade esophageal NEC have been described in the literature. The majority of these patients presented with typical dysphagia symptoms. Due to its rarity, no standardized guidelines have been proposed to treat esophageal neuroendocrine carcinoma, although general recommendations suggest surgery with adjuvant chemoradiotherapy as the treatment of choice.

Case presentation

A 67-year-old previously healthy White male presented with a year-long intermittent nonspecific retrosternal discomfort, with the absence of any other symptoms. Esophagogastroduodenoscopy revealed an ulcerative mass in his lower esophagus, with concern of malignancy. Endoscopic ultrasound-guided biopsy revealed poorly differentiated neuroendocrine carcinoma of the esophagus with metastasis to a diaphragmatic lymph node. He was treated with neoadjuvant chemoradiation followed by surgery, and he has been in remission for over 5 years.

Conclusion

Here, we review the literature and report a unique case of a patient with a vague presentation of esophageal neuroendocrine carcinoma as he enters his sixth year of survival following neoadjuvant chemoradiotherapy.
$(\omega ,c)$-periodic solutions for a class of fractional integrodifferential equations
Authors: Alvarez E. , Grau R. , Meriño R.
Published: April 2023

In this paper we investigate the following fractional order in time integrodifferential problem $$ \mathbb{D}_{t}^{\alpha}u(t)+Au(t)=f \bigl(t,u(t) \bigr)+ \int _{-\infty}^{t} k(t-s)g \bigl(s,u(s) \bigr)\,ds, \quad t \in \mathbb{R}. $$

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-periodic mild solutions assuming that −A generates an analytic semigroup on a Banach space X and f, g, and k satisfy suitable conditions. Finally, an interesting example that fits our framework is given.