bluuebunny/crossref_metadata_2025 huggingface dataset:
On Arrival Blocks: Resuscitation of an Obese Patient Following Vehicular Accident in a Resource Poor Setting
Authors: Ajiboye Olayinka , Ojebo Julian
Published: August 2024

Road traffic accidents has been reported to be on the increase, leaving patients with diverse orthopaedic injuries as well as traumatic brain injury. The accidents and emergencies unit continues to struggle during resuscitation and offer inadequate analgesia to these patients who also may be in shock or not fully resuscitated, owing to fear of worsening the haemodynamics, or the respiratory suppression from opioids, most trauma physicians refrain from using strong opioids. Intravenous access in the polytraumatized patients is usually challenging, even more so in obese patients, putting them to greater morbidity or mortality according to some published articles. This case report expresses the importance of prompt management, multi-disciplinary care of an obese polytraumatized patient, which led to shorter hospital stay and reduction in morbidity and mortality. A multi-disciplinary approach with quick involvement of the Anaesthetists made a big difference in establishing venous access promptly to commence resuscitation, preventing onset of morbidity such as acute kidney injury due to hypovolaemia. On arrival blocks, a technique developed by anesthesiologist Ravindra and plastic and hand surgeon Raja is a situation where the skilled Anaesthetist blocks different regions in order to offer patient excellent analgesia without compromising the haemodynamic or respiratory drive is important to note and emphasize.
Characteristics of Sand-Driving Wind Regime and Sand Drift Potential in Sandy Areas on Both Sides of Longyangxia Reservoir in China
Authors: Zhang Lechun , Zhang Dengshan , Xu Guoyuan , Dong Fengling , Tuo Wanbing
Published: August 2024

This study focuses on the desertification areas of Talatan and Mugetan, located on both sides of the Longyangxia Reservoir in Qinghai Province, China. These areas pose serious threats to the safety of the reservoir due to frequent wind-sand activities. The research aims to provide a scientific basis for effective sand control by deeply analyzing the dynamic change of wind.The wind speed and direction data from Shazhuyu and Guinan meteorological stations in Qinghai Province, China were used to calculate the numerical and directional characteristics of sand-driving wind and sand drift potential.The results indicate that: (1) The number of sand-driving wind at Talatan is about 7 times that at Mugetan, and the maximum and average wind speeds are about 7 m/s larger than those at Mugetan. At Talatan, the primary sand-driving wind direction is exclusively West Northwest (WNW). Conversely, at Mugetan, the sand-driving wind direction remains westward in spring, autumn, and winter, shifting eastward solely in summer. (2) The annual sand drift potential of Talatan and Mugetan is less than 200VU, two sandy areas are both in low wind energy environments; (3) The major causes of the significant differences in sand-driving wind regimes between the Talatan and Mugetan are topography, precipitation, wind direction stability.These conclusions offer valuable insights for developing targeted sand control strategies, thereby mitigating the potential hazards posed by wind-sand activities to the Longyangxia Reservoir and its surrounding ecosystems.
The Crime of Accepting Bribes in the Hong Duc Code and Their Significance as a Model for Contemporary Criminal Law in Vietnam
Authors: Van Linh , Van Anh , Minh Anh , Trong Anh
Published: August 2024

The Hong Duc Code, promulgated during the reign of King Le Thanh Tong, is regarded as a progressive and comprehensive legal code within the context of feudal Vietnam. It reflects the principles of the rule of law and demonstrates a deep commitment to humanity. The Hong Duc Code contains detailed provisions covering various forms of bribery, including accepting money or gifts, exploiting positions for personal gain, harassing individuals, making wrongful convictions, concealing crimes, and weakening the military. The law applies to incumbent officials, relatives, and other connected individuals. Penalties are clearly outlined and vary depending on the nature and severity of the offense, ranging from fines and demotion to exile and the death penalty. Although resembling a feudal society, the Hong Duc Code remains relevant in Vietnamese criminal law, particularly in corruption prevention and control, especially the clauses on bribery. The article is dedicated to analyzing the crime of bribery in the Hong Duc code, to provide valuable insights for the current Vietnamese criminal law system. The article highlights three main points: (1) The legal form is clear, easy to understand, and easy to apply; (2) Treating bribery as a separate crime rather than just an aggravating circumstance as in current law; (3) Providing rewards to those who report bribery. As a result, the article aims to improve the law, enhance the effectiveness of anti-corruption efforts, and contribute to establishing a fair and civilized society.
Socio-economic and Bio-physical Characterization of Wadego Watershed, Oda-Bultum Woreda, West Hararghe zone, Ethiopia
Authors: Gizaw Wasihun , Dekeba Shimelis
Published: August 2024

Baseline characterization is important component of watershed development of rural development and natural resource management strategies in many countries. Hence, the study was designed to; assess and document major biophysical and socio-economic constraints and potentials of Wadego watershed. Firstly, Wadego watershed boundary was delineated and its map was developed based on the preliminary outlet identified with the help of GPS reading. The households for interview were selected randomly from the small householders in the watershed based on proportional to population size. Accordingly, data was collected from 120 sample respondents using various instruments such as: key informant interview using semi-structured checklist, focused group discussion, expert interview, unstructured questionnaire and field observation on bio-physical resources and different concerns of watershed management. Collected data was summarized using descriptive statistics. The result indicated, out of the total 120 sample respondents socio-economic status were; 87.5% of them were male while the rest 12.5% were female, 93% were married, 51% were un educated. The major crops grown in the watershed were Maize, Sorghum, Khat, Teff and others while, Barley and Field Pea were the least grown ones. The result of the survey has indicated 37% uses improved variety, while 64% uses local variety. According to respondents, the slop class of the watershed was 56, 29, and 15% flat, medium and steeply slops respectively. Moreover, soil fertility class was 25%, 54% and 21% low, medium and high respectively in the watershed. Generally, the survey result have characterized and documented bio-physical and socio-economic status as: average land owned half hectare, densely populated, different slope class in the watershed, land shortage, feed problems, presence of soil fertility and erosion problems, climatic problems etc. in the watershed. Accordingly, researchable issues on different prioritized problems concerning to; soil fertility management, soil and water conservation, Agroforestry practice, forage development and forestry practices in the watershed have given prioritization and therefore, adapted and generated technologies nearby research center i.e. Mechara Agricultural Research Center and any concerned research institutions and also development work oriented NGO’S has to intervened the watershed by research development work. Accordingly, intervention areas forwarded are: Creating awareness on climate variability and change and SWC techniques, introducing different biophysical soil and water harvesting technologies, demonstration and awareness creation, Participatory demonstration on different Agroforestry and plantation forestry practices, introducing multipurpose plant species like Bamboo variety in the watershed.
Application Research of Bridge Plug Packer Rubber Tube Ablation Technology in Gas Storage
Authors: Dong Yang , Yongqiang Ren , Wei Zhang , Zhihong Wei , Jianbao Wang , Jianhua Zhou
Published: August 2024

In the production process of oil and gas fields, for old wells, sealed wells, etc., if the bridge plug or packer is inserted into the well for a long time, the sealing cylinder will harden under the high-temperature and high-pressure environment of the wellbore. The sealing cylinder cannot contract normally and tightly adhere to the inner wall of the casing. During the tool unsealing and lifting process, impurities such as scale and rust on the casing wall will be scraped off and continuously accumulated, ultimately causing the bridge plug or packer to jam and unable to successfully complete the tool unsealing and salvage. During construction, the method of repeatedly moving the pipe column and suspending it is usually used for unblocking, and nitrogen gas lifting and lowering liquid construction is added, but the results are not ideal. During the process of moving the tubing, fatigue damage to the tubing increases the risk of well control and complex wellbore conditions, while significantly prolonging the construction period and increasing construction costs. Therefore, it is urgent to develop a degradation and ablation agent for hardened rubber parts, which can degrade and soften the hardened rubber cylinder, ensuring the smooth operation of tool salvage. Rubber products obtained through normal cross-linking reactions exhibit a regular grid like molecular structure, which can resist the invasion of organic molecules and oxidant molecules. This is also the reason why rubber products are resistant to organic solvents and acid-base corrosion. The experiment proposes to use a combination of "dissolution" and "destruction" methods to soften and melt the excessively cross-linked and hardened rubber cylinder.
Willingness and Attitude Towards Human Papilloma Virus (HPV) Vaccination Among Early-Adolescent Female School Students, in Harar, Ethiopia, 2024: A Cross-Sectional Study
Authors: Darcho Samuel , Nimani Teshome , Bayisa Feyisa
Published: August 2024

Human papillomavirus (HPV) is a sexually transmitted disease that causes various cancers, particularly in women with early sexual activity, multiple partners, and unprotected sex. However, the willingness of adolescents to receive the vaccine is influenced by community, organization, policy, and parental conditions. A study was conducted in Harar, Ethiopia, from January to February 2024. The study used a questionnaire adapted from previous studies and data collection involved face-to-face interviews. Descriptive statistics were calculated and binary logistic was used to assess associated factors. The overall favorable attitude and willingness to take HPV vaccination in this study was 66.67% (95% CI: 61.9%, 71.2%) and 50.6% (95% CI: 45.7%, 55.5%), respectively. The factor associated with the willingness to get HPV vaccination was living with parents (AOR =2.06 95% CI 1.07, 3.95), having a father's education (AOR=1.63 95% CI 1.01, 2.66), vaccine hesitancy (AOR=0.63, 95% CI 0.41, 0.98), hesitancy and complacency (AOR=1.7, 95% CI 1.07, 2.69), (AOR=1.86, 95% CI1.18, 2.93) respectively. The factor associated with the attitude towards HPV vaccination was access to the minimal media, the occupation of the parents was non-governmental, vaccine hesitancy. The study indicates a moderate willingness and attitude towards HPV vaccination among early adolescent female students.
Maritime Pollution in Pakistan and Its Impact on Marine Life: Challenges and Way Forward
Authors: Sheikh Hamna , Hameed Gul
Published: August 2024

Marine pollution is a major threat to marine biodiversity, ecosystems and socio-economic conditions of coastal communities in Pakistan. Driven by industrial, agricultural and plastic pollution, mounting levels of marine pollution are largely resulting in habitat destruction, biodiversity loss and difficulties in conduct of subsistence activities. Lack of waste management system and public awareness further compound the problem. The present study gives a comprehensive analysis of marine pollution, its sources, types and mechanism as well as the damage is does to marine environment. The study also examines existing domestic and international legislation on marine pollution eradication and puts forth recommendations in the form of both short and long terms measures for pollution mitigation in Pakistan. The study also emphasizes the need to sensitize public attention on this pressing issue and advocates awareness campaigns regarding oil spill response preparedness, investment in resilient infrastructure and plastic pollution eradication initiatives. Long term measures stem from analysis of several case studies of island countries. These measures include protection of critical infrastructure, ecosystem conservation as well as increased research and development. Effective implementation of these measures can help Pakistan transition into a sustainable and secure future.
In-Vitro SEM-EDX Analysis of Surface Roughness, Shear Bond Strength, and Color Change in Polymer-Infiltrated Ceramic Treated with Rose Bengal Activated by Low-Level Laser Therapy, Non-Thermal Plasma, and Er: YAG Laser
Authors: Emam Abdel Naser M. , Bahra Shadi El , Alqhtani Mohammad Abdullah , Alsuwayyigh Nouf , Almutairi Haifa Khalid , Alaqeel Noura , Albalawi Malak , Barakat Ali , Samran Abdulaziz , Niazi Fayez Hussain
Published: August 2024

The effects of various contemporary surface conditioning methods, Non-Thermal Plasma (NTP), Rose Bengal photosensitizer (RBPS) activated by low-level laser therapy (LLLT), and Er: YAG laser, on the color change (ΔE), surface roughness (Ra), and bond strength of Polymer-infiltrated
Ceramics (PIC). One hundred discs were fabricated using PIC and categorized into four groups (n = 15) as follows: Group 1: HFA(S), Group 2: NTP, Group 3: RBPS activated by LLLT, and Group 4: Er: YAG laser. After preparing the surface, five samples from each group were analyzed for color
difference (ΔE) surface roughness (Ra), and SBS. ANOVA was employed to compute the average and standard deviation (SD) of ΔE, Ra, and SBS. Subsequently, post hoc Tukey multiple comparisons were conducted to compare the different groups. The group of samples RBPS triggered
by LLLT+HC had the highest ΔE score, while the group of HFA(S)+HC specimens had the lowest ΔE value. The specimens treated with a combination of an Er: YAG laser and HC had the highest Ra score. Collectively, the utilization of HFA+S, NTP, and Er: YAG laser yielded positive
results concerning surface roughness and bond strength. Both the RBPS triggered by LLLT and Er: YAG groups exhibited noteworthy changes in the color of the specimens.
Preoperative Hypoalbuminemia is Associated With Higher 30-day Mortality and Complications After Esophagectomy
Authors: Li Renxi , Zhu Yueyao
Published: August 2024

Background

Serum albumin level is routinely screened during preoperative assessments as a biomarker for poor nutritional status and/or concurrent inflammation. In esophagectomy, while early postoperative hypoalbuminemia is associated with a higher risk of adverse surgical outcomes, the effects of preoperative hypoalbuminemia on esophagectomy outcomes were conflicting. This study aimed to examine the effect of preoperative hypoalbuminemia on 30-day outcomes following esophagectomy.

Methods

National Surgical Quality Improvement Program (NSQIP) esophagectomy targeted database from 2016 to 2022 was used. Patients with preoperative serum albumin <3.4 g/L were defined as having hypoalbuminemia. Patients with and without hypoalbuminemia were propensity-score matched (1:3 ratio) for demographics, baseline characteristics, neoadjuvant therapy, surgical approaches, tumor diagnosis, and pathologic staging of the malignancy. Thirty-day postoperative outcomes were examined.

Results

There were 803 (10.24%) and 7046 (89.76%) patients with and without preoperative hypoalbuminemia who underwent esophagectomy, respectively. After propensity-score matching, all patients with hypoalbuminemia were matched to 2170 controls. After propensity-matching, patients with hypoalbuminemia had higher risks of mortality (4.48% vs 3.00%, P = 0.04), sepsis (14.94% vs 10.92%, P < 0.01), and bleeding requiring transfusion (21.30% vs 13.50%, P < 0.01). Also, patients with hypoalbuminemia had a higher rate of discharge not to home (42.65% vs 34.81%, P < 0.01) and longer LOS (12.69 ± 9.09 vs 11.39 ± 8.16 days, P < 0.01).

Conclusion

Patients with preoperative hypoalbuminemia had increased risks of mortality and complications after esophagectomy. Thus, preoperative hypoalbuminemia could be a useful and cost-effective tool for preoperative risk stratification for patients undergoing esophagectomy, and correcting the underlying cause of hypoalbuminemia may help decrease the risk of adverse postoperative outcomes.
The Pediatric Heart Center Melting Pot: Sharing Recipes for Success: Proceedings from the 8th World Congress of Pediatric Cardiology and Cardiac Surgery
Authors: Teele Sarah A. , Crowe Liz , Koch Joshua , Pollak Uri , Bacha Emile , Mulreany Michael P , Trice Stephen , Riley Christine M. , Winlaw David S. , May Joseph W. , Savani Rashmin C. , Wernovsky Gil
Published: August 2024

The challenges of present-day healthcare are urgent; there is a shortage of clinicians, patient care is increasingly complex, resources are limited, clinician turnover seems ever-increasing, and the expectations of providers and patients are monumental. To transform problems into innovative opportunities, diverse perspectives and a sense of possibility are needed. The following is a collaborative manuscript authored by the speakers of the 8th World Congress of Pediatric Cardiology and Cardiac Surgery session, “Teamwork, Culture Change, and Strategy.” Although this panel was diverse in the clinical roles, nationalities, and genders represented, several consistent themes emerged which are explored in this work.
How I treat adult Ph+ ALL
Authors: Chiaretti Sabina , Foà Robin
Published: August 2024

The Philadelphia (Ph) chromosome is one of the few genetic aberrations in which a casualty has been proven and, as such, represents a success in the history of medicine. This is also evident in the setting of Ph+ acute lymphoblastic leukemia (ALL), the most frequent genetic subgroup in adult ALL, whose incidence increases with age and whose prognosis, before the advent of tyrosine kinase inhibitors (TKIs), was particularly poor. The outcome and management of patients with Ph+ ALL have greatly improved since the incorporation of first-, second-, and third-generation TKIs in the therapeutic backbone and is further changing with the more recent introduction of immunotherapy. This allows for long-term survival rates currently ranging between 75% and 80%. The clinical scenario of adult Ph+ ALL has thus changed profoundly, and new challenges are emerging. In this article, illustrative clinical cases are used to discuss the current role of systemic chemotherapy and allogeneic stem cell transplant, the difficulty in treating central nervous system relapses and, more in general, relapses in the current therapeutic era, and the possibility of stopping TKIs. Finally, the challenges related to an optimal management of these patients are discussed.
Baseline tebuconazole sensitivity and potential resistant risk in Fusarium graminearum
Authors: Zhou Feng , Zhou Xiaoli , Yan Jiao  , Han Aohui , Zhou Huanhuan , Chen Zeyuan , Li Weiguo , Liu Runqiang
Published: August 2024

Background

The Fusarium head blight caused by Fusarium graminearum results in reduced crop yields and the potential for vomitoxin contamination, which poses a risk to both human and livestock health. The primary method of control relies on the application of chemical fungicides.

Results

The current study found that the tebuconazole sensitivity of 165 F. graminearum isolates collected from the Huang-Huai-Hai region of China between 2019 and 2023 ranged from 0.005 to 2.029 µg/mL, with an average EC50 value of 0.33 ± 0.03 µg/mL. The frequency distribution conformed to a unimodal curve around the mean, and therefore provides a useful reference for monitoring the emergence of tebuconazole resistance in field populations of F. graminearum. No cross-resistance was detected between tebuconazole and other unrelated fungicides such as flutriafol, propiconazole and fluazinam, but there was a clear negative cross-resistance with triazole fungicides including fludioxonil, epoxiconazole, hexaconazole, and metconazole. Analysis of five tebuconazole-resistant mutants produced under laboratory conditions indicated that although the mycelial growth of the mutants were significantly (p < 0.05) reduced, spore production and germination rates could be significantly (p < 0.05) increased. However, pathogenicity tests confirmed a severe fitness cost associated with tebuconazole resistance, as all of the mutants completely loss the ability to infect host tissue. Furthermore, in general the resistant mutants were found to have increased sensitivity to abiotic stress, such as ionic and osmotic stress, though not to Congo red and oxidative stress, to which they were more tolerant. Meanwhile, molecular analysis identified several point mutations in the CYP51 genes of the mutants, which resulted in two substitutions (I281T, and T314A) in the predicted sequence of the FgCYP51A subunit, as well as seven (S195F, Q332V, V333L, L334G, M399T, E507G, and E267G) in the FgCYP51C subunit. In addition, it was also noted that the expression of the CYP51 genes in one of the mutants, which lacked point mutations, was significantly up-regulated in response to tebuconazole treatment.

Conclusions

These results provide useful data that allow for more rational use of tebuconazole in the control of F. graminearum, as well as for more effective monitoring of fungicide resistance in the field.
Factors affecting COVID-19 vaccine uptake in populations with higher education: insights from a cross-sectional study among university students in Malawi
Authors: Madhlopa Qebo Kornelio , Mtumbuka Matthews , Kumwenda Joel , Illingworth Thomas Arron , Van Hout Marie-Claire , Mfutso-Bengo Joseph , Mikeka Chomora , Shawa Isaac Thom
Published: August 2024

Background

The Coronavirus disease-2019 (COVID-19) vaccines were rolled out in many countries; however, sub-optimal COVID-19 vaccine uptake remains a major public health concern globally. This study aimed at assessing the factors that affected the uptake, hesitancy, and resistance of the COVID-19 vaccine among university undergraduate students in Malawi, a least developed country in Africa.

Methods

A descriptive cross-sectional study design was conducted using an online semi-structured questionnaire. A total of 343 University undergraduate students in Blantyre participated in this study after obtaining ethical clearance. Data was exported from Survey Monkey to Microsoft Excel version-21 for cleaning and was analysed using SPSS version-29. Descriptive statistics, including percentages, were performed to define the sample characteristics. Pearson Chi-square and Fisher’s exact test were performed to identify significant relationships between vaccine uptake and demographics. A 95% confidence interval was set, and a p-value of < 0.05 was considered statistically significant.

Results

Of the 343 participants, 43% were vaccinated. Among the vaccinated, the majority (47.3%, n = 69/146) received Johnson & Johnson vaccine followed by AstraZeneca (46.6%, n = 68/146). The commonly reported reason for vaccine acceptance was ‘to protect me against getting COVID-19’ (49%); whereas vaccine hesitancy was attributed to ‘lack of knowledge (34%), and concerns about vaccine safety (25%).

Conclusions

This study found that adequate knowledge about benefits and safety of COVID-19 vaccine could potentially increase uptake. Lack of credible information or misinformation contributed to vaccine hesitancy. The findings provide insights for design of strategies to increase future vaccine uptake and reduce determinants of vaccine hesitancy. To reduce vaccination hesitancy in any population with or without higher education, we recommend that institutions entrusted with vaccine management must optimise health messaging, and reduce mis-information and dis-information.
Understanding barriers, enablers and motivational factors for Australian healthcare educators teaching university students on clinical placement using the validated Physician Teaching Motivation Questionnaire
Authors: Watt Natalie Ann , Backhouse Simon , Ansari Saba , Dwyer Karen Maree , McLeod Janet , Phelps Grant , Leach Deborah , Armitage James Andrew
Published: August 2024

Background

In Australia, university clinical programs rely heavily on external healthcare professionals to provide a range of authentic clinical training and professional development opportunities for students. There is, however, a limited understanding of the factors that motivate these professionals to be educators and whether this varies across different healthcare disciplines within Australia. As the demand for clinical placements continues to increase, it is critical for the ongoing success of these programs that universities identify both the barriers associated with teaching and the benefits that enhance job satisfaction.

Methods

A two-part questionnaire was emailed to 849 external healthcare educators teaching predominantly in Medicine, Medical Imaging, and Optometry programs at Deakin University. Part-one surveyed the socio-demographics, perceived benefits, and barriers to teaching, plus the utilisation of entitlements offered by the university. Part-two was modelled on Dybowski and Harendza’s validated Physician Teaching Motivation Questionnaire (PTMQ) and adapted to an Australian audience.

Results

Overall, 776 out of the 849 questionnaires were considered in the final participant pool. The response rate for part-one was 19.7% (n = 153/776) and 18.3% (n = 142/776) for part-two. Across all professions, altruism was the primary source of motivation for teaching in Deakin University’s healthcare programs. Medical Imaging educators placed a higher value on career-related teaching aspects compared to those in Medicine and Optometry (p < 0.003). The resources and benefits associated with teaching were generally perceived to be of minimal importance. External healthcare educators most commonly reported that there were no barriers to teaching (41.3%, n = 78) however, increased workloads and time constraints were the next most likely factors to affect teaching participation (31.8%, n = 60).

Conclusion

Our validated adaptation of the PTMQ successfully targeted healthcare professions not focussed on by Dybowski and Harendza. Altruistic motivation was the overarching theme for why Australian external healthcare educators contribute to teaching with some differences in career-driven motivation additionally acknowledged. Despite there being no key benefits or barriers to teaching participation, universities must remain cognisant of the factors that influence the recruitment and retention of external healthcare educators and how to optimise these for the ongoing success and sustainability of their teaching programs.
An analysis of the psychometric properties of the medication safety competence scale in Turkish
Authors: Aydinli Ayşe , Cerit Kamuran
Published: August 2024

Purpose

Considering the key roles and responsibilities of nurses in ensuring medication safety, it is necessary to understand nurses’ competence in medication safety. Therefore, it was aimed to introduce a scale evaluating the medication safety competence of nurses into Turkish and to contribute to the literature by determining the medication safety competence levels of nurses.

Methods

A methodological and descriptive research design was utilised. The population consisted of nurses in Turkey, and the sample comprised 523 nurses who volunteered to participate.

Results

The content validity index of the scale was 0.98, and the scale showed a good fit (χ2/df = 3.00, RMSEA = 0.062). The Cronbach’s alpha coefficient of the scale was 0.97, indicating high reliability. The mean score was 4.12, which was considered high. Participants who were 40 years old or above, married, and graduates of health vocational schools or postgraduate programs, along with those who had received medication safety training, had higher medication safety competence scores.

Conclusion

This study presents strong evidence that the Turkish version of the Medication Safety Competency Scale is valid and reliable when administered to nurses. The participants in this study had high levels of medication safety competence.
Cancer incidence and mortality after a first-ever venous thrombosis: a cohort study in northern Sweden
Authors: Hägg Lovisa , Ehrs Felicia , Lind Marcus , Johansson Magdalena
Published: August 2024

Background

Venous thromboembolism (VTE) has a high mortality rate and can be the first manifestation of cancer. We investigated the incidence of cancer after first-ever VTE and the association between VTE and all-cause mortality.

Methods

A Swedish cohort study that included 105,997 participants without previous cancer who underwent a health examination from 1985–2014 was conducted. Manually validated first-ever VTE events, incident cancer according to the Swedish cancer registry, and mortality were registered. Participants were followed until September 5, 2014.

Results

The mean age at inclusion was 46.2 years, and 50.3% of participants were female. We identified 1303 persons in the cohort with a VTE and no previous cancer. Among these, 179 (13.7%) were diagnosed with cancer after the VTE event, resulting in a cancer incidence of 26.4 (95% CI 22.8–30.6) cases per 1000 person-years. The incidence was highest during the first 6 months after the VTE. In the study population, VTE was associated with an increased risk of cancer (HR 1.95 [95% CI 1.67–2.29] in a multivariable model). VTE was also associated with an increased risk of death (HR 6.30 [95% CI 5.82–6.81]) in a multivariable model). There was an interaction between sex and VTE in relation to both risk of cancer and mortality, with a stronger association in women.

Conclusions

The incidence of cancer is high after first-ever VTE, especially close to the VTE event. VTE seems to be a stronger risk marker in women than in men for both cancer and death.
Targeted protein degradation in hematologic malignancies: clinical progression towards novel therapeutics
Authors: Feng Yupiao , Hu Xinting , Wang Xin
Published: August 2024

Targeted therapies, such as small molecule kinase inhibitors, have made significant progress in the treatment of hematologic malignancies by directly modulating protein activity. However, issues such as drug toxicity, drug resistance due to target mutations, and the absence of key active sites limit the therapeutic efficacy of these drugs. Targeted protein degradation (TPD) presents an emergent and rapidly evolving therapeutic approach that selectively targets proteins of interest (POI) based on endogenous degradation processes. With an event-driven pharmacology of action, TPD achieves efficacy with catalytic amounts, avoiding drug-related toxicity. Furthermore, TPD has the unique mode of degrading the entire POI, such that resistance derived from mutations in the targeted protein has less impact on its degradation function. Proteolysis-targeting chimeras (PROTACs) and molecular glue degraders (MGDs) are the most maturely developed TPD techniques. In this review, we focus on both preclinical experiments and clinical trials to provide a comprehensive summary of the safety and clinical effectiveness of PROTACs and MGDs in hematologic malignancies over the past two decades. In addition, we also delineate the challenges and opportunities associated with these burgeoning degradation techniques. TPD, as an approach to the precise degradation of specific proteins, provides an important impetus for its future application in the treatment of patients with hematologic malignancies.
Characterization of caseinate-pectin complex coacervates as a carrier for delivery and controlled-release of saffron extract
Authors: Ardestani Faezeh , Haghighi Asl Ali , Rafe Ali
Published: August 2024

In this work, microcapsules were developed by the complex coacervation of sodium caseinate and pectin as a carrier for saffron extract. Parameters such as Zeta potential, dynamic light scattering, and microscopic techniques were investigated for their influence on the formation of these complexes. Furthermore, Fourier transform infrared (FTIR) analysis confirmed the reaction mechanism between the protein and tannic acid or saffron extract. The study revealed that core/shell and protein/polysaccharide (Pr/Ps) ratios play a role in the encapsulation efficiency (EE) and loading capacity (LC) of saffron extract, with EE and LC ranging from 48.36 to 89.38% and 1.14 to 5.55%, respectively. Thermal gravimetric analysis revealed that the degradation temperature of saffron increased significantly with microencapsulation. The use of tannic acid for hardening the microcapsules led to an increase in size from 13 μm to 27 μm. Rheological findings indicated that shear-thinning behavior in the coacervates, with cross-linking, has a minor effect on the interconnected elastic gel structures. However, cross-linking improved the microcapsules' thermal and structural properties. The increase in polymer chain length due to cross-linking and the presence of the guest molecule (saffron extract) resulted in higher rheological moduli, reflecting enhanced entanglements and correlating well with the thermal, structural, and microstructural properties of the coacervates. Kinetic release studies showed a slower release in the gastric phase compared to the intestinal phase, with the Ritger–Peppas model effectively describing saffron extract release, highlighting a dominant swelling and dissolution release mechanism. Therefore, the NaCas/HMP coacervate wall materials made saffron stable in the gastric stage and sustainably release. It in the intestinal stage, promoting excellent absorption of saffron in simulated digestion.

Graphical Abstract
Complications associated with kidney transplantation, causes of graft failure and mortality following kidney transplantation in patients with systemic lupus erythematosus: a meta-analysis
Authors: Li Xin , Cao Chun Xiang , Chen Jian
Published: August 2024

Introduction

Despite improvement in the management of systemic lupus erythematosus (SLE) during the past two decades, 10–22% of patients with lupus nephritis (LN) will progress to end-stage renal disease (ESRD). Kidney transplantation is among the possible treatment for patients with SLE progressing to ESRD. However, the issue with kidney transplantation in patients with SLE is controversial. In this analysis, we aimed to compare the complications associated with kidney transplantation, causes of graft failure and causes of mortality following kidney transplantation in patients with SLE with ESRD.

Methods

The sources of data included http://www.ClinicalTrials.gov, EMBASE, MEDLINE, Google Scholar, Web of Science and the Cochrane database. Revman software version 5.4 was used for the data analysis whereby risk ratio (RR) with 95% confidence intervals (CI) were used to represent data following analysis. In addition, the Q statistic test and the I2 statistic test were used to assess heterogeneity. A random effect statistical model was used and a subgroup outcome with a P-value less than 0.05 was considered statistically significant.

Results

A total number of 149,330 participants enrolled between the years 1968 and 2018 were included in this analysis with 7534 participants with SLE.

Results of this analysis showed that mortality (RR 1.07, 95% CI 0.89–1.29; P = 0.45), graft failure (RR 1.22, 95% CI 0.99–1.55; P = 0.07) and delayed graft function (RR 1.01, 95% CI 0.44–2.34; P = 0.98) were not significantly higher in renal transplant patients with SLE versus a control group. When the causes of graft failure were analysed in renal transplant patients with SLE versus without SLE, acute graft rejection (RR 1.20, 95% CI 0.98–1.47; P = 0.07), chronic graft rejection (RR 0.76, 95% CI 0.57–1.03; P = 0.08), graft thrombosis (RR 1.47, 95% CI 0.83–2.63; P = 0.19), recurrence of disease (RR 3.08, 95% CI 1.00–9.47; P = 0.05) and chronic allograft nephropathy (RR 1.08, 95% CI 0.60–1.95; P = 0.80) were also not significantly higher in patients with SLE. On the basis of the analysis, mortality from any cardiac cause (RR 0.82, 95% CI 0.67–1.01; P = 0.06), sepsis (RR 1.19, 95% CI 0.93–1.53; P = 0.17), malignancy (RR 0.79, 95% CI 0.51–1.24; P = 0.31) and cerebrovascular attack (RR 0.76, 95% CI 0.44–1.30; P = 0.31) were not significantly different in kidney transplantation patients with versus without SLE.

Conclusions

Complications associated with kidney transplantation including mortality, graft failure and delayed graft function were not significantly higher in patients with SLE when compared with a control group. The causes of graft failure and mortality after kidney transplantation were also comparable in both groups. Therefore, kidney transplantation represents a promising treatment in patients with SLE with ESRD.
40 years of the homeobox: mechanisms of Hox spatial-temporal collinearity in vertebrates
Authors: Peraldi Rodrigue , Kmita Marie
Published: August 2024

Animal body plans are established during embryonic development by the Hox genes. This patterning process relies on the differential expression of Hox genes along the head-to-tail axis. Hox spatial collinearity refers to the relationship between the organization of Hox genes in clusters and the differential Hox expression, whereby the relative order of the Hox genes within a cluster mirrors the spatial sequence of expression in the developing embryo. In vertebrates, the cluster organization is also associated with the timing of Hox activation, which harmonizes Hox expression with the progressive emergence of axial tissues. Thereby, in vertebrates, Hox temporal collinearity is intimately linked to Hox spatial collinearity. Understanding the mechanisms contributing to Hox temporal and spatial collinearity is thus key to the comprehension of vertebrate patterning. Here, we provide an overview of the main discoveries pertaining to the mechanisms of Hox spatial-temporal collinearity.
Dual role of BdMUTE during stomatal development in the model grass Brachypodium distachyon
Authors: Spiegelhalder Roxane P. , Berg Lea S. , Nunes Tiago D. G. , Dörr Melanie , Jesenofsky Barbara , Lindner Heike , Raissig Michael T.
Published: August 2024

Grasses form morphologically derived, four-celled stomata, where two dumbbell-shaped guard cells (GCs) are flanked by two lateral subsidiary cells (SCs). This innovative form enables rapid opening and closing kinetics and efficient plant–atmosphere gas exchange. The mobile bHLH transcription factor MUTE is required for SC formation in grasses. Yet whether and how MUTE also regulates GC development and whether MUTE mobility is required for SC recruitment is unclear. Here, we transgenically impaired BdMUTE mobility from GC to SC precursors in the emerging model grass Brachypodium distachyon. Our data indicate that reduced BdMUTE mobility severely affected the spatiotemporal coordination of GC and SC development. Furthermore, although BdMUTE has a cell-autonomous role in GC division orientation, complete dumbbell morphogenesis of GCs required SC recruitment. Finally, leaf-level gas exchange measurements showed that dosage-dependent complementation of the four-celled grass morphology was mirrored in a gradual physiological complementation of stomatal kinetics. Together, our work revealed a dual role of grass MUTE in regulating GC division orientation and SC recruitment, which in turn is required for GC morphogenesis and the rapid kinetics of grass stomata.
Core Temperature Response to Cold Water Immersion in Heat Stroke Patients Is Nonlinear and Unrelated to Sex or Body Size
Authors: BONGERS COEN C. W. G. , PEGGEN MANDY A. G. , MINETT GEOFFREY M. , KRUIJT NICK , GORIS BRAM , HOPMAN MARIA T. E.
Published: August 2024

Purpose

Cold water immersion (CWI) is the most effective treatment for exertional heat stroke (EHS). However, knowledge on core temperature response during CWI treatment and the relation with patient characteristics (i.e., sex, anthropometrics) is limited. Therefore, the current study aimed to examine the core temperature response (in °C) during CWI treatment of recreational athletes participating in large running events and investigate the impact of sex and anthropometric characteristics on the cooling rate (in °C·min−1).

Methods

This observational study includes 57 athletes (n = 22 females; 39%) who suffered from EHS during an exercise event in the Netherlands. After admission to the medical facilities, a rectal temperature (T
rec) probe was inserted and all clothing was removed before immersion in an ice bath (6.4 ± 1.6°C). Rectal temperature was continuously measured throughout treatment, and treatment was continued until T
rec ≤ 38.9°C or based on the decision of the emergency physician.

Results

Initial T
rec did not differ between males (41.3 ± 0.9°C) and females (41.2 ± 0.8°C, P = 0.83). A nonlinear response to CWI was observed, with the decrease in T
rec beginning after 6 min of CWI. The decrease in T
rec did not differ between both sexes (ptime*sex = 0.96). The cooling rate did not differ between males (0.21 ± 0.15°C·min−1) and females (0.19 ± 0.08°C·min−1, P = 0.55), and was not related to body mass, body surface area and body surface area to mass ratio (all P values >0.05).

Conclusions

We demonstrated that the cooling rate during CWI did not differ between men and women suffering from EHS, and that the T
rec response to CWI is nonlinear and not dependent on anthropometric characteristics. This suggests that no sex differentiation is needed in the EHS treatment guidelines and confirms the necessity to continuously monitor T
rec during treatment.
Αξιολόγηση των πολιτικών περιφερειακής ανταγωνιστικότητας σε λιγότερο ανεπτυγμένες περιφέρειες
Authors: Κούσκουρα Αμαλία
Published: August 2024

Η παρούσα διδακτορική διατριβή έχει ως θέμα την αξιολόγηση και τη μοντελοποίηση των Περιφερειακών Πολιτικών Ανταγωνιστικότητας σε λιγότερο ανεπτυγμένες Περιφέρειες με τη χρήση της Αναλυτικής Ιεραρχικής Διαδικασίας.Σκοπός αυτής της διατριβής είναι και η επιστημονική προσέγγιση της έννοιας της περιφερειακής ανταγωνιστικότητας μιας λιγότερο ανεπτυγμένης Περιφέρειας του Ευρωπαϊκού Νότου όπως είναι η Περιφέρεια Δυτικής Μακεδονίας και η ανάδειξη των παραγόντων που την καθορίζουν και την επηρεάζουν. Μελετάται επίσης, η μεταξύ τους συσχέτιση και ο βαθμός της αλληλεπίδρασης τους. Ελέγχονται οι τρέχουσες περιφερειακές πολιτικές και ουσιαστικά αναδεικνύονται εκείνες οι οποίες μπορούν να οδηγήσουν στην ενίσχυση της ανταγωνιστικότητας με την εφαρμογή ενός πλέγματος αξιολόγησης των συσχετισμών και των παραμέτρων των Περιφερειακών Πολιτικών στην οικονομική και συνολικά στην περιφερειακή ανάπτυξη. Η διδακτορική αυτή έρευνα, εστιάζει στην ανάλυση των δεικτών και των παραγόντων της περιφερειακής ανταγωνιστικότητας μέσα και από τις πολιτικές ανάπτυξης και καινοτομίας και της οικονομικό - κοινωνικής ανάπτυξης, με τη μέθοδο της Αναλυτικής Ιεραρχικής Διαδικασίας / Analytic Hierarchy Process (ΑΙΔ / AHP). Η μέθοδος αυτή, αναδεικνύει ένα μαθηματικό μοντέλο όπου θα αναλύονται και θα συγκρίνονται τα συστήματα των περιφερειακών πολιτικών των μη ανεπτυγμένων Περιφερειών σε σχέση με τις περισσότερο ανεπτυγμένες Περιφέρειες σε Ευρωπαϊκό επίπεδο. Στόχος είναι το να αναδειχθούν και να ενισχυθούν οι παράγοντες πολιτικής, γνώσης και οι πολιτικές ενίσχυσης και ενδυνάμωσης της ανταγωνιστικότητας. Στο μοντέλο αυτό, αποτυπώνεται το περιβάλλον επίδοσης της Περιφέρειας σε σχέση με τους κρίσιμους παράγοντες ανταγωνιστικότητας και ανάπτυξης και οι σχέσεις και οι αλληλεπιδράσεις που αναπτύσσονται.
Impact of microplastics on human health: exposure mechanisms and potential health implications
Authors: Marszalek Anna , Marzec Weronika Zofia , Łakoma Aleksandra , Marzec Marcelina Teresa , Choiński Maciej , Wasiewicz-Ciach Paulina , Kuczyński Piotr , Wydra-Rojek Aleksandra , Kutyła Katarzyna , Mokot Wojciech Jan
Published: August 2024

Microplastics are a pervasive environmental contaminant and represent a newly emerging threat to human health. They enter the body through various pathways, including food consumption, drinking water, and inhalation. The present study is concerned with the issue of dietary and inhalational exposure to microplastics. The presence of microplastics has been identified in a range of food products and drinking water, with analyses of faecal samples also indicating their passage through the human digestive tract, thereby suggesting the potential for their absorption by the body. It is also important to consider the potential for inhalational exposure, given the presence of microplastics in the air. This suggests that inhalation by humans may also be a possibility. Furthermore, these particles have been identified in sputum samples from patients and lung tissues, indicating the potential for bioaccumulation and the induction of inflammatory responses.  
While there is documented evidence of microplastics in the human body, there is currently a lack of specific data on their impact on human health. The available evidence from animal studies and in vitro models indicates that microplastics have the potential to traverse epithelial barriers in the digestive and respiratory systems, resulting in inflammatory responses, oxidative stress, and, in extreme cases, tissue fibrosis. Furthermore, microplastics may act as carriers for heavy metals and toxic chemicals, thereby increasing the risk of neurotoxicity, nephrotoxicity, and potentially carcinogenic effects. Further research, including long-term clinical studies, is required to gain a full understanding of the impact of microplastics on human health.
A Bilevel Approach for Compensation and Routing Decisions in Last-Mile Delivery
Authors: Cerulli Martina , Archetti Claudia , Fernández Elena , Ljubić Ivana
Published: August 2024

In last-mile delivery logistics, peer-to-peer logistic platforms play an important role in connecting senders, customers, and independent carriers to fulfill delivery requests. As the carriers are not under the platform’s control, the platform has to anticipate their reactions while deciding how to allocate the delivery operations. Indeed, carriers’ decisions largely affect the platform’s revenue. In this paper, we model this problem using bilevel programming. At the upper level, the platform decides how to assign the orders to the carriers; at the lower level, each carrier solves a profitable tour problem to determine which offered requests to accept, based on her own profit maximization. Possibly, the platform can influence carriers’ decisions by determining also the compensation paid for each accepted request. The two considered settings result in two different formulations: the bilevel profitable tour problem with fixed compensation margins and with margin decisions, respectively. For each of them, we propose single-level reformulations and alternative formulations where the lower-level routing variables are projected out. A branch-and-cut algorithm is proposed to solve the bilevel models, with a tailored warm-start heuristic used to speed up the solution process. Extensive computational tests are performed to compare the proposed formulations and analyze solution characteristics.

Funding: The research of E. Fernandez was partially funded through the Spanish Ministerio de Ciencia y Tecnología and European Regional Development Funds (ERDF) [Grant MTM2019-105824GB-I00]. The research of C. Archetti, M. Cerulli, and I. Ljubić was partially funded by CY Initiative of Excellence, France [Grant “Investissements d’Avenir ANR-16-IDEX-0008”].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2023.0129 .