bluuebunny/crossref_metadata_2025 huggingface dataset:
FLT3/CD99 Bispecific Antibody–Based Nanoparticles for Acute Myeloid Leukemia
Authors: Ali Atham , Phan Alvin , Vaikari Vijaya , Park Mincheol , Pospiech Mateusz , Chu Ryan , Meng Yiting , MacKay J. Andrew , Alachkar Houda
Published: July 2024

Cluster of differentiation 99 (CD99) is a receptor that is significantly upregulated in acute myeloid leukemia (AML). FMS-like tyrosine kinase 3 internal tandem duplication mutation in AML (FLT3-ITD AML) exhibits even higher levels of CD99 expression. Our group previously employed a novel peptide platform technology called elastin-like polypeptides and fused it with single-chain antibodies capable of binding to FLT3 (FLT3-A192) or CD99 (CD99-A192). Targeting either FLT3 or CD99 using FLT3-A192 or CD99-A192 led to AML cell death and reduced leukemia burden in AML mouse models. Here, we report on the development of a novel Co-Assembled construct that is capable of binding to both CD99 and FLT3 and the antileukemia activity of the bispecific construct in FLT3-ITD AML preclinical models. This dual-targeting Co-Assembled formulation exhibits cytotoxic effects on AML cells (AML cell lines and primary blasts), reduced leukemia burden and prolonged survival in FLT3-ITD AML mouse models. Altogether, this study demonstrates the potential of an innovative therapeutic strategy that targets both FLT3 and CD99 in FLT3-ITD AML.

Significance:

This study investigates a dual-targeting strategy in acute myeloid leukemia (AML), focusing on FLT3 and CD99. The approach demonstrates enhanced therapeutic potential, presenting a novel option for AML treatment.
Loss of Y Chromosome and Cardiovascular Events in Chronic Kidney Disease
Authors: Weyrich Michael , Cremer Sebastian , Gerster Martin , Sarakpi Tamim , Rasper Tina , Zewinger Stephen , Patyna Sammy R. , Leistner David M. , Heine Gunnar H. , Wanner Christoph , März Winfried , Fliser Danilo , Dimmeler Stefanie , Zeiher Andreas M. , Speer Thimoteus
Published: July 2024

BACKGROUND:

Chronic kidney disease represents one of the strongest risk factors for cardiovascular diseases, and particularly for heart failure. Despite improved pharmaceutical treatments, mortality remains high. Recently, experimental studies demonstrated that mosaic loss of Y chromosome (LOY) associates with cardiac fibrosis in male mice. Since diffuse cardiac fibrosis is the common denominator for progression of all forms of heart failure, we determined the association of LOY on mortality and cardiovascular disease outcomes in patients with chronic kidney disease.

METHODS:

LOY was quantified in men with stable chronic kidney disease (CARE for HOMe study, n=279) and dialysis patients (4D study, n=544). The association between LOY and mortality, combined cardiovascular and heart failure-specific end points, and echocardiographic measures was assessed.

RESULTS:

In CARE for HOMe, the frequency of LOY increased with age. LOY >17% was associated with increased mortality (heart rate, 2.58 [95% CI, 1.33–5.03]) and risk for cardiac decompensation or death (heart rate, 2.30 [95% CI, 1.23–4.27]). Patients with LOY >17% showed a significant decline of ejection fraction and an increase of E/E’ within 5 years. Consistently, in the 4D study, LOY >17% was significantly associated with increased mortality (heart rate, 2.76 [95% CI, 1.83–4.16]), higher risk of death due to heart failure and sudden cardiac death (heart rate, 4.11 [95% CI, 2.09–8.08]), but not atherosclerotic events. Patients with LOY >17% showed significantly higher plasma levels of soluble interleukin 1 receptor-like 1, a biomarker for myocardial fibrosis. Mechanistically, intermediate monocytes from patients with LOY >17% showed significantly higher C-C chemokine receptor type 2 expression and higher plasma levels of the C-C chemokine receptor type 2 chemokine (C-C motif) ligand 2, which may have contributed to increased heart failure events.

CONCLUSIONS:

LOY identifies male patients with chronic kidney disease at high risk for mortality and heart failure events.
Digital Footprints of Obesity Treatment: GLP-1 Receptor Agonists and the Health Equity Divide
Authors: Azizi Zahra , Rodriguez Fatima , Assimes Themistocles L.
Published: July 2024

Our research investigates the societal implications of access to glucagon-like peptide-1 (GLP-1) agonists, particularly in light of recent clinical trials demonstrating the efficacy of semaglutide in reducing cardiovascular mortality. A decade-long analysis of Google Trends indicates a significant increase in searches for GLP-1 agonists, primarily in North America. This trend contrasts with the global prevalence of obesity. Given the high cost of GLP-1 agonists, a critical question arises: Will this disparity in medication accessibility exacerbate the global health equity gap in obesity treatment? This viewpoint explores strategies to address the health equity gap exacerbated by this emerging medication. Because GLP-1 agonists hold the potential to become a cornerstone in obesity treatment, ensuring equitable access is a pressing public health concern.
On Contracted Negation in Scots
Authors: Sobin Nicholas
Published: July 2024

Thoms et al. (2023) propose a system of negation involving two base–generated NegPs, one below T and the other above T, claiming that negative inflections do not syntactically attach to T, but merge with T morphophonologically. Their analysis is driven by the distribution of the contracted negative inflection –nae in Scots negative imperatives and assumptions about adverbial positioning. Clitic vs. affix is claimed insufficient to characterize –nae vs. –n’t. However, further considerations of adverb positioning and other phenomena demonstrate that the two–NegP analysis is unnecessary, and that the clitic/affix distinction can characterize –nae and –n’t, respectively.
How Interaction Techniques Affect Workload in a Virtual Environment During Multitasking
Authors: Verhulst Eulalie , Banville Frédéric , Allain Philippe , Richard Paul
Published: July 2024

Virtual environments (VEs) can be modulated and adapted to the needs of each user, but in the case of patients, performance can be affected by several factors that are difficult to expertise. The objective of the study is to explore the relationship between workload and the interaction techniques used during selection in a virtual apartment. Fifty-six participants performed tasks in a VE with 2D or, more immersive, 3D interaction techniques. The VE used was the Virtual Multitasking Test (Banville et al., 2018) where participants realized several everyday tasks in a virtual apartment. Workload and variables describing how individuals felt in the VE were measured using questionnaires, and performance in VE has been assessed. Results showed that 2D selection techniques have a better usability than 3D ones. The performance (success in task realization) on the virtual tasks was not impacted by the interaction techniques. Our results suggest that the easier it is to use an interaction technique, the less workload is associated with it. Sense of presence and cybersickness were affected by 3D interaction techniques. Thus, future VEs for cognitive assessment and rehabilitation, based on instrumental activities of daily living, will have to adapt their interaction techniques to different users.
A Priori Test of Scale-Similarity Parameterizations for Subgrid-Scale Fluxes in Convective Storms
Authors: Watanabe Shun-ich I. , Ito Junshi
Published: July 2024

This study evaluates a parameterization scheme for subgrid-scale (SGS) fluxes based on the scale-similarity assumption and employing a large-eddy simulation of an idealized back-building convective system. In this parameterization, the SGS fluxes are decomposed into the “Leonard term,” which depends only on the resolved scale components, the “Reynolds term,” which depends only on the SGS components, and the “cross term,” which corresponds to the interaction between the resolved scale and SGS components. Assuming a linear relationship between the Leonard term and the Reynolds and cross terms, SGS fluxes are expressed as the product of an empirical coefficient and the Leonard term. The Leonard term reasonably represents the SGS flux derived by a smooth filter operation, including the countergradient vertical SGS transport of potential temperature, which cannot be represented by a traditional eddy-diffusivity model. The dependence of the empirical coefficient on filter width is also evaluated. This dependence is related mainly to the Reynolds term, the magnitude of which varies widely with the filter width. The estimation based on the spectral decomposition of the Reynolds term explains the obtained dependence of the empirical coefficient for the vertical flux on filter width. In contrast, the variation of the empirical coefficient with filter width is not required to obtain the horizontal flux. For the parameterization of SGS fluxes in kilometer-scale models that use finite difference or volume methods, the Leonard term is expressed by the horizontal gradient of variables on a discrete grid. The Leonard term on a discrete grid also accurately represents the amplitude and spatial pattern of the SGS flux.

Significance Statement

Kilometer-scale numerical weather prediction models can reproduce deep convection explicitly. However, they cannot reproduce smaller inner structures within this deep convection. Therefore, a parameterization scheme that can express the nature of the transport associated with such structures is required. Using a large-eddy simulation with a horizontal resolution sufficient to express such inner structures, we evaluated a parameterization based on the scale similarity assumption, including an empirical coefficient. Based on spectral decomposition, we quantitatively estimated the relationship between the empirical coefficient and grid spacing. Our results provide guidance in selecting the value of the empirical coefficient in this parameterization.
The Impact of Intimate Partner Violence on Homelessness and Returns to Housing: A Qualitative Analysis From the California Statewide Study of People Experiencing Homelessness
Authors: Hargrave Anita S. , Knight Kelly R. , Dhatt Zena K. , Taylor Grace , Martinez Dez , Kushel Margot
Published: July 2024

Homelessness is a public health concern in California and throughout the United States. Intimate partner violence (IPV) is a risk factor for experiencing homelessness. Few studies have examined the interplay between IPV, homelessness, and housing. Qualitative methods can provide a greater understanding of the lived experience of IPV and homelessness to identify potential solutions. We purposefully sampled 104 adults who reported experiencing IPV in the California Statewide Study of People Experiencing Homelessness (CASPEH), a representative, mixed-methods study. We administered semi-structured interviews focusing on IPV and six other topic areas pertaining to homelessness from October 2021 to May 2022. We created and applied a codebook with a multidisciplinary team using a hybrid of deductive and inductive logic. Our analysis included all participants who discussed IPV and homelessness across the seven studies. We conducted a thematic analysis using an interpretivist approach and informed by grounded theory. We found that violence within a partnership was multidimensional (physical, sexual, emotional, and financial) and bidirectional. We identified six themes: (1) IPV precipitated and prolonged homelessness; (2) Need for housing, financial stability, and material resources influenced staying in abusive relationships; (3) Alcohol and illicit substance use exacerbated violence between partners; (4) Participants struggled to find resources in domestic violence (DV) shelters; (5) The healthcare system did not provide substantial support; and (6) discrimination and stigma influenced equitable access to housing and DV resources. Experiencing IPV contributed to homelessness and impeded returns to housing. Limitations in current IPV resources impede care. We propose equitable expansion of survivor-centered services that improve access to long-term subsidized housing, prevent IPV and homelessness with flexible funding options, and facilitate rapid exits from homelessness through trauma-informed, non-congregate shelter that transitions to permanent housing.
The relationship between local councillors’ representative style and their support for participatory democracy
Authors: De Smedt Nina , Haesevoets Tessa , Steyvers Kristof , Wauters Bram
Published: July 2024

The last few decades governments have operated in a challenging environment which increasingly calls for extended citizen participation. The aim of the article is to demonstrate that representative and participatory democracy are not two distinct realities, but that politicians’ opinions about their representative roles are associated with their attitudes about participatory democracy. To this end, the present paper links representative styles (partisan-delegate-trustee) with support for (1) the amount of citizen participation and (2) the type of citizen participation. Elected politicians traditionally perceive their representative roles either as ‘partisan’ (party-driven), ‘delegate’ (voter-driven) or ‘trustee’ (driven by their own judgement). We conducted a large-scale survey among Flemish (Belgium) local councillors ( N = 791). We show the biggest differences in support being between ‘delegates’ and ‘partisans’. The first group seems to be more receptive to (far-reaching) citizen participation and we explain that by their general orientation towards citizens.
Chronic graft-versus-host disease: unresolved complication or ancient history?
Authors: Pidala Joseph A. , Gooley Ted A. , Luznik Leo , Blazar Bruce R.
Published: July 2024

Chronic graft-versus-host disease (cGVHD) is associated with morbidity, mortality, impaired quality of life, prolonged immunosuppressive therapy, and infection risk after allogeneic hematopoietic cell transplantation (HCT). Major strides have occurred in the understanding of cGVHD biology; National Institutes of Health Consensus meetings have refined rigorous approaches to diagnosis, staging, and response criteria; major interventional trials have established standard benchmarks for treatment outcome; and 3 agents to date have been US Food and Drug Administration approved for treating corticosteroid-refractory cGVHD. Promising results from several recent trials have led some, but not others, to conclude that the risk of developing cGVHD is sufficiently low to be considered a major post-HCT complication of the past. We propose that it is time to critically examine the results of contemporary graft-versus-host disease (GVHD) prophylaxis regimens and discuss the state of the science and associated controversies in the spectrum of conclusions reached as to the risk of cGVHD. With these data, the current cGVHD incidence can be most precisely determined, and the present and future burden of cGVHD-affected patients can be accurately modeled. Through review of existing evidence, we highlight unresolved needs and opportunities to refine best GVHD prophylaxis or preemptive therapy approaches and optimize established cGVHD therapy, and make the argument that support of preclinical and clinical research is critical in improving patient outcomes.
A brain organoid/ALL coculture model reveals the AP-1 pathway as critically associated with CNS involvement of BCP-ALL
Authors: Gebing Philip , Loizou Stefanos , Hänsch Sebastian , Schliehe-Diecks Julian , Spory Lea , Stachura Pawel , Jepsen Vera H. , Vogt Melina , Pandyra Aleksandra A. , Wang Herui , Zhuang Zhengping , Zimmermann Johannes , Schrappe Martin , Cario Gunnar , Alsadeq Ameera , Schewe Denis M. , Borkhardt Arndt , Lenk Lennart , Fischer Ute , Bhatia Sanil
Published: July 2024

Central nervous system (CNS) involvement remains a clinical hurdle in treating childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL). The disease mechanisms of CNS leukemia are primarily investigated using 2-dimensional cell culture and mouse models. Given the variations in cellular identity and architecture between the human and murine CNS, it becomes imperative to seek complementary models to study CNS leukemia. Here, we present a first-of-its-kind 3-dimensional coculture model combining human brain organoids and BCP-ALL cells. We noticed significantly higher engraftment of BCP-ALL cell lines and patient-derived xenograft (PDX) cells in cerebral organoids than non-ALL cells. To validate translatability between organoid coculture and in vivo murine models, we confirmed that targeting CNS leukemia–relevant pathways such as CD79a/Igα or C-X-C motif chemokine receptor 4–stromal cell-derived factor 1 reduced the invasion of BCP-ALL cells into organoids. RNA sequencing and functional validations of organoid-invading leukemia cells compared with the noninvaded fraction revealed significant upregulation of activator protein 1 (AP-1) transcription factor–complex members in organoid-invading cells. Moreover, we detected a significant enrichment of AP-1 pathway genes in PDX ALL cells recovered from the CNS compared with spleen blasts of mice that had received transplantation with TCF3::PBX1+ PDX cells, substantiating the role of AP-1 signaling in CNS disease. Accordingly, we found significantly higher levels of the AP-1 gene, jun proto-oncogene, in patients initially diagnosed as CNS-positive BCP-ALL compared with CNS-negative cases as well as CNS-relapse vs non–CNS-relapse cases in a cohort of 100 patients with BCP-ALL. Our results suggest CNS organoids as a novel model to investigate CNS involvement and identify the AP-1 pathway as a critical driver of CNS disease in BCP-ALL.
Modeling and Validation of Diamagnetic Rotor Levitated by Permanent Magnetics
Authors: Xu Yuanping , Zhang Yue , Zhou Jin , Jin Chaowu
Published: July 2024

As an innovative, low-power consuming, and low-stiffness suspension approach, the diamagnetic levitation technique has attracted considerable interest because of its potential applicability in miniaturized mechanical systems. The foundation of a diamagnetic levitation system is mathematical modeling, which is essential for operating performance optimization and stability prediction. However, few studies on systematic mathematical modeling have been reported. In this study, a systematic mathematical model for a disc-shaped diamagnetically levitated rotor on a permanent magnet array is proposed. Based on the proposed model, the magnetic field distribution characteristics, diamagnetic levitation force characteristics (i.e., levitation height and stiffness), and optimized theoretical conditions for realizing stable levitation are determined. Experiments are conducted to verify the feasibility of the proposed mathematical model. Theoretical predictions and experimental results indicate that increasing the levitation height enlarges the stable region. Moreover, with a further increase in the rotor radius, the stable regions of the rotor gradually diminish and even vanish. Thus, when the levitation height is fixed, a moderate rotor radius permits stable levitation. This study proposes a mathematical modeling method for a diamagnetic levitation system that has potential applications in miniaturized mechanical systems.
Draft genome assemblies of the ponerine ant Odontoponera transversa and the carpenter ant Camponotus friedae (Hymenoptera: Formicidae)
Authors: Liu Jinlin , Xiong Zijun , Pan Youliang , Zhao Jie , Dai Wei , Guo Qunfei , Liu Weiwei , Li Qiye
Published: July 2024

Objectives

Ants are ecologically dominant insects in most terrestrial ecosystems, with more than 14,000 extant species in about 340 genera recorded to date. However, genomic resources are still scarce for most species, especially for species endemic in East or Southeast Asia, limiting the study of phylogeny, speciation and adaptation of this evolutionarily successful animal lineage. Here, we assemble and annotate the genomes of Odontoponera transversa and Camponotus friedae, two ant species with a natural distribution in China, to facilitate future study of ant evolution.

Data description

We obtained a total of 16 Gb and 51 Gb PacBio HiFi data for O. transversa and C. friedae, respectively, which were assembled into the draft genomes of 339 Mb for O. transversa and 233 Mb for C. friedae. Genome assessments by multiple metrics showed good completeness and high accuracy of the two assemblies. Gene annotations assisted by RNA-seq data yielded a comparable number of protein-coding genes in the two genomes (10,892 for O. transversa and 11,296 for C. friedae), while repeat annotations revealed a remarkable difference of repeat content between these two ant species (149.4 Mb for O. transversa versus 49.7 Mb for C. friedae). Besides, complete mitochondrial genomes for the two species were assembled and annotated.
Nitrogen-fixing bacteria promote growth and bioactive components accumulation of Astragalus mongholicus by regulating plant metabolism and rhizosphere microbiota
Authors: Zhiyong Shi , Yaxuan Guo , Yuanyuan Wang , Xiang Yan , Xu Guo , Zhenhong Lei , Jingping Niu , Jianping Liang , Zhenyu Li
Published: July 2024

Background

The excessive application of chemical fertilizers in the cultivation of Astragalus mongholicus Bunge results in a reduction in the quality of the medicinal plant and compromises the sustainable productivity of the soil. PGPB inoculant is a hot topic in ecological agriculture research. In the cultivation of Astragalus mongholicus, the screened nitrogen-fixing bacteria can promote plant growth, however, whether it can promote the accumulation of main bioactive components remains unknown. In this study, mixed inoculants containing 5 strains of growth promoting bacteria (Rhizobium T16, Sinorhizobium T21, Bacillus J1, Bacillus G4 and Arthrobacter J2) were used in the field experiment. The metabolic substances in the root tissues of Astragalus mongholicus were identified during the harvest period by non-targeted metabolomics method, and the differential metabolites between groups were identified by statistical analysis. Meanwhile, high-throughput sequencing was performed to analyze the changes of rhizosphere soil and endophytic microbial community structure after mixed microbial treatment.

Results

The results of non-targeted metabolism indicated a significant increase in the levels of 26 metabolites after treatment including 13 flavonoids, 3 saponins and 10 other components. The contents of three plant hormones (abscisic acid, salicylic acid and spermidine) also increased after treatment, which presumed to play an important role in regulating plant growth and metabolism. Studies on endosphere and rhizosphere bacterial communities showed that Rhzobiaceae, Micromonosporaceae, and Hypomicrobiaceae in endophytic, and Oxalobactereae in rhizosphere were significantly increased after treatment. These findings suggest their potential importance in plant growth promotion and secondary metabolism regulation.

Conclusions

This finding provides a basis for developing nitrogen-fixing bacteria fertilizer and improving the ecological planting efficiency of Astragalus mongholicus.
Fatty acid and nutrient profiles, diosgenin and trigonelline contents, mineral composition, and antioxidant activity of the seed of some Iranian Trigonella L. species
Authors: Bakhtiar Ziba , Hassandokht Mohammadreza , Naghavi Mohammad Reza , Rezadoost Hassan , Mirjalili Mohammad Hossein
Published: July 2024

Background

Fenugreeks (Trigonella L. spp.), belonging to the legume family (Fabaceae), are well-known multipurpose crops that their materials are currently received much attention in the pharmaceutical and food industries for the production of healthy and functional foods all over the world. Iran is one of the main diversity origins of this valuable plant. Therefore, the aim of the present study was to explore vitamins, minerals, and fatty acids profile, proximate composition, content of diosgenin, trigonelline, phenolic acids, total carotenoids, saponins, phenols, flavonoids, and tannins, mucilage and bitterness value, and antioxidant activity of the seed of thirty populations belonging to the ten different Iranian Trigonella species.

Results

We accordingly identified notable differences in the nutrient and bioactive compounds of each population. The highest content (mg/100 g DW) of ascorbic acid (18.67 ± 0.85‒22.48 ± 0.60) and α–tocopherol (31.61 ± 0.15‒38.78 ± 0.67) were found in the populations of T. filipes and T. coerulescens, respectively. Maximum content of catechin was found in the populations of T. teheranica (52.67 ± 0.05‒63.50 ± 0.72 mg/l). Linoleic acid (> 39.11% ± 0.61%) and linolenic acid (> 48.78 ± 0.39%) were the main polyunsaturated fatty acids, with the majority in the populations of T. stellata (54.81 ± 1.39‒63.46 ± 1.21%). The populations of T. stellata were also rich in trigonelline (4.95 ± 0.03‒7.66 ± 0.16 mg/g DW) and diosgenin (9.06 ± 0.06‒11.03 ± 0.17 mg/g DW).

Conclusions

The obtained data provides baseline information to expand the inventory of wild and cultivated Iranian Trigonella species for further exploitation of rich chemotypes in the new foods and specific applications.
Induced genetic diversity through mutagenesis in wheat gene pool and significant use of SCoT markers to underpin key agronomic traits
Authors: Abdelhameed Ahmed Ali , Ali Mohammed , Darwish Doaa Bahaa Eldin , AlShaqhaa Manal Abdullah , Selim Dalia Abdel-Fattah H. , Nagah Aziza , Zayed Muhammad
Published: July 2024

Background

This research explores the efficacy of mutagenesis, specifically using sodium azide (SA) and hydrazine hydrate (HZ) treatments, to introduce genetic diversity and enhance traits in three wheat (Triticum aestivum L.) genotypes. The experiment entails subjecting the seeds to different doses of SA and HZ and cultivating them in the field for two consecutive generations: M1 (first generation) and M2 (second generation). We then employed selective breeding techniques with Start Codon Targeted (SCoT) markers to select traits within the wheat gene pool. Also, the correlation between SCoT markers and specific agronomic traits provides insights into the genetic mechanisms underlying mutagenesis-induced changes in wheat.

Results

In the study, eleven genotypes were derived from parent varieties Sids1, Sids12, and Giza 168, and eight mutant genotypes were selected from the M1 generation and further cultivated to establish the M2 generation. The results revealed that various morphological and agronomical characteristics, such as plant height, spikes per plant, spike length, spikelet per spike, grains per spikelet, and 100-grain weight, showed increases in different genotypes from M1 to M2. SCoT markers were employed to assess genetic diversity among the eleven genotypes. The bioinformatics analysis identified a correlation between SCoT markers and the transcription factors ABSCISIC ACID INSENSITIVE3 (ABI3) and VIVIPAROUS1 (VP1), crucial for plant development, growth, and stress adaptation. A comprehensive examination of genetic distance and the function identification of gene-associated SCoT markers may provide valuable insights into the mechanisms by which SA and HZ act as mutagens, enhancing wheat agronomic qualities.

Conclusions

This study demonstrates the effective use of SA and HZ treatments to induce gene diversity through mutagenesis in the wheat gene pool, resulting in the enhancement of agronomic traits, as revealed by SCoT markers. The significant improvements in morphological and agronomical characteristics highlight the potential of mutagenesis techniques for crop improvement. These findings offer valuable information for breeders to develop effective breeding programs to enhance wheat quality and resilience through increased genetic diversity.
Good outcome with conservative treatment of delayed spinal epidural hematoma following combined spinal-epidural anesthesia: a rare case report
Authors: Yao Hui , Li Xuejie , Leng Shize , Zhang Hui
Published: July 2024

Background

Delayed spinal epidural hematoma (SEH) following central neuraxial block (CNB) is a rare but serious complication. The underlying causes of SEH associated with neuraxial anesthesia are still unclear. Furthermore, the decision between surgical intervention and conservative management for SEH remains a complex and unresolved issue.

Case Presentation

We report a case of delayed SEH in a 73-year-old woman who underwent vaginal hysterectomy under combined spinal-epidural anesthesia, with the administration of postoperative anticoagulants to prevent deep vein thrombosis on the 1st postoperative day (POD). She experienced symptoms 56 h after CNB. Magnetic resonance imaging (MRI) revealed a dorsal SEH at the L1-L4 level with compression of the thecal sac. On conservative treatment, full recovery was achieved after six months.

Conclusions

This case reminds anesthesiologists should be alert to the possible occurrence of a delayed SEH following CNB, particularly with the administration of anticoagulants. Immediate neurological evaluation of neurological deficit and MRI are advised. Conservative treatment combined with close and dynamic neurological function monitoring may be feasible for patients with mild or nonprogressive symptoms even spontaneous recovery.
Diagnostic performance of coronary calcifications on CT to rule out acute coronary syndrome in the emergency department
Authors: Sentagne Julie Paget , Ohana Mickaël , Severac François , Le Borgne Pierrick , Sauleau Erik-André , Bilbault Pascal , Kepka Sabrina
Published: July 2024

Background

At present, the diagnosis of acute coronary syndrome (ACS) can be made by emergency physicians using the usual complementary tests, since the current troponin and electrocardiogram (ECG) protocols have been extensively tested for their safety. However, the detection of coronary calcifications on CT associated with coronary obstruction may be of interest for the diagnostic strategy in the emergency department (ED). The aim of this study was to evaluate a strategy combining a non-ischemic ECG with an initial normal troponin assay and the diagnostic accuracy of chest CT in detecting coronary calcifications to rule out the presence of an acute coronary event in patients presenting with chest pain in the ED.

Methods

This was a retrospective, single-center study carried out in an ED in France and included all patients over 18 years of age presenting with chest pain between 1 June 2021 and 31 December 2021 with a non-ischemic ECG and a negative first troponin assay. The primary endpoint was the diagnostic performance of the combing strategy in ruling out ACS. The secondary endpoints were the sensitivity and specificity of calcifications in acute coronary syndrome, comparison with the diagnostic performance of a second troponin assay and the rate of reconsultation, rehospitalisation and investigations within 2 months of the ED.

Results

Of the 280 patients included, 141 didn’t have calcifications. A total of 14 events were found with a negative predictive value for the combining strategy of 99.8% [95%CI: 98.2 – 100]. Sensitivity and specificity were 98.4% [95%CI: 83.8 – 100] and 53% [95%CI: 47 – 58.9], respectively. Among patients with no calcification, 8.2% were admitted to hospital and none suffered an acute coronary event. A total of 36 patients (12.8%) consulted a doctor within 2 months, with 23 investigations, all of which were negative in the non-calcification group.

Conclusions

A strategy combining the detection of coronary calcifications on chest CT in patients with a non-ischemic ECG and a single troponin assay is effective to rule out ACS in the ED, and may perform better then ECG and troponin alone.
Ruthenibacterium lactatiformans isolated from a human blood culture: a first report
Authors: Sumiyoshi Shougen , Hamaguchi Shigeto , Kimura Keigo , Negishi Katsuyuki , Ninomiya Koshi , Sasaki Manabu , Kutsuna Satoshi
Published: July 2024

Background

Ruthenibacterium lactatiformans, a Gram-stain-negative, rod-shaped, obligate anaerobic bacterium of the Oscillospiraceae family, has not been previously reported in human infections. This study reports the first case of bacteraemia and potential vertebral osteomyelitis caused by Ruthenibacterium lactatiformans.

Case presentation

An 82-year-old man with a history of diabetes, chronic renal failure, and prior spinal surgery for spondylolisthesis and spinal stenosis presented with fever and lower back pain. Magnetic resonance imaging revealed multiple vertebral osteomyelitis lesions. Initial blood cultures identified methicillin-resistant Staphylococcus aureus (MRSA), which prompted vancomycin treatment. However, repeated blood cultures not only confirmed persistent MRSA, but also detected Gram-negative bacilli (GNB). Despite surgical removal of the spinal hardware and antimicrobial therapy, the patient’s osteomyelitis worsened, necessitating transfer for further management. Subsequent analysis using 16S rRNA gene sequencing identified the GNB as Ruthenibacterium lactatiformans.

Conclusions

This is the first documented instance of human infection with Ruthenibacterium lactatiformans, signifying its pathogenic potential in vertebral osteomyelitis. The involvement of anaerobic bacteria and the possibility of polymicrobial infections complicate the diagnosis and treatment of vertebral osteomyelitis. This report underscores the need for caution when identifying the causative organism and selecting an appropriate treatment.
Advancing medical imaging: detecting polypharmacy and adverse drug effects with Graph Convolutional Networks (GCN)
Authors: Dara Omer Nabeel , Ibrahim Abdullahi Abdu , Mohammed Tareq Abed
Published: July 2024

Polypharmacy involves an individual using many medications at the same time and is a frequent healthcare technique used to treat complex medical disorders. Nevertheless, it also presents substantial risks of negative medication responses and interactions. Identifying and addressing adverse effects caused by polypharmacy is crucial to ensure patient safety and improve healthcare results. This paper introduces a new method using Graph Convolutional Networks (GCN) to identify polypharmacy side effects. Our strategy involves developing a medicine interaction graph in which edges signify drug-drug intuitive predicated on pharmacological properties and hubs symbolize drugs. GCN is a well-suited profound learning procedure for graph-based representations of social information. It can be used to anticipate the probability of medicate unfavorable impacts and to memorize important representations of sedate intuitive. Tests were conducted on a huge dataset of patients’ pharmaceutical records commented on with watched medicate unfavorable impacts in arrange to approve our strategy. Execution of the GCN show, which was prepared on a subset of this dataset, was evaluated through a disarray framework. The perplexity network shows the precision with which the show categories occasions. Our discoveries demonstrate empowering advance within the recognizable proof of antagonistic responses related with polypharmaceuticals. For cardiovascular system target drugs, GCN technique achieved an accuracy of 94.12%, precision of 86.56%, F1-Score of 88.56%, AUC of 89.74% and recall of 87.92%. For respiratory system target drugs, GCN technique achieved an accuracy of 93.38%, precision of 85.64%, F1-Score of 89.79%, AUC of 91.85% and recall of 86.35%. And for nervous system target drugs, GCN technique achieved an accuracy of 95.27%, precision of 88.36%, F1-Score of 86.49%, AUC of 88.83% and recall of 84.73%. This research provides a significant contribution to pharmacovigilance by proposing a data-driven method to detect and reduce polypharmacy side effects, thereby increasing patient safety and healthcare decision-making.
Treatment with robot-assisted gait trainer Walkbot along with physiotherapy vs. isolated physiotherapy in children and adolescents with cerebral palsy. Experimental study
Authors: Olmos-Gómez Raquel , Calvo-Muñoz Inmaculada , Gómez-Conesa Antonia
Published: July 2024

Background

Improving walking ability is a key objective in the treatment of children and adolescents with cerebral palsy, since it directly affects their activity and participation. In recent years, robotic technology has been implemented in gait treatment, which allows training of longer duration and repetition of the movement. To know the effectiveness of a treatment with the robotic-assisted gait trainer Walkbot combined with physiotherapy compared to the isolated physiotherapy treatment in children and adolescents with cerebral palsy, we carried out a clinical trial.

Methods

23 participants, were divided into two groups: experimental and control. During 5 weeks, both groups received their physiotherapy sessions scheduled, in addition experimental group received 4 sessions per week of 40 min of robot. An evaluation of the participants was carried out before the intervention, at the end of the intervention, and at follow-up (two months after the end of the intervention). Gait was assessed with the Gross Motor Function Measure-88 dimensions D and E, strength was measured with a hydraulic dynamometer, and range of motion was assessed using the goniometer. A mixed ANOVA was performed when the assumptions of normality and homoscedasticity were met, and a robust mixed ANOVA was performed when these assumptions were not met. Statistical significance was stipulated at p < 0.05. For the effect size, η2 was calculated.

Results

Significant differences were found regarding the time x group interaction in the Gross Motor Function Measure-88 in dimension D [η2 = 0.016], in the flexion strength of the left [η2 = 0.128] and right [η2 = 0.142] hips, in the extension strength of the right hip [η2 = 0.035], in the abduction strength of the left hip [η2 = 0.179] and right [η2 = 0.196], in the flexion strength of the left knee [η2 = 0.222] and right [η2 = 0.147], and in the range of motion of left [η2 = 0.071] and right [η2 = 0.053] knee flexion.

Conclusions

Compared to treatments without walking robot, physiotherapy treatment including Walkbot improves standing, muscle strength, and knee range of motion in children and adolescents with cerebral palsy.

Trial registration

ClinicalTrials.gov: NCT04329793. First posted: April 1, 2020.
Changes in maternity care policies and practices that support breastfeeding as measured by the Ten Steps to Successful Breastfeeding — United States, 2018–2022
Authors: Marks Kristin J. , Gosdin Lucas , O’Connor Lauren E. , Hamner Heather C. , Grossniklaus Daurice A.
Published: July 2024

Background

Experiences during the birth hospitalization affect a family’s ability to establish and maintain breastfeeding. The Ten Steps to Successful Breastfeeding (Ten Steps) describe evidence-based hospital policies and practices shown to improve breastfeeding outcomes. We aim to describe hospitals’ implementation of the Ten Steps, changes over time, and hospitals’ implementation of a majority (≥ 6) of the Ten Steps by hospital characteristics and state.

Methods

The biennial Maternity Practices in Infant Nutrition and Care (mPINC) survey assesses all hospitals in the United States (including the District of Columbia and territories) that routinely provide maternity care services. We analyzed data from 2018, 2020, and 2022 survey cycles to describe trends in the prevalence of hospitals implementing maternity care policies and practices that are consistent with the Ten Steps. Differences were calculated using the absolute difference in percentage-points between 2018 and 2022.

Results

Between 2018 and 2022, the percentage of hospitals that implemented Step 2: Staff Competency and Step 5: Support Mothers with Breastfeeding increased 12 and 8 percentage points, respectively. The percentage of hospitals that implemented Step 6: Exclusive Breastfeeding Among Breastfed Infants was 7 percentage points lower in 2022 than 2018. Implementation of the remaining seven steps did not change by more than 5 percentage points in either direction between 2018 and 2022. Nationally, the percentage of hospitals that implemented ≥ 6 of the Ten Steps increased from 44.0% in 2018 to 51.1% in 2022. Differences were seen when comparing implementation of ≥ 6 of the Ten Steps by hospital characteristics including state, hospital size, and highest level of neonatal care offered.

Conclusions

Nationally, maternity care policies and practices supportive of breastfeeding continued to improve; however, certain practices lost progress. Differences in implementation of the Ten Steps were observed across states and by certain hospital characteristics, suggesting more work is needed to ensure all people receive optimal breastfeeding support during their delivery hospitalization.
Retinal and choroidal thickness in fuchs uveitis syndrome: a contralateral eye study
Authors: Kianersi Farzan , Taheri Athar , Mirmohammadkhani Majid , Akhlaghi Mohammadreza , Peyman Alireza , Kianersi Hamidreza , Irajpour Matin , Kianersi Hanieh , Pourazizi Mohsen
Published: July 2024

Background

To investigate the subfoveal retinal and choroidal thickness in patients with unilateral Fuchs Uveitis Syndrome (FUS).

Methods

This comparative contralateral study was performed in affected eyes with FUS versus fellow eyes. For each eye parameters such as subfoveal choroidal thickness (SCT), subfoveal choriocapillary thickness (SCCT), central macular thickness (CMT), and central macular volume (CMV) were measured; then the measured values of affected and fellow unaffected eye were compared.

Results

Thirty-seven patients (74 eyes) including 19 females (51.4%) with a mean age of 36.9 ± 7.6 years were enrolled. The mean SCT was lower in the affected eyes (344.51 ± 91.67) than in the fellow (375.59 ± 87.33) with adjusting for duration of disease and axial lengths (P < 0.001). The mean SCCT, CMT, and CMV were higher in eyes with FUS than in fellow eyes (P < 0.05).

Conclusions

The result of our study demonstrated that affected eyes in patients with FUS tend to have thinner SCT and thicker SCCT and CMT compared to uninvolved fellow eyes.
Utility of the web excision with pre-membranous incision for congenital intestinal atresia-type I and stenosis
Authors: Kudo Hironori , Kazama Takuro , Fukuzawa Taichi , Ando Ryo , Okubo Ryuji , Sakurai Tsuyoshi , Hashimoto Masatoshi , Endo Yuki , Nio Masaki , Wada Motoshi
Published: July 2024

Purpose

This study analyzed the efficacy of web excision combined with a pre-membranous incision on the dilated proximal segment for congenital intestinal atresia with type I and stenosis (CIA-I/S).

Patients and methods

Twenty-six patients underwent surgery for CIA-I/S from January 1990 to June 2022. Patients were categorized into 3 groups according to the surgical procedure: Group A, web excision with pre-membranous incision of the dilated intestine (n = 14); Group B, enteroplasty with a trans-membranous vertical incision (n = 7) and Group C, diamond-shaped anastomosis (n = 5). To minimize the impact of obstruction location on outcomes, we specifically examined 17 cases of duodenal atresia/stenosis: Group D-A, (n = 6); Group D-B, (n = 6) and Group D-C, (n = 5). We retrospectively compared the operative and postoperative parameters among the three groups.

Results

No patient experienced anastomotic leakage or obstruction. There were no significant differences in operative duration or blood loss among the 3 Groups. The median time to feeding initiation was 4, 6.5, and 5 days in Groups A, B, and C, respectively (p = 0.04) and was 4, 6.5, and 5 days in Groups D-A, D-B, and D-C, respectively (p = 0.04).

Conclusion

Web excision, when compared to enteroplasty and diamond-shaped anastomosis, showed comparable results in terms of the operative duration and postoperative complications. However, it may allow for an earlier initiation of enteral nutrition.
The effectiveness of the WHO school mental health package in promoting mental health literacy among secondary school teachers in Qatar: a randomized controlled trial
Authors: Elyamani Rowaida , Nour Omer , Singh Rajvir , Saeed Khalid , Musa Afrah , Alkubaisi Noora , Bougmiza Mohammed Iheb
Published: July 2024

Teachers’ mental health literacy (MHL) is fundamental for recognizing and assisting students with mental disorders. The aim of this study was to assess the effectiveness of the World Health Organization School Mental Health Program (WHO-SMHP) in promoting MHL among secondary schools’ teachers in Qatar. We conducted a two-arm randomized control trial. Teachers working in governmental secondary schools were eligible for selection. A total of 16 schools (8 intervention, 8 control) randomly selected and stratified by gender then randomly assigned (1:1). Participants and study team were aware of group assignment. Assessment of teachers’ MHL was at day 0, 3 then 3 months afterward. Bivariat analysis and Generalized Estimating Equations were used in analysis. The primary outcome was teachers MHL. Secondary outcome was the influence of sociodemographic characteristics on the level of MHL. Between October 30, 2018 and March 21, 2019, we randomly assigned 195 teachers from 16 schools to attend training workshop on WHO-SMHP (n = 95) or usual practice (n = 100). Compared with controls, teachers from intervention group demonstrated a significant improvement in the level of MHL at day three (mean difference = 19.1, 95% CI = 17.0–21.2, Cohen’s d = 2.63; p < 0.001).) and after three months (mean difference 16.61, 95% CI = 13.96–19.26, Cohen’s d = 1.86; p < 001). There were no significant differences related to influence of other variables on MHL. To our knowledge, this is the first trial to prove the effectiveness of the (WHO-SMHP) in promoting teachers MHL, which can be successfully implemented in a wider scale.
From traditional to transactional: exploration of khat use in Ethiopia through an interpretative phenomenological analysis
Authors: Wood Elizabeth A. , Case Stuart J. , Collins Sarah L. , Stark Heather , Wilfong Tara
Published: July 2024

Khat, a naturally growing stimulant, has seen a significant increase in both consumption and cultivation in eastern Ethiopia. This reliance on khat in the region comes despite its known physiological complications, with users unable to restrict khat use due to its pervasive impact on their livelihood. This qualitative study sought to understand the meaning that those in eastern Ethiopia attribute to khat and explore their firsthand experiences with the substance. In June and July of 2023, six unstructured interviews were conducted among residents of the Haramaya District in Ethiopia. To promote a holistic comprehension of the participants’ lived experiences, an interpretative phenomenological analysis approach was employed when collecting and analyzing the data. Participant responses were coded independently from one another by two different researchers identifying superordinate and corresponding subordinate themes. Among the participants, six superordinate themes were captured: economic backbone of the region, market disruption & fluctuation, pesticide use, societal relationships around khat, applications of khat, and access to healthcare. The participants’ responses indicated that the normalization of khat use, coupled with the downplaying of its addictive potential, has established a framework where khat consumption is not only allowed but, in some cases, even encouraged. The unique interplay between communal practice and individual preservation creates a cyclical effect of using khat to supplement energy to farm khat and then sell or stimulate further work on their farm. This study illuminates the transitionfrom what was once the traditional or spiritual use of khat, to a more practical use for ensuring economic livelihood.