bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravenous thrombolysis therapy and dementia risk in acute ischemic stroke patients: A retrospective cohort study in Taiwan
Authors: Huang Yan-Siang , Kung Te-Jung , Chuang Yi-Fang
Published: November 2024

Background

Intravenous thrombolysis (IVT) is the standard treatment for acute ischemic stroke (AIS) to improve functional outcomes. Furthermore, AIS is an important risk factor for dementia. Limited evidence has shown the long-term benefit of IVT on dementia in Western countries.

Objective

We aim to investigate the association between IVT and the risk of dementia in acute ischemic stroke patients in Asian population.

Methods

A retrospective cohort study using medical records from a medical center in Taiwan between 2017 and 2022 was conducted. We included acute ischemic stroke patients aged over 55 years old who had not previously been diagnosed with dementia. The primary outcome was incident dementia ascertained through dementia diagnosis in medical records. The inverse probability of treatment-weighted Cox proportional hazard models were used to estimate the association between IVT and incident dementia.

Results

A total of 1471 patients with AIS were included. 939 (63.8%) were male, and the mean age was 70.7[Formula: see text]9.6 years. Among them, 19.1% of patients (n = 281) received IVT. The mean follow-up time was 2.6[Formula: see text]1.7 years. Although not statistically significant, the IVT was associated with a decreased risk of dementia (HR: 0.88 [95%CI 0.54–1.41)]).

Conclusions

The IVT was associated with lower risk of dementia, although not statistically significant, in reducing the incidence of dementia in Asian patients with ischemic stroke. Studies with larger sample sizes will be needed in the future.
Deep brain stimulation of the nucleus basalis of Meynert in severe Alzheimer’s disease
Authors: Xu Junpeng , Liu Bin , Shang Guosong , Liu Shuzhen , Feng Zhebin , Yang Haonan , Liu Di , Chang Qing , Chen Yuhan , Yu Xinguang , Mao Zhiqi
Published: November 2024

Background

Alzheimer's disease (AD) is increasingly prevalent, leading to severe cognitive decline and a diminished quality of life for patients. Nucleus basalis of Meynert deep brain stimulation (NBM-DBS) is a potential treatment approach.

Objective

This study aims to assess the efficacy and safety of NBM-DBS for AD patients.

Methods

We conducted a clinical study involving 6 patients with severe AD who received NBM-DBS. The treatment's safety and efficacy were evaluated using cognitive function tests (Mini-Mental State Examination, Montreal Cognitive Assessment, Alzheimer's Disease Rating Scale- cognitive subscale, Clinical Dementia Rating) and assessments of neuropsychiatric symptoms and sleep disorders (Functional Activity Questionnaire, Functional Independence Measure, Zarit Burden Interview, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Neuropsychiatric Inventory, Pittsburgh Sleep Quality Index).

Results

NBM-DBS was safe, with no severe adverse events. It improved cognitive functions and self-care abilities without altering the disease's progression. Notably, NBM-DBS significantly alleviated neuropsychiatric symptoms and sleep disturbances.

Conclusions

NBM-DBS could be a promising therapeutic approach for severe AD, particularly for managing neuropsychiatric symptoms and sleep disorders. Further research is warranted to confirm these preliminary findings.
The gendered forest: Digital surveillance technologies for conservation and gender-environment relationships
Authors: Simlai Trishant , Sandbrook Chris
Published: November 2024

Forests are critical spaces that shape and enable gendered subjectivities in culturally and historically specific ways. However, scholarly work on forest or biodiversity conservation continues to take a very perfunctory view on gender–environment relationships. Many projects remain gender blind or view everyday practices of forest resource collection by women through a transactional or economic lens. Research has shown that forests are spaces wherein identities of women are entwined with their everyday activities in the forest. In this article, we demonstrate the gendered nature of forests of the Corbett Tiger Reserve (CTR) in India, and their different socio-cultural framings. We reveal how the forest spaces of the CTR are used by women for a wide variety of cultural and livelihood needs. We further show how biodiversity conservation practice in such forest spaces alters the activities of women in a myriad of ways. The increasing use of digital technologies in biodiversity conservation shapes how the forest space is observed and governed. We argue that the use of digital technologies for forest governance such as camera traps and drones tends to transform these forests into masculinized spaces that extend the patriarchal gaze of society to the forest. Finally, we reflect on how the use of digital technologies for biodiversity conservation is easily co-opted for purposes beyond conservation that reinforce patriarchal norms and propagate gendered structural violence.
From Girl Germs to Garage Shock: Charting Olympia and Bellingham, Washington's music scenes in the shadow of grunge, 1988–1994
Authors: Feldman-Barrett Christine
Published: November 2024

Between the late 1980s and early 1990s, the rock music genre which became known as ‘grunge’ put Seattle, Washington in the cultural limelight. However, it had been since the late 1970s that independent music – much of it emanating from scenes in American ‘college towns’ – had been shaping the underground musical landscape of the United States. This meant that while Seattle captured the global imagination by 1991 with its hard-hitting punk-meets-metal sound, DIY scenes continued to blossom in towns and cities across America. For both Olympia and Bellingham, Washington, two college towns with close proximity to Seattle, the early 1990s – with grunge's international recognition – proved an interesting and unusual time to exert local musical sensibilities. This article charts the opportunities and challenges that these two Seattle-adjacent music scenes experienced while creating and maintaining their individual identities during the heyday of grunge.
Factors Related to Receipt of Help for Alcohol Use: Extending the Focus of Treatment to the Continuum of Unhealthy Alcohol Use
Authors: Tieu Lina , Pourat Nadereh , Bromley Elizabeth , Simhan Rajat , Bastani Roshan , Glenn Beth
Published: November 2024

Background:

Unhealthy alcohol use is one of the leading preventable causes of mortality in the U.S. Despite evidence of the growing burden of alcohol-associated mortality and disease, treatment is severely underutilized. Prior literature has often focused on assessing treatment among patients with severe alcohol use.

Objectives:

Assess factors associated with uptake of treatment for alcohol use among a broad population of those regularly exceeding U.S. guidelines for alcohol use.

Design:

Cross-sectional study.

Methods:

Using data from the National Epidemiologic Survey on Alcohol and Related Conditions – Wave III (NESARC-III) collected April 2012 to June 2013, weighted descriptive statistics were used to describe the U.S. population who self-reported regularly exceeding U.S. guidelines for moderate alcohol use at least monthly. Weighted multivariable regression was used to assess the association of individual-level factors with receipt of help for unhealthy alcohol use.

Results:

In weighted analyses of 6467 NESARC-III participants, 17% of the U.S. population reported regular engagement in unhealthy alcohol use (76% use exceeding guidelines, 14% binge drinking, 11% heavy drinking) and were predominantly male (62%), below age 65 (93%), non-Hispanic White (65%), and had lower levels of education and income. Half (53%) met criteria for alcohol use disorder. Only 5% reported receipt of help for their alcohol use. Compared to non-Hispanic White individuals, non-Hispanic Asian/Native Hawaiian or Other Pacific Islander (odds ratio [OR] 0.40, 95% confidence interval [CI] 0.18-0.90) and non-Hispanic Black (OR 0.68, 95% CI 0.48-0.96) individuals were less likely to receive help for alcohol use. Factors associated with greater receipt of help included being older, educational attainment, Medicaid insurance, concomitant drug use, liver disease, acute healthcare utilization, and greater alcohol-related problems.

Conclusion:

Identification of the factors associated with receipt of alcohol-related treatment, including race and ethnicity, age, education, insurance, and drug use can inform interventions to increase treatment receipt.
The platformization of the follower factory: Para-platforms, automation, and labor in the market for social media engagements
Authors: Weltevrede Esther , Lindquist Johan
Published: November 2024

This article examines the emerging illicit, sprawling yet obfuscated global market for artificial social media engagements, which inflates follower counts and engagement metrics on social media profiles and posts. The organization of this market has previously been characterized using industrial metaphors such as “click farms,” “follower factories,” and “digital sweatshops” primarily based in the Global South. Using a mixed-methods approach that integrates ethnography with digital methods, this research delineates the platformization of the follower factory, highlighting a shift toward automation rather than manual interaction. This has facilitated the rapid expansion of a multi-sided market, enabling resellers to scale up and consequently necessitating a more complex labor organization that includes marketing and customer service, which have shaped cottage industries across the Global South. This market capitalizes on social media platform economies, using the existing infrastructure and user bases to operate. In other words, the engagement market has become centered on what we term a para-platform ecosystem, which, while operating alongside, remains reliant on social media platform infrastructure. By examining and conceptualizing platformization and platform ecosystems “from below,” as well as the conflictual asymmetry yet productive relationship between the para-platform ecosystem and social media platforms, this article provides an unprecedented description of the engagement market while challenging and expanding the boundaries of platform theory.
Deep Learning-Based Invalid Point Removal Method for Fringe Projection Profilometry
Authors: He Nan , Huang Jiachun , Liu Shaoli , Fan Sizhe , Liu Jianhua , Hu Jia , Gong Hao
Published: November 2024

Fringe projection profilometry (FPP) has been widely applied to non-contact three-dimensional measurement in industries owing to its high accuracy and speed. The point cloud, which is a measurement result of the FPP system, typically contains a large number of invalid points caused by the background, ambient light, shadows, and object edge regions. Research on noisy point detection and elimination has been conducted over the past two decades. However, existing invalid point removal methods are based on image intensity analysis and are only applicable to simple measurement backgrounds that are purely dark. In this paper, we propose a novel invalid point removal framework that consists of two aspects: (1) A convolutional neural network (CNN) is designed to segment the foreground from the background of different intensity conditions in FPP measurement circumstances to remove background points and the most discrete points in background regions. (2) A two-step method based on the fringe image intensity threshold and a bilateral filter is proposed to eliminate the small number of discrete points remaining after background segmentation caused by shadows and edge areas on objects. Experimental results verify that the proposed framework (1) can remove background points intelligently and accurately in different types of complex circumstances, and (2) performs excellently in discrete point detection from object regions.
Estimates of population-level palliative care need in the UK: a descriptive analysis of mortality data before and during the COVID-19 pandemic
Authors: Fantoni Erin Raquel , Wynne Natasha , Finucane Anne M.
Published: November 2024

Background

Existing estimates of palliative care need in the UK were produced before the COVID-19 pandemic. We sought to produce updated, population-level estimates of palliative care need for each of the four UK nations and explore how these changed during the pandemic.

Methods

We conducted a descriptive analysis of routine data. We used a well-established, diagnosis-based methodology which produced minimal estimates of palliative care need based on underlying causes of death; intermediate estimates based on underlying and contributory causes of death; and maximal estimates based on excluding unexpected causes of death. Additional estimates incorporated deaths involving COVID-19. All methods were applied to official mortality statistics from England, Wales, Scotland, and Northern Ireland for the years 2017 to 2021.

Results

From 2017 to 2019 for the UK in total, palliative care need was estimated at ~ 74% (minimal), ~ 90% (intermediate) and ~ 96% (maximal) of total deaths, which was broadly consistent with previous studies. Results were similar across all nations. In the pandemic years, 2020-21, the minimal estimates remained stable in terms of the number of people in need but dropped significantly in terms of the proportion of deaths associated with palliative care need (to ~ 66%) due to the overall increase in mortality and large number of deaths from COVID-19. The intermediate (~ 90%) and maximal (~ 96%) estimates showed an increase in the number of people in need but remained stable in proportion of deaths. When deaths involving COVID-19 were treated as deaths associated with palliative need, the minimal estimates increased to ~ 77% and intermediate estimates increased to ~ 92%.

Conclusions

In each of the UK’s nations, most people who die will have palliative care needs. Excluding deaths from COVID-19 in population-level estimates of palliative care need risks under-estimating true levels of need. Future studies which estimate population-level palliative care need should consider factoring in deaths from COVID-19.
Parental epigenetic age acceleration and risk of adverse birth outcomes: the Norwegian mother, father and child cohort study
Authors: Magnus Maria C. , Lee Yunsung , Carlsen Ellen Ø. , Arge Lise A. , Jugessur Astanand , Kvalvik Liv G. , Morken Nils-Halvdan , Ramlau-Hansen Cecilia H. , Myrskylä Mikko , Magnus Per , Håberg Siri E.
Published: November 2024

Background

Few studies have examined associations between maternal epigenetic age acceleration and adverse birth outcomes, and none have investigated paternal epigenetic age acceleration. Our objective was to assess the associations of parental (both maternal and paternal) epigenetic age acceleration in relation to birth outcomes.

Methods

Parental epigenetic age was estimated using seven established epigenetic clocks in 2198 mothers and 2193 fathers from the Norwegian Mother, Father, and Child Cohort Study (MoBa). Individual epigenetic age acceleration was then calculated as residuals from linear regressions of estimates from the epigenetic clocks on chronological age. Further, linear regression was used to analyze differences in continuous outcomes (gestational length and standardized birthweight), while logistic regression was used for binary outcomes (preterm birth, post-term birth, small-for-gestational age [SGA], large-for-gestational age [LGA], and pre-eclampsia), adjusting for chronological age, parity, educational level, smoking, and BMI.

Results

Increasing maternal, but not paternal, epigenetic age acceleration was associated with decreased gestational length for five out of six clocks, with adjusted estimates ranging from a mean 0.51-day decrease (95% CI − 1.00, − 0.02; p-value 0.043) for the Horvath clock to a 0.80-day decrease (95% CI − 1.29, − 0.31; p-value 0.002) for the Levine clock. An association with increasing maternal epigenetic age acceleration according to the DunedinPACE clock was also seen with greater standardized birthweight [mean difference 0.08 (95% CI 0.04, 0.12; p-value < 0.001]. These results were also reflected in an increased risk of spontaneous preterm birth and LGA. No associations were observed with post-term birth, SGA, or pre-eclampsia.

Conclusions

Maternal, but not paternal, epigenetic age acceleration is associated with shorter pregnancies and an increased risk of spontaneous preterm birth. This may suggest that women’s biological age acceleration, including factors such as metabolic and physiologic state, is an additional risk factor for preterm delivery, beyond chronological age.
Opportunities to enhance retention on medication for opioid use disorder for adolescents and young adults: results from a qualitative study with medical providers in Philadelphia, PA
Authors: Herrera Maria Christina , Darien Kaja , Wood Sarah , Hadland Scott E. , Deanna Wilson J. , Dowshen Nadia
Published: November 2024

Background

Medications for opioid use disorder (MOUD) are under-prescribed to adolescents and young adults (AYA). Few published studies have explored challenges to and opportunities to enhance continuous provision of MOUD for AYA. Our report focuses on this emergent theme that was identified as part of a larger qualitative study.

Methods

We purposively sampled and enrolled medical providers who prescribed MOUD to AYA. Semi-structured individual interviews using chart-stimulated recall explored barriers and facilitators to MOUD retention. We used modified grounded theory in our qualitative analysis, with double coding of interviews.

Results

Barriers to retention on MOUD included patient-level (i.e., return to substance use) and system-level factors (i.e., cost, delayed receipt, pharmacy challenges, and in-person visit requirements). Facilitators included patient-level (i.e., motivation, support networks) and system-level factors (i.e., telehealth access, availability of certified recovery specialists).

Conclusions

Our study is the first to look at retention for this key age group, setting it apart from the existing body of literature that looks at medication initiation. Our findings confirm that significant systemic barriers exist to AYA patients’ retention on MOUD. Further research is needed to develop interventions that facilitate continuous delivery of high-quality care among this key population.
How social media are changing pediatricians and pediatrics? – A claim for regulation
Authors: Bella Saverio La , Ludovico Armando Di , Parri Niccolò , Mauro Antonio Di , Corsello Antonio
Published: November 2024

Background

Social media has revolutionized the way healthcare professionals communicate with the public, particularly in Pediatrics. With over 5 billion users globally, platforms such as Facebook, Instagram, and TikTok have become increasingly popular even among caregivers in recent years. These channels offer unique opportunities to improve public health education, allowing pediatricians to reach a wide audience with evidence-based content.

Main body

However, the risks associated with misinformation pose significant challenges to health professionals and medical organizations. In response, new recommendations for the proper use of social media in pediatric health communication should be proposed, aiming to provide a network where pediatricians can collaborate, share evidence-based information, and develop effective strategies for digital communication. With the growing use of artificial intelligence in healthcare and the rise of parental self-care practices, pediatricians must actively curate and share reliable information.

Conclusion

This could serve as a new hub for ensuring that accurate, high-quality evidence-based information is disseminated, balancing the benefits of digital health advancements with the ethical responsibility of safeguarding patient care. By prioritizing professionalism, ethical communication, and technological adaptation, the aim should be to foster a more informed and health-conscious community.
Inhaled antibiotics for treating pneumonia in invasively ventilated patients in intensive care unit: a meta-analysis of randomized clinical trials with trial sequential analysis
Authors: Sella Nicolò , Pettenuzzo Tommaso , De Cassai Alessandro , Zarantonello Francesco , Congedi Sabrina , Bruni Andrea , Garofalo Eugenio , Ocagli Honoria , Gregori Dario , Longhini Federico , Navalesi Paolo , Boscolo Annalisa ,   the PADOVA ICU Group, Bertoncello Carlo Albero , Franchetti Nicola , Schiavolin Chiara , Carofiglio Giuliana , Guidotto Chiara , De Lorenzi Giovanni , Legnaro Christian , Nardelli Marco , Pistollato Elisa , Mormando Giulia , Peralta Arianna , Petranzan Enrico , Muraro Luisa , Persona Paolo , Pacchiarini Giorgia
Published: November 2024

Background

The use of inhaled antibiotics for treating pneumonia in invasively ventilated patients offers a direct approach, allowing for high local concentrations of the drug in the lower respiratory tract while simultaneously reducing systemic toxicity. However, the real efficacy and safety of nebulized antibiotics remain unclear. The aim of the present is to assess among critically adult patients with pneumonia and invasive ventilation, whether receiving adjuvant inhaled antibiotics improves the rate of microbiological eradication.

Methods

A comprehensive literature search of randomized clinical trials (RCTs) was conducted (from inception until September 20, 2024, PROSPERO-CRD592906) across Medline, Embase, and Scopus. Randomized controlled trials, enrolling intensive care units (ICU) patients with pneumonia and comparing nebulized antimicrobial therapy (inhaled group) with intravenous antimicrobial treatment or intravenous antimicrobial therapy plus inhaled placebo (control group), were included. The primary outcome was the rate of microbiological eradication after treatment. Secondary outcomes were the rate of clinical recovery, the incidence of drug-related adverse events, ICU and hospital mortality. A qualitative analysis was conducted according to the GRADE framework. Data were pooled using an odds-ratio analysis. The heterogeneity and reliability of our results were evaluated using the I2-statistic and trial sequential analysis (TSA), respectively.

Results

A total of 11 RCTs (1472 patients) met the inclusion criteria. Compared to controls, the use of adjuvant inhaled antibiotics determined a greater rate of microbiological eradication (OR 2.63, 95% CI 1.36–5.09; low certainty of evidence). The TSA confirmed the reliability of our primary outcome. Moreover, nebulized antibiotics increased the risk of bronchospasm (OR 3.15, 95% CI 1.33–7.47; high evidence), while nephrotoxicity, clinical recovery, ICU and hospital survival (either in the case of pneumonia caused by MDR bacteria or not) were not different between groups.

Conclusions

In conclusion, compared to the sole intravenous therapy, the use of adjuvant inhaled antibiotics for treatment of pneumonia in invasively ventilated critically ill patients was associated with a greater incidence of microbiological eradication (low GRADE and high risk of publication bias), but not with clinical recovery and survival.
Influenza vaccination in patients with acute heart failure (PANDA II): study protocol for a hospital-based, parallel-group, cluster randomized controlled trial in China
Authors: Zhang Yiqun , Liu Rong , Zhao Yangyang , Wang Zhiyan , Wang Chi , Li Qiang , Han Dorothy , Anderson Craig S. , Du Xin , Dong Jianzeng
Published: November 2024

Background

Influenza vaccination confers broad benefits in the elderly and certain high-risk populations, but its effectiveness in patients with acute heart failure (HF) is uncertain. Rates of influenza vaccination are low in China due to poor awareness, cultural misunderstandings, and cost.

Aims

To determine the effectiveness of influenza vaccination in patients with acute HF admitted to hospitals in China.

Methods

The second Population Assessment of Influenza and Disease Activity (PANDA II) study is a two-arm, parallel-group, county-level hospital-based, cluster randomized controlled trial to determine the benefits and risks of full access to routine free influenza vaccination before hospital discharge, compared to routine limited use of influenza vaccination, on the primary endpoint of death or hospital readmission. Consecutive hospitalized patients at each site are enrolled to a target of 50 participants in each autumn–winter influenza outbreak period (October to March) over 3 consecutive years to reach the required sample size. Patients are centrally followed up at 1, 3, 6, and 12 months after hospital discharge (or death if earlier). Site numbers varied across year according to predicted influenza activity and logistical reasons.

Conclusions

This study offers a unique chance to clarify uncertainties surrounding the effectiveness of influenza vaccination in patients with HF and to lay the groundwork for future prevention strategies.

Trial registration

This trial was registered with the acronym PANDA II (Population Assessment of Influenza and Disease Activity) at ChiCTR.org.cn (ChiCTR2100053264). Registered on 17 November 2021.
Road traffic noise and breast cancer: DNA methylation in four core circadian genes
Authors: Thacher Jesse D. , Snigireva Anastasiia , Dauter Ulrike Maria , Delaval Mathilde N. , Oudin Anna , Mattisson Kristoffer , Sørensen Mette , Borgquist Signe , Albin Maria , Broberg Karin
Published: November 2024

Background

Transportation noise has been linked with breast cancer, but existing literature is conflicting. One proposed mechanism is that transportation noise disrupts sleep and the circadian rhythm. We investigated the relationships between road traffic noise, DNA methylation in circadian rhythm genes, and breast cancer. We selected 610 female participants (318 breast cancer cases and 292 controls) enrolled into the Malmö, Diet, and Cancer cohort. DNA methylation of CpGs (N = 29) in regulatory regions of circadian rhythm genes (CRY1, BMAL1, CLOCK, and PER1) was assessed by pyrosequencing of DNA from lymphocytes collected at enrollment. To assess associations between modeled 5-year mean residential road traffic noise and differentially methylated CpG positions, we used linear regression models adjusting for potential confounders, including sociodemographics, shiftwork, and air pollution. Linear mixed effects models were used to evaluate road traffic noise and differentially methylated regions. Unconditional logistic regression was used to investigate CpG methylation and breast cancer.

Results

We found that higher mean road traffic noise was associated with lower DNA methylation of three CRY1 CpGs (CpG1, CpG2, and CpG12) and three BMAL1 CpGs (CpG2, CpG6, and CpG7). Road traffic noise was also associated with differential methylation of CRY1 and BMAL1 promoters. In CRY1 CpG2 and CpG5 and in CLOCK CpG1, increasing levels of methylation tended to be associated with lower odds of breast cancer, with odds ratios (OR) of 0.88 (95% confidence interval (CI) 0.76–1.02), 0.84 (95% CI 0.74–0.96), and 0.80 (95% CI 0.68–0.94), respectively.

Conclusions

In summary, our data suggest that DNA hypomethylation in CRY1 and BMAL1 could be part of a causal chain from road traffic noise to breast cancer. This is consistent with the hypothesis that disruption of the circadian rhythm, e.g., from road traffic noise exposure, increases the risk of breast cancer. Since no prior studies have explored this association, it is essential to replicate our results.

Graphical abstract
3D in vitro modelling of post-partum cardiovascular health reveals unique characteristics and signatures following hypertensive disorders in pregnancy
Authors: Chung Ming Clara Liu , Pienaar Dillan , Ghorbanpour Sahar , Chen Hao , Roberts Lynne Margaret , Cole Louise , McGrath Kristine C. , Padula Matthew P. , Henry Amanda , Gentile Carmine , McClements Lana
Published: November 2024

Background

Hypertensive disorders of pregnancy (HDP) affect 2–8% of pregnancies and are associated postpartum with increased cardiovascular disease (CVD) risk, although mechanisms are poorly understood.

Methods

Human induced pluripotent stem cells (iPSC)-derived cardiomyocytes, cardiac fibroblasts and coronary artery endothelial cells were cocultured to form cardiac spheroids (CSs) in collagen type-1 hydrogels containing 10% patient plasma collected five years postpartum [n = 5 per group: normotensive control, gestational hypertension (GH) and preeclampsia (PE)]. Plasma-treated CSs were assessed for cell viability and contractile function and subjected to immunofluorescence staining and imaging. A quantitative proteomic analysis of plasma samples was conducted (controls n = 21; GH n = 5; PE n = 12).

Results

Contraction frequency (CF) was increased in PE-treated CSs (CF: 45.5 ± 3.4 contractions/minute, p < 0.001) and GH-treated CSs (CF: 45.7 ± 4.0 contractions/minute, p < 0.001), compared to controls (CF = 21.8 ± 2.6 contractions/min). Only PE-treated CSs presented significantly increased fractional shortening (FS) % (9.95 ± 1.8%, p < 0.05) compared to controls (3.7 ± 1.1%). GH-treated CSs showed a reduction in cell viability (p < 0.05) and an increase in α-SMA expression (p < 0.05). Proteomics analyses identified twenty differentially abundant proteins, with hemoglobin A2 being the only protein perturbed in both GH and PE versus control plasma (p < 0.05).

Conclusions

The innovative patient-relevant CS platforms led to the discovery of biomarkers/targets linked to cell death signaling and cardiac remodeling in GH-induced CVD and vascular/endothelial cell dysfunction in PE-induced CVD.
The positive influence of Tibetan Buddhist monasteries on forest conservation
Authors: Zhang Shidong , Wu Tong , Guo Luo
Published: November 2024

The Qinghai-Tibetan Plateau (QTP) is vital for stabilizing climate in East and South Asia and its glaciers and snow meltwater nourish key continental rivers. The region’s forests are not only ecologically essential but also fragile. The practices of local herdsmen, shaped by long-standing cultural traditions, significantly affect forest dynamics. This study examines the vital role that Tibetan Buddhist monasteries play in forest conservation on the QTP. We utilize data sources including extensive field surveys and geospatial data to assess the impact of monastery and village locations on forest conditions. Spatial analysis techniques, such as Moran’s I and Ripley’s K function, reveal significant clustering of monasteries and villages, which are closely linked with forest conditions. Our findings indicate that forests near Buddhist monasteries have higher aboveground biomass and better quality compared to other areas, suggesting that their presence supports better forest conservation practices. This positive influence is attributed to the cultural significance of these sites and the environmental consciousness promoted by Buddhist cultural teachings. Additionally, this study employs analytical methods including Random Forest and Partial Least Squares Structural Equation Modeling (PLS-SEM) to explore the drivers of forest quality. Initial aboveground biomass, climatic factors, and monastery density emerge as key influences on forest quality within monastery buffer zones, indicating that cultural factors are crucial in shaping forest landscapes.
Replicability of paleotemperature records in the northern Okinawa Trough and its implications for paleoceanographic reconstructions
Authors: Tung Ru-Yun , Ho Sze Ling , Kubota Yoshimi , Yamamoto Masanobu , Hefter Jens , Shen Chuan-Chou
Published: November 2024

Geochemical proxies are frequently utilized in the reconstruction of past ocean temperatures. Due to resource constraints, these reconstructions typically rely on a single sediment core, raising questions about the local and regional representativeness of paleotemperature records. To address this, we analyzed four sediment cores located within a 10-km radius in the northern Okinawa Trough (OT), which share the same climatic forcing and thus should reflect similar climate variations. We compiled published data and generated new paleotemperature estimates based on three widely used geochemical proxies (foraminiferal Mg/Ca, $${\text{U}}_{37}^{{{\text{K}}^{\prime}}}$$

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, $${\text{TEX}}_{86}$$

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). Analysis of the mean absolute deviations for nearby records based on the same proxy revealed that $${\text{U}}_{37}^{{{\text{K}}^{\prime}}}$$

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has the highest reproducibility, followed by Mg/Ca and $${\text{TEX}}_{86}$$

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. However, inconsistencies in inter-proxy offsets among nearby sites suggest the presence of noise in the proxy records, likely stemming from instrumental errors and sediment heterogeneity. Furthermore, the Mg/Ca and $${\text{U}}_{37}^{{{\text{K}}^{\prime}}}$$

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paleotemperature records agree within uncertainty when accounting for inter-site variability and calibration uncertainties, challenging previous interpretations of temperature signals from different seasons. All proxies indicate similar glacial-interglacial trends, albeit with varying magnitudes of temperature change. Both Mg/Ca and $${\text{U}}_{37}^{{{\text{K}}^{\prime}}}$$

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records suggest a glacial cooling of ~ 3 °C, whereas $${\text{TEX}}_{86}$$

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sea surface temperature (SST) data indicate a stronger glacial cooling of approximately ~ 6–8 °C. Modern observations indicate a subsurface $${\text{TEX}}_{86}$$

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recording depth of 50–100 m, coinciding with the thermocline. However, the $${\text{TEX}}_{86}$$

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subsurface temperature (subT) record does not resemble the Mg/Ca records of thermocline-dwelling foraminifera species. Instead, there is a better agreement with benthic foraminiferal Mg/Ca records of Uvigerina spp. (~ 700 m) and the intermediate temperature record derived from radiolarian assemblages (~ 500 m), pointing to a $${\text{TEX}}_{86}$$

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recording depth that is deeper than the thermocline. In summary, our findings show that proxy noise can impact inter-proxy comparisons of paleotemperature records, but not the direction of glacial-interglacial shifts. Future research should prioritize constraining the recording depth of paleotemperature proxies and reducing calibration uncertainty for more precise and reliable quantitative paleotemperature reconstruction.
How to interpret patient-reported outcomes? - Stratified adjusted minimal important changes for the EQ-5D-3L in hip and knee replacement patients
Authors: Salvi Irene , Ehlig David , Vogel Justus , Bischof Anja , Geissler Alexander
Published: November 2024

Background

As one of the main goals of hip and knee replacements is to improve patients’ health-related quality of life, a meaningful evaluation can be achieved by calculating minimal important changes (MICs) for improvements in patient-reported outcome measures (PROMs). This study aims at providing MICs adjusted for patient characteristics for EQ-5D-3L index score improvements after hip and knee replacements. It adds to existing literature by relying on a large national sample and precise clustering algorithms, and by employing a state-of-the-art methodology for the calculation of improved adjusted MICs.

Methodology

A retrospective observational study was conducted using the publicly available National Health Service (NHS) PROMs dataset for primary hip and knee replacements. We used information on 252,331 hip replacements and 279,668 knee replacements from all NHS-funded providers in England between 2013 and 2020. Clusters of patients were created based on pre-operative EQ-VAS, depression status, and sex. Unstratified and stratified estimates for meaningful EQ-5D-3L improvements were obtained through anchor-based predictive MICs corrected for the proportion of improved patients and the reliability of transition ratings.

Results

Stratifying patients showed that MICs varied across subgroups based on pre-operative EQ-VAS, depression status, and sex. MICs were larger for patients with worse pre-operative EQ-VAS scores, while patients with better pre-operative scores required smaller MICs to achieve a meaningful change. We show how after stratification the percentage of patients achieving their stratified MIC was better in line with the actual share of improved patients. Larger MICs were found for patients with depression and for female patients. MICs calculated for knee replacements were consistently lower than those for hip replacements.

Conclusions

Our findings show the importance of adjusting MICs for patients’ characteristics and should be considered for quality-related choices and policy initiatives.
Combinatorial chance-constrained economic optimization of distributed energy resources
Authors: Sager Jens , Nieße Astrid
Published: November 2024

The transformation of the energy system towards sustainable energy sources is characterized by an increase in weather dependent distributed energy resources (DER). This adds a layer of uncertainty in energy generation on top of already uncertain load distribution. At the same time, many households are fitted with renewable generation units and storage systems. The increased intermittent generation in the distribution grid leads to new challenges for the commitment and economic dispatch of DER. The main challenge addressed in this work is to decide which available resources to select for a given task. To solve this, we introduce Stochastic Resource Optimization (SRO), a general purpose, combinatorial, chance-constrained optimization model for the short-term economic selection of stochastic DER. It incorporates correlations between stochastic resources are using copula theory. The contributions of this paper are twofold: First, we validate the applicability of the SRO formulation on a simplified congestion management use-case in a small neighbourhood grid comprised of prosumer households. Second, we provide an analysis of the performance of different solving algorithms for SRO problems and their run-times. Our results show that a fast metaheuristic algorithm can provide high quality solutions in acceptable time on the evaluated problem sets.
Knowledge, attitude, and use of electronic cigarettes among Cairo University medical students
Authors: Mostafa Ola A. , Taha Mahmoud A.
Published: November 2024

Background

Electronic cigarette use has increased exponentially in Egypt and all over the world. However, there is insufficient information about their use among Cairo University medical students. This study aimed to assess e-cigarette knowledge, attitude, and use among Cairo University medical students.

Methods

A cross-sectional study of 300 consenting Cairo University medical students in the period of 1st November 2023 to 15th December 2023 was conducted using a self-administered questionnaire. A multistage sampling technique was used to randomly select 300 students: 150 students from the third year and 150 from the fifth year of the Cairo University Medical School.

Results

The mean age was 22.12 ± 1.87 years and 69.3% were males and 30.7% were females. Most of them (88.3%) had heard about e-cigarettes, with higher knowledge for students in their clinical years. The main sources of information were the media and friends (41.8% and 37.5%). By type, 14%, 12.7%, and 7.3% were cigarette, shisha, and e-cigarette smokers. Smoking prevalence was higher among males and students in their clinical years (12% and 4.7% in clinical and preclinical years respectively, p = 0.02).

Among all, 39.3%, 10.2%, and 3.3% of the participants’ friends, siblings, and parents smoked e-cigarettes respectively; compared to 16.7%, 17.9%, and 33% among the subset of participants who were e-cigarette smokers. A significantly lower percentage of e-cigarette smokers believed that e-cigarettes are addictive or cause respiratory problems, and a higher percentage thought that e-cigarettes are less harmful, help in smoking cessation, and that their nicotine content is lower than traditional cigarettes. Predictors of e-cigarette smoking were being in clinical years, cigarette and shisha smoking, and having friends who are e-cigarette smokers.

Conclusion

The study revealed several students’ misconceptions and a wide variation in their attitudes about the harmful and addictive effects of e-cigarettes. This underscores the urgent need for the development of a medical school curriculum to provide accurate information about e-cigarettes to address the problem of its growing use in Egypt.
Preparation, characterization and application in environmental protection of low-molecular-weight chitosan: a review
Authors: Niu Yaolan , Hu Wei
Published: November 2024

Chitosan is a biopolymer derived from chitin, which is the second most abundant and renewable polymer in nature after cellulose. Low-molecular-weight chitosan (LMWC) is the degradation product of chitosan through depolymerization. Compared with conventional chitosan, LMWC is considered as one of the most promising functional materials due to its characteristics of lower polymerization degree, lower viscosity, good water solubility, reactivity and degradability. This review focused on the preparation and characterization methods as well as the application in environmental remediation of LMWC. The three main methods of LMWC preparation including chemical, physical and enzymatic methods were summarized and compared in this paper. The mechanism, advantages and disadvantages of various preparation methods were also discussed. In addition, the applications of LMWC in environmental fields such as water treatment, soil remediation and air purification were briefly reviewed. With the continuous progress of science and technology and the improvement of environmental awareness, it is believed that more efficient, economical and environmentally friendly chitosan degradation methods will be developed, providing strong support for the wide application of LMWC in the field of environmental protection.
Modifiable and non-modifiable risk factors affecting surgical failure after revision ACL reconstruction: a cohort study
Authors: Moon Hyun-Soo , Jung Min , Choi Chong-Hyuk , Chung Kwangho , Jung Se-Han , Byun Junwoo , Kim Jin-Gyu , Lee Seungmin , Kim Sung-Hwan
Published: November 2024

Background

Research on factors influencing the outcomes of revision anterior cruciate ligament (ACL) reconstruction is relatively scarce and mostly relies even on reports from a single group. Understanding the factors contributing to the failure of revision ACL reconstruction can provide valuable information for achieving better clinical outcomes and assist in patient counseling before surgery. Therefore, this study aimed to analyze the factors contributing to surgical failure after revision ACL reconstruction.

Methods

The medical records of consecutive patients who underwent single-bundle revision ACL reconstruction using the transportal technique between 2010 and 2020 and had a minimum follow-up of 2 years were retrospectively reviewed. Eligible patients were classified into two groups on the basis of the presence of surgical failure during the follow-up period (group NF, patients who did not experience surgical failure; group F, patients who experienced surgical failure). In this study, surgical failure after revision ACL reconstruction was defined as meeting any of the following conditions during follow-up: the presence of graft re-tear confirmed by magnetic resonance imaging (MRI), anterior–posterior laxity graded ≥ 2, or rotational laxity graded ≥ 2. A comparative analysis was conducted on demographic data, as well as peri-, intra-, and postoperative data between the groups. Additionally, a regression analysis was performed to investigate factors influencing surgical failure after revision ACL reconstruction.

Results

A total of 58 patients were included (group NF, 40 patients; group F, 18 patients). In between-group comparisons of demographic, peri-, and intra-operative data, group F exhibited a higher frequency of multiple revision surgeries (P = 0.001), increased preoperative osteoarthritis grade (P = 0.001), and shallower femoral tunnel depth (P = 0.002) compared with group NF. At the final follow-up, group F demonstrated relatively poor clinical outcomes, both subjectively and objectively. Multivariate regression analysis revealed that all variables that showed differences in the preceding comparisons were independent factors affecting surgical failure after revision ACL reconstruction.

Conclusions

Surgical failure after revision ACL reconstruction can occur in a substantial number of patients, influenced by non-modifiable factors, such as cases corresponding to multiple revision surgery and preoperative osteoarthritis grade, and modifiable factors, such as femoral tunnel depth.
STEM major’s decision to teach: examining teaching experiences in high-needs communities
Authors: Edwards Laura A. , Gerberry Carla
Published: November 2024

A significant teacher shortage exists in the US, particularly in STEM teaching fields. Professionals in STEM fields make higher wages while teachers manage intense and challenging work conditions. Teacher dissatisfaction and shortage negatively impacts students’ learning outcomes. This paper examines how teacher self-efficacy developed for university science, technology, engineering, and mathematics (STEM) majors who participated in an internship and the shifts in their career path decisions to teaching STEM. Self-efficacy in potential teachers is key to future teachers’ perception of lowered levels of emotional exhaustion and higher job satisfaction influencing their transition to the teaching profession This study identifies how STEM major interns developed multiple sources of self-efficacy that transitioned half of the intern’s career choice to enter teaching STEM fields. Results reveal early exposure to teaching experiences and responsibilities influenced the decisions of the STEM majors to enter the teaching profession. This study contributes to teacher self- efficacy with insights into how early teaching experiences cultivate self-efficacy. Mastery teaching practice in authentic settings through the internships built self-efficacy. Additionally, relationships with peers as co-teaching assisted interns to develop their teaching self-efficacy. Findings point to lessons learned from curriculum and instruction in STEM teacher education that bridges research and practice for STEM education improvement and demonstrate teacher education programs benefit from early, authentic field-based experiences which motivate STEM majors’ desire to teach. It is crucial for future students to uncover how teacher-efficacy is developed for STEM teachers and their decisions to teach and persist in the teaching profession.