bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracellular vimentin is a damage-associated molecular pattern protein serving as an agonist of TLR4 in human neutrophils
Authors: Suprewicz Łukasz , Fiedoruk Krzysztof , Skłodowski Karol , Hutt Evan , Zakrzewska Magdalena , Walewska Alicja , Deptuła Piotr , Lesiak Agata , Okła Sławomir , Galie Peter A. , Patteson Alison E. , Janmey Paul A. , Bucki Robert
Published: February 2025

Background

Vimentin is a type III intermediate filament protein that plays an important role in cytoskeletal mechanics. It is now known that vimentin also has distinct functions outside the cell. Recent studies show the controlled release of vimentin into the extracellular environment, where it functions as a signaling molecule. Such observations are expanding our current knowledge of vimentin as a structural cellular component towards additional roles as an active participant in cell signaling.

Methods

Our study investigates the immunological roles of extracellular vimentin (eVim) and its citrullinated form (CitVim) as a damage-associated molecular pattern (DAMP) engaging the Toll-like receptor 4 (TLR4) of human neutrophils. We used in vitro assays to study neutrophil migration through endothelial cell monolayers and activation markers such as NADPH oxidase subunit 2 (NOX2/gp91phox). The comparison of eVim with CitVim and its effect on human neutrophils was extended to the induction of extracellular traps (NETs) and phagocytosis of pathogens.

Results

Both eVim and CitVim interact with and trigger TLR4, leading to increased neutrophil migration and adhesion. CitVim stimulated the enhanced migratory ability of neutrophils, activation of NF-κB, and induction of NET formation mainly mediated through reactive oxygen species (ROS)-dependent and TLR4-dependent pathways. In contrast, neutrophils exposed to non-citrullinated vimentin exhibited higher efficiency in favoring pathogen phagocytosis, such as Escherichia coli and Candida albicans, compared to CitVim.

Conclusions

Our study identifies new functions of eVim in its native and modified forms as an extracellular matrix DAMP and highlights its importance in the modulation of immune system functions. The differential effects of eVim and CitVim on neutrophil functions highlight their potential as new molecular targets for therapeutic strategies aimed at regulation of neutrophil activity in different pathological conditions. This, in turn, opens new windows of therapeutic intervention in inflammatory and immunological diseases characterized by immune system dysfunction, in which eVim and CitVim play a key role.
Training and education provided to local change champions within implementation trials: a rapid systematic review
Authors: Jolliffe Laura , Lannin Natasha A. , Larcombe Stacy , Major Brendan , Hoffmann Tammy , Lynch Elizabeth
Published: February 2025

Background

Translating research into clinical practice is challenging. One implementation intervention that supports translation is employment of a change champion. It is important to understand how individuals are prepared for the change champion role. This rapid systematic review aimed to identify the education, training, and support provided to individuals in change champion roles within implementation trials.

Method

Rapid review approach. We searched the Scopus database to identify systematic reviews on champions, knowledge brokers, facilitators, and implementation support practitioners. The most recent reviews on each topic were screened to find eligible studies. To identify studies published after these reviews, we searched Medline, PsycINFO, OVID, CINAHL, ProQuest, SCOPUS, and EBSCO. We included randomised and cluster randomised controlled trials that reported on implementation interventions in healthcare settings involving a local change champion.

Results

Fifteen cluster randomised controlled trials were included. Specific champion training was provided in 12 studies (80%), but none reported incorporating adult learning principles into their education program. Some form of post-training support was reported in 11 studies (73%). Only two studies included content on behaviour or organizational change in the champion preparation program. Most programs were not individualized, and details of training and support were poorly reported.

Conclusions

Training needs and educational outcomes of change champions are poorly reported in implementation trials. Training tends not to align with adult learning. More rigorous development and reporting of programs to prepare change champions to support implementation of evidence in healthcare is recommended.

Registration

PROSPERO registration number CRD42022368276.
The mutational landscape of ARMC5 in Primary Bilateral Macronodular Adrenal Hyperplasia: an update
Authors: Bouys Lucas , Vaczlavik Anna , Cavalcante Isadora P. , Violon Florian , Jouinot Anne , Berthon Annabel , Vaduva Patricia , Espiard Stéphanie , Perlemoine Karine , Kamenicky Peter , Vantyghem Marie-Christine , Tabarin Antoine , Raverot Gérald , Ronchi Cristina L. , Dischinger Ulrich , Reincke Martin , Fragoso Maria C. , Stratakis Constantine A. , Chansavang Albain , Pasmant Eric , Ragazzon Bruno , Bertherat Jérôme ,   for the COMETE and ENSAT Networks
Published: February 2025

Background

Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH) is a rare cause of Cushing’s syndrome due to bilateral adrenocortical macronodules. Germline inactivating variants of the tumor suppressor gene ARMC5 are responsible for 20–25% of apparently sporadic PBMAH cases and 80% of familial presentations. ARMC5 screening is now routinely performed for PBMAH patients and families. Based on literature review and own observation, this study aims to give an overview of both published and unpublished ARMC5 genetic alterations and to compile the available evidence to discriminate pathogenic from benign variants.

Results

146 different germline variants (110 previously published and 36 novel) are identified, including 46% missense substitutions, 45% truncating variants, 3% affecting splice sites, 4% in-frame variants and 2% large deletions. In addition to the germline events, somatic 16p loss-of-heterozygosity and 104 different somatic events are described. The pathogenicity of ARMC5 variants is established on the basis of their frequency in the general population, in silico predictions, familial segregation and tumor DNA sequencing.

Conclusions

This is the first extensive review of ARMC5 pathogenic variants. It shows that they are spread on the whole coding sequence. This is a valuable resource for genetic investigations of PBMAH and will help the interpretation of new missense substitutions that are continuously identified.
Pain assessment and management of adult patients in the Swedish EMS: a nationwide registry study
Authors: Larsson Glenn , Wennberg Pär , Wibring Kristoffer
Published: February 2025

Background

Pain is a frequent reason for contacting the Emergency Medical Services (EMS), and effective pain management constitutes one of its cornerstones. The aims of this study have been: (a) to describe the prevalence of pain intensity ratings in EMS care of patients with pain-related conditions; (b) to describe pain treatment in the EMS setting in terms of drugs administered and the proportion of patients receiving analgesics and (c) to investigate the relationship between patients’ self-reported pain intensity and vital signs.

Methods

This is a retrospective observational cohort study using data from 394,700 EMS missions conducted 2021 and 2022, as recorded in the Swedish Ambulance Registry. The study focused on patients who contacted the EMS due to pain, trauma, or injury. Pain intensity was recorded using the Numeric Rating Scale (NRS). NRS scores of 5–10 were considered as high-level pain and NRS ≤ 4 as low-level. Descriptive statistics were used to present categorical and continuous variables. Chi-square tests were applied for dichotomous variables, while Kruskal–Wallis tests were used for ordinal data. Logistic regression analysis was carried out to identify factors associated with pain intensity and analgesic treatment. p value < 0.001 was considered statistically significant.

Results

Pain intensity was recorded in 23.6% of cases. Most patients rated their pain as high-level (NRS 5–10, 57.4% of those assessed). Analgesics were administered in 27.5% of cases, with higher administration rates observed when pain intensity was documented. Female sex, higher breathing rates, and higher systolic blood pressure were associated with higher pain intensity, while increasing age was associated with lower odds of reporting high-level pain intensity. No significant association was found between heart rate and pain intensity.

Conclusion

This 2-year cohort study highlights significant deficiencies in recorded pain assessment and management in the Swedish EMS. Only 22.5% of the patients had their pain assessed with a validated scale, while 27.5% received analgesics, although pain-related conditions were a common reason for contacting the EMS. The findings indicate a lack of systematic pain assessment which puts many patients at risk of insufficient pain relief.
Effect of an intensive care unit virtual reality intervention on relatives´ mental health distress: a multicenter, randomized controlled trial
Authors: Drop Denzel L. Q. , Vlake Johan H. , Wils Evert-Jan , Van Bommel Jasper , Jung Christian , Hilling Denise E. , Bienvenu O. Joseph , Korevaar Tim I. M. , Schut Anna F. C. , van Mol Margo M. C. , Gommers Diederik , van Genderen Michel E.
Published: February 2025

Background

Relatives of intensive care unit (ICU) patients often endure symptoms of post-traumatic stress, anxiety, and depression during and after treatment of a family member’s hospitalization. The aim of this study was to evaluate the effect of ICU-specific virtual reality (ICU-VR) on mental health among relatives, 6 months after patient’s ICU discharge.

Methods

This multicenter, randomized controlled trial included relatives of ICU patients who were assigned to receive either standard care or standard care plus ICU-VR, by randomizing the ICU patients. Relatives were assessed up to 6 months after patient discharge from the ICU for post-traumatic stress, anxiety, depression, quality of life, relatives’ understanding of ICU care, and appreciation of ICU-VR.

Results

One hundred relatives of 81 patients and 89 relatives of 80 patients were randomized to the intervention and control groups, respectively. Relatives’ median age was 48 years and 53% were female. Compared to the control group, relatives who received ICU-VR did not experience a decrease in post-traumatic stress (23% vs. 18%; p = 0.99), anxiety (22% vs. 30%; p = 0.35), or depression (17% vs. 23%; p = 0.44). There was no significant difference between median mental quality of life (50.2 vs. 52.6; p = 0.51), physical quality of life (56.1 vs. 54.3; p = 0.16), or understanding of ICU care between groups. Patients in the intervention group highly endorsed ICU-VR (90%), favoring it over traditional informational brochures and the majority (82%) stated it improved their understanding of ICU treatment.

Conclusion

ICU-VR did not significantly improve mental health distress symptoms among relatives 6-months after a patient’s discharge. Relatives highly endorsed ICU-VR and self-reported that it improved their understanding of ICU treatment.
A novel protein encoded by porcine circANKRD17 activates the PPAR pathway to regulate intramuscular fat metabolism
Authors: He Xiao , Xie Fang , Nie Ying , Wang Xuefeng , Luo Junyi , Chen Ting , Xi Qianyun , Zhang Yongliang , Sun Jiajie
Published: February 2025

Background

Intramuscular fat is an important factor in evaluating pork quality and varies widely among different pig breeds. However, the regulatory mechanism of circular RNAs (circRNAs) in lipid metabolism remains largely unexplored.

Results

We combined circRNA-seq and Ribo-seq data to screen a total of 18 circRNA candidates with coding potential, and circANKRD17 was found to be significantly elevated in the longissimus dorsi muscle of Lantang piglets, with a length of 1,844 nucleotides. Using single-cell sequencing, we identified 477 differentially expressed genes in IMF cells between Lantang and Landrace piglets, with enrichment in the PPAR signaling pathway. These genes included FABP4, FABP5, CPT1A, and UBC, consistent with the high levels of acylcarnitines observed in the longissimus dorsi muscles of the Lantang breed, as determined by lipidomic analysis. Further in vitro and in vivo experiments indicated that circANKRD17 can regulate lipid metabolism through various mechanisms involving the PPAR pathway, including promoting adipocyte differentiation, fatty acid transport and metabolism, triglyceride synthesis, and lipid droplet formation and maturation. In addition, we discovered that circANKRD17 has an open reading frame and can be translated into a novel 571-amino-acid protein that promotes lipid metabolism.

Conclusions

Our research provides new insights into the role of protein-coding circANKRD17, especially concerning the metabolic characteristics of pig breeds with higher intramuscular fat content.
A large elevation in 15N/14N of collagenous amino acids: an insight from starvation experiments of marine organisms
Authors: Choi Hyuntae , Takizawa Yuko , Park Nayeon , Chikaraishi Yoshito
Published: February 2025

Nitrogen isotope ratios of amino acids (δ15NAA) have widely been employed as a powerful tool for estimating the trophic position of organisms in food webs. This estimation is based on an elevation pattern in the δ15NAA value, a large elevation for the trophic amino acids (e.g., 8.0‰ for glutamic acid) while a little elevation for the source amino acids (e.g., 0.4‰ for phenylalanine), associated with the deamination of amino acids in consumers. However, several elevation patterns can be found in natural environments, one of which may be caused by the hydrolysis of specific protein under nutritional stress. In the present study, we identified ‘protein-specific elevation pattern’ for collagen, which connected to muscle tissues of fish and gastropods under nutritional stress. Time-series starvation for 45 days results in that collagen is consumed by 86% for the fish Girella punctata and by 50% for the gastropod Turbo sazae. Moreover, during the starvation, although a little change in the δ15NAA value is found in muscle fibers, a gradual elevation in the δ15NAA value is found in collagen for both trophic and source amino acids (e.g., by up to 11‰ for glutamic acid and up to 3‰ for phenylalanine, respectively, which can be explained by the Rayleigh fractionation model). We thus demonstrate that the consumption of collagen in organisms under starvation shows a unique elevation pattern in the δ15NAA value, which is consistent with the observation that collagen is degraded non-quantitatively by the collagenase reaction, whereas muscle is degraded quantitatively by the chaperone-mediated autophagy. The effect of δ15N elevation in all amino acids of collagen is negligible for G. punctata and diluted for T. sazae to the elevation in whole muscle tissue (i.e., = muscle fibers + collagen) even under long-term starvation, because the collagen proportion in the whole muscle is relatively small and is considerably decreased under the nutritional stress. Based on these results, we predict that the difference in the δ15NAA value between collagen and muscle fibers can be useful for evaluating the nutritional stress of fishes. However, great care will be required if studying food webs where collagen-rich organisms (i.e., gelatinous zooplankton) are abundant or if using collagen-rich materials in our studies.
Discordance between 90Y-PET/CT(MR)-estimated activity and dose calibrator measured administered activity: an international study in SIRT patients treated with resin and glass microspheres
Authors: Carlier Thomas , Gnesin Silvano , Mikell Justin K. , Conti Maurizio , Prior John O. , Schaefer Niklaus , Pérez Lago Maria del Sol , Bailly Clément , Dewaraja Yuni K. , Lima Thiago V. M.
Published: February 2025

Purpose

Therapeutic administration of 90Y-loaded microspheres is routinely used for primary and secondary liver tumours. For activity-based therapeutic prescription the activity must be within 10% of the intended activity. Previous studies reported significant discrepancies between manufacturer-declared vial activities and both experimental and Monte-Carlo assessments, greater than 10%, for resin/glass 90Y-microspheres. The objective of this work was to investigate whether these discrepancies were also seen in patients.

Methods

We analysed patient 90Y-PET reconstructions (99 glass and 15 resin microspheres) from 4 different institutions and 4 different systems. We considered tail-fitting background scaling (TFBS) and absolute scaling (ABS), for scatter correction. Residuals after therapeutic injection were measured. Eighty-one patients were imaged with PET/CT and 33 with PET/MR. The PET measured activity (APET) was assessed in the whole liver. The ratio APET/Acalibrator was calculated for each patient, where Acalibrator was the injected activity measured by the dose calibrator corrected for residual and lung shunt.

Results

Quantification ratio between calibrators and PET was significantly different from 1, regardless of the scatter correction used. In glass microspheres, the mean APET/CT/Acalibrator was 0.84 ± 0.06 for TFBS and 0.90 ± 0.06 for ABS (0.66 ± 0.09 and 0.76 ± 0.07 for (APET/MR/Acalibrator)). The mean APET/CT/Acalibrator ratio for resin microspheres was 1.16 ± 0.09 for TFBS and 1.30 ± 0.12 for ABS.

Conclusions

We observed in patients similar activity discrepancies as reported for vials, with a relative difference of 44 ± 16% between glass and resin 90Y-loaded microspheres. In 90Y hepatic radioembolization, the 10% accuracy prerequisite on knowing the administered therapeutic activity is then unlikely to be met.
Assessing the impact on mode competitiveness of improvements of the Trans-Eurasian railway network
Authors: Mohseni Seyed , van Hassel Edwin , Vanelslander Thierry
Published: February 2025

This paper deals with the potential of the different modes of transport on the Eurasian connection, focusing on rail, and comparing with sea and air. Since 2008, a substantial uptake of the rail connection has been observed. The main question then is whether the competitiveness of this land bridge is actual and sustainable or not. First, the paper focuses on the latest developments of the actual physical capacity on the Eurasian connection. Mainly under Chinese impetus, substantial improvements of rail connections but also border crossings have been made. Second, the paper focuses on the actual competitiveness of the different modes on the Eurasian connection in the current-day transport volumes. It can be observed that also the transport on the Eurasian connection has been growing, especially by rail. However, by far the largest volumes of transport still happen by maritime transport. The third and main question of the paper is on whether the land bridge by rail would cost-wise be competitive enough to favour a large shift from sea to land. An adapted version of a chain cost model applied to seven city pairs shows that the cost of the maritime solution is notably higher the further away from the coast origin and/or destination are located. For rail, such significant cost differences are not found. Furthermore, the value of the goods plays a bigger role for rail than for maritime transport. Air transport, due to its higher charges, typically is only used by higher-value goods. When comparing the (combinations of) transport modes, it turns out that the rail costs are on average 1.5 times to twice as high as when using maritime transport, but the more westward the origin on the Chinese territory, the closer the ratio gets to 1. The sensitivity analysis shows that in particular using longer trains will allow strongly further reducing generalized rail chain costs, easily over a third of the base case costs. Substantially less generalized chain cost reductions are achieved when shortening transit times, even when the latter goes up to half the initial transit time. Fourth, looking at what would be needed to make a further shift to rail materialize on the Eurasian connection, three items pop up: rail border crossing capacity, traffic balance between both directions and backups to the TEN-T rail network.
Validity and reliability of the Manchester Oxford Foot Questionnaire (MOXFQ) in one-year postoperative ankle fracture patients—a validation study
Authors: Nguyen Michael Quan , Iversen Marjolein Memelink , Harboe Knut , Dalen Ingvild , Paulsen Aksel
Published: February 2025

Background

Ankle fracture patients are a heterogenous group with differences in age, sex, fracture morphology, and treatment provided. With the increased focus on patient-centered treatment, patient-reported outcome measures (PROMs) are increasingly adopted by clinicians to facilitate best clinical practice. The Manchester Oxford Foot Questionnaire (MOXFQ) has demonstrated good measurement properties when used in patients with foot or ankle disease. The PROM has three domains: (1) Pain; (2) Walking/Standing; and (3) Social Interaction. One study found sufficient content validity for the Pain and Walking/Standing domains when used in the evaluation of ankle fracture patients. Another validation study demonstrated acceptable structural validity and reliability for the MOXFQ in ankle fracture patients 12 weeks after injury. The aim of this study is to assess the structural validity and reliability of the Norwegian version of the MOXFQ in the context of an ankle fracture patients one year after surgery and provide patient acceptable symptom state (PASS) estimates.

Methods

A pragmatic cross-sectional study design was used to collect the one-year MOXFQ follow-up data from patients surgically treated for an ankle fracture in the period 2017 to 2020 at (Stavanger University Hospital). The structural validity and internal consistency were assessed using confirmatory factor analysis. A separate test-retest study including patients at least one year since ankle surgery was used in the assessment of reliability and measurement error.

Results

A confirmatory factor analysis of the three-factor model of the MOXFQ had a good model fit (TLI 0.94; CFI 0.95; RMSEA 0.094; SRMR 0.039). However, the measurement model demonstrated poor discriminant validity of the three factors. A unidimensional model of the 16 items had worse model fit, while a second-order factor model demonstrated strong factor loadings for a second-order factor. A bi-factor model also revealed a strong general factor but also unique variance in the Pain and Social Interaction domain. The domains had good internal consistency (McDonald’s omega 0.80 to 0.95) and test-retest reliability (ICC 0.80 to 0.92). The standard errors of measurements for the three domains were between 6.5 and 7.5, and 5.5 for the MOXFQ-Index (scale 0 to 100). PASS estimates for the (sub)scales were: Pain 45; Walking/Standing 39; Social Interaction 19; and MOXFQ-Index 34.

Conclusion

The MOXFQ with three domains demonstrated sufficient structural validity and reliability when used in the evaluation of a one-year postoperative ankle fracture population. Reporting the scores of the Pain and Walking/Standing domains was best supported.
Associated adverse outcomes with tumor treating fields when combined to temozolomide versus temozolomide alone for the treatment of glioblastoma: a meta-analysis of randomized trials
Authors: Chen Yuanyuan , Chen Yan , Zhen Hong , Lou Danhua
Published: February 2025

Background

Glioma is a brain tumor and glioblastoma represents its most common type, accounting for almost 40% of primary tumors of the central nervous system, and is associated with the worst prognosis. Glioblastoma remains one of the major challenges in neurooncology. Recently, the Food and Drug Administration (FDA) has approved tumor treating fields (TTF) for the treatment of glioblastoma. In this analysis, we aimed to systematically assess the adverse outcomes associated with TTF when combined to temozolamide versus temozolamide alone for the treatment of glioblastoma.

Methods

MEDLINE (subset PubMed), EMBASE, Web of Science, Cochrane databases, Google scholar, and http://www.ClinicalTrials.gov were searched for publications comparing TTF in combination with temozolomide versus temozolomide alone for the treatment of glioblastoma. The adverse outcomes were considered as the endpoints in this analysis. The statistical analysis was carried out by the latest version of the RevMan software (version 5.4). Risk ratios (RR) with 95% confidence intervals (CI) were used to represent the data following assessment. A random effect model was used during the statistical analysis.

Results

A total number of 994 participants were included in this analysis whereby 572 participants were assigned to TTF + temozolomide, whereas 422 participants were assigned to temozolomide alone. All the studies were randomized trials. The majority of the participants were males (68.0–75.0%) with a mean age of the varying from 54.0 to 69.0 years. Results of this analysis showed that TTF in combination with temozolomide was not associated with significantly higher adverse outcomes related to blood and lymphatic system disorders (RR:0.87, 95% CI 0.30–2.48; P = 0.79), gastrointestinal disorders (RR: 0.83, 95% CI 0.14–4.72; P = 0.83), general deterioration and malaise (RR: 1.43, 95% CI 0.90–2.25; P = 0.13), infections and infestations (RR: 1.21, 95% CI 0.33–4.45; P = 0.78), injury/poison and procedural complications (RR: 1.78, 95% CI 0.88–3.61; P = 0.11), metabolic and nutritional disorders (RR: 0.61, 95% CI 0.34–1.08; P = 0.09), central nervous system disorders (RR: 1.14, 95% CI 0.89–1.46; P = 0.31), musculoskeletal and connective tissue disorders (RR: 0.99, 95% CI 0.48–2.07; P = 0.99), respiratory/thoracic/mediastinal disorders (RR: 0.85, 95% CI 0.44–1.62; P = 0.62), and psychiatric disorders (RR: 1.27, 95% CI 0.42–3.79; P = 0.67). Similar adverse effects were observed.

Conclusion

TTF in combination with temozolomide was not associated with significantly worse adverse outcomes for the treatment of patients with glioblastoma. Hence, future trials should focus on the cost-effectiveness of TTF for the treatment of glioblastoma.
Anatomical regions of residual hemorrhage in chronic subdural hematoma
Authors: Taçyıldız Abdullah Emre , Üçer Melih , Gezici Kübra , Canaz Gökhan , Apaydın Aydın Sinan
Published: February 2025

Background

Chronic subdural hematoma (CSH) is a persistent challenge for neurosurgeons, with current relapse, mortality, and morbidity rates not meeting desired outcomes. This study aims to identify the anatomical regions of postoperative residual hemorrhage and discuss their potential implications for surgical practice.

Methods

This retrospective, observational study reviewed the demographic, clinical, functional, and radiographic outcomes of 74 patients who underwent surgery for CSH between January 1, 2017, and October 1, 2021, at a single-center. Data were collected from the hospital's electronic database, including patient history, physical examination records, and preoperative and postoperative imaging.

Results

Postoperative day 1 computed tomography scans revealed the most common region for residual hemorrhage was the inferior frontal gyrus in 17 cases (23.0%; valid percentage: 42.5%). Residual hemorrhage was detected in the superior parietal lobe in 9 cases (12.2%; valid percentage: 22.5%). High valid percentages of residual hemorrhage were also noted in the temporal (62.5%) and occipital (66.6%) regions.

Conclusions

The inferior frontal gyrus, temporal, and occipital regions are the most common sites for postoperative residual hemorrhage in CSH patients. Identifying these regions can guide surgical planning and intraoperative focus, potentially improving patient outcomes. This study provides valuable insights for refining presurgical strategies and targeting specific anatomical areas during surgery.
Evaluation of the efficacy of percutaneous spinal cord stimulation according to the single or double leads
Authors: Ertilav Esra , Aydin Osman Nuri
Published: February 2025

Aim

The aim of the study was to compare the efficacy of single or double lead in percutaneous spinal cord stimulation (SCS).

Method

Follow-up data of 41 patients (20 patients with double lead, 21 patients with single lead) who underwent percutaneous SCS were analysed. Demographic and clinical examination findings (gender, age, pain characteristic, neurological examination, medications used) and visual analogue scale (VAS) scores were recorded. VAS pain scores, clinical and neurological examination and complication findings were recorded at 1st and 12th months at post-procedure follow-up.

Results

Twenty patients had double lead and 21 patients had single lead. Five patients had root avulsion, 1 patient had complex regional pain syndrome, 1 patient had postherpetic neuralgia, 2 patients had phantom pain, 3 patients had ischaemic pain and 29 patients had postlaminectomy syndrome. In 10 patients, leads were placed in the cervical region and in 31 patients in the thoracic region. There was at least 50% reduction in VAS scores in 71.4% (15 patients) with single lead implantation and 65% (13 patients) with double lead implantation (p = 0.7). Infection was significantly higher in patients with double lead than in patients with single lead implantation (p < 0.05). In 1 patient, generator exchange was performed because the generator was exposed due to skin necrosis. No major complication was recorded.

Conclusion

SCS with single and double lead is an effective method in chronic pain syndromes. SCS with single lead can be preferred in terms of time, cost and labour saving.
Effect of a tailor-made hydrotherapy on physical functions in patients after unilateral unicompartmental knee arthroplasty—A feasibility study
Authors: Chau Wai-Wang , Lau Mei-Yan , Choi Tsz-Lung , Lam Gloria Yan-Ting , Ong Michael Tim-Yun , Ho Kevin Ki-Wai
Published: February 2025

Introduction

Unicompartmental knee arthroplasty (UKA) is one of the treatment options for patients whose osteoarthritis involves one out of the 3 compartments. Patients who underwent UKA benefited from shorter hospital stays, better range of motion, and lower risk of postoperative complications compared with patients who underwent total knee arthroplasty (TKA). Hydrotherapy is being introduced complementary to conventional postoperative rehabilitation programs. No report on the use of hydrotherapy evaluating physical functions on patients who underwent UKA leads us to carry out the present study. This is a feasibility study to investigate the effects of hydrotherapy on physical functions in patients after primary unilateral UKA.

Methods

A retrospective cohort study recruited 68 patients who underwent primary unilateral UKA. Nineteen patients were allocated to the hydrotherapy group and 49 patients were in the convention group. Patients in the hydrotherapy group received hydrotherapy and conventional physiotherapy, and the convention group was given conventional physiotherapy only. The primary outcome was Knee Society Function Score (KFS) measured before surgery, six months, and one year after UKA. Self-reported walking tolerance, Timed Up and Go Test (TUGT), and 30-s Chair Stand Test (30CST) were conducted before and after the completion of rehabilitation. Pain and range of motion were also covered.

Results

Hydrotherapy group showed significantly higher KFS at 6 months (P = 0.038) and one year (P = 0.030) after operation. Range of motion flexion and extension in the hydrotherapy group were significantly improved at postoperative 4 weeks and the last session of rehabilitation. Self-reported walking tolerance in the hydrotherapy group was significantly longer at the last session (P = 0.011). No significant difference was found in TUGT, 30CST, and pain between the two groups after rehabilitation. In both groups, all outcomes were significantly better as compared to preoperative findings.

Conclusion

Patients who underwent UKA after hydrotherapy complementary to conventional physiotherapy showed significant improvements in functions, range of motion, and time to tolerating walking before rest. Pain, mobility, balance, leg strength, and endurance were comparable between the two groups. Combination of hydrotherapy with conventional postoperative physiotherapy rehabilitation yielded even better outcomes than conventional physiotherapy alone. Further research with advanced study design, larger sample size and longer follow-up periods for patients who underwent UKA is recommended.

Trial registration

NCT06459960, retrospectively registered on 13.06.2024 (ClinicalTrials.gov).
Retained Continuous Glucose Monitor Sensor Wire Fragments Presenting as a Swollen Nodule of the Thigh
Authors: Deng Lily , Galganski Laura , Krishnamurthy Mansa
Published: February 2025

A 2-year-old male with genetic-negative, diazoxide-responsive hyperinsulinism presented with a knot in his left, lateral thigh. His hypoglycemia was managed with diazoxide, chlorothiazide, and monitoring via a Dexcom G6 continuous glucose monitor (CGM). X-ray showed 3 metallic wire foreign bodies, consistent with retained Dexcom sensor wires. He was referred to surgery for foreign body removal. Intraoperative fluoroscopy revealed 4 pieces of wire. Two superficial pieces were removed, but 2 small pieces deep to the fascia remained because of significant risk of injury or bleeding if removal was attempted. We present this case to increase awareness in the literature regarding retention of CGM wires. Raised nodules at sites of CGM insertion without fluctuation or erythema and persistent pain should raise suspicion for retention of sensor wires.
Developing a Novel Artificial Intelligence Framework to Measure the Balance of Clinical Versus Nonclinical Influences on Posthepatectomy Length of Stay
Authors: Putman Kristin , Moheb Mohamad El , Shen Chengli , Witt Russell G. , Ruff Samantha M. , Tsung Allan
Published: February 2025

Background

Length of stay (LOS) is a key indicator of posthepatectomy care quality. While clinical factors influencing LOS are identified, the balance between clinical and nonclinical influences remains unquantified. We developed an artificial intelligence (AI) framework to quantify clinical influences on LOS and infer the impact of hard-to-measure nonclinical factors.

Methods

Patients from the 2017 to 2021 ACS NSQIP Hepatectomy-Targeted database were stratified into major and minor hepatectomy groups. A three-tiered model—multivariable linear regression (MLR), random forest (RF), and extreme gradient boosting (XGBoost)—was developed to evaluate the effect of 52 clinical variables on LOS. Models were fine-tuned to maximize clinical variables’ explanatory power, with residual unexplained variability attributed to nonclinical factors. Model performance was measured using R
2 and mean absolute error (MAE).

Results

A total of 21,039 patients (mean age: 60 years; 51% male) were included: 70% underwent minor resection (mean LOS: 5.0 days), and 30% underwent major resection (mean LOS: 6.9 days). Random forest had the best performance, explaining 75% of LOS variability for both groups (R
2: 0.75). The significant improvement in R
2 from MLR to RF suggests significant nonlinear interactions of clinical factors’ impact on LOS. Mean absolute errors were 1.15 and 1.38 days for minor and major resections, indicating that clinical factors could not explain 1.15 to 1.38 days of LOS.

Conclusions

This study is the first to measure the true influence of clinical factors on posthepatectomy LOS, showing that they explain 75% of the variability. Furthermore, it indirectly evaluated the overall impact of hard-to-measure nonclinical factors, revealing that they account for 25% of LOS.
Η επίδραση της διατροφής στη σαρκοπενία και στην απόδοση σε ασθενείς με διαβήτη τύπου ΙΙ
Authors: Αργυροπούλου Διονυσία
Published: February 2025

Εισαγωγή: Η συμπληρωματική χορήγηση με πρωτεΐνη έχει προταθεί ως μια αποτελεσματική διατροφική στρατηγική για τη διατήρηση της μυϊκής μάζας στους ηλικιωμένους. Όμως ο σακχαρώδης διαβήτης τύπου 2 (ΣΔ2) τροφοδοτεί την απώλεια μυϊκής μάζας και έτσι οι ηλικιωμένοι που πάσχουν από αυτόν συχνά εμφανίζουν σαρκοπενία, ενώ και η σαρκοπενία τροφοδοτεί το ΣΔ2. Καθώς ο ΣΔ2 επηρεάζει την μυϊκή μάζα, στόχος μας ήταν η αξιολόγηση του αντίκτυπου της αυξημένης πρόσληψης πρωτεϊνών σε παράγοντες που αφορούν τη σαρκοπενία, τη μυϊκή οξυγόνωση, την ποιότητα της διατροφικής παρέμβασης καθώς και την εξέλιξη του ΣΔ2 σε άτομα μέσης και αυξημένης ηλικίας που πάσχουν από ΣΔ2. Μεθοδολογία: Είκοσι-έξι άτομα (ηλικίας >50 ετών) με ΣΔ2 προσφέρθηκαν εθελοντικά να συμμετάσχουν στην παρούσα έρευνα. Σε ένα σχέδιο τυχαιοποιημένης μελέτης που διήρκεσε 12 εβδομάδες, η ομάδα ελέγχου (OE) έλαβε 0,8-1,0 gr/kg/ημέρα πρωτεΐνες, ενώ η ομάδα παρέμβασης (OΠ) έλαβε 1,2-1,5 gr/kg/ημέρα πρωτεΐνες. Η σύσταση σώματος, η μυϊκή μάζα, η μυϊκή δύναμη, η μυϊκή οξυγόνωση και αιματολογικοί-βιοχημικές παράμετροι μετρήθηκαν πριν και μετά την περίοδο παρέμβασης προκειμένου να αξιολογηθεί η εξέλιξη της απώλειας μυϊκής μάζας καθώς και η εξέλιξη του ΣΔ2. Αποτελέσματα: Η ΟΠ έδειξε σημαντική βελτίωση (p<0,05) στη μυϊκή δύναμη και στη σωματική απόδοση. Σημαντική βελτίωση παρατηρήθηκε επίσης στο προφίλ των αμινοξέων φτάνοντας τις τρέχουσες συστάσεις. Αντίθετα, στην ΟΕ μειώθηκαν σημαντικά (p<0,05) η άλιπη μάζα σώματος, ο δείκτης σκελετικών μυών και η μυϊκή δύναμη. Δεν παρατηρήθηκαν σημαντικές επιδράσεις για την οξυγόνωση των μυών, τους εξεταζόμενους δείκτες αίματος και τις βιοχημικές παραμέτρους εκτός από τη λιποπρωτεΐνη υψηλής πυκνότητας (p=0,023) στην ΟΠ. Παραδόξως, η πρόσληψη πρωτεϊνών 0,8-1,0 gr/kg/ημέρα δεν είναι αρκετή για να επιτευχθούν οι τρέχουσες συστάσεις για την πρόσληψη αμινοξέων. Συμπέρασμα: Η τρέχουσα σύσταση για πρόσληψη πρωτεϊνών δεν επαρκεί ούτε για τη βελτίωση της απώλειας μυϊκής μάζας ούτε για τη βελτίωση της ποιότητας της διατροφής σε άτομα μέσης και αυξημένης ηλικίας με ΣΔ2. Η πρόσληψη πρωτεϊνών 1,2-1,5 gr/kg/ημέρα φαίνεται να είναι καταλληλότερη σύσταση για την καταπολέμηση της επερχόμενης σαρκοπενίας αλλά όχι και των δεικτών ΣΔ2, ενώ φαίνεται και πιο κατάλληλη επιλογή για την επίτευξη των τρεχουσών συστάσεων για αμινοξέα.
Η συμβολή του θεατροπαιδαγωγικού εργαστηρίου στην επιμόρφωση των εκπαιδευτικών σε ζητήματα εκπαίδευσης στα ανθρώπινα δικαιώματα.
Authors: Χολέβα Νάσια
Published: February 2025

Η διδακτορική διατριβή πραγματοποιήθηκε στο Τμήμα Επιστημών Προσχολικής Αγωγής και Εκπαίδευσης του Αριστοτελείου Πανεπιστημίου Θεσσαλονίκης με επιβλέποντα τον Αντώνη Λενακάκη (Αναπληρωτή Καθηγητή στο ΤΕΠΑΕ, ΑΠΘ) και μέλη της Τριμελούς Συμβουλευτικής Επιτροπής τον Αργύρη Κυρίδη (Καθηγητή στο ΤΕΠΑΕ, ΑΠΘ) και τον Κώστα Μάγο (Αναπληρωτή Καθηγητή στο Παιδαγωγικό Τμήμα Προσχολικής Εκπαίδευσης, Πανεπιστήμιο Θεσσαλίας). Παρουσιάστηκε τον Ιούλιο του 2022.
Το Θέατρο-Ντοκουμέντο ως μέσο καλλιέργειας και ενίσχυσης της "ιδιότητας του πολίτη" σε ενήλικες μαθητές του Σχολείου 18 Άνω (Πρόγραμμα Απεξάρτησης)
Authors: Δαφνή Ρουμπίνη
Published: February 2025

Το άρθρο αναφέρεται σε έρευνα δράσης που πραγματοποιήθηκε στο Σχολείο του 18 Άνω για να διερευνήσει την επίδραση του Θεάτρου-Ντοκουμέντο ως μέσου για την καλλιέργεια της «ιδιότητας του πολίτη» των ενήλικων μαθητών του σχολείου. Για τον σκοπό αυτό, σχεδιάστηκε ένα πρόγραμμα δώδεκα παρεμβάσεων που βασίστηκε σε τεχνικές του Θεάτρου Ντοκουμέντο και του Εκπαιδευτικού Δράματος και εφαρμόστηκε σε 11 μαθητές του σχολείου κατά το σχολικό έτος 2022-2023. Ακολουθήθηκε μεικτή ερευνητική προσέγγιση, με στόχο τη σφαιρικότερη προσέγγιση των ερευνητικών ερωτημάτων. Η ανάλυση των ποσοτικών δεδομένων έδωσε ενδείξεις βελτίωσης της «ιδιότητας του πολίτη» της πειραματικής ομάδας, δεν κατέδειξε όμως στατιστικά σημαντικές διαφοροποιήσεις πριν και μετά τις παρεμβάσεις. Αντίθετα, η ανάλυση των ποιοτικών δεδομένων υπέδειξε βελτίωση των «πολιτειακών» δεξιοτήτων (συνεργασία, κριτική ανάλυση), των στάσεων (συμμετοχής και προς τη διαφορετικότητα), αλλά και του ενδιαφέροντος και της προσωπικής συμμετοχής, και μάλιστα η βελτίωση αυτή σχετίζεται με τις τεχνικές του Θεάτρου Ντοκουμέντο.
Using food democracy to overcome the commodification-driven tragedy of the EU’s food system commons
Authors: Tonello Samuele , Jani Anant
Published: February 2025

Current European food system is unsustainable, being leading causes of Non-communicable diseases, having a significant environmental impact, and causing numerous socioeconomic inequalities. The fact that politics governance conceives food as a commodity is a core feature of this unsustainability, so several voices have called for a transition to a politics governance that considers food as commons, namely a good with elementary forms other than profit that belong to the whole population. Central to this transition is the fact that in a politics governance where food is conceived as a commons, those sharing a concern for the commons musty be able to equally participate in addressing it. A commonification of the food system thus requires finding a new balance of forces between governments, industries and the people. This paper describes why food democracy is necessary for this transition of politics governance to occur, while making sure that the people’s right to the management of the commons is respected. However, we specify that the realisation of a food democracy can occur so only insofar as both the deliberative and epistemic properties of democracy are maximised. That is, only insofar as the increase in citizens’ participation goes hand in hand with the regulation of the settings in which the participation occurs. By doing so, it is possible to realise a sustainably governed food system commons capable of addressing four main challenges of current food systems: tackling the Commercial Determinants of Health, enhancing civic education, setting an adversarial democracy and increasing awareness for the imperative of responsibility.
The therapeutic potential of exercise in post-traumatic stress disorder and its underlying mechanisms: A living systematic review of human and non-human studies
Authors: Wright Simonne , Chiocchia Virginia , Elugbadebo Olufisayo , Simple Ouma , Furukawa Toshi A. , Friedrich Claire , Austin Charlotte , Dehdarirad Hossein , Gilbert David , Kennett Jaycee , Ostinelli Edoardo G. , Potts Jennifer , Ramage Fiona , Sena Emily , Siafis Spyridon , Stansfield Claire , Thomas James , Tinsdeall Francesca , Tonia Thomy , Macleod Malcolm , Cipriani Andrea , Salanti Georgia , Seedat Soraya
Published: February 2025

Background Exercise for post-traumatic stress disorder (PTSD) is a potentially effective adjunct to psychotherapy. However, the biopsychosocial mechanisms of exercise are not well understood. This co-produced living systematic review synthesizes evidence from human and non-human studies. Methods We Included controlled human and non-human studies involving searches of multiple electronic databases (until 31.10.23). Records were screened, extracted, assessed for risk of bias, and reconciled by two independent reviewers. The primary outcome for human studies was PTSD symptom severity, while outcomes of interest for non-human studies included freezing behaviour, fear memory, fear generalization, startle response, and locomotion. Data were synthesised with random-effects meta-analysis. Results Eleven human studies met the eligibility criteria. Overall, exercise was not associated with symptom severity improvement compared to control (standardized mean difference [SMD] -0.08, 95% confidence interval [CI] -0.24 to 0.07; 8 studies, one at low risk of bias). High-intensity exercise reduced PTSD symptoms scores more than moderate-intensity exercise. There was insufficient data to examine the effects of exercise on functional impairment, PTSD symptom clusters, and PTSD remission. Only three studies, all at high risk of bias, examined mechanisms of exercise with inconclusive results. Exercise was associated with improvement in all behavioural outcomes, including locomotor activity (SMD 1.30, 95% CI 0.74 to 1.87, 14 studies), and changes in several neurobiological markers, including increase in brain-derived neurotrophic factor (SMD 1.79, 95% CI 0.56 to 3.01). Conclusions While non-human studies provide compelling evidence for the beneficial effects of exercise, human trials do not. Evidence from non-human studies suggest that exercise might increase the levels of brain-derived neurotrophic factor, enhance cognitive appraisal, and improve perceived exertion. Overall, the paucity of data on the effectiveness of exercise in PTSD and mechanisms of action underscore the need for rigorous trials. Registration The protocol was registered with PROSPERO (ID:453615; 22.08.2023).
Features of the Functioning of the Grain-Product Subcomplex of the Agroindustrial Complex of Russia and the Conditions for Its Development
Authors: Dorofeeva V. , Rudkovskiy V.
Published: February 2025

The article defines the role of the grain-product subcomplex of the agroindustrial complex of Russia in ensuring the country's food security. The features of the functioning and development of the Russian grain product subcomplex in modern realities are outlined. It is noted that geopolitical tensions, economic sanctions and changes in the global food market situation are forcing Russia to look for new opportunities to sell agricultural products. The expediency of reorienting exports to developing countries in Africa, the Middle East and Southeast Asia, as well as the need for a large-scale restructuring of export activities, is substantiated. The need for the development of a holistic scientifically based strategy for the development of Russian agricultural exports in order to improve the quality of strategic planning and management, as well as to ensure consistency of strategies at various levels (regional and municipal) is substantiated.
Correlation between Income Growth Processes and the Level of Social Inequality
Authors: Averina Tatyana
Published: February 2025

The article presents the results of statistical assessment of the influence of per capita income on the Gini coefficient. The main part of the materials concerns the regions of the Volga Federal District of Russia and covers the period 2012-2023. For 57% of the regions of the Volga Federal District, a close direct relationship between the basic growth rates of per capita income and the level of social inequality was identified and statistically confirmed. The polynomial nature of the dependence was determined; for half of the regions, the rate of factor growth of the Gini coefficient is decreasing.