bluuebunny/crossref_metadata_2025 huggingface dataset:
IL-16 Mediates the Effect of Circulating Metabolites on Postmenopausal Osteoporosis: A Two-Step, Multivariable Mendelian Randomization Study
Authors: Chen Yi , Xiao Hefang , Teng Fei , Yang Ao , Yang Fei , Chen Changshun , Chen Rongjin , Geng Bin , Xia Yayi
Published: August 2024

Objectives: This study aimed to explore the relationship between circulating metabolites and postmenopausal osteoporosis (PMOP) and to assess the mediating role of inflammatory factors. Methods: Utilizing summary-level data from genome-wide association studies (GWAS) and employing a Mendelian Randomization approach, a two-sample MR analysis was conducted to assess the relationship between circulating metabolites and PMOP. Additionally, a two-step MR was used to quantify the mediating impact of inflammatory factors on the effect of circulating metabolites on PMOP. Results: The results revealed a significant association between certain metabolites and the risk of PMOP, notably the ratio of free cholesterol to total lipids in very large VLDL particles (OR: 1.399, 95% CI: 1.002-1.954, p = 0.048) and IL-16 (OR: 0.773, 95% CI: 0.608-0.983, p = 0.036). IL-16 was found to partially mediate the impact of circulating metabolites on PMOP, with a mediation effect of 10.4%. Conclusion: This study underscores the crucial role of circulating metabolites and inflammatory factors in PMOP pathogenesis. A causal relationship between circulating metabolites and PMOP was established, with IL-16 mediating some effects. These findings hold promise for clinical applications in early detection, personalized medicine, and the identification of therapeutic targets for PMOP.
How to detect fake online physician reviews: A deep learning approach
Authors: Zhao Yuehua , Li Tianyi , Yuan Qinjian , Deng Sanhong
Published: August 2024

Objective

The COVID-19 pandemic has spurred an increased interest in online healthcare and a surge in usage of online healthcare platforms, leading to a proliferation of user-generated online physician reviews. Yet, distinguishing between genuine and fake reviews poses a significant challenge. This study aims to address the challenges delineated above by developing a reliable and effective fake review detection model leveraging deep learning approaches based on a fake review dataset tailored to the context of Chinese online medical platforms.

Methods

Inspired by prior research, this paper adopts a crowdsourcing approach to assemble the fake review dataset for Chinese online medical platforms. To develop the fake review detection models, classical machine learning models, along with deep learning models such as Convolutional Neural Network and Bidirectional Encoder Representations from Transformers, were applied.

Results

Our experimental deep learning model exhibited superior performance in identifying fake reviews on online medical platforms, achieving a precision of 98.36% and an F2-Score of 97.97%. Compared to the traditional machine learning models (i.e., logistic regression, support vector machine, random forest, ridge regression), this represents an 8.16% enhancement in precision and a 7.7% increase in F2-Score.

Conclusion

Overall, this study provides a valuable contribution toward the development of an effective fake physician review detection model for online medical platforms.
Local radiation enhances systemic CAR T-cell efficacy by augmenting antigen crosspresentation and T-cell infiltration
Authors: Kostopoulos Nektarios , Costabile Francesca , Krimitza Elisavet , Beghi Silvia , Goia Denisa , Perales-Linares Renzo , Thyfronitis George , LaRiviere Michael J. , Chong Elise A. , Schuster Stephen J. , Maity Amit , Koumenis Constantinos , Plastaras John P. , Facciabene Andrea
Published: August 2024

Chimeric antigen receptor (CAR) T-cell therapy targeting CD19 (CART-19) represents a significant advance in the treatment of patients with relapsed or refractory CD19+ B-cell lymphomas. However, a significant portion of patients either relapse or fail to respond. Moreover, many patients have symptomatic disease, requiring bridging radiation therapy (RT) during the period of CAR T-cell manufacturing. To investigate the impact of 1 to 2 fractions of low-dose RT on CART-19 treatment response, we developed a mouse model using A20 lymphoma cells for CART-19 therapy. We found that low-dose fractionated RT had a positive effect on generating abscopal systemic antitumor responses beyond the irradiated site. The combination of RT with CART-19 therapy resulted in additive effects on tumor growth in irradiated masses. Notably, a significant additional increase in antitumor effect was observed in nonirradiated tumors. Mechanistically, our results validate activation of the cyclic guanosine adenosine synthetase/stimulator of interferon genes pathway, tumor-associated antigen crosspriming, and elicitation of epitope spreading. Collectively, our findings suggest that RT may serve as an optimal priming and bridging modality for CAR T-cell therapy, overcoming treatment resistance and improving clinical outcomes in patients with CD19+ hematologic malignancies.
Autologous stem cell transplantation in T-cell/histiocyte-rich large B-cell lymphoma: EBMT Lymphoma Working Party study
Authors: Renders Simon , Ngoya Maud , Finel Herve , Rubio Marie-Thérèse , Townsend William , Schroers Roland , Novak Urban , Schaap Nicolaas , Aljurf Mahmoud , Helbig Grzegorz , Collin Matthew , Kobbe Guido , Huynh Anne , Pérez-Simón José Antonio , Bloor Adrian , Ghesquieres Hervé , Sureda Anna , Schmitz Norbert , Glass Bertram , Dreger Peter
Published: August 2024

Although broadly used, consolidative autologous hematopoietic stem cell transplantation (auto-HCT) for relapsed/refractory (R/R) T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) has never been specifically investigated. Here, we have analyzed outcomes of auto-HCT for THRLBCL compared with diffuse large cell B-cell lymphoma not otherwise specified (DLBCL). Eligible for this retrospective registry study were adult patients with R/R THRLBCL and DLBCL, respectively, who underwent a first auto-HCT in a salvage-sensitive disease status as assessed by positron emission tomography–computed tomography between 2016 and 2021 and were registered with the European Society for Blood and Marrow Transplantation database. The primary end point was progression-free survival (PFS) 2 years after transplantation. A total of 201 patients with THRLBCL and 5543 with DLBCL were included. There were no significant differences in terms of disease status at HCT, pretreatment lines, and interval from diagnosis to transplant between the cohorts, but patients with THRLBCL were significantly younger, contained a higher proportion of men, and had a better performance status. Compared with DLBCL, THRLBCL was associated with significantly better 2-year PFS (78% vs 59%; P < .001) and overall survival (OS, 81% vs 74%; P = .02) because of a significantly lower 2-year relapse incidence (16% vs 35%; P < .001). On multivariate analysis, favorable relapse risk (hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.31-0.7) and PFS (HR, 0.58; 95% CI, 0.41-0.82) of patients with THRLBCL remained significant, whereas OS benefits (HR, 0.78; 95% CI, 0.54-1.12) did not. These results were validated in a propensity score–matched analysis. These data prove auto-HCT as an effective treatment option for salvage-sensitive R/R THRLBCL.
Magrolimab plus rituximab in relapsed/refractory indolent non-Hodgkin lymphoma: 3-year follow-up of a phase 1/2 trial
Authors: Mehta Amitkumar , Popplewell Leslie , Collins Graham P. , Smith Sonali M. , Flinn Ian W. , Bartlett Nancy L. , Ghosh Nilanjan , Hacohen-Kleiman Gal , Huo Yanan , Su-Feher Linda , Renard Camille , Advani Ranjana , Roschewski Mark
Published: August 2024

Relapsed/refractory (R/R) indolent non-Hodgkin lymphoma (iNHL) is generally considered incurable with current treatment options. Previous phase 1b/2 results showed combining magrolimab (anti–cluster-of-differentiation [CD] 47 antibody) with the anti-CD20 antibody rituximab (M+R) has antitumor activity against R/R iNHL. We report 3-year follow-up data from this phase 1b/2 study assessing long-term safety and efficacy of M+R in R/R iNHL. After magrolimab priming, 4 patient groups in phase 1b M+R received 10 to 45-mg/kg magrolimab doses with 375 mg/m2 rituximab. Phase 2 explored 30 and 45 mg/kg magrolimab. Primary end points were treatment-emergent adverse events (TEAEs) and objective response rate (ORR). Secondary end points included duration of response (DOR), progression-free survival (PFS), and overall survival (OS). Exploratory analysis included circulating tumor DNA, biomarkers of magrolimab tumor penetration, and drug target expression assessments. Of 46 patients treated in phase 1b/2, 42 had follicular lymphoma and 4 had marginal zone lymphoma. All patients experienced ≥1 any-grade TEAE, and 44 reported ≥1 treatment-related TEAE. No additional toxicities were reported during long-term follow-up, and there were no treatment-related deaths. Median follow-up was 36.7 (range, 1.2-62.3) months. The ORR was 52.2%, with 30.4% achieving a complete response. The median DOR was 15.9 months, and median time-to-response was 1.8 months. Median PFS and OS were 7.4 (95% confidence interval, 4.8-13.0) months and not reached, respectively. These results demonstrate the long-term safety and efficacy of M+R in patients with iNHL and support further exploration of CD47-based treatment combinations. This trial was registered at www.ClinicalTrials.gov as #NCT02953509.
Evaluation of prognostic factors in patients with high-risk classical Hodgkin lymphoma undergoing autologous transplantation
Authors: Epperla Narendranath , Huang Ying , Cashen Amanda F. , Vaughn John L. , Hanel Walter , Badar Talha , Barta Stefan K. , Caimi Paolo F. , Sethi Tarsheen K. , Reddy Nishitha , Karmali Reem , Bello Celeste , Chavez Julio C. , Kothari Shalin K. , Hernandez-Ilizaliturri Francisco J. , Svoboda Jakub , Lansigan Frederick , Glenn Martha J. , Cohen Jonathon B. , Sorge Caryn , Christian Beth , Herrera Alex F. , Hamadani Mehdi , Costa Luciano J. , Xavier Ana C.
Published: August 2024

There are limited data assessing the risk scores for primary treatment failure (PTF) in patients with classical Hodgkin lymphoma (cHL; PTF-cHL) undergoing autologous hematopoietic cell transplantation (auto-HCT). ECLIPSE (Evaluation of Classical Hodgkin Lymphoma patients wIth Primary treatment failure and analySis of outcomEs) is a multicenter retrospective cohort of patients with PTF-cHL (aged ≥15 years) diagnosed on or after 1 January 2005, at 15 US medical centers. PTF was defined as 1 of the following patterns of failure: (1) progressive disease by imaging during or within 6 weeks of completion of frontline chemotherapy (primary progression [PP]); (2) partial response (PR) or stable disease (SD) by imaging after completion of frontline treatment (PR/SD); (3) progression of disease by imaging (and confirmed by biopsy) within 12 months of frontline therapy completion after prior documentation of complete response (CR; early relapse [ER]). A total of 478 patients were included in the analysis. Among these, 217 (45%) were PP, 86 (18%) were PR/SD, and 175 (37%) were ER. The 6-month and 1-year cumulative incidence of nonrelapse mortality after auto-HCT were 0.9% and 1.1%, respectively. The median progression-free survival (PFS) and overall survival (OS) after auto-HCT were 4.33 and 10.09 years, respectively. Although those not in CR at the time of auto-HCT were associated with inferior PFS and OS, advanced age and diagnosis before 2011 were associated with inferior OS. This study showcases the safety and long-term efficacy of auto-HCT, even in patients with high-risk disease who are traditionally considered chemotherapy refractory, and will serve as a benchmark for the ongoing transplant vs no transplant trials.
Identifying exercise and cognitive intervention parameters to optimize executive function in older adults with mild cognitive impairment and dementia: a systematic review and meta-analyses of randomized controlled trials
Authors: Chen Wenxin , Siew-Pin Jessie Leuk , Wu Yuhang , Huang Ning , Teo Wei-Peng
Published: August 2024

Physical exercise is recognized for its beneficial effects on brain health and executive function, particularly through the careful manipulation of key exercise parameters, including type, intensity, and duration. The aim of this systematic review and meta-analysis was to delineate the optimal types, intensities, and durations of exercise that improve cognitive functions in older adults with mild cognitive impairment (MCI) or dementia. A comprehensive search was conducted in Scopus, Web of Science, and PubMed from their inception until December 2023. The methodological quality and publication bias of the included studies were assessed using the PEDro scale and Egger’s regression test, respectively. Separate meta-analyses were performed to assess the overall impact of exercise on cognitive assessments and to explore the effects of different exercise types (i.e., aerobic, resistance, dual-task, mind-body, and multi-component exercises) and intensities (i.e., low, moderate, and high) on executive function. Results were presented as standardized mean differences (SMD) and 95% confidence intervals (95% CI). A meta-regression analysis was conducted to examine the correlation between exercise duration and mean effects. In total, 15,087 articles were retrieved from three databases, of which 35 studies were included in our final analyses. The results indicated high overall methodological quality (PEDro score = 8) but a potential for publication bias (t = 2.08, p = 0.045). Meta-analyses revealed that all types of exercise (SMD = 0.691, CI [0.498 to 0.885], p < 0.001) and intensities (SMD = 0.694, CI [0.485 to 0.903], p < 0.001) show significant effects favoring exercise. Notably, dual-task exercises (SMD = 1.136, CI [0.236 to 2.035], p < 0.001) and moderate-intensity exercises (SMD = 0.876, CI [0.533 to 1.219], p < 0.001) exhibited the greatest effect. No significant correlation was observed between exercise duration and SMD (R² = 0.038, p = 0.313). Overall, our meta-analyses support the role of physical exercise in enhancing executive function in older adults with MCI or dementia. It is essential to carefully tailor exercise parameters, particularly type and intensity, to meet the specific needs of older adults with MCI or dementia. Such customization is crucial for optimizing executive function outcomes and improving overall brain health.
Adaptation in landlocked Atlantic salmon links genetics in wild and farmed salmon to smoltification
Authors: R Cairnduff , E Kjærner-Semb , F Ayllon , M Solberg , E Andersson , C.R. Primmer , W Perry , K.A Glover , A Wargelius
Published: August 2024

Increased knowledge of heritable traits in Atlantic Salmon (Salmo salar) is important to overcome bottlenecks in salmonid aquaculture. Atlantic salmonid populations, both landlocked and anadromous, represent an interesting model to gain insight into anadromy related traits, most notably, the probability to smoltify. While a previous study has identified several genomic regions diverging between anadromous and landlocked populations across the species range, the present study explores these data further with the aim to uncover if some of these genomic regions are linked to beneficial genetic traits associated with smoltification. In this study 17 of these loci were monitored in 669 anadromous salmon originating from 36 full-sibling families that had been reared under common garden conditions. The Smolt Index was calculated, using multiple visual markers, and provided a means of assessing smoltification stage. One SNP, located in Ssa04, showed a significant association with probability to smoltify, where individuals homozygous for the landlocked variant (LL) displayed a decrease in probability of smoltifying after one winter when compared with the homozygous for the anadromous variant (AA). This effect was independent of individual fish size. A separate common garden study comprising 200 individuals from either anadromous or landlocked strains showed that expression levels of ncor1, a thyroid mediator hormone located on the same chromosomal region (Ssa04), were significantly reduced in landlocked individuals post smoltification but remained constant in their anadromous counterparts. This study therefore suggests that while size is still the most important trigger for the induction of smoltification, there may also be an additional genetic component or trigger that has been ‘lost’ during the years deprived of SW transfer. In conclusion, the LL genotype identified here could potentially be used by the industry to delay smoltification and may also represent one of the first clues to the genetic regulation of smoltification in Atlantic salmon.
The interplay between social environment and opportunities for physical activity within the built environment: a scoping review
Authors: Høyer-Kruse Jens , Schmidt Eva Berthelsen , Hansen Anne Faber , Pedersen Marlene Rosager Lund
Published: August 2024

Background

The association between social and built environments plays a crucial role in influencing physical activity levels. However, a thorough understanding of their combined impact remains unclear. This scoping review seeks to clarify the interplay between social environments and opportunities for physical activity within different built environments, with a particular focus on the implications of socioeconomic status and urban planning on physical activity participation.

Methods

We conducted a systematic literature search across several databases to identify studies exploring the associations between social factors, built environment characteristics, and physical activity levels. The inclusion criteria were studies published in English between 2000 and 2022, encompassing urban, suburban, and rural contexts. Thematic analysis was employed to categorise studies based on the specific aspects of the built environment they investigated (walking infrastructure, cycling infrastructure, parks and open spaces, and sports facilities) and the social determinants they examined.

Results

A total of 72 studies were included in the review, illustrating a multifaceted relationship between access to physical activity opportunities and social determinants such as socioeconomic status, community engagement, and urban design. The findings highlight the significant role of socioeconomic factors and the quality of PA infrastructure in promoting or hindering PA across communities. Effective urban planning was identified as crucial in providing expanded physical activity opportunities, notably through more pedestrian-friendly environments, comprehensive cycling infrastructure, and accessible green spaces and sports facilities.

Conclusions

This review emphasises the significant impact of socioeconomic status and urban planning on access to physical activity opportunities. This underscores the necessity for urban planning policies to adopt an inclusive approach, considering the varied needs of different population groups to ensure equitable access to physical activity resources. Such strategies are crucial for public health initiatives aimed at enhancing physical activity levels across diverse community sectors, offering a potential avenue to alleviate health disparities associated with inactivity.
Cytotoxicity and cell migration evaluation of a strontium silicate-based root canal sealer on stem cells from rat apical papilla: an in vitro study
Authors: Zhou Guanglei , Zhao Yu , Cai Liangjing , Liu Liwei , Li Xu , Sun Lu , Deng Jiayin
Published: August 2024

Background

Calcium silicate-based bioceramics have been applied in endodontics as advantageous materials for years, many chemical components and new synthesizing methods were used to improve the base formulation of the materials for positively affecting the sealers properties. Recently, a novel biomaterial formulation, grounded in strontium silicate, has been introduced to the market, offering potential advancements in the field.

Objective

To comparatively analyze the cytotoxicity and cell migration effects of a novel strontium silicate-based bioceramic material (CRoot SP) and those of calcium silicate-based (iRoot SP) and epoxide amine resin (AH Plus) sealers on stem cells derived from rat apical papilla(rSCAPs).

Methods

rSCAPs were isolated and characterized in vitro and subsequently cultured in the presence of various concentrations of CRoot SP, iRoot SP and AH Plus extracts. Cytotoxicity was assessed by CCK-8 assay, and cell-migration capacity was assessed by using wound healing assays .

Results

No significant differences in cell viability were observed in the 0.02 mg/mL and 0.2 mg/mL sealer groups. The cell viability of CRoot SP was consistently greater than that of iRoot SP at concentrations of 5 mg/mL and 10 mg/mL across all time points. Maximum cytotoxic effect was noted on day 5 with 10 mg/mL AH Plus.The scratch was partly healed by cell migration in all groups at 24 h, and the 0.02 mg/mL, and 0.2 mg/mL CRoot SP exerted beneficial effects on rSCAPs migration.

Conclusions

CRoot SP exhibited less cytotoxic than the iRoot SP and AH Plus extracts after setting. A lower concentration of CRoot SP thus promotes the cell migration capacity of rSCAPs, and it may achieve better tissue repair during root canal treatment.
Network pharmacology-based mechanism analysis of dauricine on the alleviating Aβ-induced neurotoxicity in Caenorhabditis elegans
Authors: Zhang Ranran , Huang Xiaoyan , Zhou Chunling , Zhang Qian , Jia Dongsheng , Xie Xiaoliang , Zhang Ju
Published: August 2024

Background

Dauricine (DAU), a benzyl tetrahydroisoquinoline alkaloid isolated from the root of Menispermum dauricum DC, exhibits promising anti-Alzheimer’s disease (AD) effects, but its underlying mechanisms remain inadequately investigated. This paper aims to identify potential targets and molecular mechanisms of DAU in AD treatment.

Methods

Network pharmacology and molecular docking simulation method were used to screen and focus core targets. Various transgenic Caenorhabditis elegans models were chosen to validate the anti-AD efficacy and mechanism of DAU.

Results

There are 66 potential DAU-AD target intersections identified from 100 DAU and 3036 AD-related targets. Subsequent protein-protein interaction (PPI) network analysis identified 16 core targets of DAU for anti-AD. PIK3CA, AKT1 and mTOR were predicted to be the central targets with the best connectivity through the analysis of “compound-target-biological process-pathway network”. Molecular docking revealed strong binding affinities between DAU and PIK3CA, AKT1, and mTOR. In vivo experiments demonstrated that DAU effectively reduced paralysis in AD nematodes caused by Aβ aggregation toxicity, downregulated expression of PIK3CA, AKT1, and mTOR homologues (age-1, akt-1, let-363), and upregulated expression of autophagy genes and the marker protein LGG-1. Simultaneously, DAU increased lysosomal content and enhanced degradation of the autophagy-related substrate protein P62. Thioflavin T（Th-T）staining experiment revealed that DAU decreased Aβ accumulation in AD nematodes. Further experiments also confirmed DAU’s protein scavenging activity in polyglutamine (polyQ) aggregation nematodes.

Conclusion

Collectively, the mechanism of DAU against AD may be related to the activation of the autophagy-lysosomal protein clearance pathway, which contributes to the decrease of Aβ aggregation and the restoration of protein homeostasis.
Comparison of three rapid diagnostic tests for Plasmodium falciparum diagnosis in Ghana
Authors: Kayode Tolulope Adeyemi , Addo Agyapong Kofi , Addison Thomas Kwame , Tweneboah Austine , Afriyie Stephen Opoku , Abbas Dawood Ackom , Seth Ayesha , Badu-Tawiah Abraham K. , Badu Kingsley , Koepfli Cristian
Published: August 2024

Background

Accurate diagnosis and timely treatment are crucial in combating malaria.

Methods

A total of 449 samples were screened for Plasmodium falciparum infection by expert microscopy, qPCR, and three RDTs, namely Rapigen Biocredit Malaria Ag Pf (detecting HRP2 and pLDH on separate bands), Abbott NxTek Eliminate Malaria Ag Pf (detecting HRP2), and SD Bioline Malaria Ag Pf (detecting HRP2). hrp2/3 deletion typing was done by digital PCR.

Results

45.7% (205/449) individuals tested positive by qPCR for P. falciparum with a mean parasite density of 12.5 parasites/μL. Using qPCR as reference, the sensitivity of microscopy was 28.3% (58/205), the Biocredit RDT was 52.2% (107/205), the NxTek RDT was 49.3% (101/205), and the Bioline RDT was 39.5% (81/205). When only samples with densities > 20 parasites/μL were included (n = 89), sensitivity of 62.9% (56/89) by microscopy, 88.8% (79/89) by Biocredit, 88.8% (79/89) by NxTek, and 78.7% (70/89) by Bioline were obtained. All three RDTs demonstrated specificities > 95%. The limits of detection (95% probability that a sample tested positive) was 4393 parasites/μL (microscopy), 56 parasites/μL (Biocredit, considering either HRP2 or pLDH), 84 parasites/μL (NxTek), and 331 parasites/μL (Bioline). None of the three qPCR-confirmed P. falciparum positive samples, identified solely through the pLDH target, or eight samples negative for all RDTs but qPCR-positive at densities > 20 parasites/µL carried hrp2/3 deletions.

Conclusion

The Biocredit and NxTek RDTs demonstrated comparable diagnostic efficacies. All three RDTs performed better than microscopy.
Syringe services program staff and participant perspectives on changing drug consumption behaviors in response to xylazine adulteration
Authors: Eger William H. , Plesons Marina , Bartholomew Tyler S. , Bazzi Angela R. , Hauschild Maia H. , McElrath Corbin C. , Owens Cyrus , Forrest David W. , Tookes Hansel E. , Crable Erika L.
Published: August 2024

Background

Xylazine is an increasingly common adulterant in the North American unregulated drug supply that is associated with adverse health outcomes (e.g., skin infections, overdose). However, there are significant knowledge gaps regarding how xylazine was initially identified and how syringe services program (SSP) staff and clients (people who use drugs) responded to its emergence.

Methods

From June–July 2023, we conducted qualitative interviews with medical (e.g., clinicians) and frontline SSP staff (e.g., outreach workers) and adult clients with a history of injection drug use at a Miami-based SSP. Inductive memos identified emergent codes; thematic analysis involving team consensus established final themes.

Results

From interviews with SSP staff (n = 8) and clients (n = 17), xylazine emergence was identified at different times, in various ways. Initially, during summer 2022, clients identified a “tranquilizer-like substance” that worsened sedation and withdrawal and caused wounds. SSP medical staff later identified this adulterant as xylazine by treating new medical cases and through diverse information-sharing networks that included professional societies and news sources; however, frontline SSP staff and clients needed additional educational resources about xylazine and its side effects. With limited guidance on how to reduce harm from xylazine, SSP clients altered their drug consumption routes, reduced drug use, and relied on peers’ experiences with the drug supply to protect themselves. Some individuals also reported preferring xylazine-adulterated opioids and increasing their drug use, including the use of stimulants to avoid over sedation.

Conclusions

Xylazine’s emergence characterizes the current era of unprecedented shifts in the unregulated drug supply. We found that xylazine spurred important behavioral changes among people who use drugs (e.g., transitioning from injecting to smoking). Incorporating these experiences into early drug warning surveillance systems and scaling up drug-checking services and safer smoking supply distribution could help mitigate significant health harms caused by xylazine and other emergent adulterants.
Pilot study of using transcranial temporal interfering theta-burst stimulation for modulating motor excitability in rat
Authors: Wu Chun-Wei , Lin Bor-Shing , Zhang Zhao , Hsieh Tsung-Hsun , Liou Jian-Chiun , Lo Wei-Lun , Li Yu-Ting , Chiu Shao-Chu , Peng Chih-Wei
Published: August 2024

Transcranial temporal interference stimulation (tTIS) is a promising brain stimulation method that can target deep brain regions by delivering an interfering current from surface electrodes. Most instances of tTIS stimulate the brain with a single-frequency sinusoidal waveform generated by wave interference. Theta burst stimulation is an effective stimulation scheme that can modulate neuroplasticity by generating long-term potentiation- or depression-like effects. To broaden tTIS application, we developed a theta burst protocol using tTIS technique to modulate neuroplasticity in rats. Two cannula electrodes were unilaterally implanted into the intact skull over the primary motor cortex. Electrical field of temporal interference envelopes generated by tTIS through cannula electrodes were recorded from primary motor cortex. Theta burst schemes were characterized, and motor activation induced by the stimulation was also evaluated simultaneously by observing electromyographic signals from the corresponding brachioradialis muscle. After validating the stimulation scheme, we further tested the modulatory effects of theta burst stimulation delivered by tTIS and by conventional transcranial electrical stimulation on primary motor cortex excitability. Changes in the amplitude of motor evoked potentials, elicited when the primary motor cortex was activated by electrical pulses, were measured before and after theta burst stimulation by both techniques. Significant potentiation and suppression were found at 15 to 30 min after the intermittent and continuous theta burst stimulation delivered using tTIS, respectively. However, comparing to theta burst stimulations delivered using conventional form of transcranial electrical stimulation, using tTIS expressed no significant difference in modulating motor evoked potential amplitudes. Sham treatment from both methods had no effect on changing the motor evoked potential amplitude. The present study demonstrated the feasibility of using tTIS to achieve a theta burst stimulation scheme for motor cortical neuromodulation. These findings also indicated the future potential of using tTIS to carry out theta burst stimulation protocols in deep-brain networks for modulating neuroplasticity.
Direct aortic TAVI via anterior right mini-thoracotomy using 32 mm myval for pure aortic regurgitation
Authors: Aljanadi Firas , McNeilly Graham , Manoharan Ganesh , McNiece Andrew , Jeganathan Reuben
Published: August 2024

Background

Aortic regurgitation with dilated annulus presents a technical challenge for conventional transcatheter aortic valve implantation (TAVI) procedures.

Case presentation

We report a case of an 84-year-old frail patient with a history of breathlessness found to have severe aortic regurgitation and moderately impaired left ventricular systolic function. The patient underwent a successful TAVI procedure using the XL-Myval 32 mm transcatheter heart valve (THV) via an anterior right mini-thoracotomy with a direct aortic approach. The patient recovered well post-operatively with good hemodynamic resolution.

Conclusions

This first in human case highlights the efficacy and potential of applying innovative approaches, such as the new sizes of Myval THV and direct aortic access via anterior right mini thoracotomy, in addressing challenging anatomical variations in TAVI procedures with good outcome.
Human errors in emergency medical services: a qualitative analysis of contributing factors
Authors: Poranen Anna , Kouvonen Anne , Nordquist Hilla
Published: August 2024

Background

The dynamic and challenging work environment of the prehospital emergency care settings creates many challenges for paramedics. Previous studies have examined adverse events and patient safety activities, but studies focusing on paramedics’ perspectives of factors contributing to human error are lacking. In this study, we investigated paramedics’ opinions of the factors contributing to human errors.

Method

Data was collected through semi-structured individual interviews (n = 15) with paramedics and emergency medical field supervisors in Finland. The data was analyzed using inductive content analysis. Consolidated criteria for reporting qualitative research were used.

Results

Contributing factors to human errors were divided into three main categories. The first main category, Changing work environment, consisted of two generic categories: The nature of the work and Factors linked to missions. The second main category, Organization of work, was divided into three generic categories: Inadequate care guidelines, Interaction challenges and Challenges related to technological systems. The third main category, Paramedics themselves, consisted of four generic categories: Issues that complicate cognitive processing, Individual strains and needs, Attitude problems and Impact of work experience.

Conclusion

Various factors contributing to human errors in emergency medical services (EMS) settings were identified. Although many of them were related to individual factors or to the paramedics themselves, system-level factors were also found to affect paramedics’ work and may therefore negatively impact patient safety. The findings provide insights for organizations to use this knowledge proactively to develop their procedures and to improve patient safety.
The influence of environmental factors related to Juvenile Dermatomyositis (JDM), its course and refractoriness to treatment
Authors: Valões Clarissa C.M. , Arabi Tamima M. , Braga Alfésio L.F. , Campos Lúcia M.A. , Aikawa Nádia E. , Kozu Kátia T. , Silva Clovis A. , Farhat Sylvia C.L. , Elias Adriana M.
Published: August 2024

Objective

To evaluate the influence of environmental factors and prematurity relating to juvenile dermatomyositis (JDM), its course and refractoriness to treatment.

Methods

A case-control study with 35 patients followed up at a tertiary hospital and 124 healthy controls, all residents of São Paulo. Patients were classified according to monocyclic, polycyclic or chronic disease courses and refractoriness to treatment. The daily concentrations of pollutants (inhalable particulate matter-PM10, sulfur dioxide-SO2, nitrogen dioxide-NO2, ozone-O3 and carbon monoxide-CO) were provided by the Environmental Company of São Paulo. Data from the population were obtained through a questionnaire.

Results

Fifteen patients had monocyclic courses, and 19 polycyclic/chronic courses. Eighteen patients were refractory to treatment. Maternal occupational exposure to inhalable agents (OR = 17.88; IC 95% 2.15–148.16, p = 0.01) and exposure to O3 in the fifth year of life (third tertile > 86.28µg/m3; OR = 6.53, IC95% 1.60–26.77, p = 0.01) were risk factors for JDM in the multivariate logistic regression model. The presence of a factory/quarry at a distance farther than 200 meters from daycare/school (OR = 0.22; IC 95% 0.06–0.77; p = 0.02) was a protective factor in the same analysis. Prematurity, exposure to air pollutants/cigarette smoke/sources of inhalable pollutants in the mother’s places of residence and work during the gestational period were not associated with JDM. Prematurity, maternal exposure to occupational pollutants during pregnancy as well as patient’s exposure to ground-level pollutants up to the fifth year of life were not associated with disease course and treatment refractoriness.

Conclusion

Risk factors for JDM were maternal occupational exposure and exposure to O3 in the fifth year of life.
Determining the accuracy of the leukocyte esterase reagent strip test in the rapid diagnosis of adult septic arthritis
Authors: Mirghaderi Peyman , Pahlevan-Fallahy Mohammad-Taha , Mahmoudi Jamil , Mortazavi S.M. Javad
Published: August 2024

Backgrounds

Septic arthritis is a dangerous disease that occurs when microorganisms enter synovial fluid. It needs fast and accurate management; otherwise, it can harm the patient’s life. Currently, the tests measure WBC and PMN in SF, so we hypothesized to use a proxy that is easier and faster to measure. Leukocyte esterase is an enzyme secreted by neutrophils that can be found in the synovial fluid of SA patients. In this study, we tried to investigate the sensitivity and specificity of leukocyte esterase in diagnosing septic arthritis.

Methods

We obtained synovial fluid samples from forty-six patients suspected of having septic arthritis and fifty-eight healthy individuals and measured the WBCs, ESR, CRP, PMN, glucose, and protein of SF in 2021. We also used the leukocyte esterase dipstick test to investigate the level of LE in synovial fluid for one minute.

Results

Based on clinical and paraclinical criteria, sixteen out of the forty-six patients were diagnosed with SA. When (++) was considered positive, the sensitivity and specificity of the LE dipstick test for the diagnosis of SA were 93.7% (95% CI: 81.8–100%) and 60% (95% CI: 42.4–77.5%, P = 0.000), respectively. When both (+) and (++) were considered positive, they were 100% and 43.3% (95% CI: 25.6–61.0% P = 0.000), respectively. All the patients in the control group had negative cultures and LE test readings (specificity = 100%).

Conclusion

The LE dipstick test can be a valuable diagnostic tool in the initial diagnosis of SA since it is affordable, fast, and reliable.
Neogene shale-detached extension and contraction linked system in the Akal Fold and Thrust Belt, Southeast Mexico
Authors: Portillo Pineda Rodrigo , Cerca Mariano
Published: August 2024

Structures related to shale mobility represent an important challenge for proper interpretation in seismic data sets. The large number of seismic sections obtained in recent times of the Akal Fold and Thrust Belt (AFTB) makes this province a natural laboratory for studying shale-related structural styles. The interpretation of two orthogonal 2D seismic sections reveals the geometry of a gravity-driven extension-contraction structural system that developed in the central portion of the AFTB during the Late Miocene to the Early Pliocene. The gravity-driven system was triggered by increasing the sedimentary load in the Miocene and developed a set of listric faults and related growth strata. The contracting structures are the in-sequence fold thrust that evolved from shale-cored detachment anticlines. An Oligocene sequence of soft, weak shale with alternating, rigid layers of sandstone and limestone and a low-resistivity signature acts as the detachment of the gravity-driven system. The progressive sequential restoration of a structural cross section provides more information about the progression of the gravity-driven system. We suggest that mobility started when the Oligocene shale reached a critical condition at >2–3 km burial depth. The coeval northeastward regional Chiapanecan shortening interferes with the last stage of the shale detachment (the Early Pliocene) in the study area and masks the previous interpretation of the gravity-driven system.
Deprivation of liberty in hospital: the MHA versus DoLS dilemma
Authors: Cave Jeremy , Ruck Keene Alex , Lowe Matthew
Published: August 2024

When admitting patients to hospital and treating them, psychiatrists and other health professionals may need to deprive them of their liberty. Where this occurs, professionals will need to work within a statutory framework to practice legally and protect their patients’ right to liberty under Article 5 of the European Convention on Human Rights. Within England and Wales, some clinical scenarios will require a choice to be made between the Mental Health Act 1983 (MHA) and the Mental Capacity Act 2005 (MCA) and its Deprivation of Liberty Safeguards (DoLS). This choice can be complex, is often overlooked and frequently misunderstood in clinical practice. Deciding between the two frameworks must be done on a case-specific basis. With the use of code of practice guidelines, case law and an unfolding clinical scenario we aim in this article to support clinicians in taking a clear-sighted approach to the dilemma and the factors to consider when deciding between the two regimes.
Understanding gait alterations: trunk flexion and its effects on walking neuromechanics
Authors: Núñez-Lisboa M. , Echeverría K. , Willems P. A. , Ivanenko Y. , Lacquaniti F. , Dewolf A. H.
Published: August 2024

Evolutionary and functional adaptations of morphology and postural tone of the spine and trunk are intrinsically shaped by the field of gravity in which humans move. Gravity also significantly impacts the timing and levels of neuromuscular activation, particularly in foot-support interactions. During step-to-step transitions, the centre of mass velocity must be redirected from downwards to upwards. When walking upright, this redirection is initiated by the trailing leg, propelling the body forward and upward before foot contact of the leading leg, defined as an anticipated transition. In this study, we investigated the neuromechanical adjustments when walking with a bent posture. Twenty adults walked on an instrumented treadmill at 4 km h−1 under normal (upright) conditions and with varying degrees of anterior trunk flexion (10, 20, 30 and 40 deg). We recorded lower-limb kinematics, ground reaction forces under each foot, and the electromyography activity of five lower-limb muscles. Our findings indicate that with increasing trunk flexion, there is a lack of these anticipatory step-to-step transitions, and the leading limb performs the redirection after the ground collision. Surprisingly, attenuating distal extensor muscle activity at the end of stance is one of the main impacts of trunk flexion. Our observations may help us to understand the physiological mechanisms and biomechanical regulations underlying our tendency towards an upright posture, as well as possible motor control disturbances in some diseases associated with trunk orientation problems.
Blending rebetiko with blues, jazz, and rock
Authors: Πολυζωίδης Αθανάσιος
Published: August 2024

Αυτή η έρευνα εξερευνά τα κοινά χαρακτηριστικά προσέγγισης και σύλληψης μεταξύ δύο ξεχωριστών μουσικών ειδών – του Ελληνικού ρεμπέτικου και της Αφροαμερικανικής μπλουζ – με στόχο τη σύλληψη μιας δημιουργικής μεθόδου για τη δημιουργία διαπολιτισμικής μουσικής και στίχων. Και οι δύο αυτές παραδόσεις εμφανίστηκαν στα τέλη του δεκάτου ενάτου αιώνα μεταξύ των περιθωριοποιημένων κοινοτήτων: η μπλουζ στο Βαθύ Νότο των ΗΠΑ· και το ρεμπέτικο σε ελληνικά λιμάνια. Η μελέτη καθιερώνει μία νέα γλώσσα, μία παλέτα ρυθμών, και ενορχήστρωση εντοπίζοντας εργαλεία από τη μίξη του ρεμπέτικου με την μπλουζ, καθώς και τις τζαζ και ροκ, οδηγώντας σε πειραματικές μουσικές φόρμες μεταξύ των ειδών, αναμειγνύοντας τες σε νέα πρωτότυπα τραγούδια. Η τζαζ εξελίχθηκε από την μπλουζ μέσω της προσαρμογής της τροπικότητας, των πολυρυθμιών, των πολύπλοκων αρμονικών δομών της τζαζ, και άλλων μελωδικών στοιχείων από τη Δυτική σύγχρονη μουσική, παρόμοια με το πολυποίκιλο λεξιλόγιο τροπικών κλιμάκων και ρυθμών του ρεμπέτικου. Χρησιμοποιώντας μία αυτοεθνολογική μεθοδολογία, αυτή η έρευνα καταγράφει τις πειραματικές πτυχές της δημιουργικής πράξης, υποστηριζόμενη από μεταγραφή τραγουδιών, ανάλυση, συνεργασία με καλλιτέχνες, συνεντεύξεις και παρατήρηση. Στοιχεία καταξιωμένων μουσικών που αποπειράθηκαν να συνδυάσουν το ρεμπέτικο με την μπλουζ, ήτοι ο Παύλος Σιδηρόπουλος και ο Ζωρζ Πιλαλί, και η τεχνική ρεμπέτικης κιθάρας με τα δάχτυλα (τσιμπιτή), που ξέθαψε ο Δημήτρης Μυστακίδης, ενσωματώνονται στην συνθετική μου πράξη, όπως φαίνεται στο συνοδευτικό πορτφόλιο των δεκαοχτώ τραγουδιών. Οι ρεμπέτικοι τρόποι (δρόμοι) συλλέγονται, αντιπαραβάλλονται, και επαναπροσδιορίζονται από δεκαοκτώ πηγές. Τα τραγούδια συνδυάζουν τους ρεμπέτικους δρόμους με τις μπλουζ κλίμακες και τους τρόπους της τζαζ, εναλλασσόμενους χρόνους, χρησιμοποιώντας κοινά στιχουργικά θέματα εμπλουτισμένα με αργκό, και αντιπαραθέτοντας μουσικά όργανα που είναι τυπικά στο ρεμπέτικο, την μπλουζ και την τζαζ. Αντισυμβατικές τεχνικές τραγουδοποιΐας χρησιμοποιούνται κυρίως για τη διαμόρφωση φορμών, ρυθμικών δομών, και ενοργάνωσης με ανορθόδοξο παίξιμο. Στους ρόλους μου ως τραγουδοποιός, τραγουδιστής, πολυοργανίστας, ενορχηστρωτής, μηχανικός ήχου και παραγωγός, έχω αναπτύξει ένα μοντέλο για την ανάμειξη αυτών των ειδών. Η κριτική ερμηνεία εμβαθύνει στα υποκείμενα θεματικά στοιχεία, αναγνωρίζει τις διαφορετικές ποιότητες και τους περιορισμούς τους, και υφαίνει μια πλούσια ταπετσαρία συνδέσεων μέσα από αυτό το συνθετικό ταξίδι.
Επίδραση εισροών βιοεξανθρακωμάτων (biochar) στη δέσμευση του άνθρακα και σε φυσικές ιδιότητες δύο εδαφών διαφορετικής υφής
Authors: Κουιμτζή Μαρίνα
Published: August 2024

Η κλιματική αλλαγή και οι επιπτώσεις της στο φυσικό περιβάλλον είναι πλέον επιστημονικά αδιαμφισβήτητες. Οι αυξανόμενες περιβαλλοντικές ανησυχίες σχετικά με την ανθρωπογενή εκπομπή του CO2, την υπερθέρμανση του πλανήτη και τον ευτροφισμό των υδάτων καθιστούν αναγκαία την εύρεση νέων στρατηγικών για τον μετριασμό τους. Η αειφορική διαχείριση των εδαφικών πόρων και η βελτίωση της γονιμότητας των εδαφών αποτελούν κεντρικά ζητήματα, καθώς συνδέονται άμεσα με την παραγωγικότητα των καλλιεργειών και την περιβαλλοντική προστασία. Μία από τις επιλογές που έχει προσελκύσει το ενδιαφέρον της επιστημονικής κοινότητας είναι η αξιοποίηση βιοεξανθρακωμάτων (biochars), που προέρχονται από αγροτικά οργανικά υπολείμματα, η οποία αναδεικνύεται ως μια πολλά υποσχόμενη στρατηγική για τη βελτίωση της ποιότητας των εδαφών και τη δέσμευση του άνθρακα.Το biochar παράγεται μέσω της πυρόλυσης της βιομάζας υπό συνθήκες περιορισμένης παρουσίας ή πλήρους απουσίας οξυγόνου. Η διαδικασία αυτή δημιουργεί ένα προϊόν πλούσιο σε άνθρακα που μπορεί να παραμείνει στο έδαφος για εκατοντάδες χρόνια, συμβάλλοντας στη μακροχρόνια δέσμευση του άνθρακα. Επιπλέον, το biochar έχει τη δυνατότητα να βελτιώνει τις φυσικές, χημικές και μικροβιακές ιδιότητες του εδάφους, επηρεάζοντας θετικά την ποιότητα του. Στη παρούσα διδακτορική διατριβή έγινε προσθήκη σε ποσοστό 1% κ.β. ξηρών και εξανθρακωμένων οργανικών υπολειμμάτων (biochar) και διερευνήθηκε η επιδραση τους σε ορισμένες χημικές, μικροβιακές και φυσικές ιδιότητες δύο γεωργικών εδαφών διαφορετικής υφής κατά την διάρκεια 390 ημέρων επώασης. Χρησιμοποιήθηκε ξηρό υλικό και βιοεξανθρακώματα σε δύο θερμοκρασίες πυρόλυσης (250 και 500 0C) από δύο διαφορετικά αγροτικά οργανικά υπολείμματα: άχυρο σίτου και βίκο. Τα οργανικά υλικά, άχυρο και βίκος, επιλέχθηκαν λόγω του διαφορετικού λόγου C/N και της σημασίας τους στην ελληνική γεωργία και βιομηχανία. Τα αποτελέσματα της έρευνας έδειξαν ότι: •τα biochar υψηλής θερμοκρασίας πυρόλυσης έχουν μεγαλύτερη ανθεκτικότητα στην αποικοδόμηση και ο προστιθέμενος άνθρακας παραμένει δεσμευμένος στο έδαφος για μεγαλύτερο χρονικό διάστημα. •οι ενώσεις του οργανικού C που δεσμεύθηκε στο έδαφος δεν συνέβαλαν στη σταθερότητα της δομής στον ίδιο βαθμό που συμβάλουν οι οργανικές ενώσεις που προέρχονται από την αποικοδόμηση των μη πυρολυμένων υλικών •η προσθήκη 1% biochar στο έδαφος προκάλεσε μεταβολές κυρίως στην αρχή της επώασης στις περισσότερες από τις ιδιότητες που μελετήθηκαν. •η θερμοκρασία πυρόλυσης επηρεάζει το μέγεθος της επίδρασης (οι μεταβολές ήταν μεγαλύτερες με τη προσθήκη biochar χαμηλής θερμοκρασίας πυρόλυσης) •η υφή του εδάφους επηρεάζει το μέγεθος της επίδρασης (οι μεταβολές ήταν μεγαλύτερες και διήρκησαν περισσότερο στο αμμώδες έδαφος). Συνολικά, η προσθήκη biochar αποτελεί μια πολλά υποσχόμενη στρατηγική για τη βελτίωση της ποιότητας του εδάφους. Ωστόσο, θα πρέπει να λαμβάνονται υπόψιν, τόσο ο τύπος του εδάφους όσο και ο τύπος του προστιθέμενου οργανικού υλικού.