bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-windup design for supercavitating vehicle based on sliding mode control combined with RBF network
Authors: Zhao Xinhua , Chen Shangze , Wang Kang
Published: July 2024

During the longitudinal motion of a supercavitating vehicle, the stability control problem is complicated because of the nonlinear planing force on the tail part. The dynamic model of a supercavitating vehicle in longitude plane is nonlinear, simultaneously, the control instructions of a supercavitating vehicle may exceed the physical limits of an actuator. Therefore, designing a longitudinal stability control system for a supercavitating vehicle, not only the treatment of nonlinear planing force, but also the physical constraints of the actuator should be considered. For the longitudinal motion model of supercavitating vehicle, a cascade model is proposed, which decomposes the longitudinal motion of supercavitating vehicle into two subsystems. Sliding mode control based on RBF neural network compensation is adopted in the controller design process, and RBF neural network is exploited to approach the deviation caused by actuator saturation. The proposed control method can effectively compensate the performance degradation caused by control variable saturation, and has strong robustness.
Laparoscopic surgery for endometriosis of the round ligament: A case of a patient with right-sided inguinal pain
Authors: Rokhgireh Samaneh , MehdizadehKashi Abolfazl , Noroozi Shima Ghafourian , Aminzade Zahra , Derakhshan Roya
Published: July 2024

Round ligament endometriosis is a rare phenomenon reported in approximately 0.3% to 0.6% of endometriosis cases. Presurgical diagnosis is carried out for about 50% of the cases. The association of the right-sided inguinal hernia, nonspecific pain in the organs, and no history of surgery or labor make the diagnosis intricate. We report a case of endometriosis of the round ligament in a 39-year-old woman who complained of intense pain in the right groin during the menstrual period for about 4 years, with no complaints of bulging or change in the size of the mentioned area. The clinical suspicion of inguinal endometriosis, supported by sonography and magnetic resonance imaging, was confirmed by histological examination of the surgical specimen after laparoscopic surgery, which included the mass and the extraperitoneal segment of the round ligament. After surgery, the patient’s pain disappeared completely. The round ligament endometriosis or endometriosis of the inguinal region could be considered an important differential diagnosis in women of reproductive age without a history of surgery who presented with inguinal region pain during menstruation but no clear mass was palpable in the physical exam.
Design and development of a feedback system for automatic treadmill speed adaptation
Authors: Fruet Damiano , Zignoli Andrea , Modena Roberto , Pellegrini Barbara , Gastaldi Laura , Bortolan Lorenzo
Published: July 2024

Treadmills with automatic speed adjustment offer a unique advantage: they can mimic outdoor conditions for specific training or testing protocols. This versatility makes them highly applicable in both sports and rehabilitation settings. This study presents a novel framework based on a feedback control loop system, conceived to control a treadmill belt speed using a non-invasive and low-cost sensor (Microsoft Kinect) to detect the users’ position and avoid object obstruction issues. The speed of the treadmill belt is regulated according to the user’s speed, by means of a proportional-integrative-derivative (PID) controller and a parabolic gain function. By tuning the gain function parameters, the user can customize the response of the treadmill. Position data collected during exercise using the Microsoft Kinect sensor was compared with that collected with a stereophotogrammetric motion capture system, showing promising results in terms of accuracy in position assessment. The comparison highlighted a 0.9 degree of correlation between the two systems during the running and cross-country indoor skiing tests performed. In addition, upon considering the relationship between the differences and averages of the two measures, no systematic bias was identified. The system proved to be functional for running and cross-country skiing, and it can therefore re-create similar typical characteristics of outdoor environments (e.g., speed and slope) thanks to the non-invasive user’s position detection and the customizable gain function.
“Why Couldn’t We?”: Experiences of Adversity, Cultural Strengths and Support Among First, Second, and Third+ Generation Mexican-origin Youth in Los Angeles
Authors: Villamil Grest Carolina , Cederbaum Julie A.
Published: July 2024

Latino/a/Hispanic adversity and adaptation literature has focused on cultural, acculturative and immigration-related stressors. Cultural and social strengths, key Latino/a/Hispanic features, and their concurrence, remain qualitatively underexplored. To enhance intervention and prevention, research understanding experiences of Latino/a/Hispanic youth adaptation representing three generations is needed. Forty participants participated in semi-structured interviews detailing adversity, cultural strengths and support during their youth. Thematic analysis approach guided coding of transcripts. Three coders met regularly to discuss and resolve differences, identifying emergent themes. The sample included 24 females and 16 males ( Mage = 27.9) characterizing three generations (first n = 15; second n = 14; third+ n = 11). Three main themes emerged: (1) perceived adversity, described discrimination, and related adversities; (2) cultural adaptation, adjustment, and the shaping of bicultural identities; and (3) supportive and formative relationships buffering adversity. Themes illustrated adversity and cultural strengths within Latino/a/Hispanic protective relationships and contexts. Findings inform policies that support Latino/a/Hispanic youth and family engagement and intervention approaches.
Usage of Padlock Over-the-Scope-Clip in Difficult-to-Control Recurrent Gastrointestinal Bleeding Due to a Gastric Dieulafoy Lesion
Authors: Joyce John , Kumar Vishnu , Nasr Dayana , Aswath Ganesh , Khan Hafiz M. , John Savio
Published: July 2024

Dieulafoy’s lesions (DLs) are a rare cause of acute gastrointestinal bleeds (GIBs). Here we describe Over-the-Scope Clip Padlock System (OTSC-P) use to treat a gastric fundus DL with recurrent bleeding despite other interventions. The OTSC-P was created for full-thickness defect closure in the event of a perforation, but use has expanded to treatment of GIB. They consist of metal clips mounted on transparent caps, delivered via endoscope. Their size allows control of larger bleeding lesions, provides enhanced tissue stability and the firmer clip grasp reduces rebleeding or clip dislodgement.
Accessibility Score – Data analytics for the holistic assessment of urban mobility networks and the case of Braunschweig
Authors: Mumm Olaf , Murad Majd , Carlow Vanessa Miriam
Published: July 2024

The accessibility and quality of urban mobility networks (UMN) depend on a multitude of static and dynamic conditions for each individual. Promoting sustainable mobility, such as walking, requires a very specific assessment of UMN’s qualities given the specific needs of pedestrians. The objective of this research is to provide a new approach for the comprehensive, mode-specific understanding of a UMN as a base for good planning and decision making. With the Accessibility Score (AccessS), we propose an integrated, indicator-based, holistic geospatial framework for the quantified assessment of qualitative UMN attributes identified in an extensive literature review.
The role of hypertension in the relationship between leisure screen time, physical activity and migraine: a 2-sample Mendelian randomization study
Authors: Gan Quan , Song Enfeng , Zhang Lily , Zhou Yanjie , Wang Lintao , Shan Zhengming , Liang Jingjing , Fan Shanghua , Pan Songqing , Cao Kegang , Xiao Zheman
Published: July 2024

Background

The relationship between lifestyle and migraine is complex, as it remains uncertain which specific lifestyle factors play the most prominent role in the development of migraine, or which modifiable metabolic traits serve as mediators in establishing causality.

Methods

Independent genetic variants strongly associated with 20 lifestyle factors were selected as instrumental variables from corresponding genome-wide association studies (GWASs). Summary-level data for migraine were obtained from the FinnGen consortium (18,477 cases and 287,837 controls) as a discovery set and the GWAS meta-analysis data (26,052 cases and 487,214 controls) as a replication set. Estimates derived from the two datasets were combined using fixed-effects meta-analysis. Two-step univariable MR (UVMR) and multivariable Mendelian randomization (MVMR) analyses were conducted to evaluate 19 potential mediators of association and determine the proportions of these mediators.

Results

The combined effect of inverse variance weighted revealed that a one standard deviation (SD) increase in genetically predicted Leisure screen time (LST) was associated with a 27.7% increase (95% CI: 1.14–1.44) in migraine risk, while Moderate or/and vigorous physical activity (MVPA) was associated with a 26.9% decrease (95% CI: 0.61–0.87) in migraine risk. The results of the mediation analysis indicated that out of the 19 modifiable metabolic risk factors examined, hypertension explains 24.81% of the relationship between LST and the risk of experiencing migraine. Furthermore, hypertension and diastolic blood pressure (DBP) partially weaken the association between MVPA and migraines, mediating 4.86% and 4.66% respectively.

Conclusion

Our research findings indicated that both LST and MVPA in lifestyle have independent causal effects on migraine. Additionally, we have identified that hypertension and DBP play a mediating role in the causal pathway between these two factors and migraine.
Developing benzylisoquinoline alkaloid-enriched opium poppy via CRISPR-directed genome editing: A review
Authors: Aghaali Zahra , Naghavi Mohammad Reza
Published: July 2024

Among plant-derived secondary metabolites are benzylisoquinoline alkaloids (BIAs) that play a vital role in medicine. The most conspicuous BIAs frequently found in opium poppy are morphine, codeine, thebaine, papaverine, sanguinarine, and noscapine. BIAs have provided abundant clinically useful drugs used in the treatment of various diseases and ailments With an increasing demand for these herbal remedies, genetic improvement of poppy plants appears to be essential to live up to the expectations of the pharmaceutical industry. With the advent of clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated9 (Cas9), the field of metabolic engineering has undergone a paradigm shift in its approach due to its appealing attributes, such as the transgene-free editing capability, precision, selectivity, robustness, and versatility. The potentiality of the CRISPR system for manipulating metabolic pathways in opium poppy was demonstrated, but further investigations regarding the use of CRISPR in BIA pathway engineering should be undertaken to develop opium poppy into a bioreactor synthesizing BIAs at the industrial-scale levels. In this regard, the recruitment of RNA-guided genome editing for knocking out miRNAs, flower responsible genes, genes involved in competitive pathways, and base editing are described. The approaches presented here have never been suggested or applied in opium poppy so far.
PPGV: a comprehensive database of peach population genome variation
Authors: An Yanlin , Ban Qiuyan , Liu Li , Zhang Feng , Yu Shirui , Jing Tingting , Zhao Shiqi
Published: July 2024

Peach tree is one of the most important fruit trees in the world, and it has been cultivated for more than 7,500 years. In recent years, the genome and population resequencing of peach trees have been published continuously, which has effectively promoted the research of peach tree genetics and breeding. In order to promote the further mining and utilization of these data, we integrated and constructed a comprehensive peach genome and variation database (PPGV, http://peachtree.work/home). The PPGV contains 10 sets of published peach tree genome data, as well as genomic variation information for 1,378 peach tree samples (the resequencing data of 1,378 samples were aligned with the high-quality genomes of Lovell, CN14 and Chinesecling, respectively, for mutation detection). A variety of useful and flexible tools, such as BLAST, Gene ID Convert, KEGG/GO Enrichment, Primer Design and Gene function, were also specially designed for searching data and assisting in breeding.
Setting reasonable goals for kidney transplant referral among dialysis facilities
Authors: Harding Jessica L. , Dixon Meredith A. , Di Mengyu , Hogan Julien , Pastan Stephen O. , Patzer Rachel E.
Published: July 2024

Background

Determining whether a patient is eligible for kidney transplantation is complex. In this study, we estimate what proportion of patients with end-stage kidney disease (ESKD) might have been suitable candidates for kidney transplantation but were not referred.

Methods

We identified 43,952 people initiating dialysis for kidney failure between 2012 and 2017 in the states of Georgia, North Carolina, or South Carolina from the United States Renal Data System and linked to the Early-Steps to Transplant Access Registry to obtain data on referral and waitlisting up until December 2020. We identified ‘good transplant candidates’ as those who were waitlisted within 2-years of referral, among all patients referred within 1-year of dialysis initiation. Using propensity score cut-offs, logistic regression, and area under the curve (AUC), we then estimated the proportion of individuals who may have been good transplant candidates, but were not referred.

Results

Overall, 42.6% of incident dialysis patients were referred within one year and among them, 32.9% were waitlisted within 2 years of referral. Our model had reasonably good discrimination for identifying good transplant candidates with an AUC of 0.70 (95%CI 0.69–0.71), sensitivity of 0.68 and specificity of 0.61. Overall, 25% of individuals not referred for transplant may have been ‘good’ transplant candidates. Adding these patients to the existing 18,725 referred patients would increase the proportion of incident ESKD patients being referred within one year from 42.6% to 57.2% (a ~ 14.6% increase).

Conclusions

In this study, we show that a significant proportion of potentially good transplant candidates are not being referred for transplant. A ~ 14% increase in the proportion of patients being referred from dialysis facilities is both a meaningful and realistic goal and could lead to more qualified patients being referred and subsequently waitlisted for a lifesaving transplant.
Clinical features and treatment of apoplectic intratumoral hemorrhage of glioma
Authors: Zhou Jia-hua , Wang Chao , Yang Di , Wu Ying-xi , Feng Da-yun , Qin Huaizhou , Wang Ju-lei , Wei Ming-hao
Published: July 2024

Objective

The primary objective of this study was to explore the clinical characteristics of apoplectic intratumoral hemorrhage in gliomas and offer insights for improving the diagnosis and treatment of this disease.

Methods

We analyzed the clinical data of 35 patients with glioma and hemorrhage. There were eight cases of multiple cerebral lobe involvement, and 22 cases involved a single lobe. Twenty-one patients had a preoperative Glasgow Coma Scale (GCS) score of ≥ 9 and had a craniotomy with tumor resection and hematoma evacuation after undergoing preoperative preparation. A total of 14 patients with GCS < 9, including one with thalamic hemorrhage breaking into the ventricles and acute obstructive hydrocephalus, underwent craniotomy for tumor resection after external ventricular drainage (EVD). One patient had combined thrombocytopenia, which was surgically treated after platelet levels were normalized through transfusion. The remaining 12 patients received immediate intervention in the form of craniotomy hematoma evacuation and tumor resection.

Results

We performed subtotal resection on three tumors of thalamic origin and two tumors of corpus callosum origin, but we were able to successfully resect all the tumors in other locations that were gross total resection Pathology results showed that 71.43% of cases accounted for WHO-grade 4 tumors. Among the 21 patients with a GCS score of ≥ 9, two died perioperatively. Fourteen patients had a GCS score < 9, of which eight patients died perioperatively.

Conclusions

Patients with a preoperative GCS score ≥ 9 who underwent subemergency surgery and received aggressive treatment showed a reasonable prognosis. We found their long-term outcomes to be correlated with the pathology findings. On the other hand, patients with a preoperative GCS score < 9 required emergency treatment and had a high perioperative mortality rate.
Mental health preparedness and response to epidemics focusing on COVID-19 pandemic: a qualitative study in Iran
Authors: Akbari Khadijeh , Zareiyan Armin , Yari Arezoo , Najafi Mehdi , Azizi Maryam , Ostadtaghizadeh Abbas
Published: July 2024

Background

During epidemics, the number of individuals whose mental health is affected is greater than those affected by the infection itself. This is because psychological factors have a direct relationship with the primary causes of the disease and mortality worldwide. Therefore, an increasing investment in research and strategic actions for mental health is essential globally, given the prevalence of infectious diseases.

The aim of this study was to elucidate and describe the strategies for mental health preparedness and response during epidemics, with a focus on the COVID-19 pandemic in Iran.

Methods

A qualitative study was conducted in Iran from 2022 to 2023. Purposeful Sampling was employed, continuing until data saturation was achieved. Data collection involved semi-structured interviews and observational notes with 20 managers and experts possessing expertise, experience, and knowledge in mental health. Ultimately, the participants' opinions, based on their experiences, were analyzed using the qualitative content analysis method with a conventional approach, resulting in the categorization of data into codes, subcategories, and categories.

Results

The study revealed participants' opinions and experiences, categorized into two overarching categories: Preparedness, Policy-Making, and Planning Strategies (with four subcategories), and Response Strategies (comprising thirteen subcategories).

Conclusion

The opinions and experiences of managers and experts in this study revealed that an appropriate mental health response during pandemics requires preparedness before the occurrence of such crises and the implementation of suitable response strategies after the occurrence. Managers, policymakers, and decision-makers in this field should pay attention to the solutions derived from the experiences of such crises to respond more preparedly in the future.
Comprehensive appraisal of lung function in young COPD patients: a single center observational study
Authors: Tan Lunfang , Li Yun , Wang Zhufeng , Wang Zihui , Liu Shuyi , Lin Junfeng , Huang Jinhai , Liang Lina , Peng Kang , Gao Yi , Zheng Jinping
Published: July 2024

Purpose

The present study aimed to investigate the clinical characteristics and lung function impairment in young people diagnosed with chronic obstructive pulmonary disease (COPD).

Patients and methods

We retrospectively enrolled patients with COPD who underwent symptom assessment and comprehensive pulmonary function tests at the First Affiliated Hospital of Guangzhou Medical University between August 2017 and March 2022. The patients were categorized into two groups based on age: a young COPD group (aged 20–50 years) and an old COPD group (aged > 50 years).

Results

A total of 1282 patients with COPD were included in the study, with 76 young COPD patients and 1206 old COPD patients. Young COPD patients exhibited a higher likelihood of being asymptomatic, lower rates of smoking, and a lower smoking index compared to old COPD patients. Although young COPD patients had higher median post-bronchodilator forced expiratory volume in 1 s (post-BD FEV1) (1.4 vs.1.2 L, P = 0.019), diffusing capacity of the lung for carbon monoxide (DLCO) (7.2 vs. 4.6, P<0.001), and a lower median residual volume to total lung capacity ratio (RV/TLC) compared to their older counterparts, there were no differences observed in severity distribution by GOLD categories or the proportion of lung hyperinflation (RV/TLC%pred > 120%) between two groups. Surprisingly, the prevalence of reduced DLCO was found to be 71.1% in young COPD, although lower than in old COPD (85.2%).

Conclusion

Young COPD showed fewer respiratory symptoms, yet displayed a similar severity distribution by GOLD categories. Furthermore, a majority of them demonstrated lung hyperinflation and reduced DLCO. These results underscore the importance of a comprehensive assessment of lung function in young COPD patients.
Pathological response and survival outcomes after neoadjuvant chemotherapy with radical cystectomy in octogenarians for muscle-invasive bladder cancer: an observational database study
Authors: Avudaiappan Arjun Pon , Prabhakar Pushan , Sandman Mayer Simcha , Rubens Muni , Garje Rohan , Eldefrawy Ahmed , Manoharan Murugesan
Published: July 2024

Background

Neoadjuvant chemotherapy (NAC) with radical cystectomy (RC) is the preferred first-line treatment for localized muscle-invasive bladder cancer (MIBC). In recent years, octogenarians have been undergoing RC uneventfully, but studies showed older adults receive NAC less often. We studied the utilization and effect of RC with or without NAC in octogenarians and compared survival outcomes between responders and non-responders.

Methods

In our retrospective study using the National Cancer Database (NCDB), we identified octogenarians with MIBC and urothelial histology who underwent RC with or without NAC between 2004 and 2018. The NAC cohort included patients who underwent RC with NAC, and the non-NAC cohort included those with or without adjuvant chemotherapy. The NAC cohort was subcategorized into responders and non-responders based on surgical pathology. Patients with comorbidity index > 1 were not included, thereby excluding patients with possible renal impairment. After propensity-matching, we compared the overall survival (OS) between NAC and non-NAC cohorts and responders and non-responders.

Results

33924 patients underwent RC, and 3056 octogenarians met our selection. Among them, 396 received NAC, and 2660 did not receive NAC. Among those who received NAC, 112(28.3%) experienced downstaging, and 223(56.4%) exhibited upstaging or no change (p < 0.001). After propensity-matching, the median OS of the NAC and non-NAC cohorts were 51.6 months and 31.3 months, respectively (p<0.001). Similarly, the median OS of responders and non-responders were 89.4 months and 26.5 months, respectively(p < 0.0001).

Conclusion

In our study, we observed that NAC with RC for MIBC may help to improve OS among healthy octogenarians. Similarly, responders had better OS than non-responders.
Impact of acidic beverages on composition and surface characteristics of human teeth: scanning electron microscopic, stereomicroscopic and energy dispersive x-ray analyses
Authors: Kumar Naresh , Amin Faiza , Dahri Waheed Murad , Khan Sara , Zaidi Huma , Rahman Sehrish , Farhan Tooba , Zafar Muhammad Sohail , Fareed Muhammad Amber
Published: July 2024

Objectives

The objective of this study was to evaluate the effect of acidic beverages on the surface topography and elemental composition of human teeth.

Methods

A total of five highly acidic beverages (Red Bull, Pepsi, Apple Cidra, Tang Mosambi, and Tang Orange) were investigated. The tooth specimens of experimental groups were submerged in each beverage and incubated at 37 °C for 7 days, whereas, the tooth specimens of control groups were placed in distilled water. Afterwards, tooth specimens were analyzed using scanning electron microscopic (SEM), stereomicroscopic, and energy dispersive x-ray (EDX) techniques.

Results

All experimental groups revealed a decline in the tooth elements compared to controls, however, such decline was not statistically significant. Nevertheless, comparing the experimental groups, the Red Bull beverage caused a marked reduction in the percentage of both calcium and phosphorus elements compared to the Pepsi, Apple Cidra, Tang Mosambi, and Tang Orange beverages but it was insignificant as well in contrast to its control counterpart. All five acidic beverages demonstrated erosive potential under SEM analysis; however, each group of specimens showed a diverse amount of demineralization. In addition, all experimental groups exhibited significant discoloration of tooth specimens compared to their respective control counterparts.

Conclusions

Within the limitations of study, all five acidic beverages demonstrated erosive potential in the simulated in vitro conditions under SEM analysis; however, each group of specimens exhibited a different extent of demineralization. In addition, the overall effect of all beverages was insignificant under EDX analysis as no substantial difference was revealed between the elemental composition of experimental and control group specimens.
Evaluation of the levels of salivary paxillin in oral potentially malignant disorders and malignant lesions
Authors: Hussine Amal A. , Selim Khaled , Shaker Olfat , Kamal Yasmine
Published: July 2024

Background

The scientific community has been particularly interested in oral squamous cell carcinoma (OSCC) because of the cancer’s extremely high incidence and fatality rates worldwide. It has been proposed that paxillin is involved in certain malignancies as an oncogene. Additionally, several investigations have assessed paxillin expression and investigated its function in developing distinct human carcinomas, including squamous cell carcinoma. Furthermore, it was discovered that there is a strong link between paxillin levels and cancer progression and spread.

Objective

This investigation was carried out to analyze and compare the salivary paxillin levels between oral potentially malignant disorders (OPMDs), OSCC and the healthy controls to assess its potential role as a biomarker of oral cancer aiming for early diagnosis and better prognosis of OSCC.

Methods

Forty-five patients, ranging in age from thirty to seventy-five, were divided into three groups: fifteen patients with OPMDs, fifteen patients with OSCC, and fifteen controls. Paxillin was identified in saliva samples by using an ELISA kit.

Results

Patients with OSCC and OPMDs have considerably greater salivary Paxillin levels than the healthy control group. The receiver operating curve (ROC) analysis was used in our study to distinguish patients with OPMDs from those with OSCC. The ROC curve constructed with the OPMDs group as the positives had lower sensitivity and area under the curve (AUC) values [100% and 1] than the ROC curve with the malignant group as the positives [93.3% and 0.997], respectively. Furthermore, ROC analysis performed between OPMDs group and the malignant group showed a specificity of 73.3% and a cut-off value ≥ 7.9 .

Conclusion

Paxillin can be considered a reliable biomarker for identifying and comparing OPMDs and OSCC cancerous changes.

ClinicalTrials.gov Identifier

NCT06154551- 4/12/2023.
Immediate risk of cervical intraepithelial neoplasia and diagnostic value of colposcopy among cytology-negative women with oncogenic HPV: a retrospective study
Authors: Dai Weichao , Wang Tongfei , Chen Lin , Qiu Zhongyuan , Chen Peifang , Chen Dezhao
Published: July 2024

Background

Cervical cancer screening results that are negative for cytology but positive for high-risk human papillomavirus (HR-HPV) are not uncommon. One-year follow-up is suggested for patients with no history of HPV positivity under the most recent American Society of Colposcopy and Cervical Pathology (ASCCP) guidelines (2019). The aim of this study was to evaluate the immediate risk of cervical intraepithelial neoplasia (CIN) among cytology-negative patients positive for HR-HPV. The diagnostic accuracy of colposcopy in these patients was investigated.

Methods

A retrospective study was conducted in patients who were cytology negative but HR-HPV positive and referred for colposcopy from January 2022 to August 2023. Patients were compared in terms of the immediate rate of CIN lesions among the HPV16-positive group, the HPV18-positive group and the non-16/18 HR-HPV-positive group. The distribution of CIN2 + lesions according to age was evaluated. The factors associated with the accuracy of colposcopy were evaluated using univariate and multivariate logistic regression.

Results

Among the 372 patients, 195 had chronic cervicitis, 131 had CIN1, 37 had CIN2/3, and nine had carcinoma. The immediate rates of CIN2 + lesions and CIN3 + lesions in patients who were not HR-HPV16/18-positive were comparable to those in patients who were HPV16/18-positive (P = 0.699). In addition, among patients diagnosed with CIN2 + lesions, 8 (17.39%) patients were women aged < 30 years. When pathological results were used as a reference, the consistency rate of colposcopy was 61.0% (227/372). Multivariate analyses revealed that age and the type of cervical transformation zone were independent factors affecting the accuracy of colposcopy (P < 0.001).

Conclusions

In countries with limited resources, immediate colposcopy referral should be recommended for patients who are cytology negative but HR-HPV-positive (including non-16/18 HR-HPV-positive), and cervical cancer screening via cotesting should be suggested for women aged < 30 years. Colposcopy has moderate diagnostic value and can be affected by age and the type of cervical transformation zone.
Influence of a rural Longitudinal Integrated Clerkship on medical graduates’ geographic and specialty decisions: a constructivist grounded theory study
Authors: Beattie Jessica , Binder Marley , Beks Hannah , Fuller Lara
Published: July 2024

Background

Like many countries, Australia is suffering from a longstanding and persistent medical workforce maldistribution with fewer doctors per capita in rural locations and a trend towards sub-specialisation. Longitudinal Integrated Clerkships (LIC), a medical education model, are more likely than other clerkship models to produce graduates who work rurally, in communities of increasing remoteness and in primary care. While this quantitative data is essential, there has been a dearth of program-specific evidence explaining this phenomenon.

Methods

To address this knowledge gap, a constructivist qualitative grounded theory approach was employed to identify how the Deakin University comprehensive rural LIC influences graduates’ (2011–2020) career decisions in terms of both medical specialty and geographic practice location.

Results

Thirty-nine graduates participated in qualitative interviews. The Rural LIC Career Decision Making Framework was developed, postulating that an alignment of personal and program factors under the central concept of ‘choosing to participate’ can influence graduates’ geographic and specialist career decisions, both individually and symbiotically. Once embedded in the clerkship, participation was augmented by the concepts of learning design affordance and learning in place, providing the participants with longitudinal opportunities to experience and compare medical disciplines in an integrated manner.

Conclusions

The developed framework presents contextual elements of the program that were deemed influential on graduates’ subsequent career decisions. The alignment of these elements with the program’s mission statement has the capacity to enhance the program’s rural workforce goals. Regardless of graduates’ willingness to participate in the program, a transformation occurred. Transformation occurs through reflection, either challenging or confirming the graduate’s pre-conceived ideas about career decisions and in turn influencing professional identity formation.
Real-world evidence evaluation of LDL-C in hospitalized patients: a population-based observational study in the timeframe 2021–2022
Authors: Capece Umberto , Iacomini Chiara , Mezza Teresa , Cesario Alfredo , Masciocchi Carlotta , Patarnello Stefano , Giaccari Andrea , Di Giorgi Nicoletta
Published: July 2024

Aims

European registries and retrospective cohort studies have highlighted the failure to achieve low-density lipoprotein-cholesterol (LDL-C) targets in many very high-risk patients. Hospitalized patients are often frail, and frailty is associated with all-cause and cardiovascular mortality. The aim of this study is to evaluate LDL-C levels in a real-world inpatient setting, identifying cardiovascular risk categories and highlighting treatment gaps in the implementation of LDL-C management.

Methods

This retrospective, observational study included all adult patients admitted to an Italian hospital between 2021 and 2022 with available LDL-C values during hospitalization. Disease-related real-world data were collected from Hospital Information System using automated data extraction strategies and through the implementation of a patient-centered data repository (the Dyslipidemia Data Mart). We performed assessment of cardiovascular risk profiles, LDL-C target achievement according to the 2019 ESC/EAS guidelines, and use of lipid-lowering therapies (LLT).

Results

13,834 patients were included: 17.15%, 13.72%, 16.82% and 49.76% were low (L), moderate (M), high (H) and very high-risk (VH) patients, respectively. The percentage of on-target patients was progressively lower towards the worst categories (78.79% in L, 58.38% in M, 33.3% in H and 21.37% in VH). Among LLT treated patients, 28.48% were on-target in VH category, 47.60% in H, 69.12% in M and 68.47% in L. We also analyzed the impact of monotherapies and combination therapies on target achievement.

Conclusions

We found relevant gaps in LDL-C management in the population of inpatients, especially in the VH category. Future efforts should be aimed at reducing cardiovascular risk in these subjects.
Challenges of the COVID-19 pandemic on women’s HIV harm reduction centers: a mixed-methods study
Authors: Rahmani Azam , Janatolmakan Maryam , Rezaei Elham , Allahqoli Leila , Fallahi Arezoo , Ebrahimi Elham , Motamedi Mahnaz , Yousefi Fatemeh , Apay Serap Ejdar
Published: July 2024

Background

The COVID-19 pandemic has posed significant challenges to nations worldwide, affecting various sectors of society. Women’s HIV harm reduction centers, which provide critical services, have also been affected by these difficulties. This study aimed to examine the challenges of the COVID-19 pandemic on the services offered by women’s HIV harm reduction centers from the perspective of clients.

Methods

A convergent mixed-method design was utilized to gain in-depth insights into the challenges of COVID-19 on the services provided by women’s HIV harm reduction centers, counseling centers, and night shelters that cater to women at risk, such as drug users, sex workers, and the homeless population, in three provinces (Tehran, Khuzestan, and Kermanshah) in Iran. The study was conducted from January to May 2023. The quantitative aspect of the study employed a cross-sectional method with a sample size of 430 individuals. A researcher-developed questionnaire was used to assess a range of services. The qualitative part of the study involved traditional content analysis and included 32 individual interviews. The integration of qualitative and quantitative results was performed during the interpretation phase to provide a comprehensive understanding of the challenges of COVID-19 on women’s HIV harm reduction centers.

Results

In the quantitative phase, the mean age of women was 39.0 ± 10.2 years. 165 women reported a history of COVID-19, which accounts for 38.4% of the total. More than half of them (n = 102, 61.8%) recovering at home. The majority of women (n = 365, 84.9%) mentioned receiving the COVID-19 vaccine. COVID-19 diagnostic tests were conducted for 74.2% (n = 319) of women. Women expressed higher satisfaction with the services (HIV prevention services, and accommodation services) before the COVID-19 pandemic compared to the satisfaction during the pandemic. The qualitative analysis identified emerging challenges related to the COVID-19 pandemic in two categories: personal challenges and mismanagement of services, comprising nineteen subcategories.

Conclusion

The findings of this study highlight the adverse impact of the COVID-19 pandemic on the services provided by women’s HIV harm reduction centers, in contrast to the pre-pandemic period. To mitigate these negative effects, it is crucial to implement preventive measures and practical solutions. This may involve addressing the personal and management challenges of the centers.
Genetic variants of LncRNAs HOTTIP and MEG3 influence nasopharyngeal carcinoma susceptibility and clinicopathologic characteristics in the Southern Chinese population
Authors: Lao Xiaoxia , Wang Yujie , Huang Rongxin , He Yanying , Lu Huabiao , Liang Dan
Published: July 2024

Objective

Recent studies have indicated that HOTTIP and MEG3 are associated with the initiation and progression of various types of tumors, including nasopharyngeal carcinoma (NPC). This investigation aimed to elucidate the impact of HOTTIP and MEG3 polymorphisms on the susceptibility and clinicopathologic characteristics of NPC.

Methods

This research employed next-generation sequencing and multiplex PCR to assess the polymorphisms of HOTTIP rs1859168 and MEG3 rs7158663 in 200 NPC and 200 healthy individuals respectively. HOTTIP and MEG3 expression were assessed via qRT-PCR assessment. Furthermore, the genotypes and alleles frequency of rs1859168 and rs7158663 were compared between healthy and NPC individuals to elucidate their influence on NPC susceptibility and relation with clinicopathologic characteristics.

Results

In comparison with the healthy cohort, the presence of HOTTIP rs1859168 CC genotype and the C allele were markedly linked with increased NPC incidence (p < 0.05). Furthermore, the MEG3 rs7158663 AA genotype and the A allele also indicated an increased risk of NPC (p < 0.05). The subgroup analysis of age, EBV infection, gender, nationality, smoking, and drinking status revealed no marked association between rs1859168 and rs7158663 genotypes and these potential confounding factors. Moreover, it was observed that rs1859168 CC and rs7158663 AA genotypes were related to local tumor invasion and lymph node metastasis. Additionally, HOTTIP indicated a marked elevation, while MEG3 substantially reduced in NPC samples than the normal nasopharyngeal biospecimens. Patients who carried CC or CA genotypes rather than the HOTTIP rs1859168 AA genotype, had substantially higher HOTTIP levels, while patients with rs7158663 AA or GA genotypes indicated notably lower expression of MEG3 than GG genotype carriers.

Conclusion

Individuals with genetic variants of HOTTIP rs1859168 and MEG3 rs7158663 might have an increased risk of NPC susceptibility and related clinicopathologic characteristics, potentially by affecting the expression of HOTTIP and MEG3.
Guardian’s knowledge and attitude towards inhaled corticosteroids aerosol therapy and medication compliance of children with wheezing diseases
Authors: Liu Zuojiao , Dai Haiqing , Tao Fengjiao , He Xiaoxiao , Jin Ting
Published: July 2024

Background

Glucocorticoids are widely used in inhalation aerosol therapy for wheezing diseases. This study aims to explore guardians’ knowledge and attitude towards inhaled corticosteroids (ICS) aerosol therapy and the medication compliance of children with wheezing diseases in China.

Methods

This cross-sectional study enrolled guardians of children with wheezing diseases at the First Hospital Affiliated to Shaoyang College between October 2022 and February 2023. A self-administered questionnaire was developed to collect demographic information of the participants and evaluate their knowledge and attitude towards ICS aerosol therapy. The 8-item Morisky Medication Adherence Scale was used to assess the medication compliance of children.

Results

A total of 506 valid questionnaires were collected. 260 (51.38%) participants were guardians of a ≤ 3-year-old child and 327 (64.62%) were children’s mothers. The knowledge, attitude, and medication compliance scores of all participants were 12.61 ± 5.78, 20.95 ± 2.37, and 4.69 ± 2.18, respectively. Multivariate logistic regression showed that knowledge scores [OR = 1.053, 95% CI (confidence interval): 1.017–1.090, P = 0.003], attitude scores (OR = 1.121, 95% CI: 1.030–1.219, P = 0.008), guardians of children aged 4–6 years (OR = 0.385, 95% CI: 0.242–0.612, P < 0.001), and grandparents of children (OR = 2.633, 95% CI: 1.104–6.275, P = 0.029) were independently associated with children’s medication compliance.

Conclusions

In conclusion, guardians of children with wheezing diseases in China had insufficient knowledge, unsatisfactory attitude, and poor medication compliance towards ICS aerosol therapy.

Trial registration

Retrospectively registered.
β-catenin mediates endodermal commitment of human ES cells via distinct transactivation functions
Authors: Ma Xun , Dai Liujiang , Tan Chunlai , Li Jiangchuan , He Xiangjun , Wang Yaofeng , Xue Junyi , Huang Min , Ren Jianwei , Xia Yin , Wu Qiang , Zhao Hui , Chan Wai-Yee , Feng Bo
Published: July 2024

Background

β-catenin, acting as the core effector of canonical Wnt signaling pathway, plays a pivotal role in controlling lineage commitment and the formation of definitive endoderm (DE) during early embryonic development. Despite extensive studies using various animal and cell models, the β-catenin-centered regulatory mechanisms underlying DE formation remain incompletely understood, partly due to the rapid and complex cell fate transitions during early differentiation.

Results

In this study, we generated new CTNNB1-/- human ES cells (hESCs) using CRISPR-based insertional gene disruption approach and systematically rescued the DE defect in these cells by introducing various truncated or mutant forms of β-catenin. Our analysis showed that a truncated β-catenin lacking both N- and C-terminal domains (ΔN148C) could robustly rescue the DE formation, whereas hyperactive β-catenin mutants with S33Y mutation or N-terminal deletion (ΔN90) had limited ability to induce DE lineage. Notably, the ΔN148C mutant exhibited significant nuclear translocation that was positively correlated with successful DE rescue. Transcriptomic analysis further uncovered that two weak β-catenin mutants lacking the C-terminal transactivation domain (CTD) activated primitive streak (PS) genes, whereas the hyperactive β-catenin mutants activated mesoderm genes.

Conclusion

Our study uncovered an unconventional regulatory function of β-catenin through weak transactivation, indicating that the levels of β-catenin activity determine the lineage bifurcation from mesendoderm into endoderm and mesoderm.
Ultrasensitive detection of aggregated α-synuclein using quiescent seed amplification assay for the diagnosis of Parkinson’s disease
Authors: Mao Hengxu , Kuang Yaoyun , Feng Du , Chen Xiang , Lu Lin , Xia Wencheng , Gan Tingting , Huang Weimeng , Guo Wenyuan , Yi Hancun , Yang Yirong , Wu Zhuohua , Dai Wei , Sun Hui , Wu Jieyuan , Zhang Rui , Zhang Shenqing , Lin Xiuli , Yong Yuxuan , Yang Xinling , Li Hongyan , Wu Wenjun , Huang Xiaoyun , Bian Zhaoxiang , Wong Hoi Leong Xavier , Wang Xin-Lu , Poppell Michael , Ren Yi , Liu Cong , Zou Wen-Quan , Chen Shengdi , Xu Ping-Yi
Published: July 2024

Background

Seed amplification assays (SAA) enable the amplification of pathological misfolded proteins, including α-synuclein (αSyn), in both tissue homogenates and body fluids of Parkinson’s disease (PD) patients. SAA involves repeated cycles of shaking or sonication coupled with incubation periods. However, this amplification scheme has limitations in tracking protein propagation due to repeated fragmentation.

Methods

We introduced a modified form of SAA, known as Quiescent SAA (QSAA), and evaluated biopsy and autopsy samples from individuals clinically diagnosed with PD and those without synucleinopathies (control group). Brain biopsy samples were obtained from 14 PD patients and 6 controls without synucleinopathies. Additionally, skin samples were collected from 214 PD patients and 208 control subjects. Data were analyzed from April 2019 to May 2023.

Results

QSAA successfully amplified αSyn aggregates in brain tissue sections from mice inoculated with pre-formed fibrils. In the skin samples from 214 PD cases and 208 non-PD cases, QSAA demonstrated high sensitivity (90.2%) and specificity (91.4%) in differentiating between PD and non-PD cases. Notably, more αSyn aggregates were detected by QSAA compared to immunofluorescence with the pS129-αSyn antibody in consecutive slices of both brain and skin samples.

Conclusion

We introduced the new QSAA method tailored for in situ amplification of αSyn aggregates in brain and skin samples while maintaining tissue integrity, providing a streamlined approach to diagnosing PD with individual variability. The integration of seeding activities with the location of deposition of αSyn seeds advances our understanding of the mechanism underlying αSyn misfolding in PD.
Blue petrel electrocardiograms measured through a dummy egg reveal a slow heart rate during egg incubation
Authors: Bonadonna Francesco , Caro Samuel P. , Belle Solenne , Torrente Angelo G.
Published: July 2024

Background

Seabirds like penguins and petrels, living in Antarctic and sub-Antarctic regions, often feed hundreds or even thousands of kilometers away from the islands where they breed. They therefore adapted to endure prolonged fasting during egg incubation, enabling their partner to undertake foraging trips that can last up to two weeks. Aside from accumulating and consuming fat reserves, it is unclear whether seabirds have developed further adaptations to extended fasting periods. This lack of knowledge is in part due to their remote nesting location and their extreme sensitivity to manipulation. To overcome this lack of knowledge, we developed a non-invasive device to record the heart rate (HR) of burrow-nesting blue petrels (Halobaena caerulea) during egg incubation. For that, we encapsulated a small-size logger in a dummy egg to record electrocardiograms (ECGs) through the featherless incubation patch of the birds.

Results

The blue petrels’ HR (208 ± 15 beats per min [bpm]; n = 6) that we recorded during egg incubation was slower than the HR predicted by two different allometric functions regressing HR against body mass (242 and 250 bpm). Blue petrels’ HR also presented cyclical variation correlated to respiration, resembling the physiological Respiratory Sinus Arrhythmia (RSA) described in humans and other species, and that is mainly modulated by the vagal nerve. Moreover, the basal HR of incubating blue petrels increased about every minute during egg movements that presumably reflect egg turning, important for embryo survival and development. During these events, blue petrels’ HR increased up to a maximum of 296 ± 27 bpm for 18 ± 2 s (n = 6). We estimated that those egg movements increased energy expenditure (EE) by 8.4 ± 1.3%, which is approximately 10 times less than the energy increase induced by the disturbance linked with the removal of the dummy egg at the end of the experiment. Interestingly, we noticed that the beginning of HR increase preceded egg movements by 4.3 ± 0.9 s (n = 6), as if birds needed to gradually increase their metabolism to achieve the following action. As well, blue petrels needed 9.1 ± 1.3 s (n = 6) to recover basal levels of HR after the end of egg movements.

Conclusion

We recorded for the first time ECGs, HR and RSA in blue petrels in a completely non-invasive way. This allowed us to observe (1) slow basal HR during egg incubation, which could save energy for prolonged fasting and (2) temporal HR increase, possibly necessary to reposition the egg for proper embryonic development.