bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender-responsive health promotion for women: regulating the sociopolitical landscape of alcohol product marketing
Authors: Lunnay Belinda , Foley Kristen
Published: September 2024

This perspective piece calls for health promotion action to regulate alcohol product marketing targeting women and create environments where it is possible to mitigate the harms of alcohol and protect women’s health. Drawing on the Global Alcohol Action Plan in the context of the Australian National Women’s Health Strategy 2020–30, we consider critical actions for gender-responsive health promotion to protect women from the ways alcohol companies market their products utilizing women’s gendered social roles and entrenched stereotypes. We show how these subtle yet powerful gendered approaches to alcohol marketing have the potential for harm yet are not covered by the current mechanisms of the self-regulated Alcohol Beverages Advertising Code. We draw on the World Health Organization’s 2024 Framework on Gender-Responsive Approaches to the Acceptability Availability and Affordability of Alcohol and make a call to regulate alcohol marketing targeting women.
Not just new wine in old bottles: Seeing refugee law and human rights as entangled regimes
Authors: Scott Ford Sarah
Published: September 2024

This article re-examines the relationship between international human rights and refugee law as a story of mutual interaction, by harnessing and developing the nascent concept of legal entanglement. While entanglement serves as an alternative starting point to understand how legal regimes mutually affect each other, this new concept still lacks sufficient clarity for making sense of the interfaces and development of international law. This article proposes an analytical framework for international legal theory by outlining a model of the normative, interpretive, and socio-political drivers of entangled regimes. It argues that new norms, interpretations, and socio-political shifts explain the rapprochement and distancing between refugee law and human rights over time. Acknowledging the risk that entanglement framing may become altogether too encompassing, the proposed approach to entangled regimes allows for precision and nuance in the empirical tracing of international law.
Capacity Allocation in Distributed Wind Power Generation Hybrid Energy Storage Systems
Authors: Wang Yupeng , Fan Yuxing
Published: September 2024

The inherent variability and uncertainty of distributed wind power generation exert profound impact on the stability and equilibrium of power storage systems. In response to this challenge, we present a pioneering methodology for the allocation of capacities in the integration of wind power storage. Firstly, we introduce a meticulously designed uncertainty modeling technique aimed at optimizing wind power forecasting deviations, thus augmenting the controllability of distributed wind power variations. Subsequently, we establish a cutting-edge real-time dynamic optimization model for state of charge, which effectively mitigates the fluctuations associated with grid-connected wind power. Moreover, we employ a state-of-the-art distributed robust optimization algorithm to enhance the stability of the distributed wind power storage system. Through comprehensive simulation testing, our findings unequivocally demonstrate the efficacy of our approach in preserving a harmonious balance between wind power load and output demand, thereby assuring the unwavering operation of the entire system. Notably, our approach attains an exceptional capacity allocation efficiency of 91% in the rigorous wind power grid-smoothing test, outperforming comparable methodologies. Lastly, we proffer essential recommendations pertaining to attenuation optimization at the effective capacity level of the batteries, effectively safeguarding the long-term stability of the energy storage system.
Generative AI in orthopedics: an explainable deep few-shot image augmentation pipeline for plain knee radiographs and Kellgren-Lawrence grading
Authors: Littlefield Nickolas , Amirian Soheyla , Biehl Jacob , Andrews Edward G , Kann Michael , Myers Nicole , Reid Leah , Yates Adolph J , McGrory Brian J , Parmanto Bambang , Seyler Thorsten M , Plate Johannes F , Rashidi Hooman H , Tafti Ahmad P
Published: September 2024

Objectives

Recently, deep learning medical image analysis in orthopedics has become highly active. However, progress has been restricted by the absence of large-scale and standardized ground-truth images. To the best of our knowledge, this study is the first to propose an innovative solution, namely a deep few-shot image augmentation pipeline, that addresses this challenge by synthetically generating knee radiographs for training downstream tasks, with a specific focus on knee osteoarthritis Kellgren-Lawrence (KL) grading.

Materials and Methods

This study leverages a deep few-shot image augmentation pipeline to generate synthetic knee radiographs. Despite the limited availability of training samples, we demonstrate the capability of our proposed computational strategy to produce high-fidelity plain knee radiographs and use them to successfully train a KL grade classifier.

Results

Our experimental results showcase the effectiveness of the proposed computational pipeline. The generated synthetic radiographs exhibit remarkable fidelity, evidenced by the achieved average Frechet Inception Distance (FID) score of 26.33 for KL grading and 22.538 for bilateral knee radiographs. For KL grading classification, the classifier achieved a test Cohen’s Kappa and accuracy of 0.451 and 0.727, respectively. Our computational strategy also resulted in a publicly and freely available imaging dataset of 86 000 synthetic knee radiographs.

Conclusions

Our approach demonstrates the capability to produce top-notch synthetic knee radiographs and use them for KL grading classification, even when working with a constrained training dataset. The results obtained emphasize the effectiveness of the pipeline in augmenting datasets for knee osteoarthritis research, opening doors for broader applications in orthopedics, medical image analysis, and AI-powered diagnosis.
Reinvention mediates impacts of skin tone bias in algorithms: implications for technology diffusion
Authors: Overbye-Thompson Hannah , Hamilton Kristy A , Mastro Dana
Published: September 2024

Two studies examine how skin tone bias in image recognition algorithms impacts users’ adoption and usage of image recognition technology. We employed a diffusion of innovations framework to explore perceptions of compatibility, complexity, observability, relative advantage, and reinvention to determine their influence on participants' utilization of image recognition algorithms. Despite being more likely to encounter algorithm bias, individuals with darker skin tones perceived image recognition algorithms as having greater levels of compatibility and relative advantage, being more observable, and less complex and thus used them more extensively compared to those with lighter skin tones. Individuals with darker skin tones also displayed higher levels of reinvention behaviors, suggesting a potential adaptive response to counteract algorithm biases.
Phase II study of carboplatin plus weekly paclitaxel with bevacizumab for non-squamous, non-small cell lung cancer with idiopathic interstitial pneumonia (Hanshin Cancer Group IP002)
Authors: Katakami Nobuyuki , Nagata Kazuma , Nakakura Akiyoshi , Okamoto Tadashi , Kaneda Toshihiko , Oki Masahide , Watanabe Kana , Tokito Takaaki , Amano Yoshihiro , Tamiya Motohiro , Morita Satoshi , Hatachi Yukimasa
Published: September 2024

Background

There is an increased risk of acute exacerbation of idiopathic interstitial pneumonia when treating patients with advanced non-small cell lung cancer with idiopathic interstitial pneumonia. There is no standard optimal treatment regimen for patients with lung cancer complicated with idiopathic interstitial pneumonia. We aimed to evaluate the efficacy and safety of carboplatin (CBDCA), bevacizumab (Bmab) and weekly paclitaxel (PXT) in patients with idiopathic interstitial pneumonia.

Methods

This phase 2 study involved chemotherapy-naïve patients with advanced non-small cell lung cancer with idiopathic interstitial pneumonia. Patients received CBDCA (area under the curve: 5 on day 1), PXT (70 mg/m2 on days 1, 8 and 15) and Bmab (15 mg/kg on day 1) every 4 weeks. The primary endpoint was the overall response rate.

Results

Twenty-one patients were enrolled between January 2013 and October 2018 and received at least one course of the protocol treatment. The study was terminated before enrolling the planned number of patients because of poor accrual. The median patient age was 69 (range: 62–79) years, and 19 (90.5%) patients were men. The overall response rate was 61.9% (95% confidence interval [CI], 38.4–81.9), meeting the primary endpoint. The median progression-free survival, time to treatment failure, and overall survival were 9.69 (95% CI, 5.78–11.63), 8.21 (95% CI, 3.75–11.63) and 20.93 (95% CI, 13.17–29.83) months, respectively. There was no acute exacerbation or treatment-related death during protocol treatment.

Conclusion

The results indicate that patients with advanced non-squamous, non-small cell lung cancer with idiopathic interstitial pneumonia could be effectively and safely treated using a combination of CBDCA, PXT and Bmab.
Dendritic cell–specific deletion of PKCδ in offspring of allergic mothers prevents the predisposition for development of allergic lung inflammation in offspring
Authors: Lajiness Jacquelyn D , Bloodworth Jeffrey C , Blankenship Ross L , Kosins Allison E , Cook-Mills Joan M
Published: September 2024

In humans and in mice, maternal allergy predisposes offspring to development of allergy. In murine models, increased levels of maternal β-glucosylceramides are both necessary and sufficient for the development of allergic predisposition in offspring. Furthermore, increased numbers of CD11b+ dendritic cell subsets in the offspring of allergic mothers are associated with allergic predisposition. In vitro, β-glucosylceramides increase CD11b+ dendritic cell subset numbers through increased PKCδ signaling, but it is not known if enhanced PKCδ signaling in dendritic cells is required in vivo. We demonstrate that dendritic cell–specific deletion of PKCδ prevents the β-glucosylceramide–induced increase in CD11b+ dendritic cell subset numbers both in vitro as well as in vivo in the fetal liver of offspring of mothers injected with β-glucosylceramides. Furthermore, dendritic cell–specific deletion of PKCδ in offspring prevents the maternal allergy–induced increase in CD11b+ dendritic cell subsets and decreases allergen-induced interleukin-5 and eosinophilia in lungs of offspring. However, loss of PKCδ in dendritic cells did not prevent development of allergen-specific IgE. Our study provides mechanistic insight into the function of PKCδ in the origins of allergic disease beginning in utero as well as in the development of postnatal allergic lung inflammation.
A numbers game: mosquito-based arbovirus surveillance in two distinct geographic regions of Latin America
Authors: Mojica Jacqueline , Arévalo Valentina , Juarez Jose G , Galarza Ximena , Gonzalez Karla , Carrazco Andrés , Suazo Harold , Harris Eva , Coloma Josefina , Ponce Patricio , Balmaseda Angel , Cevallos Varsovia
Published: September 2024

Aedes mosquitoes, as vectors of medically important arthropod-borne viruses (arboviruses), constitute a major public health threat that requires entomological and epidemiological surveillance to guide vector control programs to prevent and reduce disease transmission. In this study, we present the collaborative effort of 1 year of Aedes ageypti (Linnaeus, 1762) mosquito-based arbovirus surveillance in 2 geographically distinct regions of Latin America (Nicaragua and Ecuador). Adult female mosquitoes were collected using backpack aspirators in over 2,800 randomly selected households (Nicaragua, Ecuador) and 100 key sites (Nicaragua) from 8 distinct communities (Nicaragua: 2, Ecuador: 6). A total of 1,358 mosquito female pools were processed for RNA extraction and viral RNA detection using real-time reverse transcription-polymerase chain reaction. Ten positive dengue virus (DENV) pools were detected (3 in Nicaragua and 7 in Ecuador), all of which were found during the rainy season and matched the serotypes found in humans (Nicaragua: DENV-1 and DENV-4; Ecuador: DENV-2). Infection rates ranged from 1.13 to 23.13, with the Nicaraguan communities having the lowest infection rates. Our results demonstrate the feasibility of detecting DENV-infected Aedes mosquitoes in low-resource settings and underscore the need for targeted mosquito arbovirus sampling and testing, providing valuable insights for future surveillance programs in the Latin American region.
COVID-19 and the Limits of Critical Security Theory: Securitization, Cosmopolitanism, and Pandemic Politics
Authors: Holland Jack , Jarvis Lee
Published: September 2024

Recent years have witnessed a growing and important series of efforts to make sense of the post-2019 coronavirus (COVID-19) pandemic through diverse lenses within the field of critical security studies (css). In this article, we set out to reverse this analytical gaze, asking not “what can css tell us about COVID-19?” but rather, “what can COVID-19 tell us about css?” In order to do this, we pair two important moments in the UK pandemic response with two prominent, yet very different, strands of critical security research: (i) “covid-secure spaces” with securitization theory and (ii) “self-isolation” imperatives with security cosmopolitanism. COVID-secure spaces, we argue, pose a significant challenge to securitization theory’s framing of security’s spaces and times. Self-isolation practices, meanwhile, raise profound ethical questions for the universalizing aspirations of security cosmopolitanism. By analyzing a ubiquitous, if heterogeneous, security challenge to everyday lived experiences within as well as beyond the Global North, the article develops a novel theoretical contribution to recent work rendering visible the Eurocentric foundations and limitations of critical security theory.
Will trust move mountains? Fostering radical ideas in public organizations
Authors: Avilton Meneses Júnior Raimundo , Jorge Fernandes Coelho Filipe , Dórdio Dimas Isabel
Published: September 2024

Demands for greater quality of public services and enhanced efficiency have intensified changes in public organizations. Not surprisingly, these organizations are increasingly searching for new and useful ideas, including disruptive ones, to meet current demands. Whereas previous studies on team radical creativity (TRC) have focused on the influence that subordinates’ trust in the supervisor has on this type of creativity, this work innovates by testing the leader’s trust in the team as an antecedent. Drawing on Self-Determination Theory, we further add to knowledge by considering the mediating role of team-perceived organizational support for creativity and the moderating role of team collaborative climate (TCC). The research model was tested with a sample of 228 teams from public organizations with data collected from two sources at three moments in time. We found that the leader’s trust in the team has a direct positive relationship with TRC and an indirect positive relationship with creativity via team-perceived organizational support. We also observed that TCC positively moderates the relationship between the leader’s trust in the team and TRC. These results deliver meaningful theoretical and practical insights into how organizations, especially public ones, can improve team creativity and thus enhance organizational performance.
Systems pharmacology-based drug discovery from Amaryllidaceae alkaloids and investigation of mechanisms of action in treatment of Alzheimer’s disease
Authors: Li Jianing , Chen Jialiang , Qu Dan , Zhu Lin , Ye Shuhong , Li Ming , Li Wei , Ding Yan
Published: September 2024

Objectives

Given the success of galanthamine in treating Alzheimer’s disease, this study aims to establish an effective method to find drugs from Amaryllidaceae alkaloids and to clarify its mechanism in treating Alzheimer’s disease.

Methods

The pharmacodynamic basis and mechanism of action between Amaryllidaceae alkaloids and Alzheimer’s disease were explored by constructing a compound-target-disease network, targets protein-protein interaction, gene ontology, Kyoto Encyclopedia of Genes and Genomes pathway enrichment, and molecular docking verification.

Key findings

In total, a chemical library of 357 potential alkaloids was constructed. A total of 100 active alkaloid components were identified. Thirty-nine associated targets were yielded based on network construction, and the key targets were defined as HSP90AA1, ESR1, NOS3, PTGS2, and PPARG using protein–protein interaction network. Gene ontology items (490) and 68 Kyoto Encyclopedia of Genes and Genomes pathways were selected through the enrichment of target functions, including neuroactive ligand–receptor interaction, calcium signaling pathway, cAMP signaling pathway, Alzheimer disease, and serotonergic synapse that were related to Alzheimer’s disease. Lastly, molecular docking demonstrated good stability in combining selected alkaloids with targets.

Conclusions

This study explained the mechanisms of Amaryllidaceae alkaloids in preventing and treating Alzheimer’s disease and established a novel strategy to discover new drugs from biological chemical sources.
Uterine didelphys with transverse vaginal septum in a 16-year-old female: the third case report in the medical literature
Authors: Alhalak Fadi , Baddoura Mouna , Abboud Fares , Haddad Sultaneh , Hersi Marwa Ahmed , Hamed Rand , Hani Majd Dakhalalah Bani , Jendi Yaren
Published: September 2024

Müllerian duct anomalies (MDAs) are congenital disorders of the female genital tract resulting from abnormal embryological development of the Müllerian ducts. These abnormalities occur in approximately 0.5%–5.0% of the general population. The case involves a 16-year-old Middle Eastern female referred to the clinic due to primary amenorrhea and lower abdominal pain. Upon evaluation, we identified a congenital anomaly known as uterine didelphys with a transverse vaginal septum. Uterine didelphys is a type of Müllerian duct anomaly characterized by the complete duplication of the uterus, cervix, and sometimes the vagina. Our case is exceptional, as most reported instances feature a longitudinal vaginal septum with uterine didelphys, and it is rare to find both longitudinal and transverse vaginal septa. The combination of uterine didelphys with only a transverse vaginal septum is extremely rare. To the best of our knowledge, this is only the third reported case of its kind.
Differentiating appendiceal neoplasm from perforated appendiceal diverticulum in chronic appendicitis: a case report
Authors: Edwards Tracey , Anthony Phelopatir , Andrawis Nagy
Published: September 2024

Low mucinous neoplasm of the appendix (LAMN) and appendiceal diverticulum are both uncommon pathologies that may pose a diagnostic challenge. Both may present as either appendicitis or asymptomatically and have a risk of perforation. LAMN, carries the additional risk of pseudomyxoma pertitonei and metastasis. Ensuring correct histopathology is crucial, as computed tomography (CT) abdomen/pelvis may only demonstrate a mildly dilated appendix, delaying diagnostic laparoscopy and appendicectomy. Here, we describe the case report of a 56-year-old woman who presented with chronic intermittent right iliac fossa pain initially determined to be chronic appendicitis. Following laparoscopic appendicectomy, histopathology demonstrated LAMN, however, on further re- assessment of histopathology, as well as the completion of a normal pan-CT and colonoscopy, a final diagnosis of ruptured appendiceal diverticulum was made. Our case demonstrates the utility of a multi-disciplinary approach in evaluating patients with possible appendiceal LAMN or appendiceal diverticulum.
Case report from Somalia: access to diagnose retinoblastoma among children in a resource-limited country
Authors: Roble Abdullahi Ali , Mohamed Hassan Muhumed , Bekdemir Şükran , Nor Yahye Abshir , Mohamed Said Abdi , Yussuf Asha Abdirahman , Hassan Ibrahim Ali , Kadiye Mohamed Salad
Published: September 2024

Retinoblastoma, a rare cancer mostly affecting children, makes up ~3% of childhood cancers in developed countries. However, it is more prevalent in sub-Saharan Africa, where late diagnosis often leads to advanced disease and higher mortality rates. Here, we present a 3-year-old girl presented with leukocoria and esotropia in her left eye for 3 months. Imaging revealed lens calcification and vitreous seeding, classified as group D, stage I. The child underwent enucleation to save her life, and histopathology showed Flexner–Wintersteiner rosette cells. This case underscores the importance of eye exams at birth and during childhood. Primary healthcare providers should recognize symptoms like leukocoria and esotropia to facilitate early diagnosis of retinoblastoma.
Venous thromboembolism after aesthetic surgeries in low-risk patients without hypercoagulability
Authors: Palacios Huatuco René M , Giovanardi Gabriel , Coloccini Alejandro , Ramírez Mariano F , Sala Hernán F , Mayer Horacio F
Published: September 2024

Venous thromboembolism (VTE) is a serious but rare complication of aesthetic surgery, with an incidence of 0.017% for liposuction and 0.01%–0.02% for augmentation mammoplasty. Despite the low incidence and appropriate patient selection, we present two cases of VTE in low-risk patients without hypercoagulability undergoing aesthetic procedures. In the first case, a 45-year-old woman with a history of anemia developed bilateral pulmonary embolism after ultrasound-assisted liposuction. In the second case, a 33-year-old woman with a history of oral contraceptive use developed deep vein thrombosis in the right upper extremity after augmentation mammoplasty. The patients were treated early and fully recovered after 12 months. This report highlights the importance of early diagnosis and treatment of VTE in aesthetic surgery, even in low-risk patients.
Descriptive analysis of professional societies in travel and tropical medicine
Authors: Kakoullis Loukas , Flaherty Gerard T , Chen Lin H
Published: September 2024

An internet-based search identified 59 national and regional travel and tropical medicine societies across 193 UN member states. The analysis revealed diverse educational activities, with 61% hosting conferences and 32% publishing journals. Findings underscore the potential for ISTM to enhance global collaboration and support in travel medicine education.
The power of bureaucracies: Shaping migration policy paradigms in Colombia and Ecuador
Authors: Fernández-Rodríguez Nieves , Célleri Daniela
Published: September 2024

This study explores how bureaucratic structures shape shifting migration policy paradigms in Colombia and Ecuador during the Venezuelan forced displacement. Despite an underdeveloped legal framework, Colombia adopted a welcoming policy, granting Venezuelans a 10-year stay permit, driven by its operational migration bureaucracy Colombia Migration and the newly established Border Management Office. Conversely, Ecuador enforced restrictive measures influenced by its Ministry of the Interior, in spite of enshrining the right to human mobility in its constitution. Analyzing thirty-four interviews with key policy-makers, we reveal that the Venezuelan forced displacement led to a reallocation of migration responsibilities within bureaucracies, shifting migration policy paradigms. Our findings highlight the influence of bureaucratic structures—including institutional culture, mission, hierarchy, and specialization—on dominant migration policy paradigms. In doing that, this research bridges the literature on migration governance paradigms and national bureaucracies and challenges assumptions about the weakness of Southern bureaucracies.
Healthy Warrior Effect With Deployment to United Nations Peacekeeping Operation: A Longitudinal Study Among Japan Ground Self-Defense Forces
Authors: Saito Taku , Shigemura Jun , Kitano Masato , Waki Fumiko , Nagamine Masanori
Published: September 2024

Introduction

The “healthy warrior effect” (HWE), in which deployed military personnel are healthier than those not deployed, is known to be associated with deployment. However, the HWE associated with deployment to United Nations (UN) peacekeeping operations (PKO) has not been examined. This study examined the HWE associated with deployment to UN PKO by examining the impact of pre-deployment mental health on the likelihood of deployment and whether this difference persisted after deployment.

Materials and Methods

This retrospective cohort study included 2,712 Japan Ground Self-Defense Forces personnel from four engineering units who consented to participate in annual mental health checks conducted between August and October 2015. The Kessler Psychological Distress Scale (K6) was used to assess general psychological distress before and after deployment. Logistic regression analysis adjusted for age, sex, and rank was conducted with deployment as the dependent variable and the pre-deployment K6 total score as the independent variable. Additionally, a mixed-effects model was performed with K6 total scores as the dependent variable, time and deployment as fixed effect factors, and the individual as the random effect factor.

Results

Of the participants, 254 were in the deployed group, and 2,458 were in the non-deployed group. The pre-deployment K6 total score was significantly lower (t = 5.2, P < .001) for the deployed group (0.67 ± 1.60) than for the non-deployed group (1.26 ± 2.41). Logistic regression analysis showed an odds ratio for the K6 total score before deployment as 0.87 (95% CI = 0.79-0.94). The mixed-effects model exhibited a significant negative main effect of being deployed (t = −5.1, P < .001) and a significant interaction effect between time and being deployed (t = −2.5, P = .012).

Conclusions

Psychologically healthier personnel were more likely to be deployed for UN PKO and their better mental health status persisted after deployment, reflecting the HWE. However, personnel in good health may develop new mental health issues after their deployment, and more attention to health management will be essential before and after deployment.
Sick Call
Authors: Williams Alexander
Published: September 2024

An internal medicine resident from Naval Medical Center San Diego uses poetry to contemplate how easily a future can be ended for an aspiring warfighter. This poem explores the power of military physicians to end a career and how distressing the process is for patient and doctor alike.
Association Between Cumulative G-force Exposure and Cervical Spine Degenerative Changes
Authors: Keskimölö Tuomas , Oura Petteri , Honkanen Tuomas , Niinimäki Jaakko , Sovelius Roope , Leino Tuomo , Karppinen Jaro
Published: September 2024

Introduction

Fighter pilots work in a unique environment and are subject to high G-force loads under simultaneous head movements. Neck pain is reported to be a common health problem among fighter pilots leading to time lost flying and flight duty limitations. The present study aimed to find out if differences in early military flight career G-force exposure levels could increase the risk for degenerative changes in the cervical spine.

Materials and Methods

The study population consisted of 56 20-year-old Finnish Air Force male fighter pilot cadets, who underwent MRI of the cervical spine at baseline and after 5 years. During follow-up, the G-force exposure was measured using the individual Fatigue Index (FI) recordings. The FI data were collected from each flight with BAE Hawks and is determined by the number of times certain levels of G-forces are exceeded during the flights. The incidence or progression of each degenerative change was compared to individual FI values using Pearson correlation coefficients.

Results

The pilots flew on average 220 (±21) hours with high performance aircraft during follow-up, resulting in an average FI of 1.98 (±0.47). A statistically significant progression was found in intervertebral disc (IVD) degeneration sum score with no correlation to corresponding FI values. A statistically significant increase was also found in the prevalence of IVD herniations with a negative correlation with FI values. Other degenerative cervical spine changes did not progress or did not correlate with corresponding FI values.

Conclusions

The prevalence of IVD degeneration and IVD herniations increases in the early phases of fighter pilots’ career. Only the incidence of IVD herniations correlated with FI values and the correlation was negative. The negative correlation may be attributed to avoidance behavior due to neck pain, which was not measured in our study, or other unmeasured confounding factors. This was the first study to compare individual G-force exposure levels to high-quality MRI data over a follow-up of several years. Finnish fighter pilots are known to report increasing cervical symptoms during the Hawk training phase, but longer follow-up periods are likely needed to determine the association between G-force exposure levels and cervical degenerative changes.
Partial Recovery of Telomere Length After Long-term Virologic Suppression in Persons With HIV-1
Authors: Cadiñanos Julen , Rodríguez-Centeno Javier , Montejano Rocío , Esteban-Cantos Andrés , Mena-Garay Beatriz , Jiménez-González María , Saiz-Medrano Gabriel , de Miguel Rosa , Rodríguez-Artalejo Fernando , Bernardino José I , Marcelo-Calvo Cristina , Gutierrez-García Lucía , Martínez-Martín Patricia , Díez Vidal Alejandro , de Gea Grela Alejandro , Ortolá Rosario , Rodés Berta , Arribas José R
Published: September 2024

Background

People with HIV-1 (PWH) age differently than the general population. Blood telomere length (BTL) attrition is a surrogate biomarker of immunosenescence and aging in PWH. BTL is reduced immediately after HIV-1 infection and recovers in PWH with long-term virologic suppression, but the extent of this recovery is unknown.

Methods

This prospective 6-year observational study assessed the evolution of BTL in PWH who were virologically suppressed. A cross-sectional analysis additionally compared BTL with age- and sex-matched blood donors and sex-matched persons older than 60 years from a general population cohort. DNA from whole blood was isolated, and relative BTL was determined by monochrome quantitative multiplex polymerase chain reaction assay and expressed as the ratio of telomere to single-copy gene (T/S).

Results

A total of 128 PWH were included in the prospective 6-year observational study. These same 128 PWH (median age, 55 years; 27.3% women) were compared cross-sectionally at 6-year follow-up with 128 age- and gender-matched blood donors (median age, 55 years) and 128 gender-matched individuals older than 60 years from a general population cohort (median age, 70 years). An inverse correlation between age and BTL was observed. The median BTL of PWH was shorter than their matched blood donors (T/S, 1.07 [IQR, 0.95–1.17] vs 1.28 [IQR, 1.12–1.48]; P < .001) but longer than the elderly population (T/S, 0.89 [IQR, 0.77–0.98], P < .001). PWH experienced a BTL increase at 6 years of 2.9% (T/S, 1.04 vs 1.07; P = .002). In PWH, age was associated with a shorter BTL (coefficient, −0.007 45, SE = 0.002 04, P = .002) and baseline lower CD4 count with a gain in BTL (coefficient, −0.000 06, SE = 0.000 02, P = .004). Shorter baseline BTL (odds ratio, 0.91 [95% CI, .87–.94]; P < .001) and higher glucose levels (odds ratio, 1.04 [95% CI, 1.02–1.07]; P = .003) were associated with a greater similarity of BTL to the elderly population.

Conclusions

PWH with long-term virologic suppression experience a trend toward an increased BTL after 6 years of follow-up. Middle-aged people with long-term controlled HIV-1 have a shorter BTL than expected for their chronologic age but longer than that of people 15 years older in the general population.
Subcapsular Liver Hematoma: One of the Many Faces of Acute Fascioliasis
Authors: Alave Jorge , Leon Mey , Terashima Angelica , Concha-Velasco Fatima , Gotuzzo Eduardo , Seas Carlos , Cabada Miguel M
Published: September 2024

Subcapsular liver hematoma is an uncommon and underdiagnosed manifestation of fascioliasis. We report 6 cases and review 21 previous reports. The mean age was 51 years; 12 cases were from Peru; and 18 were women. Only 6 patients required surgical drainage. Medical management is the mainstay treatment.
Gene expression plasticity in response to rapid and extreme elevation changes in Perdix hodgsoniae (Tibetan Partridge)
Authors: Wang Nan , Palacios Catalina , Brown Megan , Raba Teresa , Heid Jonathan , Ding Xujie , Ou Zhibu , Dahal Nishma , Lamichhaney Sangeet
Published: September 2024

Phenotypic plasticity is a vital biological process facilitating the persistence of organisms amid rapid environmental changes. Investigating the genetic basis of plastic traits necessitates transplantation experiments, but much of the existing research has focused on laboratory model systems. Transplant experiments in the wild may provide better understanding of how plasticity operates in the context of real-world challenges. However, performing transplantation experiments in non-model systems, such as birds, could be challenging. In this study, we aim to develop Perdix hodgsoniae (Tibetan Partridge) inhabiting the highlands of the Tibetan Plateau as a suitable system to study genetic basis underlying short-term plastic response to rapid changes in elevation. We did a first attempt of field-based transplantation experiment by exposing P. hodgsoniae individuals to extreme change in elevation from their native elevation (3,623 m) to a low elevation outside their natural distribution range (500 m). We compared changes in gene expression in these birds at different time points, pre-transplant (day 0), and post-transplant (days 3 and 22). The birds successfully survived transplantation and exhibited well-being after 22 days. We identified a total of 715 differentially expressed genes (DEGs) across these time points. Our analysis revealed a genome-wide decrease in expression following the transplantation, indicating that the birds possibly exhibited stress-induced transcriptional attenuation (SITA) because of the extreme change in elevation, suggesting a broader response at the transcriptional level, possibly as a mechanism to cope with extreme changes in the environment. Our analysis further suggested that heat stress posed an immediate challenge for the birds following the transplant, as we identified changes in expression in many genes associated with heat stress response. Our findings affirm the viability of conducting transplant experiments in the P. hodgsoniae and provides initial insights into gene expression changes associated with the plastic response to rapid changes in elevation in these birds.
Temporal stability in songs across the breeding range of Geothlypis philadelphia (Mourning Warbler) may be due to learning fidelity and transmission biases
Authors: Pitocchelli Jay , Albina Adam , Bentley R Alexander , Guerra David , Youngblood Mason
Published: September 2024

We found a stable pattern of geographic variation in songs across the breeding range of the Geothlypis philadelphia (Mourning Warbler) over a 36-year period. The Western, Eastern, Nova Scotia, and Newfoundland regiolects found in 2005 to 2009 also existed in 1983 to 1988 and 2017 to 2019. Each regiolect contained a pool of syllables that were unique and different from the other regiolects. The primary syllable types that defined each regiolect were present throughout the study, but there were changes in the frequencies of variants of these syllable types in each regiolect. We developed an agent-based model of birdsong learning within each regiolect to explore whether these frequency changes were consistent with unbiased copying or 2 forms of transmission bias: frequency bias and content bias. Strong content bias, possibly for more complex syllables, best models the temporal dynamics across regiolects. In combination with a high estimated learning fidelity, this may explain why regiolects and syllable types were stable for 36 years. We also examined whether variation in physical parameters of song over time could be attributed to acoustic adaptation to breeding habitat, using Landsat variables as a proxy for vegetation characteristics of each male’s breeding territory. The physical parameters of the songs, which changed little over time, revealed no coherent relationships with the Landsat variables and therefore little evidence for acoustic adaptation.
Evaluating lead-free alternatives for radiation shielding in diagnostic radiology: a case study from a tertiary general hospital in Korea
Authors: Kim Eunhye , Kim Byeungeun , Han Taeho , Kim Jungmin , Jeong Hoiwoun , Chung Sookyung , Choi Harim
Published: September 2024

With the continued increase in the number of pieces of diagnostic medical radiography equipment being used, radiation shielding in radiology departments is becoming increasingly important. Lead is the most commonly used material for radiation protection; however, there are numerous disadvantages associated with the use of lead, including environmental hazards and harm to the human body. Alternative shielding materials that can be used as replacements include barium sulfate, tungsten, or bismuth. Among alternative materials, barium sulfate appears to be the most cost-effective and easiest to process. In the present study, before constructing shielding barriers, a barrier thickness program for lead-free barrier materials based on National Council on Radiation Protection and Measurements (NCRP) Report No. 147 was used to determine the appropriate barrier thickness. The required thickness for lead-free boards for each type of diagnostic radiography room was calculated based on a tertiary general hospital in the Republic of Korea.
Bayesian-based analysis of the causality between 731 immune cells and erectile dysfunction: a two-sample, bidirectional, and multivariable Mendelian randomization study
Authors: Chen Junhao , Liu Yidao , Zhan Peiqin , Gao Tianci , Zuo Jieming , Li Xiangyun , Zhang Fangfei , Wang Haifeng , Fu Shi
Published: September 2024

Background

The causal relationship between certain immune cells and erectile dysfunction (ED) is still uncertain.

Aim

The study sought to investigate the causal effect of 731 types of immune cells on ED through Mendelian randomization (MR) using genome-wide association studies (GWAS).

Methods

Genetic instruments for 731 immune cells were identified through GWAS, and ED data were obtained from the FinnGen database. Univariable and multivariable bidirectional MR studies were conducted to explore potential causal relationships between these immune cells and ED. The inverse-variance weighted method was primarily used, with Cochran’s Q test and MR-Egger intercept test assessing pleiotropy and heterogeneity. Bayesian weighted Mendelian randomization (BWMR) was also employed.

Outcomes

Six immune cells were identified as related to ED. CD45 on Natural Killer (NK) cells, CD33dim HLA DR+ CD11b + Absolute Count, CD19 on IgD- CD38dim B cells, and CD3 on CD39+ resting CD4 regulatory T cells were identified as risk factors, whereas CD20 on IgD+ CD38dim B cells and Activated & resting CD4 regulatory T cell %CD4+ T cells were protective factors. Further multivariable MR analysis confirmed that 5 of these immune cells independently impacted ED, except for CD45 on NK cells. Reverse MR analysis indicated that ED occurrence decreases certain immune cell counts, but BWMR found no causal relationship for CD20 on IgD+ CD38dim B cells.

Results

Our MR analysis confirmed a potential bidirectional causal relationship between immune cells and ED, providing new insights into potential mechanisms and therapeutic strategies.

Clinical Translation

This study provides evidence for the impact of certain immune cells on the development of ED and suggests potential therapeutic targets.

Strengths and Limitations

We performed both univariable and multivariable MR to strengthen the causal relationship between exposures and outcomes. However, the population in this study was limited to European ancestry.

Conclusion

Our MR analysis confirmed a potential bidirectional causal relationship between immune cells and ED. This provides new insights into potential mechanisms of pathogenesis and subsequent therapeutic strategies.
The Need for Automatic Review of Death Penalty Cases in Botswana: A Commentary on Pholo v the State
Authors: Dambe Baboki Jonathan
Published: September 2024

Given the irreversible nature of the death penalty, automatic review of death penalty cases is a necessary safeguard. The process mitigates against errors committed by the trial court and ensures that only those who are deserving are executed. In acknowledgement of this necessity, Rule 44 of the Rules of the Court of Appeal empowered the Court of Appeal of Botswana to automatically review all death penalty cases. In undertaking this review, the Court was required to satisfy itself on the soundness of the conviction and also confirm that the trial court had properly addressed the question of extenuating circumstances. However, on the 4th November 2022, in Pholo v The State,1 the Court of Appeal declared that Rule 44 was ultra vires the Court of Appeal Act. Consequently, the Court of Appeal held that it did not have jurisdiction to automatically review death penalty cases. This paper assesses the reasoning of the Court in the case and the implications of the judgment. The paper recommends amendment of the Court of Appeal Act to properly clothe the Court of Appeal with jurisdiction to automatically review death penalty cases.
The role of radiotherapy in extensive-stage small cell lung cancer after durvalumab-based immunochemotherapy: A retrospective study
Authors: Chen Lingjuan , Kong Yi , Tong Fan , Zhang Ruiguang , Ding Peng , Zhang Sheng , Wang Ye , Zhou Rui , Pu Xingxiang , Chen Bolin , Liang Fei , Tan Qiaoyun , Xu Yu , Wu Lin , Dong Xiaorong
Published: September 2024

Background:

The purpose of this study was to evaluate the safety and efficacy of subsequent radiotherapy (RT) following first-line treatment with durvalumab plus chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC).

Methods:

A total of 122 patients with ES-SCLC from three hospitals during July 2019 to December 2021 were retrospectively analyzed. Inverse probability of treatment weighting (IPTW) analysis was performed to address potential confounding factors. The primary focus of our evaluation was to assess the impact of RT on progression-free survival (PFS) and overall survival (OS).

Results:

After IPTW analysis, 49 patients received durvalumab plus platinum–etoposide(EP) chemotherapy followed by RT (Durva + EP + RT) and 72 patients received immunochemotherapy (Durva + EP). The median OS was 17.2 months vs. 12.3 months (hazard ratio [HR]: 0.38, 95% CI: 0.17–0.85, P = 0.020), and the median PFS was 8.9 months vs. 5.9 months (HR: 0.56, 95% CI: 0.32–0.97, P = 0.030) in Durva + EP + RT and Durva + EP groups, respectively. Thoracic radiation therapy (TRT) resulted in longer OS (17.2 months vs. 14.7 months) and PFS (9.1 months vs. 7.2 months) compared to RT directed to other metastatic sites. Among patients with oligo-metastasis, RT also showed significant benefits, with a median OS of 17.4 months vs. 13.7 months and median PFS of 9.8 months vs. 5.9 months compared to no RT. Continuous durvalumab treatment beyond progression (TBP) prolonged OS compared to patients without TBP, in both the Durva + EP + RT (NA vs. 15.8 months, HR: 0.48, 95% CI: 0.14–1.63, P = 0.238) and Durva + EP groups (12.3 months vs. 4.3 months, HR: 0.29, 95% CI: 0.10–0.81, P = 0.018). Grade 3 or 4 adverse events occurred in 13 (26.5%) and 13 (18.1%) patients, respectively, in the two groups; pneumonitis was mostly low-grade.

Conclusion:

Addition of RT after first-line immunochemotherapy significantly improved survival outcomes with manageable toxicity in ES-SCLC.
A NOVEL FOUR-POINT SCLERAL FIXATION TECHNIQUE WITH A HYDROPHOBIC INTRAOCULAR LENS
Authors: Ghazi Nicola G. , Goldsmith Jason , Weston James , Sabah Shafiya , Teo Jeremy C.M.
Published: September 2024

Purpose:

To describe a new surgical technique that combines four-point, flanged polypropylene scleral fixation with a hydrophobic intraocular lens (IOL).

Methods:

Using the Envista MX60 and 6.0 polypropylene, scleral four-point fixation was achieved using a flanged-suture technique five times in a model eye and in a case series of eight patients, retrospectively reviewed. The polypropylene is passed through each eyelet in a novel configuration Loop to Optic and Trailing ends to Outside. Conjunctival peritomies, scleral flaps/pockets, glue, and suture knots are avoided. The load needed for haptic fracture and scanning electron microscopy at fracture sites were studied.

Results:

Haptic fracture occurred once following the first model eye implantation due to excessive suture tension. The fracture load was similar between the Loop to Optic and Trailing end to Outside and the simple-pass technique (1.08 ± 0.52 N vs. 1.09 ± 0.32 N), suggesting no safety compromise. Scanning electron microscopy did not disclose the cheese-wiring effect. Over a mean follow-up of 10.8 months (range: 3–19; median 11.5 months), all cases experienced visual improvement with best-achieved-postoperative uncorrected visual acuity of 20/25 to 20/200, and the IOL was well-centered. Postoperative IOL tilt averaged 2.9° (range: 0–9.6; median: 2.9°). Two patients developed postoperative cystoid macular edema treated topically. The first case developed flange extrusion that was readily repaired in the clinic.

Conclusion:

This novel technique adds two main advantages to previously described flanged-suture techniques: 1) four-point fixation of a hydrophobic IOL; 2) immediate application at the time of initial complicated cataract surgery because it requires no additional supply, IOL, or instrumentation.
NONPHARMACOLOGICAL ASPECTS OF INTRAVITREAL DEXAMETHASONE IMPLANT INJECTIONS
Authors: Kiristioglu Mehmet Omer , Ucan Gunduz Gamze , Abdullayeva Nigar , Doganay Selim , Yalcinbayir Ozgur
Published: September 2024

Purpose:

This study aims to evaluate the nonpharmacological safety profile of intravitreal dexamethasone implants in cases with different etiologies.

Methods:

This retrospective university-based study analyzed clinical reports of patients receiving 0.7 mg dexamethasone implant injections between 2013 and 2023. The study recorded patient demographics, injection indications, and follow-up data. Complications caused by the injection procedure and adverse events other than pharmacological side effects within a 3-month period were included.

Results:

In this study, 3,430 dexamethasone implant injections were made into 1,471 eyes of 1,091 patients. Nonpharmacological complications developed in 611 injections (17.8%). Subconjunctival hemorrhage was noted as the leading nonpharmacological complication (n = 576, 16.8%). Sight-threatening 35 nonpharmacological adverse events and complications (1.0%) were recorded. Cases of anterior chamber migration, vitreous hemorrhage, retinal detachment, endophthalmitis, hypotony, and implant misplacement were observed. Cases requiring intensive treatments and additional surgical interventions were encountered.

Conclusion:

The injection of the dexamethasone implant may lead to nonpharmacological complications caused by the mechanical impact of the injection or improper positioning of the implant, potentially resulting in vision loss. Severe outcomes such as corneal decompensation, retinal detachment, and endophthalmitis can ensue, emphasizing the gravity of these complications. Careful selection of patients and adherence to proper injection techniques are essential in reducing these risks.