bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel protein-based prognostic signature linked to immunotherapeutic efficiency in ovarian cancer
Authors: Chen Shuo-Fu , Wang Liang-Yun , Lin Yi-Sian , Chen Cho-Yi
Published: September 2024

Background

Personalized medicine remains an unmet need in ovarian cancer due to its heterogeneous nature and complex immune microenvironments, which has gained increasing attention in the era of immunotherapy. A key obstacle is the lack of reliable biomarkers to identify patients who would benefit significantly from the therapy. While conventional clinicopathological factors have exhibited limited efficacy as prognostic indicators in ovarian cancer, multi-omics profiling presents a promising avenue for comprehending the interplay between the tumor and immune components. Here we aimed to leverage the individual proteomic and transcriptomic profiles of ovarian cancer patients to develop an effective protein-based signature capable of prognostication and distinguishing responses to immunotherapy.

Methods

The workflow was demonstrated based on the Reverse Phase Protein Array (RPPA) and RNA-sequencing profiles of ovarian cancer patients from The Cancer Genome Atlas (TCGA). The algorithm began by clustering patients using immune-related gene sets, which allowed us to identify immune-related proteins of interest. Next, a multi-stage process involving LASSO and Cox regression was employed to distill a prognostic signature encompassing five immune-related proteins. Based on the signature, we subsequently calculated the risk score for each patient and evaluated its prognostic performance by comparing this model with conventional clinicopathological characteristics.

Results

We developed and validated a protein-based prognostic signature in a cohort of 377 ovarian cancer patients. The risk signature outperformed conventional clinicopathological factors, such as age, grade, stage, microsatellite instability (MSI), and homologous recombination deficiency (HRD) status, in terms of prognoses. Patients in the high-risk group had significantly unfavorable overall survival (p < 0.001). Moreover, our signature effectively stratified patients into subgroups with distinct immune landscapes. The high-risk group exhibited higher levels of CD8 T-cell infiltration and a potentially greater proportion of immunotherapy responders. The co-activation of the TGF-β pathway and cancer-associated fibroblasts could impair the ability of cytotoxic T cells to eliminate cancer cells, leading to poor outcomes in the high-risk group.

Conclusions

The protein-based signature not only aids in evaluating the prognosis but also provides valuable insights into the tumor immune microenvironments in ovarian cancer. Together our findings highlight the importance of a thorough understanding of the immunosuppressive tumor microenvironment in ovarian cancer to guide the development of more effective immunotherapies.
Microwave-assisted organic acids and green hydrogen production during mixed culture fermentation
Authors: Barth Maximilian , Werner Magdalena , Otto Pascal , Richwien Benjamin , Bahramsari Samira , Krause Maximilian , Schwan Benjamin , Abendroth Christian
Published: September 2024

Background

The integration of anaerobic digestion into bio-based industries can create synergies that help render anaerobic digestion self-sustaining. Two-stage digesters with separate acidification stages allow for the production of green hydrogen and short-chain fatty acids, which are promising industrial products. Heat shocks can be used to foster the production of these products, the practical applicability of this treatment is often not addressed sufficiently, and the presented work therefore aims to close this gap.

Methods

Batch experiments were conducted in 5 L double-walled tank reactors incubated at 37 °C. Short microwave heat shocks of 25 min duration and exposure times of 5–10 min at 80 °C were performed and compared to oven heat shocks. Pairwise experimental group differences for gas production and chemical parameters were determined using ANOVA and post–hoc tests. High-throughput 16S rRNA gene amplicon sequencing was performed to analyse taxonomic profiles.

Results

After heat–shocking the entire seed sludge, the highest hydrogen productivity was observed at a substrate load of 50 g/l with 1.09 mol H2/mol hexose. With 1.01 mol H2/mol hexose, microwave-assisted treatment was not significantly different from oven-based treatments. This study emphasised the better repeatability of heat shocks with microwave-assisted experiments, revealing low variation coefficients averaging 29%. The pre-treatment with microwaves results in a high predictability and a stronger microbial community shift to Clostridia compared to the treatment with the oven. The pre-treatment of heat shocks supported the formation of butyric acid up to 10.8 g/l on average, with a peak of 24.01 g/l at a butyric/acetic acid ratio of 2.0.

Conclusion

The results support the suitability of using heat shock for the entire seed sludge rather than just a small inoculum, making the process more relevant for industrial applications. The performed microwave-based treatment has proven to be a promising alternative to oven-based treatments, which ultimately may facilitate their implementation into industrial systems. This approach becomes economically sustainable with high-temperature heat pumps with a coefficient of performance (COP) of 4.3.

Graphical abstract
PRKACB is a novel imprinted gene in marsupials
Authors: Newman Trent , Bond Donna M. , Ishihara Teruhito , Rizzoli Phoebe , Gouil Quentin , Hore Timothy A. , Shaw Geoff , Renfree Marilyn B.
Published: September 2024

Background

Genomic imprinting results in parent-of-origin-specific gene expression and, among vertebrates, is found only in therian mammals: marsupials and eutherians. A differentially methylated region (DMR), in which the methylation status of CpG dinucleotides differs between the two alleles, can mark the parental identity of imprinted genes. We developed a computational pipeline that detected CpG islands (CGIs) marked by both methylated and unmethylated signals in whole genome bisulfite sequencing data. This approach identified candidate marsupial DMRs in a publicly available koala methylome. One of these candidate DMRs was associated with PRKACB, a gene encoding the protein kinase A catalytic subunit beta. Nothing is known about the imprinting status of PRKACB in eutherian mammals although mutations of this gene are associated with endocrine neoplasia and other developmental disorders.

Results

In the tammar wallaby and brushtail possum there was parent-of-origin-specific DNA methylation in the PRKACB DMR in which the maternal allele was methylated and the paternal allele was unmethylated. There were multiple RNAs transcribed from this locus. Allele-specific expression analysis identified paternal expression of a PRKACB lncRNA and an mRNA isoform. Comparison of the PRKACB gene start site between marsupials and eutherians demonstrated that the CGI is longer in marsupials. The PRKACB gene product functions in the same signalling pathway as the guanine nucleotide-binding protein alpha subunit encoded at the GNAS locus, a known eutherian imprinted gene. In a mouse methylome Gnas had three differentially methylated CGIs, while in the koala methylome the GNAS locus had two unmethylated CGIs.

Conclusions

We conclude that PRKACB is a novel, DMR-associated marsupial imprinted gene. Imprinting of PRKACB in marsupials and GNAS in eutherians may indicate a conserved selection pressure for imprinting of the protein kinase A signalling pathway in therians with the two lineages adapting by imprinting different genes.
Small extracellular vesicles derived from synovial fibroblasts contain distinct miRNA profiles and contribute to chondrocyte damage in osteoarthritis
Authors: Asghar Sabha , Litherland Gary J. , Cole John J. , McInnes Iain B. , Meek R. M. D. , Lockhart John C. , Goodyear Carl S. , Crilly Anne
Published: September 2024

Background

Small extracellular vesicles (sEV) derived from synovial fibroblasts (SF) represent a novel molecular mechanism regulating cartilage erosion in osteoarthritis (OA). However, a comprehensive evaluation using disease relevant cells has not been undertaken. The aim of this study was to isolate and characterise sEV from OA SF and to look at their ability to regulate OA chondrocyte effector responses relevant to disease. Profiling of micro (mi) RNA signatures in sEV and parental OA SF cells was performed.

Methods

SF and chondrocytes were isolated from OA synovial membrane and cartilage respectively (n = 9). sEV were isolated from OA SF (± IL-1β) conditioned media by ultracentrifugation and characterised using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Particle size was confirmed by nanoparticle tracking analysis (NTA). sEV regulation of OA chondrocyte and cartilage effector response was evaluated using qPCR, ELISA and sulphated glycosaminoglycan assay (sGAG). RNA-sequencing was used to establish miRNA signatures in isolated sEV from OA SF.

Results

OA SF derived sEV were readily taken up by OA chondrocytes, with increased expression of the catabolic gene MMP 13 (p < 0.01) and decreased expression of the anabolic genes aggrecan and COL2A1 (p < 0.01) observed. Treatment with sEV derived from IL-1β stimulated OA SF significantly decreased expression of aggrecan and COL2A1 (p < 0.001) and increased SOX 9 gene expression (p < 0.05). OA chondrocytes cultured with sEV from either non-stimulated or IL-1β treated OA SF, resulted in a significant increase in the secretion of IL-6, IL-8 and MMP-3 (p < 0.01). Cartilage explants cultured with sEV from SF (± IL-1β) had a significant increase in the release of sGAG (p < 0.01). miRNA signatures differed between parental SF cells and isolated sEV. The recently identified osteoclastogenic regulator miR182, along with miR4472-2, miR1302-3, miR6720, miR6087 and miR4532 were enriched in sEV compared to parental cells, p < 0.01. Signatures were similar in sEVs derived from non-stimulated or IL-1β stimulated SF.

Conclusions

OA SF sEV regulate chondrocyte inflammatory and remodelling responses. OA SF sEV have unique signatures compared to parental cells which do not alter with IL-1β stimulation. This study provides insight into a novel regulatory mechanism within the OA joint which could inform future targeted therapy.
Special Issue: 100 years of scientific excavations at UNESCO World Heritage Site Monte San Giorgio and global research on Triassic marine Lagerstätten
Authors: Klug Christian , Scheyer Torsten M. , Klein Nicole , Liu Jun , Albisetti Daniele , Furrer Heinz , Stockar Rudolf
Published: October 2024

Only a few Swiss fossil localities are known globally and of which, the UNESCO World Heritage Site Monte San Giorgio, which extends from Switzerland into Italy, is the most important one. Following the discovery of the occurrence of articulated skeletons of marine reptiles in the local mines, large excavations were organized by Bernhard Peyer from the University of Zurich starting 1924. With this collection of articles, we commemorate the successful excavations and research, which initiated the publication of a series of monographies, mostly on the vertebrates but also on the invertebrates of this locality. Especially with the discovery of several remarkably similar Konservat-Lagerstätten in China, the discoveries from Monte San Giorgio gained global relevance. New methodologies such as computed tomography produced a wealth of new data, particularly on endocranial anatomy of several tetrapods.
Hepatic transcriptomic analysis reveals differential regulation of metabolic and immune pathways in three strains of chickens with distinct growth rates exposed to mixed parasite infections
Authors: Oladosu Oyekunle John , Reyer Henry , Weikard Rosemarie , Grafl Beatrice , Liebhart Dieter , Metges Cornelia C. , Kühn Christa , Daş Gürbüz
Published: September 2024

During parasite infections, the liver may prioritise immune-related pathways over its metabolic functions. Intestinal infections caused by Ascaridia galli and Heterakis gallinarum impair feed intake, nutrient absorption, and weight gain. Histomonas meleagridis, vectored by H. gallinarum, can also damage liver tissues, potentially impairing liver functions. This study examined the hepatic gene expression in three strains of chickens: Ross-308 (R), Lohmann Brown Plus (LB), and Lohmann Dual (LD), 2 weeks after an experimental infection (n = 18) with both A. galli and H. gallinarum or kept as uninfected control (n = 12). Furthermore, H. gallinarum infection led to a co-infection with H. meleagridis. The mixed infections reduced feed intake and the average daily weight gain (P < 0.001). The infections also increased the plasma concentrations of alpha (1)-acid glycoprotein and the antibody titre against H. meleagridis (P = 0.049), with no strain differences (P > 0.05). For host molecular response, 1887 genes were differentially expressed in LD, while 275 and 25 genes were differentially expressed in R and LB, respectively. The up-regulated genes in R and LD were mostly related to inflammatory and adaptive immune responses, while down-regulated genes in LD were involved in metabolic pathways, including gluconeogenesis. Despite performance differences among the strains, worm burdens were similar, but hepatic molecular responses differed significantly. Moreover, there was an indication of a shift in hepatic functions towards immune-related pathways. We, therefore, conclude that the liver shifts its functions from metabolic to immune-related activities in chickens when challenged with mixed parasite species.
“To exercise sustainably” – Patients’ experiences of compulsive exercise in eating disorders and the Compulsive Exercise Activity Therapy (LEAP) as a treatment: a qualitative interview study
Authors: Simón Emma Thell , Monell Elin , Lindstedt Katarina , Wiberg Anne-Charlotte , Mantilla Emma Forsén
Published: October 2024

Background

Compulsive exercise is common in eating disorders (EDs), but a systematic treatment model is lacking. The CompuLsive Exercise Activity TheraPy (LEAP) is a cognitive behavioral therapy treatment for compulsive exercise in EDs, delivered by trained therapists in groups over four consecutive weeks (8 groupsessions and 1 individual session), aiming to promote healthy physical activity. LEAP is currently evaluated in a randomized efficacy trial. In parallel, it is crucial to learn more about how it is perceived by qualitatively investigating participants’ subjective experiences.

Methods

Nine patients with various EDs participating in the LEAP trial were interviewed about their experiences of taking part in LEAP and about compulsive exercise as an ED symptom using a semi-structured interview guide. The interview transcripts were analyzed according to thematic analysis.

Results

The informants expressed that compulsive exercise had not been addressed in their standard ED treatment and that LEAP as such provided an important complement, spurring reflection, awareness, and changed feelings and behaviors in relation to compulsive exercise. Initially, increased PA was triggered for some, but this side effect was transitory. A wish for more treatment time, in terms of longer or additional sessions, was expressed.

Conclusions

Overall, LEAP seemed to fill an important treatment need and seemed both acceptable and feasible to patients. However, treatment time and the initial increase in PA may need further investigation and attention in order to optimize this treatment.

Trial registration

The trial is registered with the ISRCTN registry (registration date 20200325), trial ID ISRCTN80711391.
Study Protocol for a Cluster, Randomized, Controlled Community Effectiveness Trial of the Early Start Denver Model (ESDM) Compared to Community Early Behavioral Intervention (EBI) in Community Programs serving Young Autistic Children: Partnering for Autism: Learning more to improve Services (PALMS)
Authors: Stahmer Aubyn C. , Dufek Sarah , Rogers Sally J. , Iosif Ana-Maria
Published: September 2024

Background

The rising number of children identified with autism has led to exponential growth in for-profit applied behavior analysis (ABA) agencies and the use of highly structured approaches that may not be developmentally appropriate for young children. Multiple clinical trials support naturalistic developmental behavior interventions (NDBIs) that integrate ABA and developmental science and are considered best practices for young autistic children. The Early Start Denver Model (ESDM) is a comprehensive NDBI shown to improve social communication outcomes for young autistic children in several controlled efficacy studies. However, effectiveness data regarding NDBI use in community-based agencies are limited.

Methods

This study uses a community-partnered approach to test the effectiveness of ESDM compared to usual early behavioral intervention (EBI) for improving social communication and language in autistic children served by community agencies. This is a hybrid type 1 cluster-randomized controlled trial with 2 conditions: ESDM and EBI. In the intervention group, supervising providers will receive training in ESDM; in the control group, they will continue EBI as usual. We will enroll and randomize 100 supervisors (50 ESDM, 50 EBI) by region. Each supervisor enrolls 3 families of autistic children under age 5 (n = 300) and accompanying behavior technicians (n = 200). The primary outcome is child language and social communication at 6 and 12 months. Secondary outcomes include child adaptive behavior, caregiver use of ESDM strategies, and provider intervention fidelity. Child social motivation and caregiver fidelity will be tested as mediating variables. ESDM implementation determinants will be explored using mixed methods.

Discussion

This study will contribute novel knowledge on ESDM effectiveness, the variables that mediate and moderate child outcomes, and engagement of its mechanisms in community use. We expect results from this trial to increase community availability of this model and access to high-quality intervention for young autistic children, especially those who depend on publicly funded intervention services. Understanding implementation determinants will aid scale-up of effective models within communities.

Trail registration

Clinicaltrials.gov identifier number NCT06005285. Registered on August 21, 2023.

Protocol version

Issue date 6 August 2024; Protocol amendment number: 02.
Geothermal resources in Latin-America and their exploration using electromagnetic methods
Authors: Castillo-Reyes Octavio , Prol-Ledesma Rosa María , Corbo-Camargo Fernando , Rojas Otilio
Published: September 2024

The global priority for sustainable societies drives the transition to green energy, with geothermal power as a promising alternative. Latin-American countries benefit from the active volcanism along the Pacific Rim, which fuels their significant geothermal potential. Geothermal electricity production in the region is steadily growing and currently represents approximately $$11\%$$

11
%

of global output (16 GW). This paper provides details on the installed capacity of electrical generation in the most geothermally significant Latin-American countries, as well as the estimated potential production from existing prospects in the region. We also discuss the multiple challenges that limit the widespread development and exploitation of this valuable resource in Latin-America. As México stands as the top electricity producer in the region and ranks sixth worldwide, we offer an overview of its geothermal potential, the use of electromagnetic imaging technologies to enhance Mexican geothermal resource exploration, and the challenges and limitations associated with traditional exploration techniques. Additionally, we present recent case studies on the combined use of these technologies in México, highlighting best practices and lessons learned. The paper identifies open questions and outlines future research directions, particularly in México, to unlock the geothermal potential of the entire region.
Determination of thermal properties of grouting materials for borehole heat exchangers (BHE)
Authors: Albers Anna , Huttenloch Petra , Zorn Roman , Steger Hagen , Blum Philipp
Published: September 2024

Thermal properties of grouting materials for borehole heat exchangers (BHE) are currently analysed with varying measurement methods and analysis procedures, resulting in difficulties when comparing values of different studies. This study therefore provides the first comprehensive investigation of different analysis procedures by systematically comparing the influence of the measurement method and the sample preparation on the determination of the thermal conductivity and the volumetric heat capacity. Seven dissimilar grouting materials with varying water–solid ratios (W/S) and compositions are analysed. The thermal conductivities of the materials range between 0.9 and 1.8 W m−1 K−1 (transient plane source method, TPS). The volumetric heat capacities range between 3.01 and 3.63 MJ m−3 K−1 (differential scanning calorimetry, DSC). From the findings of this study, a standardised analysis of grouting materials is provided which suggests mixing of the grouting material at a high mixing speed and sample curing under water for 28 days at room temperature. The benefits of calculating the volumetric heat capacities of grouting materials from the specific heat capacities of dry samples measured with the DSC, the water content and the bulk density are demonstrated. Furthermore, an estimation procedure of volumetric heat capacity from the W/S and suspension density with an uncertainty of smaller ± 5% is provided. Finally, this study contributes to consistency and comparability between existing and future studies on the thermal properties of grouting materials.
Admission neutrophil-to-lymphocyte ratio to predict mortality in burn patients: a meta-analysis
Authors: Awad Mohamed K. A. , Elsahhar Ahmed , Alwakeel Mahmoud , Awad Radwa , Gomaa Nada , Salem Amr Muhammad Abdo , Ramadan Mahmood , Elsahhar Ghada , Abdelbaky Reyad Essam Reyad , Fadell Francois
Published: October 2024

Background

The neutrophil-to-lymphocyte ratio (NLR) proves to be a convenient and cost-effective marker with studies showing that a high NLR can serve as a mortality indicator in burn cases. We conducted a meta-analysis aiming to explore whether on-admission NLR values could serve as predictors of mortality in burn patients.

Methods

PubMed, Web of Science, Scopus and Embase were searched from inception until January 2024. We included all studies investigating burn patients that contain information on the NLR value at the time of hospital admission and mortality outcomes. The studies were critically appraised using the NIH Quality Assessment Tool.

Results

Nine studies fulfilled our criteria with a total population of 1837 participants, including 1526 survivor Burn patients and 311 non-survivor Burn patients. The overall mean difference measured by random model showed a significant increase in NLR by 5.06 (95% CI 3.42, 6.68) p ≤ 0.001 for the non-survivor group over the survivors group with heterogeneity I2 = 67.33%, p ≤ 0.001. A meta-regression was done to investigate the potential source of heterogeneity among studies. The results showed that age (p = 0.394), gender (p = 0.164), and sample size (p = 0.099) did not contribute to the source of heterogeneity, however, the burn surface area contributed significantly (p = 0.002). A leave-one-out meta-analysis was done, showing that omitting Le Qui et al., leads to significantly decrease the heterogeneity to be I2 = 2.73%. Meta-regression repeated to assess the burn surface area again to be found noncontributing (p = 0.404).

Conclusions

Our findings support that elevated NLR values can serve as a mortality indicator in burn cases. This will have a great clinical impact by aiding in stratifying the burn patients on admission.
Public health implications of antibiotic resistance in sewage water: an epidemiological perspective
Authors: Rahim Kashif , Nawaz Muhammad Naveed , Almehmadi Mazen , Alsuwat Meshari A. , Liu Luo , Yu Changyuan , Khan Shahin Shah
Published: September 2024

The emergence and rapid spread of antibiotic resistance pose a major threat to global health, attributing to misuse and overuse of antibiotics resulting in antibiotics-resistant bacteria through natural mutation or transfer of resistance genes. A cross-sectional study was carried out, in which a total of 36 samples were systematically collected; of these, 26 were derived from the wastewater efflux and 10 from the receiving waters at several critical junctures along the Sutlej River. Herein, this study elucidated elevated levels of antibiotic resistance among bacterial isolates sourced from urban wastewater. Escherichia coli (E. coli) was the highest at 90% among the isolates, followed by Klebsiella pneumoniae (K. pneumoniae) at 58%, Pseudomonas aeruginosa (P. aeruginosa) at 55%, and Salmonella spp. at 53%. Many antibiotics were found to be more resistant including Ciproflaxacin, Co-Trimaxazole, Ampicillin and Tetracycline. Several antibiotic-resistance genes were found in isolated bacterial spp., such as Aminoglycosides (aadA), Sulfonamides (Sul1, Sul3), Tetracyclines (Tet (A/B/D)) and Cephalosporins (Bla_CTM X) at 41%, 35%, 29% and 12% respectively. Furthermore, the development of innovative wastewater treatment models and surveillance programs are crucial to counteract the dissemination of antibiotic resistance. To investigate the genetic determinants of antibiotic resistance, molecular analysis was performed, including DNA isolation, PCR amplification, and sequence analysis. The study helps investigate a diverse range of ARBs and ARGs in wastewater, which highlights the need of better laws for antibiotic usage and wastewater treatment processes. This investigation also stresses on regular monitoring of ARBs and ARGs in sewage wastewater. Through proactive interventions and sustained scientific inquiry, we can strive toward preserving environmental integrity and public health for successive generations.

Graphical Abstract
Non-antibiotic feed additives production by Acremonium terricola solid-fermented Camellia oleifera meal
Authors: Zhang Peng , Xiong Ying , Bi Luanluan , Zhong Haiyan , Ren Jiali , Zhou Bo
Published: September 2024

The Camellia oleifera meal (COM), a primary byproduct of oil-tea processing, often being discarded or used as a low-grade fertilizer due to its low value. The underutilization has become a significant bottleneck hindering the high-quality development of the oil-tea industry. In this study, the production of antibiotic-free feed additives through the solid-state fermentation of COM by Acremonium terricola was investigated. Our findings revealed that a saponin concentration of 5 mg/mL significantly enhanced the production of cordycepic acid (70.4 mg/g), ergosterol (3.32 mg/g), and chitin (110 mg/g) by A. terricola. This concentration also promoted chitin production and the activities of peroxidase (POD) and Na+/K+-ATPase, thereby maintaining cellular homeostasis and energy balance in A. terricola. Solid-state fermented rice bran (RB), wheat bran (WB), and desaponificated COM (containing 2.6 mg/100 g of tea saponin) were all found to be beneficial for increasing the production of cordycepic acid and ergosterol. The blend of COM, RB, and WB in the ratio of 15:65:20 was particularly advantageous for the production and accumulation of cordycepic acid and ergosterol, yielding 1.54 and 1.43 times, 1.27 and 1.37 times, and 1.98 and 5.52 times more than those produced by WB, RB, and COM alone, respectively.Meantime, the difference in contents of sugar and protein in A. terricola cultures (ATCs) using combination were not significant compared to RB and WB. These results indicated that COM can partially replace foodstuffs or food by-products to prepare antibiotic-free feed additives by A. terricola.

Graphical Abstract
Weakening of the state by occupying more lands: evidence from the Five Dynasties
Authors: Li Li , He Shengyu , Ji Ruixin
Published: October 2024

Can wars truly build states and rationalize their structures? This study focuses on the administrative origin of state-building and finds historical evidence that seems contrary to the idea of "war-making states". As states acquire more territory, they become increasingly vulnerable to setbacks in subsequent military activities, even when facing state failure or demise. Drawing upon geospatial data spanning from 906 to 969 AD during Chinas Five Dynasties and utilizing a difference-in-differences method, our study reveals that (1) states did not progressively expand in size due to continuous warfare, and (2) larger territorial acquisitions were associated with decreased probabilities of state survival, as expanding net territorial areas corresponded to higher likelihoods of state failure in the following years. (3) The relationship between civilian and military systems within a state profoundly impacts the validity of the "war-making states" hypothesis. This study highlights that war makes states more susceptible to collapse if the military system dominates the civilian bureaucracy. Conversely, if the civilian system controls the military and forms a centralized regime, the "war-making states" hypothesis holds true. These findings revise the prevailing hypothesis of "war-making states" in historical sociology, showing that the "war-making states" hypothesis depends on a specific political structure and bureaucratic system.
Assessing the effects of interprofessional education by hospital pharmacists on pharmaceutical students using a self-evaluation scale
Authors: Aizawa Fuka , Hamano Hirofumi , Okada Naoto , Yagi Kenta , Goda Mitsuhiro , Nawa Hideki , Horinouchi Yuya , Nakamura Toshimi , Hakuno Harumasa , Shinomiya Kazuaki , Zamami Yoshito , Azuma Masahiko , Akaike Masashi , Ishizawa Keisuke
Published: October 2024

Background

Understanding the roles and competencies of professions outside of one’s specialty is essential for providing efficient healthcare. However, it is difficult for medical professionals to understand the roles and competencies of other related professions while performing their duties. This study examined the impact of clinical practice-based interprofessional education (IPE) on pharmacy students, who are future medical professionals.

Methods

Sixty-eight pharmaceutical students undergoing clinical practice were divided into non-IPE or IPE groups, with the IPE group attending an educational program with medical students conducted by doctors, pharmacists, and teachers during the clinical practice period. The effect was evaluated through a group survey using self-administered questionnaires focusing on contributing to multidisciplinary team medicine based on the Readiness for Interprofessional Learning Scale. The survey included specific behavioral objectives (SBOs), the Readiness for Interpersonal Learning Scale (RIPLS), and Kikuchi’s Scale of Social Skills (KiSS-18).

Results

Regardless of group, SBOs [non-IPE: 3.2, 95% CI (2.6–3.8), p < 0.001; IPE: 3.7, 95% CI (2.5–4.9), p < 0.001] and social skills [non-IPE: 4.0, 95% CI (2.5–6.1), p < 0.001; IPE: 6.7 95% CI (3.0–10.4), p < 0.001] showed improvement after the clinical practice. In RIPLS Factor 3, pharmacy students with IPE awareness scored significantly higher by 1.5 points [95% CI (0.2–2.8), p = 0.025] post-practice than those without IPE awareness.

Conclusions

This study suggests that IPE for students during clinical practice could enhance their expertise in multidisciplinary medicine and facilitate the development of seamless team care in the future.

Trial registration

This study was retrospectively registered and conducted in compliance with the “Ethical Guidelines for Medical Research Involving Human Subjects” and was approved by The Ethics Committee of Tokushima University Hospital (approval number: 3544).
A randomized pragmatic feasibility trial to promote student perspective-taking on client physical activity level: a collaborative project
Authors: Hoplock Lisa B. , Lobchuk Michelle M. , Strachan Shaelyn M. , Halas Gayle , Olfert Cheryl , Webber Sandra , Parsons Joanne L.
Published: September 2024

Background

Health-care practitioners have opportunities to talk with clients about unhealthy behaviors. How practitioners approach these conversations involves skill to be effective. Thus, teaching health-care students to communicate empathetically with clients should promote effective client-practitioner conversations about health behavior change. The primary objective of this pilot trial was to assess the feasibility, acceptability, and appropriateness of a theoretically informed intervention designed to improve perspective-taking.

Methods

For inclusion in this randomized mixed-methods parallel two-arm trial, participants needed to be a student at the investigators’ Canadian university and have completed course content on behavior change communication. Using a 1:1 allocation ratio, participants in Respiratory, Physical, and Occupational Therapy; Nurse Practitioner; and Kinesiology programs were randomly assigned to full or partial intervention conditions. Full intervention participants completed a perspective-taking workshop and practiced perspective-taking prior to an in-lab dialogue with a client-actor (masked to condition) about physical activity. Partial intervention participants received the workshop after the dialogue. We assessed feasibility and appropriateness by comparing recruitment rates, protocol, and psychometric outcomes to criteria. We assessed acceptability (secondary outcome) by analyzing exit interviews.

Results

We screened and randomized 163 participants (82 = full intervention; 81 = partial intervention). We fell slightly short of our recruitment success criteria (10–15 participants per program) when 2/50 Occupational Therapy students participated. We met some but not all of our protocol criteria: Some full intervention participants did not practice perspective-taking before the dialogue, because they did not see anyone during the practice period or did not have a practice opportunity. Psychometric outcomes met the criteria, except for one measure that demonstrated ceiling effects and low reliability (Cronbach’s alpha < .70). There were no adverse events related to participation.

Conclusions

The intervention should be largely feasible, appropriate, and acceptable to deliver. We suggest changes that are large enough to warrant conducting another pilot study. We outline recommended improvements that are applicable to researchers and educators interested in recruitment, adherence to home practice, and online uptake of the intervention.

Trial registration

This trial was registered retrospectively on November 8, 2023, at https://clinicaltrials.gov/study/NCT06123507.
A successful combined spinal-epidural anesthesia for cesarean section in a patient with neurofibromatosis type 1-associated dural ectasia
Authors: Taka Hitomi , Kusama Nobuyoshi , Sakamoto Minami , Sasano Nobuko , Tanaka Motoshi
Published: October 2024

Background

Dural ectasia is a common manifestation of neurofibromatosis type 1. Although there have been reports of unsuccessful spinal anesthesia due to dual ectasia in Marfan syndrome, reports describing similar unsuccessful spinal anesthesia in neurofibromatosis type 1 are lacking.

Case presentation

A parturient with neurofibromatosis type 1 was scheduled for a repeat cesarean section. During a previous cesarean section, she had experienced a failed spinal anesthesia, which resulted in a conversion to general anesthesia. Preoperative lumbar magnetic resonance imaging revealed dural ectasia, which was speculated to be the cause of the previous spinal anesthesia failure. Therefore, combined spinal-epidural anesthesia was implemented. Because the block level of spinal anesthesia was insufficient as predicted, supplemental administration of epidural anesthesia successfully provided adequate analgesia for the surgery.

Conclusions

Combined spinal-epidural anesthesia can be useful for the management of cesarean sections in patients with neurofibromatosis type 1-associated dural ectasia.
Survey analysis of workplace violence among public healthcare workers in Yogyakarta, Indonesia
Authors: Pidada Ida Bagus Gede Surya Putra , Wahab Abdul
Published: September 2024

Background

Workplace violence in the healthcare sector has become a global issue that poses a threat to the safety and well-being of healthcare staff. This study aims to understand and analyze workplace violence experienced by public healthcare workers in Yogyakarta, Indonesia.

Results

This is an observational analytical descriptive study using a cross-sectional design across 482 healthcare workers from 7 general public hospitals taken through stratified random sampling with a standardized questionnaire. The surveys found that 65 from 482 healthcare workers (13.6%) admitted to experiencing physical violence, verbal abuse, bullying, and/or sexual harassment. It is most prevalent among nurses, with the majority occurring in the emergency department ward. Verbal abuse is the most common type, mainly perpetrated by patients’ relatives. Most workers who experience violence take no action. In the bivariate analysis, there was a significant relationship between professions (p = 0.045) and their workplace (p < 0.001) with workers experiencing violence. No significant relationships were found regarding age, gender, marital status, duration of work, and years of service.

Conclusions

A low prevalence of workplace violence was noted in public hospitals in Yogyakarta, suggesting that underreporting might be a major concern. Nurses and the emergency department are the most vulnerable and thus need more urgent interventions. Further research should focus on private hospitals and more effective preventive and responsive measures.
The diagnosis of Creutzfeldt–Jakob disease in a SARS-CoV-2-infected patient should be confirmed by brain biopsy or autopsy
Authors: Mehri Sounira , Finsterer Josef
Published: October 2024

This letter to the Editor discusses the case of a 73-year-old male with mild SARS-CoV-2 infection who one month later developed rapidly progressive cognitive decline, and imaging findings suggestive of Creutzfeldt–Jakob disease (CJD). The diagnosis of sporadic CJD was made on the basis of clinical presentation (rapidly progressive decline, depression, gait disturbance, incontinence, mutism), cerebral MRI (small infarcts, atrophy), hybrid FDG-PET (putaminal and thalamic diffusion restriction, bifrontal hypometabolism), and elevated 14-3-3 in the cerebrospinal fluid (CSF). Despite administration of glucocorticoids, the patient died three months after the onset of symptoms. No autopsy was performed. This case raises the question of a possible link between SARS-CoV-2 infection and the subsequent development of CJD-like syndromes, which warrants further investigation.
Kidney transplant artery and vein stenting: 15-year follow-up
Authors: Peregrin Jan H. , Vedlich Daniel , Viklický Ondřej
Published: September 2024

Background

We would like to present an unusual case of simultaneous stenosis of renal graft artery and vein diagnosed four months after transplantation. both treated by stent placement. Our aim is to point at the fact that renal graft venous stenosis is very rarely reported in the literature and – as it is not easy to diagnose by routine US - it could be overlooked. If early detected it can be treated by stent placement.

Case presentation

We present a case of 36-old-male with renal failure who received a kidney graft from deceased donor. The patient experienced delayed graft function. No rejection was found in the biopsy. Four months after transplantation the kidney function deteriorated to sCr 280 µmol/l. Graft artery stenosis together with graft vein stenosis was revealed. Both lesions were dilated with stent placement, the graft function returned to 230 µmol/l and became stable for 10 years. Ten years after stent placement graft function deteriorated to 300 µmol/l. An in stent restenosis of arterial stent was detected. It was successfully dilated by the balloon, the graft function returned to 230 µmol/l and stays stable for another 5 years.

Conclusions

An unusual simultaneous transplanted kidney artery and vein stenosis treated by stent placement is presented. The patient had stable graft function for 15 years after the procedure with one re-intervention on arterial stent.
Evaluation of the balance system in amateur kickboxers
Authors: Karaman Ebru , Aksu Büşra , Çögen Talha , Ataş Ahmet
Published: October 2024

Background

Kickboxing is defined as an eclectic combat sport created by combining close combat practices. While the effect of kickboxing on balance function may seem evident, controlled studies that investigate the impact of kickboxing on static and dynamic balance using objective tests are limited.

Objective

The primary aim of this study was to evaluate the effects of kickboxing on the development of static and dynamic balance in amateur kickboxers using objective tests. Specifically, we sought to assess how kickboxing training influences postural abilities and balance systems.

Methods

A total of 20 amateur kickboxers between ages 18 and 26 years (mean age, 21.6 ± 5.65 years) and 20 healthy subjects between ages 19 and 25 years (mean age, 21.3 ± 1.41 years) who had no previous experience with kickbox sports training were recruited. The sensory organization test (SOT), adaptation test (ADT), limit of stability (LOS), rhythmic weight shift (RWS) test, weight bearing/squat (WBS) test, and unilateral stance (US) test of the computerized dynamic posturography (CDP) were used to evaluate both groups. All these subtest results were compared between amateur kickboxers and the control group. All subtest results were compared between amateur kickboxers and the control group using independent sample t-tests. An alpha level of 0.05 was set for statistical significance.

Results

A statistically significant difference was found in the weight bearing/squat (WBS) and limit of stability (LOS) subtest results of the CDP between amateur kickboxers and the control group compared to the control group in amateur kickboxers (p < 0.05).

Conclusions

An increase in LOS and WBS skills was observed in the amateur kickboxers who participated in this study when compared to similar-aged individuals who did not participate in kickboxing. These balance differences may be greater in more elite-level kickboxers who have trained for longer. In addition, other balance parameters may also improve with longer periods of exposure and increasing skill complexity performed at more elite levels.
Improvements of right ventricular function after intervention with CPAP in patients with obstructive sleep apnoea
Authors: Murphy Greg , Coss Peter , King Gerard , Coyle Mark , McLaughlin Anne-Marie , Murphy Ross
Published: October 2024

Background

Obstructive sleep apnoea (OSA) is present in 40–80% of patients with cardiovascular morbidity and is associated with adverse effects on cardiovascular health. Continuous positive airway pressure (CPAP) maintains airway patency during sleep and is hypothesised to improve cardiac function. In the present study, we report on the impact of 12 weeks of CPAP and improvements in echocardiographic parameters of the right ventricle (RV).

Methods

Nineteen newly diagnosed patients with OSA and a respiratory disturbance index (RDI) greater than 10 were enrolled. Echocardiography was performed before treatment and with a follow-up assessment after 12 weeks of CPAP. Echocardiographic and Doppler measurements were made following the American Society for Echocardiography guidelines. The primary outcome was isovolumetric acceleration (IVA). Secondary outcomes include tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), RV % strain, TEI index and RV dimension (RVD1).

Results

There was significant improvement in isovolumetric acceleration of 0.5ms2 (P = 0.0012 (95% CI -0.72, -0.20)) and significant improvement of 2.05 mm in TAPSE (p = 0.0379 (95% CI -3.98 - -0.13). There was no significant difference in FAC, RV % strain, TEI index or RVD1 with twelve weeks of CPAP therapy.

Conclusion

The present study highlights significant improvement in TAPSE and IVA with 12 weeks of CPAP treatment and no significant improvement in FAC, RVD1 and RV % strain. These data indicate favourable characteristics on both load dependent and load independent markers of RV function with CPAP.
Understanding the hydrocarbon accumulation process in deep-ultradeep oil and gas reservoirs in complex structural areas — The Qixia Formation in the Shuangyushi structure in the Northwestern Sichuan Basin, China
Authors: Li Qiufen , Tongshan Wang , Tan Cong , Li Yongxin , Sun Qisen , Liu Ce , Yuan Miao
Published: October 2024

Deep-ultradeep oil and gas reservoirs in complex structural areas have typically undergone multistage tectonic processes that have a considerable influence on the hydrocarbon composition, isotopic composition, and other geochemical characteristics of petroleum. By assessing the charging period of hydrocarbon accumulation during a particular age, we can determine these changes. We study the characteristics of fluid inclusions developed in the dolomite reservoir in the Middle Permian Qixia Formation in the Shuangyushi structure of the northwestern Sichuan Basin using methods such as inclusion petrography, microbeam fluorescence spectroscopy, and inclusion homogenization temperature. Furthermore, the main peak wavelength of the fluorescence spectrum, the red-green ratio/chromatic parameter, Q650/500, as well as the chromatic parameter corresponding to the emission flux at 535 nm (QF535), and their correlations with the homogenization temperature distribution are used to identify the charging period of hydrocarbons in the Qixia Formation. The results indicate that different types of fluid inclusions are developed in the Qixia Formation. The fluorescence of hydrocarbon inclusions is mainly blue, with a small amount of yellow-green and orange-yellow. The [Formula: see text] of orange-yellow, yellow-green, and blue fluorescence of the hydrocarbon inclusions ranges between 562 and 579 nm, 497 and 548 nm, and 447 and 497 nm, respectively. The distribution of the homogenization temperatures during the same period ranges from 100°C to 110°C, 120°C to 140°C, and 160°C to 170°C, respectively. By combining the burial and thermal evolution histories of the Qixia Formation, we conclude that the Qixia Formation has experienced three stages of oil and gas charging, with the time of 204, 185, and 158 Ma. This method is of great significance in determining the date and duration of oil and gas accumulation and provides technical support for the recovery of ultra-deep hydrocarbon accumulations in complex structural areas.