bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a population-wide, systematic screening initiative for tuberculosis on Daru island, Western Province, Papua New Guinea
Authors: Dakulala Paison , Kal Margaret , Honjepari Alice , Morris Lucy , Rehan Richard , Akena Simon Peter , Codlin Andrew J. , Jadambaa Narantuya , Islam Tauhid , Yanagawa Manami , Morishita Fukushi
Published: April 2024

Background

A population-wide, systematic screening initiative for tuberculosis (TB) was implemented on Daru island in the Western Province of Papua New Guinea, where TB is known to be highly prevalent. The initiative used a mobile van equipped with a digital X-ray device, computer-aided detection (CAD) software to identify TB-related abnormalities on chest radiographs, and GeneXpert machines for follow-on diagnostic testing. We describe the results of the TB screening initiative, evaluate its population-level impact and examine risk factors associated with TB detection.

Methods

Through a retrospective review of screening data, we assessed the effectiveness of the screening by examining the enrolment coverage and the proportion of people with TB among screened subjects. A cascade analysis was performed to illustrate the flow of participants in the screening algorithm. We conducted univariate and multivariate analyses to identify factors associated with TB. Furthermore, we estimated the number of additional cases detected by the project by examining the trend of routine TB case notifications during the intervention period, compared to the historical baseline cases and trend-adjusted expected cases.

Results

Of the island’s 18,854 residents, 8,085 (42.9%) were enrolled and 7,970 (98.6%) had chest X-ray interpreted by the CAD4TB software. A total of 1,116 (14.0%) participants were considered to have abnormal CXR. A total of 69 Xpert-positive cases were diagnosed, resulting in a detection rate of 853 per 100 000 population screened. 19.4% of people with TB had resistance to rifampicin. People who were in older age groups (aOR 6.6, 95%CI: 1.5–29.1 for the 45–59 age group), were severely underweight (aOR 2.5, 95%CI:1.0-6.1) or underweight (aOR 2.1, 95%CI: 1.1–3.8), lived in households < 5 people (aOR 3.4, 95%CI:1.8–6.6) and had a past history of TB (aOR 2.1, 95%CI: 1.2–3.6) were more likely to have TB. The number of bacteriologically confirmed TB notified during the intervention period was 79.3% and 90.8% higher than baseline notifications and forecasted notifications, respectively.

Conclusion

The screening project demonstrated its effectiveness with the high Xpert-positive TB prevalence among the participants and by successfully yielding additional cases of bacteriologically confirmed TB including rifampicin-resistant TB. The results and lessons learnt from the project should inform future TB screening initiatives in Papua New Guinea.
Gender differences in the impact of anatomical factors on non-contact anterior cruciate ligament injuries: a magnetic resonance study
Authors: Jin Xixin , Wu Xujin , Xu Wei , She Chang , Li Liubing , Mao Yongtao
Published: April 2024

Purpose

To identify MRI-detected anatomical risk factors for non-contact anterior cruciate ligament (ACL) injuries across genders.

Methods

A retrospective analysis was performed on 141 ACL-reconstructed patients (35 females, 106 males) and 142 controls (37 females, 105 males) from January 2020 to April 2022. Inclusion criteria were primary non-contact ACL injuries. The tibial plateau slope, lateral femoral condyle index, Insall-Salvati index, and patellar tendon angle were measured, using binary logistic regression for gender-specific risk evaluation.

Results

Increased lateral tibial plateau slope, reduced intercondylar notch width index, lateral femoral condyle index, and patellar tendon angle correlated with ACL injuries in both genders. The Insall-Salvati index was a significant risk factor in females but not in males.

Conclusion

This study identifies the lateral tibial plateau slope, notch width index, lateral femoral condyle index, and patellar tendon angle at near-extension as risk factors for ACL injuries in both genders, with the Insall-Salvati index also implicated in females.
Feasibility of outpatient daycase local anaesthestic Rezūm™ without sedation
Authors: Khadhouri S , Guillaumier S , Drummond L , Dreyer B , Clelland C , Jaafari F Al
Published: April 2024

Background

Rezūm™ is a relatively new bladder outflow obstruction (BOO) procedure that uses thermal energy through water vapour to cause necrosis of prostatic tissue. The standard delivery of this treatment is in an operating theatre under a general or spinal anaesthetic, or under local anaesthetic with sedation that requires patient monitoring.

Methods

We propose an outpatient daycase method of delivering Rezūm™ under local anaesthetic without sedation, using a prostatic local anaesthetic block and cold local anaesthetic gel instillation into the urethra.

Results

Preliminary results of our first thirteen patients demonstrate the feasibility of this new technique, with a mean pain score of 2.1 out of 10 on a visual analogue scale, a successful trial without catheter in all 13 patients (one patient voided successfully on second trial), a reduction in mean International Prostate Symptom Score (IPSS) from 20.6 to 5.4, and improvement in maximum flow from 8.8 ml/s to 14.4 ml/s. The complications were minor (Clavien-Dindo less than III) and included a UTI, minor bleeding not requiring admission, and retrograde ejaculation.

Conclusions

We demonstrate that an outpatient local anaesthetic daycase service without sedation is feasible. This can be delivered in a clinic setting, reduce waiting times for BOO surgery, and increase availability of operating theatre for other general anaesthetic urological procedures.
Panax notoginseng saponins prevent dementia and oxidative stress in brains of SAMP8 mice by enhancing mitophagy
Authors: Yang Yingying , Chen Wenya , Lin Zhenmei , Wu Yijing , Li Yuqing , Xia Xing
Published: April 2024

Background

Mitochondrial dysfunction is one of the distinctive features of neurons in patients with Alzheimer’s disease (AD). Intraneuronal autophagosomes selectively phagocytose and degrade the damaged mitochondria, mitigating neuronal damage in AD. Panax notoginseng saponins (PNS) can effectively reduce oxidative stress and mitochondrial damage in the brain of animals with AD, but their exact mechanism of action is unknown.

Methods

Senescence-accelerated mouse prone 8 (SAMP8) mice with age-related AD were treated with PNS for 8 weeks. The effects of PNS on learning and memory abilities, cerebral oxidative stress status, and hippocampus ultrastructure of mice were observed. Moreover, changes of the PTEN-induced putative kinase 1 (PINK1)-Parkin, which regulates ubiquitin-dependent mitophagy, and the recruit of downstream autophagy receptors were investigated.

Results

PNS attenuated cognitive dysfunction in SAMP8 mice in the Morris water maze test. PNS also enhanced glutathione peroxidase and superoxide dismutase activities, and increased glutathione levels by 25.92% and 45.55% while inhibiting 8-hydroxydeoxyguanosine by 27.74% and the malondialdehyde production by 34.02% in the brains of SAMP8 mice. Our observation revealed the promotion of mitophagy, which was accompanied by an increase in microtubule-associated protein 1 light chain 3 (LC3) mRNA and 70.00% increase of LC3-II/I protein ratio in the brain tissues of PNS-treated mice. PNS treatment increased Parkin mRNA and protein expression by 62.80% and 43.80%, while increasing the mRNA transcription and protein expression of mitophagic receptors such as optineurin, and nuclear dot protein 52.

Conclusion

PNS enhanced the PINK1/Parkin pathway and facilitated mitophagy in the hippocampus, thereby preventing cerebral oxidative stress in SAMP8 mice. This may be a mechanism contributing to the cognition-improvement effect of PNS.
Catharanthus roseus intoxication mimicking acute cholangitis
Authors: Chuah Yoen Young , Lee Yeong Yeh , Chou Chu-Kuang , Chang Li-Jen
Published: April 2024

Background

Catharanthus roseus, a Madagascar native flowering plant, is known for its glossy leaves and vibrant flowers, and its medicinal significance due to its alkaloid compounds. As a source of vinblastine and vincristine used in chemotherapy, Catharanthus roseus is also employed in traditional medicine with its flower and stalks in dried form. Its toxicity can lead to various adverse effects. We report a case of Catharanthus roseus juice toxicity presenting as acute cholangitis, emphasizing the importance of healthcare providers obtaining detailed herbal supplement histories.

Case presentation

A 65-year-old woman presented with abdominal pain, fever, anorexia, and lower limb numbness. Initial diagnosis of acute cholangitis was considered, but imaging excluded common bile duct stones. Further investigation revealed a history of ingesting Catharanthus roseus juice for neck pain. Laboratory findings showed leukocytosis, elevated liver enzymes, and hyperbilirubinemia. The patient developed gastric ulcers, possibly due to alkaloids in Catharanthus roseus. No bacterial growth was noted in blood cultures. The patient recovered after discontinuing the herbal extract.

Conclusions

Catharanthus roseus toxicity can manifest as fever, hepatotoxicity with cholestatic jaundice, and gastric ulcers, mimicking acute cholangitis. Awareness of herbal supplement use and potential toxicities is crucial for healthcare providers to ensure prompt diagnosis and appropriate management. This case emphasizes the need for public awareness regarding the possible toxicity of therapeutic herbs and the importance of comprehensive patient histories in healthcare settings.
Developing a responsive model to societal needs in medical education
Authors: Khanpoor Hooman , Amerzadeh Mohammad , Alizadeh Ahad , Khosravizadeh Omid , Rafiei Sima
Published: April 2024

Background

Responsiveness is relevant in the context of treatment and the provision of medical services. However, if we delve deeper into the subject, we must establish and develop responsiveness within the medical sciences education system. This study aims to identify the dimensions that significantly impact responsiveness in the medical education system based on a comprehensive review and expert opinions in healthcare.

Methods

The present research is descriptive-analytical in terms of its objective and follows a mixed-method approach. This study was conducted in three stages. Initially, we utilized relevant keywords related to education in databases, such as Web of Science, Scopus, ScienceDirect, OVID, CINHAL, EBSCO, Google Scholar, Iranmedex, SID, and Irandoc. Subsequently, in the expert panel session stage, the factors influencing responsiveness were identified in the comprehensive review stage, and with this thematic background, they were conceptualized. Finally, the Confirmatory Factor Analysis (CFA) technique was employed to coherently examine the relationships between variables and present the final model.

Results

We obtained 32 articles from the comprehensive review of studies. Four components in planning, implementation, monitoring and evaluation, and intersectoral cooperation were identified based on expert panel opinions. Based on the standardized coefficients, the components of research-based educational planning, community-oriented education evaluation indicators, and utilization of modern educational methods are statistically significant.

Conclusion

The establishment and development of responsiveness in the medical sciences education system involve training specialized and responsive human resources through innovative educational methods that have sufficient familiarity with the multidimensional concepts of health and how to achieve them. This approach allows for practical and responsible steps toward training competent and committed physicians in line with the needs of society. On the other hand, responsiveness in the medical sciences education system can be improved by enhancing research-based educational planning and developing community-oriented evaluation indicators that can assess the number of revised educational programs based on societal needs. Therefore, understanding the critical elements in revising medical education programs, which play the most significant role in addressing societal needs and responding to changing disease patterns and new health priorities, is both a necessity and an important priority.
A service mapping exercise of four health and social care staff mental health and wellbeing services, Resilience Hubs, to describe health service provision and interventions
Authors: Allsopp Kate , Varese Filippo , French Paul , Young Ellie , White Hannah , Chung Priscilla , Davey Jessica , Hassan Alysha A. , Wright Sally-Anne , Barrett Alan , Bhutani Gita , McGuirk Katherine , Shields Gemma , Huntley Fay , Jordan Joanne , Rowlandson Aleix , Sarsam May , Ten Cate Hein , Walker Holly , Watson Ruth , Willbourn Jenni , Hind Daniel
Published: April 2024

Background

NHS England funded 40 Mental Health and Wellbeing Hubs to support health and social care staff affected by the COVID-19 pandemic. We aimed to document variations in how national guidance was adapted to the local contexts of four Hubs in the North of England.

Methods

We used a modified version of Price’s (2019) service mapping methodology. Service level data were used to inform the analysis. A mapping template was adapted from a range of tools, including the European Service Mapping Schedule, and reviewed by Hub leads. Key data included service model; staffing; and interventions. Data were collected between March 2021 – March 2022 by site research assistants. Findings were accuracy-checked by Hub leads, and a logic model developed to theorise how the Hubs may effect change.

Results

Hub goals and service models closely reflected guidance; offering: proactive outreach; team-based support; clinical assessment; onward referral, and rapid access to mental health support (in-house and external). Implementation reflected a service context of a client group with high mental health need, and high waiting times at external mental health services. Hubs were predominantly staffed by experienced clinicians, to manage these mental health presentations and organisational working. Formulation-based psychological assessment and the provision of direct therapy were not core functions of the NHS England model, however all Hubs incorporated these adaptations into their service models in response to local contexts, such as extensive waiting lists within external services, and/or client presentations falling between gaps in existing service provision. Finally, a standalone clinical records system was seen as important to reassure Hub users of confidentiality. Other more nuanced variation depended on localised contexts.

Conclusion

This study provides a map for setting up services, emphasising early understandings of how new services will integrate within existing systems. Local and regional contexts led to variation in service configuration. Whilst additional Hub functions are supported by available literature, further research is needed to determine whether these functions should comprise essential components of staff wellbeing services moving forward. Future research should also determine the comparative effectiveness of service components, and the limits of permissible variation.

Study registration

researchregistry6303.
Use of qualitative research in World Health Organisation guidelines: a document analysis
Authors: Taylor Melissa , Garner Paul , Oliver Sandy , Desmond Nicola
Published: April 2024

Background

Guidelines depend on effect estimates, usually derived from randomised controlled trials, to inform their decisions. Qualitative research evidence may improve decisions made but where in the process and the methods to do this have not been so clearly established. We sought to describe and appraise how qualitative research has been used to inform World Heath Organization guidance since 2020.

Methods

We conducted a document analysis of WHO guidelines from 2020 to 2022. We purposely sampled guidelines on the topics of maternal and newborn health (MANH) and infectious diseases, as most of the qualitative synthesis to date has been conducted on these topics, likely representing the ‘best case’ scenario. We searched the in-built repository feature of the WHO website and used standardised search terms to identify qualitative reporting. Using deductive frameworks, we described how qualitative evidence was used to inform guidelines and appraised the standards of this use.

Results

Of the 29 guidelines, over half used qualitative research to help guide decisions (18/29). A total of 8 of these used qualitative research to inform the guideline scope, all 18 to inform recommendations, and 1 to inform implementation considerations. All guidelines drew on qualitative evidence syntheses (QES), and five further supplemented this with primary qualitative research. Qualitative findings reported in guidelines were typically descriptive, identifying people’s perception of the benefits and harms of interventions or logistical barriers and facilitators to programme success. No guideline provided transparent reporting of how qualitative research was interpreted and weighed used alongside other evidence when informing decisions, and only one guideline reported the inclusion of qualitative methods experts on the panel. Only a few guidelines contextualised their recommendations by indicating which populations and settings qualitative findings could be applied.

Conclusions

Qualitative research frequently informed WHO guideline decisions particularly in the field of MANH. However, the process often lacked transparency. We identified unmet potential in informing implementation considerations and contextualisation of the recommendations. Use in these areas needs further methods development.
Development and validation of a model and nomogram for breast cancer diagnosis based on quantitative analysis of serum disease-specific haptoglobin N-glycosylation
Authors: Li Linrong , Xu Yali , Lai Zhizhen , Li Dan , Sun Qiang , Li Zhili , Zhou Yidong
Published: April 2024

Background

A better diagnostic marker is in need to distinguish breast cancer from suspicious breast lesions. The abnormal glycosylation of haptoglobin has been documented to assist cancer diagnosis. This study aims to evaluate disease-specific haptoglobin (DSHp)-β N-glycosylation as a potential biomarker for breast cancer diagnosis.

Methods

DSHp-β chains of 497 patients with suspicious breast lesions who underwent breast surgery were separated from serum immunoinflammatory-related protein complexes. DSHp-β N-glycosylation was quantified by mass spectrometric analysis. After missing data imputation and propensity score matching, patients were randomly assigned to the training set (n = 269) and validation set (n = 113). Logistic regression analysis was employed in model and nomogram construction. The diagnostic performance was analyzed with receiver operating characteristic and calibration curves.

Results

95 N-glycopeptides at glycosylation sites N207/N211, N241, and N184 were identified in 235 patients with benign breast diseases and 262 patients with breast cancer. DSHp-β N-tetrafucosyl and hexafucosyl were significantly increased in breast cancer compared with benign diseases (p < 0.001 and p = 0.001, respectively). The new diagnostic model and nomogram included GN2F2, G6N3F6, GN2FS at N184, G-N&G2S2, G2&G3NFS, G2N3F, GN3 at N207/N211, CEA, CA153, and could reliably distinguish breast cancer from benign diseases. For the training set, validation set, and training and validation sets, the area under the curves (AUCs) were 0.80 (95% CI: 0.75–0.86, specificity: 87%, sensitivity: 62%), 0.77 (95% CI:0.69–0.86, specificity: 75%, sensitivity: 69%), and 0.80 (95% CI:0.76–0.84, specificity: 77%, sensitivity: 68%), respectively. CEA, CA153, and their combination yielded AUCs of 0.62 (95% CI: 0.56–0.67, specificity: 29%, sensitivity: 90%), 0.65 (95% CI: 0.60–0.71, specificity: 74%, sensitivity: 51%), and 0.67 (95% CI: 0.62–0.73, specificity: 60%, sensitivity: 68%), respectively.

Conclusions

The combination of DSHp-β N-glycopeptides, CEA, and CA153 might be a better serologic marker to differentiate between breast cancer and benign breast diseases. The dysregulated N-glycosylation of serum DSHp-β could provide insights into breast tumorigenesis.
A rare case of isolated persistent left superior vena cava diagnosed by echocardiography
Authors: Smolarek Dorota , Jankowska Hanna , Dorniak Karolina , Hellmann Marcin
Published: April 2024

Background

The persistent left superior vena cava (PLSVC) is an infrequent vascular variant. PLSVC with absent right superior vena cava, also known as isolated PLSVC, is an exceptionally rare entity. In this case we present a patient with isolated PLSVC draining to coronary sinus, diagnosed incidentally during echocardiography.

Case presentation

A 35-year-old man underwent a transthoracic echocardiography which showed an enormously dilated coronary sinus. Hand-agitated saline was injected via peripheral intravenous cannulas. The contrast appeared firstly in the coronary sinus before it opacified the right atrium. Since this was also visible by the right antecubital saline injection, it indicated an extremely rare case of PLSVC with the absence of right superior vena cava which was confirmed by cardiac magnetic resonance.

Conclusions

The finding of a distinctively dilated coronary sinus in echocardiography led us to further investigation using agitated saline that revealed an infrequent anomaly termed isolated PLSVC. The in-depth diagnosis of this vascular variant is crucial considering that it may lead to important clinical implications, such as difficulties with central venous access, especially in the current era of a rapid development of cardiac device therapies.
GBA1 as a risk gene for osteoporosis in the specific populations and its role in the development of Gaucher disease
Authors: Wang Chung-Hsing , Huang Yu‐Nan , Liao Wen-Ling , Hsieh Ai-Ru , Lin Wei-De , Liu Kai-Wen , Lu Wen-Li , Huang Chieh‐Chen , Chien Yin-Hsiu , Lee Ni-Chung , Su Pen-Hua , Tsai Fuu-Jen
Published: April 2024

Background

Osteoporosis and its primary complication, fragility fractures, contribute to substantial global morbidity and mortality. Gaucher disease (GD) is caused by glucocerebrosidase (GBA1) deficiency, leading to skeletal complications. This study aimed to investigate the impact of the GBA1 gene on osteoporosis progression in GD patients and the specific populations.

Methods

We selected 8115 patients with osteoporosis (T-score ≤ − 2.5) and 55,942 healthy individuals (T-score > − 1) from a clinical database (N = 95,223). Monocytes from GD patients were evaluated in relation to endoplasmic reticulum (ER) stress, inflammasome activation, and osteoclastogenesis. An in vitro model of GD patient’s cells treated with adeno-associated virus 9 (AAV9)-GBA1 to assess GBA1 enzyme activity, chitotriosidase activity, ER stress, and osteoclast differentiation. Longitudinal dual-energy X-ray absorptiometry (DXA) data tracking bone density in patients with Gaucher disease (GD) undergoing enzyme replacement therapy (ERT) over an extended period.

Results

The GBA1 gene variant rs11264345 was significantly associated [P < 0.002, Odds Ratio (OR) = 1.06] with an increased risk of bone disease. Upregulation of Calnexin, NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) and Apoptosis-associated speck-like protein containing a C-terminal caspase recruitment domain (ASC) was positively associated with osteoclastogenesis in patients with GD. In vitro AAV9-GBA1 treatment of GD patient cells led to enhanced GBA1 enzyme activity, reduced chitotriosidase activity, diminished ER stress, and decreased osteoclast differentiation. Long-term bone density data suggests that initiating ERT earlier in GD leads to greater improvements in bone density.

Conclusions

Elevated ER stress and inflammasome activation are indicative of osteoporosis development, suggesting the need for clinical monitoring of patients with GD. Furthermore, disease-associated variant in the GBA1 gene may constitute a risk factor predisposing specific populations to osteoporosis.
Social support and medication adherence among adult myasthenia gravis patients in China: the mediating role of mental health and self-efficacy
Authors: Yu Jiazhou , Xie Luyao , Chen Shanquan , Fang Zhilan , Zhu Liling , Zhang Huanyu , Xu Richard H. , Yang Huan , Dong Dong
Published: April 2024

Background

Myasthenia gravis (MG), a rare chronic neuromuscular disorder, is characterized by progressive physical decline and requires long-term pharmacological treatment. Due to the decline of physical and social abilities, MG patients are in great need of social support, including tangible and emotional support. This study aims to examine the association between social support and medication adherence and the possible mediating effects of mental health and self-efficacy among MG patients.

Methods

A cross-sectional analysis of a nationwide MG registry was conducted on 865 patients under oral medication treatment in China between June and July 2022. Validated scales were used to measure the respondent’s mental distress (Four-item Patient Health Questionnaire), social support (Modified Medical Outcomes Study Social Support Scale), self-efficacy for medication use (Self-efficacy for Appropriate Medication Use Scale), and medication adherence (Morisky Medication Adherence Scale, MMAS).

Results

The association between social support and medication adherence and possible mediating effects of mental distress and self-efficacy were tested by structural equation model, with significant demographic and disease-related factors adjusted. The respondents showed a very low level of medication adherence (71.2% poor adherence; 1.4% high adherence; mean MMAS = 4.65). The level of social support was positively associated with medication adherence, and such association was fully mediated by two indirect pathways: through self-efficacy (β = 0.07, proportion mediated = 63.8%); and through mental distress and then self-efficacy (β = 0.01, proportion mediated = 6.7%).

Conclusion

Provision of social support and interventions on mental health with emphasis on improving self-efficacy for medication use may effectively improve medication adherence among MG patients.
Enhanced therapeutic potential of antibody fragment via IEDDA-mediated site-specific albumin conjugation
Authors: Go Eun Byeol , Lee Jae Hun , Cho Jeong Haeng , Kwon Na Hyun , Choi Jong-il , Kwon Inchan
Published: April 2024

Background

The use of single-chain variable fragments (scFvs) for treating human diseases, such as cancer and immune system disorders, has attracted significant attention. However, a critical drawback of scFv is its extremely short serum half-life, which limits its therapeutic potential. Thus, there is a critical need to prolong the serum half-life of the scFv for clinical applications. One promising serum half-life extender for therapeutic proteins is human serum albumin (HSA), which is the most abundant protein in human serum, known to have an exceptionally long serum half-life. However, conjugating a macromolecular half-life extender to a small protein, such as scFv, often results in a significant loss of its critical properties.

Results

In this study, we conjugated the HSA to a permissive site of scFv to improve pharmacokinetic profiles. To ensure minimal damage to the antigen-binding capacity of scFv upon HSA conjugation, we employed a site-specific conjugation approach using a heterobifunctional crosslinker that facilitates thiol-maleimide reaction and inverse electron-demand Diels-Alder reaction (IEDDA). As a model protein, we selected 4D5scFv, derived from trastuzumab, a therapeutic antibody used in human epithermal growth factor 2 (HER2)-positive breast cancer treatment. We introduced a phenylalanine analog containing a very reactive tetrazine group (frTet) at conjugation site candidates predicted by computational methods. Using the linker TCO-PEG4-MAL, a single HSA molecule was site-specifically conjugated to the 4D5scFv (4D5scFv-HSA). The 4D5scFv-HSA conjugate exhibited HER2 binding affinity comparable to that of unmodified 4D5scFv. Furthermore, in pharmacokinetic profile in mice, the serum half-life of 4D5scFv-HSA was approximately 12 h, which is 85 times longer than that of 4D5scFv.

Conclusions

The antigen binding results and pharmacokinetic profile of 4D5scFv-HSA demonstrate that the site-specifically albumin-conjugated scFv retained its binding affinity with a prolonged serum half-life. In conclusion, we developed an effective strategy to prepare site-specifically albumin-conjugated 4D5scFv, which can have versatile clinical applications with improved efficacy.
A vocal cord palsy caused by the uterine cancer metastatic tumor in the mediastinum revealed in a patient with a thyroid lesion: a case report and review of the literature
Authors: Hryshchyshyn Andrii , Bahrii Andrii , Bazyshen Andrii , Bohush Hryhorii
Published: April 2024

Background

The main cause of vocal cord palsy (VCP) is idiopathic impairment of the recurrent laryngeal nerve (RLN). However, solid tumors along the pathway of the RLN can also impact the nerve’s function. We presented a patient with a thyroid lesion and VCP due to a bulky metastatic mass (uterine cancer) on the aortic arch field in the mediastinum. The report aims to show the significance of comorbid tumors in thyroid pathology and the importance of additional diagnostic methods in avoiding unnecessary surgeries. A patient’s lifetime and the outcome of the disease were also presented.

Case presentation

A 58-year-old Ukrainian woman with a hoarse voice, intermittent dry cough, and weakness was presented to an endocrine surgeon. Thyroid pathology included signs of hypothyroidism treated with Thyroxine 112.5 µg and a nodule in the left lobe. The lesion is located on the posterior aspect of the lobe, which could probably be a cause of RLN involvement. Fine needle aspiration biopsy (FNAB) was performed twice with Bethesda category 2 result. Fibrolaryngoscopy (FLS) revealed the median position of the left vocal cord. Idiopathic, laryngeal, and thyroid causes of the VCP were excluded. Additionally, the patient displayed her anamnesis of the endometrial clear cell carcinoma following hysterectomy, external beam radiation therapy, and chemotherapy. The mediastinal metastasis was revealed sixteen years later. A chest computed tomography (CT) with intravenous contrast was done. A bulky tumor was found right under the aortic arch. Subsequently, the voice complaints reduced significantly after 4 chemotherapy courses. Cancer progression had led to the appearance of lymph node metastases on the supraclavicular region. Following six months the 60-year-old patient had passed away.

Conclusion

A history of the disease should always be kept in mind when assessing a patient’s complaints. VCP in case of thyroid pathology and previous secondary malignancy may be caused by metastatic tumor anywhere along the RLN pathway. Such a rare case shows the importance of additional methods of examination which may avoid unnecessary thyroid surgeries.
Establishment of stellate ganglion block in mice
Authors: Duan Qirui , Zhou Ying , Zhi Juan , Liu Quanle , Xu Jin , Yang Dong
Published: April 2024

Background

There have been no reports on the successful implementation of stellate ganglion block (SGB) in mice.

Objectives

This study aims to investigate a new method for implementing SGB in mice by placing them in a supine position with abducted upper limbs and touching the trachea and sternoclavicular joint with the hand.

Methods

Fifty BABL/C mice, 8–10 weeks, were selected and randomly divided into four groups: control group (n = 5); SGB-R group (n = 15); SGB-L group (n = 15); and SGB-L + R (group n = 15). SGB was administered with 0.15% ropivacaine solution in a volume of 0.1 mL. The control group received equal volumes of saline. Horner's syndrome, heart rate, and complications such as brachial plexus block, vascular injury, pneumothorax, local anesthetic toxicity, and death were observed.

Results

Horner's syndrome developed in 100% of SGB surviving mice; no difference was seen in the time to onset (100.4 ± 13.4 vs 96.7 ± 12.4, mean ± SD, seconds) and duration (264.1 ± 40.5 vs 296.3 ± 48.0, mean ± SD, min) of Horner's syndrome in the left and right SGB (P > 0.05). Compared with the control group (722 [708–726], median [IQR], bpm), the heart rate was significantly slowed down in the right SGB (475 [451.5–491], median [IQR], bpm) (P < 0.05). While the heart rate was slowed down after performing the left SGB, the difference was not statistically significant (P > 0.05). The overall complication rate was 18.4%, with a brachial plexus block rate of 12.3%, a vascular injury rate of 4.6%, and a mortality rate of 1.5%, as well as no local anesthetic toxicity (includes bilateral implementation of SGB) or pneumothorax manifestations were found.

Conclusions

This method allows for the successful implementation of SGB in a mouse model.
Models and tools for the digital organisation of knowledge: accessible and adaptive narratives for cultural heritage
Authors: Nappi Maria Laura , Buono Mario , Chivăran Camelia , Giusto Rosa Maria
Published: April 2024

The cultural heritage sector includes a significant variety and complexity of data and information. Making this accessible today represents one of the main aims of cultural institutes. The connections between digital archives and knowledge enable the extension of this wealth of information beyond the physical existence of cultural assets by fostering the creation of digital libraries based on the comparison and interaction of data and on sharing the most up-to-date scientific literature. To this purpose, the results of the analysis on the Italian system of cataloguing and dissemination of knowledge related to cultural heritage are first illustrated. These are indispensable for enhancing the experience of cultural heritage, starting from guidebooks and travel literature, which represent the first codified forms of description of cultural heritage addressed to an audience of visitors/users, and ending with the most recent ways of sharing knowledge related to cultural heritage. Among these, digital platforms for participatory storytelling and the drafting of innovative texts and narratives stand out. Particular attention is paid to the innovative models for the use and enjoyment of cultural heritage employed in some of the main institutes and museums, where examples are analysed to effectively illustrate the emergence of new forms and modes of knowledge and narrative of cultural heritage, between big data and digital devices. Through these analyses, this article provides an overall picture of the current models and methods for the digital organisation of cultural heritage knowledge in order to raise awareness of the main critical issues encountered and to activate targeted planning and design processes capable of responding adequately to the needs of an increasingly active and participative user base in the processes of learning and enjoyment of cultural heritage. The interactions between scientific and technological research characterise the field of cultural heritage knowledge and are both instrumental in facilitating established approaches and contribute to changing the very parameters of research by posing new epistemological questions.
Unveiling the mechanism of diachronic changes and regional characteristics differences in the built environment of traditional villages from the perspective of color data: evidence from Macheng City, China
Authors: Tan Gangyi , Chen Zhanxiang , Xue Miao , Jia Yanfei
Published: April 2024

Traditional villages hold a vital place in Chinese vernacular built heritage continuation with their colors being a significant constituent of the built environment. While digital technology has advanced our understanding of built environment, current research pays little attention on how color influences the environment, often overlooking temporal changes and regional differences, especially neglects color protection measures. This study establishes an diachronic image dataset using national traditional villages in Macheng City, Hubei Province. By using of K-Means and CIEDE2000 algorithms, we analyze color characteristics differences among 4 regions in Macheng City in 2022. And, we select five year’ s diachronic image data of Dongyuan Village (2017–2022) to elucidate the color changes mechanisms. The results show that: (1) Elements influenced by the government, construction techniques dissemination, and environmental factors exhibit regional similarity, while the color of wall differs significantly. Specifically, K-Means values for northern and eastern wall elements indicate light brown tones [RGB: (159, 151, 136), (163, 159, 147)], whereas southwestern and central wall elements exhibit distinct colors, including grayish brown [RGB: (132, 127, 119)] and light yellow [RGB: (190, 182, 161)], respectively. (2) Dongyuan Village underwent color corrections in accordance with government policies, resulting in a shift from blue [RGB: (138, 154, 213)] to yellow [RGB: (223, 206, 196)] for the walls and a gradual unification of road colors into light gray [RGB: (239, 238, 243)]. This initiative led to increased consistency with government guidelines, and the color data stabilized with minimal changes in the surrounding environment. This study enhances our comprehension of traditional village color and regional characteristics changes, contributing to effective measures for the preservation of these culturally significant built heritage.
Susceptibility of immature Telenomus remus, an egg parasitoid of Spodoptera frugiperda (J.E. Smith), to entomopathogenic fungi from South Sumatra, Indonesia
Authors: Putri Qarina Shafira , Oktapiani Wenti , Herlinda Siti , Suwandi Suwandi
Published: April 2024

Background

The fall armyworm (FAW) Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae) is a newly introduced pest that damages maize production in Indonesia. To control this pest in maize fields, better solution is to use the egg parasitoid, such as Telenomus remus Nixon (Hymenoptera: Scelionidae), as another better option to apply topically entomopathogenic fungi (EPF). Therefore, it is necessary to study the effect of the EPF on the egg parasitoid of T. remus. The objective of this research was to evaluate susceptibility of immature T. remus to the EPFs, Beauveria bassiana, Chaetomium sp., Curvularia lunata, Penicillium citrinum, and Metarhizium anisopliae. The EPFs (1 × 106 conidia mL−1) were sprayed topically on one-day-old mummies (immature T. remus) in post-parasitism periods.

Results

The results showed that the cumulative percentage of T. remus adult emergence from the mummies treated with EPF on 11 days after treatment ranged 54–100% and was non-significantly different than those of control (untreated with EPF) (90.48%). Therefore, the immature stage of T. remus was not susceptible to the EPF topical application. The EPFs were harmless to the immature stage of T. remus. Percentage of aborted mummies (embryonic death) of T. remus after treated with the EPF was also non-significantly different than those of control. However, the EPFs could significantly affect developmental times of immatures stages of T. remus. The EPF also could shorten the adult longevity of the egg parasitoid.

Conclusions

The immature T. remus is less sensitive to the EPFs; B. bassiana, Chaetomium sp., C. lunata, P. citrinum, and M. anisopliae. It can be considered integrating the EPF with T. remus inundation in maize field. However, it is necessary to limit the topical application of the EPF to avoid negative effects on the adult longevity of the egg parasitoid. Thus, it needed to be further investigated that the application of the endophytic EPFs by inoculating the fungi within the plant tissue could be harmless to the egg parasitoids.
Impact of change in coronal plane alignment of knee (CPAK) classification on outcomes of robotic-assisted TKA
Authors: Agarwal Sarang , Ayeni Femi E. , Sorial Rami
Published: April 2024

Background

Mechanical alignment with total knee arthroplasty (TKA) has been widely used since the implantation of the first prosthetic knee. Multiple studies have reported 80% patient satisfaction with TKA. However, the reported patients’ dissatisfaction is believed to be caused by having to convert different knee alignments to neutral alignments. It is postulated that a change in the CPAK classification of knees leads to patient dissatisfaction.

Thus, we hypothesized that a change in CPAK classification with robot-assisted TKA with mechanical alignment does not significantly lead to patient dissatisfaction.

Methods

We retrospectively analyzed 134 patients who underwent robot-assisted mechanical alignment total knee arthroplasty (MA-TKA) using cementless implants and classified them into CPAK system pre- and post-operatively. One year after TKA surgery, we recorded binary responses to patients’ satisfaction with the outcome of surgery and analyzed if a change in CPAK classification is associated with the outcome of surgery.

Results

We found that 125 out of 134 patients (93.28%) were happy with the outcome of surgery. CPAK classification was changed in 116 patients (86.57%) and maintained in 18 patients (13.43%). Our results also showed that 111 (95.7%) out of 116 patients who had a change in CPAK and 14 (77.8%) out of 18 patients who maintained their CPAK post-surgery were happy with the outcome of surgery (OR = 6.3, CI 1.741–25.17, P value = 0.019).

Conclusion

We concluded that changing the patient’s native joint line and CPAK classification does not significantly change the outcome of surgery in terms of satisfaction. The dissatisfaction rate of 20% as published by previous researchers may be confounded by other reasons and not just due to changes in alignment and joint line.
Modern Multidisciplinary Management of Soft Tissue Sarcoma of the Extremity and Trunk
Authors: Campbell Shauna R. , Wooley Joseph R. , Nystrom Lukas M.
Published: April 2024

Soft tissue sarcomas (STS) of the extremity and trunk are heterogeneous and rare tumors that require coordinated multidisciplinary management. Surgical resection remains the backbone of treatment for localized tumors, with the addition of radiotherapy to surgery to achieve high rates of local control. Despite this, overall survival is limited because of significant distant metastatic risk and a lack of efficacious systemic therapies. Clinical trials have produced conflicting results on the impact of systemic therapy in the neoadjuvant and adjuvant settings for patients with localized disease, leaving systemic treatment decisions largely guided by shared decision making and prognostic prediction tools such as nomograms. This article will review the foundational data as well as latest developments in surgical, radiotherapy, and systemic management supporting current practice guidelines for localized STS of the extremity and trunk.
Association of Serum AGR With All-Cause and Cause-Specific Mortality Among Individuals With Diabetes
Authors: Wen He , Niu Xiaona , Yu Rui , Zhao Ran , Wang Qiuhe , Sun Nan , Ma Le , Li Yan
Published: April 2024

Context

There are insufficient data to support a link between serum albumin-to-globulin ratio (AGR) and mortality in individuals with diabetes.

Objective

This prospective study sought to investigate the relationship between serum AGR and all-cause and cause-specific mortality in adult diabetics.

Methods

This study included 8508 adults with diabetes from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Death outcomes were ascertained by linkage to National Death Index records through December 31, 2019. Hazard ratios (HR) and 95% CIs for mortality from all causes, cardiovascular disease (CVD), and cancer were estimated using weighted Cox proportional-hazards models.

Results

A total of 2415 all-cause deaths, including 688 CV deaths and 413 cancer deaths, were recorded over an average of 9.61 years of follow-up. After multivariate adjustment, there was a significant and linear relationship between higher serum AGR levels and reduced all-cause and cause-specific mortality in a dose-response manner. The multivariate-adjusted HR and 95% CI for all-cause mortality (Ptrend < .0001), cardiovascular mortality (Ptrend < .001), and cancer mortality (Ptrend < .01) were 0.51 (0.42-0.60), 0.62 (0.46-0.83), and 0.57 (0.39-0.85), respectively, for individuals in the highest AGR quartile. There was a 73% decreased risk of all-cause death per 1-unit rise in natural log-transformed serum AGR, as well as a 60% and 63% decreased risk of mortality from CVD and cancer, respectively (all P < .001). Both the stratified analysis and the sensitivity analyses revealed the same relationships.

Conclusion

AGR is a promising biomarker in risk predictions for long-term mortality in diabetic individuals, particularly in those younger than 60 years and heavy drinkers.
Cervical Epidural Anesthesia Combined with Sedation for Neck Cancer Surgery: A Case Report
Authors: Coral Gina , Ayala Marcela
Published: April 2024

Cervical epidural anesthesia (CEA) is a well-established technique and is suitable for various surgeries, including carotid, thyroid, airway, neck cancer, breast, and upper limb procedures. We report the case of an elderly woman with a recurrent neck mass secondary to metastatic papillary thyroid carcinoma causing neurovascular compression, who underwent surgery under CEA. Five milliliters of 0.5% bupivacaine and 5 mL of 2% lidocaine (total 10 mL) were administered into the cervical epidural space. Combined with sedation, CEA in our case provided optimal anesthetic conditions, maintaining spontaneous ventilation, preventing airway collapse, ensuring patient comfort, and facilitating surgery.
Frottage of Ephemera
Authors: Adams Adrienne
Published: April 2024

Gregory D. Victorianne's Buti Voxx is a window into the diffuse erotic networks across the African diaspora who forged international information networks between the 1980s and early 2000s. The Afro-erotic zine occasions an opportunity to tease out what the author calls ephemera fever, the compulsion across contemporary Black queer studies and queer of color critique to frame the trace as evidence of imagining otherwise. The author attunes to the frictions, or what Keguro Macharia calls “frottage,” between the production of Buti Voxx and José Esteban Muñoz's paradigm of “ephemera as evidence” in an effort to query the conceptual pressures undergirding the process of scaling the quotidian to the erotic and political blueprint. The conundrum of the black vernacular is that objects like Buti Voxx become locked into the affective expectations and hermeneutic feedback loops set in motion by altruistic grammars like ephemera. Frottage of ephemera is a launchpad for thinking through how grammatical possibility concurrently functions as hermeneutic enclosure.