bluuebunny/crossref_metadata_2025 huggingface dataset:
Burden of urolithiasis: a systematic review of epidemiological and clinical trends in Somalia
Authors: Dirie Najib Isse , Hassan Jihaan , Hussein Abdirahman Omar , Garba Bashiru , Asowe Hodo Aideed , Orey Fartun Abdullahi Hassan , Mohamud Abdirahman Khalif , Adam Mohamed Hussein , Mohamoud Jamal Hassan , Ahmed Mohamed Mustaf , Nur Maryan Abdullahi Sh.
Published: December 2024

Background

Urolithiasis has become a global major disease that affects millions of people every year. The data regarding the disease in sub-Saharan Africa are limited. Our purpose is to evaluate the prevalence, epidemiological, and clinical data related to urolithiasis in Somalia.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematic review utilized Medical Subject Headings (MeSH) on the following sites; PubMed, Web of Science, EBSCO host, EMBase, Medline, and Cochrane Libraries, using the keywords “Urolithiasis”, “Urinary stone disease”, “Urinary stones” “Renal stone” “Nephrolithiasis”, “Kidney stone”, “Ureter stone”, “Uretero-lithiasis”, “Bladder stone”, “Cystolithiasis”, and “Urethral stone” singly and in combinations terms like “Somalia”, “Somaliland”, “Puntland” and “Mogadishu” to identify relevant published studies. After removing 57 duplicate articles and those with incomplete published results, 141 articles were screened based on their abstracts and titles. Finally, only six studies were eligible to be included in the final systematic review.

Results

Of the six articles included, 14,612 patient records were reviewed for urinary stone disease prevalence, patient demographics, radiological stone characteristics, and urinary stone management. The mean patient age was 34.6. Males were predominantly affected compared to females with 65.7% and 34.3%, respectively. Adults (≥ 18 years old) accounted for 87.9% of the patients while 12.1% being children. Reported urolithiasis prevalence ranged from 8.1% to 17%. Of the 1,442 nephrolithiasis cases, 180 (14.6%) were staghorn calculi while 72.4% had a single stone and 27.6% had multiple stones. The mean stone size was 14.13 mm (± 5.96). The majority of the patients, 389 (36.8%), underwent open lithotomy. Percutaneous nephrolithotomy (PCNL) was performed in 234 (22.1%) of cases, out of which 126 (11.9%) underwent standard PCNL and 108 (10.2%) super mini PCNL (SMP). Ureteroscopic pneumatic surgery (URS) and retrograde intrarenal surgery (RIRS) were performed in 122 (11.5%) and 199 (18%) cases, respectively.

Conclusion

Somalia reported high urolithiasis prevalence. Urological centers in the capital have started using the new advanced techniques for stone management, nevertheless, open lithotomy is still predominantly utilized. No study has detailed patient demographics and stone composition has still not been reported.
Role of vascularised fibula graft in the surgical management of radiation-induced midshaft femoral fractures. Case report and literature review
Authors: Khasin Monique , Darcy Genevieve M. , Mah Eldon , Bella Claudia Di
Published: December 2024

Background

Post-radiation fractures (PRF) are a recognised complication of radiation treatment for soft tissue sarcomas. They have a low incidence and typically occur up to 5 years following treatment, more commonly affecting the pelvis, ribs and femur. Due to radiation-induced changes in bone, PRFs typically require more complicated intervention compared to post-trauma fractures, however, limited literature exists, particularly in regards to mid-shaft femoral PRFs. We report a case of a mid-shaft femoral PRF managed with a modified onlay free vascularised fibular grafting (FVFG).

Case presentation

A 40-year-old male with a history of left quadriceps clear cell sarcoma successfully treated with wide local excision, chemotherapy and radiotherapy 18 years prior presented with a displaced oblique pathological fracture of his left femoral shaft. He was initially treated operatively with intramedullary nailing, however, repeat imaging at the one-year post-operative review demonstrated persistent hypotrophic non-union of the fracture. 16 months following the initial fracture, the patient underwent further surgical intervention with implantation of a modified onlay FVFG to the anterior aspect of the distal femur without nail removal. One-year post-revision, the patient was pain-free with normal mobility and imaging of both the graft and fracture site demonstrated complete union.

Conclusion

Despite their operative complexity, we suggest that FVFGs should be considered for treating non-union of mid-shaft femoral PRFs due to their ability to promote healing and bone union in irradiated bone. Here we describe an original technique of a modified onlay FVFG which can be used in PRFs, and we have put this technique in the context of the current literature in FVFG.
Improved aboveground biomass estimation and regional assessment with aerial lidar in California’s subalpine forests
Authors: Winsemius Sara , Babcock Chad , Kane Van R. , Bormann Kat J. , Safford Hugh D. , Jin Yufang
Published: December 2024

Background

Understanding the impacts of climate change on forest aboveground biomass is a high priority for land managers. High elevation subalpine forests provide many important ecosystem services, including carbon sequestration, and are vulnerable to climate change, which has altered forest structure and disturbance regimes. Although large, regional studies have advanced aboveground biomass mapping with satellite data, typically using a general approach broadly calibrated or trained with available field data, it is unclear how well these models work in less prevalent and highly heterogeneous forest types such as the subalpine. Monitoring biomass using methods that model uncertainty at multiple scales is critical to ensure that local relationships between biomass and input variables are retained. Forest structure metrics from lidar are particularly valuable alongside field data for mapping aboveground biomass, due to their high correlation with biomass.

Results

We estimated aboveground woody biomass of live and dead trees and uncertainty at 30 m resolution in subalpine forests of the Sierra Nevada, California, from aerial lidar data in combination with a collection of field inventory data, using a Bayesian geostatistical model. The ten-fold cross-validation resulted in excellent model calibration of our subalpine-specific model (94.7% of measured plot biomass within the predicted 95% credible interval). When evaluated against two commonly referenced regional estimates based on Landsat optical imagery, root mean square error, relative standard error, and bias of our estimations were substantially lower, demonstrating the benefits of local modeling for subalpine forests. We mapped AGB over four management units in the Sierra Nevada and found variable biomass density ranging from 92.4 to 199.2 Mg/ha across these management units, highlighting the importance of high quality, local field and remote sensing data.

Conclusions

By applying a relatively new Bayesian geostatistical modeling method to a novel forest type, our study produced the most accurate and precise aboveground biomass estimates to date for Sierra Nevada subalpine forests at 30 m pixel and management unit scales. Our estimates of total aboveground biomass within the management units had low uncertainty and can be used effectively in carbon accounting and carbon trading markets.
Hymenoptera venom allergy in children
Authors: Giovannini Mattia , Mori Francesca , Barni Simona , Saretta Francesca , Arasi Stefania , Castagnoli Riccardo , Liotti Lucia , Mastrorilli Carla , Pecoraro Luca , Caminiti Lucia , Sturm Gunter Johannes , Marseglia Gian Luigi , del Giudice Michele Miraglia , Novembre Elio
Published: December 2024

From a taxonomic point of view, Hymenoptera are subclassified into families: Apidae, including honeybees (Apis mellifera) and bumblebees (Bombus), and Vespidae, which, in turn, are divided into the subfamilies of Vespinae (wasps, including hornets, vespules, dolichovespules) and Polistinae (paper wasp). Hypersensitivity to Hymenoptera venom can be linked to immunological (IgE-mediated or non-IgE-mediated) and non-immunological mechanisms. Reactions are classified into local reactions, large local reactions, systemic reactions, toxic reactions, and unusual reactions. In general, children sensitize less frequently and have less severe reactions than adults, probably due to less exposure to repeated stings and fewer comorbidities. There are risk factors for systemic reactions that should be discussed with patients and their parents as appropriate. A correct diagnosis of Hymenoptera venom allergy relies on a careful clinical history and the appropriate use of skin and in vitro tests. The in vitro tests include serum specific IgE toward venom extracts and toward allergenic molecules. In complex diagnoses, CAP-inhibition and the Basophil Activation Test can also be used. In the presence of a systemic reaction, the basal serum tryptase measurement should be performed to rule out mastocytosis. In case of allergic reactions to Hymenoptera stings, in the acute phase, according to the current guidelines, the treatment of signs and symptoms mainly includes the use of adrenaline as first-line treatment in case of anaphylaxis and antihistamines and corticosteroids as subsequent lines of treatment. Given the impossibility of avoiding a new sting with certainty, the treatment of choice in subjects with hypersensitivity to Hymenoptera venom who have experienced systemic reactions is based on venom immunotherapy (VIT), with the venom of the responsible stinging insect identified after an adequate allergological work-up. VIT is performed in a suitable environment and has proved to be safe and effective with various administration protocols, both accelerated and conventional. The prevention of Hymenoptera venom anaphylaxis in patients who have already developed a previous episode is crucial and must be supported by environmental protection interventions and early therapy. Places where one is more likely to encounter insects and risky behaviors should be avoided.
Inclusivity is child’s play: pilot study on usability, acceptability and user experience of a sensory-motor PC game for children with cerebral palsy (GiocAbile)
Authors: Consales Alessandra , Biffi Emilia , Nossa Roberta , Pittaccio Simone , Lazzari Fabio , Malosio Matteo , Lavit Nicora Matteo , Tauro Giovanni , Redaelli Davide Felice , Chaudhary Atul , Diella Eleonora , Valoriani Matteo , Fedeli Francesca , Picciolini Odoardo , Giannì Maria Lorella , Porro Matteo
Published: December 2024

Background

The use of video games in rehabilitation settings is gaining increasing popularity. However, the lack of commercial video games suitable for children with disabilities and the disappointing user experience of serious games limit their applicability. The aim of this study was to assess the usability, acceptability and user experience of GiocAbile, an active video game for children with cerebral palsy (CP).

Methods

This multicenter pilot observational study was conducted from May to September 2022 at the participating institutions, and enrolled school-aged children affected by CP. Enrolled children played GiocAbile in single-player mode for one hour. The gaming experience was evaluated through self-assessment questionnaires. Non-parametric correlation analysis was conducted to examine the influence of motor and cognitive abilities (GMFCS, MACS, ICF) on declared usability and acceptability.

Results

Nineteen children (9.01 ± 1.95 years, 63.1% male) with mild to severe CP were enrolled. The 100% of respondents expressed satisfaction and fulfillment associated with gameplay, with no reports of frustration or disappointment. The 83% would recommend the game to a friend. The controllers were generally deemed easy to use and maneuver, with very few reports of discomfort associated with their use. No correlations were found between usability/acceptability levels and measures of impairment (i.e., GMFCS, MACS, and ICF scales), while cognitive impairment positively correlated with satisfaction during gameplay.

Conclusions

GiocAbile is an accessible, user-friendly and enjoyable tool for children with CP, regardless of level of impairment. Based on existing literature, we hypothesize that GiocAbile may improve motivation, participation, and rehabilitation outcomes in children with CP, although further studies are needed to confirm our hypothesis.
Azadirachtin disrupts ecdysone signaling and alters sand fly immunity
Authors: Vieira Cecilia Stahl , Bisogno Sara , Salvemini Marco , Loza Telleria Erich , Volf Petr
Published: December 2024

Background

Leishmaniasis is a group of neglected vector-borne diseases transmitted by phlebotomine sand flies. Leishmania parasites must overcome various defenses in the sand fly midgut, including the insects’s immune response. Insect immunity is regulated by the ecdysone hormone, which binds to its nuclear receptor (EcR) and activates the transcription of genes involved in insect immunity. However, the role of ecdysone in sand fly immunity has never been studied. Phlebotomus perniciosus is a natural vector of Leishmania infantum; here, we manipulated its neuroendocrine system using azadirachtin (Aza), a natural compound known to affect ecdysone synthesis.

Methods

Phlebotomus perniciosus larvae and adult females were fed on food containing either Aza alone or Aza plus ecdysone, and the effects on mortality and ecdysis were evaluated. Genes related to ecdysone signaling and immunity were identified in P. perniciosus, and the expression of antimicrobial peptides (AMPs), EcR, the ecdysone-induced genes Eip74EF and Eip75B, and the transcription factor serpent were analyzed using quantitative polymerase chain reaction (PCR).

Results

Aza treatment inhibited molting of first-instar (L1) larvae to L2, with only 10% of larvae molting compared to 95% in the control group. Serpent and Eip74EF, attacin, defensin 1, and defensin 2 genes were downregulated by Aza treatment in larvae. Similarly, Aza-treated adult females also presented suppression of ecdysone signaling-related genes and the AMPs attacin and defensin 2. Notably, all gene repression caused by Aza was reversed by adding ecdysone concomitantly with Aza to the larval or female food, indicating that these genes are effective markers for ecdysone repression.

Conclusions

These results highlight the critical role of ecdysone in regulating the development and immunity of P. perniciosus, which potentially could interfere with Leishmania infection.

Graphical Abstract
Maximizing insights from longitudinal epigenetic age data: simulations, applications, and practical guidance
Authors: Großbach Anna , Suderman Matthew J. , Hüls Anke , Lussier Alexandre A. , Smith Andrew D. A. C. , Walton Esther , Dunn Erin C. , Simpkin Andrew J.
Published: December 2024

Background

Epigenetic age (EA) is an age estimate, developed using DNA methylation (DNAm) states of selected CpG sites across the genome. Although EA and chronological age are highly correlated, EA may not increase uniformly with time. Departures, known as epigenetic age acceleration (EAA), are common and have been linked to various traits and future disease risk. Limited by available data, most studies investigating these relationships have been cross-sectional, using a single EA measurement. However, the recent growth in longitudinal DNAm studies has led to analyses of associations with EA over time. These studies differ in (1) their choice of model; (2) the primary outcome (EA vs. EAA); and (3) in their use of chronological age or age-independent time variables to account for the temporal dynamic. We evaluated the robustness of each approach using simulations and tested our results in two real-world examples, using biological sex and birthweight as predictors of longitudinal EA.

Results

Our simulations showed most accurate effect sizes in a linear mixed model or generalized estimating equation, using chronological age as the time variable. The use of EA versus EAA as an outcome did not strongly impact estimates. Applying the optimal model in real-world data uncovered advanced GrimAge in individuals assigned male at birth that decelerates over time.

Conclusion

Our results can serve as a guide for forthcoming longitudinal EA studies, aiding in methodological decisions that may determine whether an association is accurately estimated, overestimated, or potentially overlooked.
Whole genome sequence and LC-Mass for identifying antimicrobial metabolites of Bacillus licheniformis endophyte
Authors: Soliman Nourhan K. , Abbas Ahmad M. , El tayeb Wafaa N. , Alshahrani Mohammad Y. , Aboshanab Khaled M.
Published: December 2024

Antimicrobial resistance (AMR) represents a critical public health issue that requiring immediate action. Wild halophytic plants can be the solution for the AMR crisis because they harbor unique endophytes capable of producing potent antimicrobial metabolites. This study aimed at identifying promising and antimicrobial metabolites produced by endophytic/epiphytic bacteria recovered from the wild Bassia scoparia plant. Standard methods were employed for the isolation of endophytes/epiphytes. Whole genome sequence (WGS) using Oxford Nanopore technology followed by antiSMASH analysis coupled with advanced LC-MS spectroscopic analysis were used for identification of the active antimicrobial metabolites. This study identified Bacillus licheniformis strain CCASU-B18 as a promising endophytic bacterium from the Bassia scoparia plant. In addition, the strain showed broad-spectrum antibacterial activity against three standard and five MDR clinical Gram-positive and Gram-negative isolates, and antifungal activity against the standard C. albicans strain. Six main antimicrobial metabolites—thermoactinoamide A, bacillibactins, lichenysins, lichenicidins, fengycin, and bacillomycin—were verified to exist by whole genome sequencing for identifying the respective conserved biosynthetic gene clusters in conjunction with LC/MS-MS analysis. The complete genomic DNA (4125835) and associated plasmid (205548 bp) of the promising endophytic isolate were sequenced, assembled, annotated, and submitted into the NCBI GenBank database under the accession codes, CP157373. In conclusion, Bacillus licheniformis strain CCASU-B18, a promising endophytic bacterium exhibiting broad-spectrum antimicrobial activities, was isolated. Future research is highly recommended to optimize the culture conditions that will be employed to enhance the production of respective antimicrobial metabolites, as well as testing these compounds against a broader range of MDR-resistant pathogens.
Impact of c-JUN deficiency on thalamus development in mice and human neural models
Authors: Shi Jiantao , Chen Qing , Lai Jianheng , Zhu Jieying , Zhang Ran , Mazid Md. Abdul , Li Dongwei , Su Huanxing , Qin Dajiang
Published: December 2024

Background

c-Jun is a key regulator of gene expression. Through the formation of homo- or heterodimers, c-JUN binds to DNA and regulates gene transcription. While c-Jun plays a crucial role in embryonic development, its impact on nervous system development in higher mammals, especially for some deep structures, for example, thalamus in diencephalon, remains unclear.

Methods

To investigate the influence of c-JUN on early nervous system development, c-Jun knockout (KO) mice and c-JUN KO H1 embryonic stem cells (ESCs)-derived neural progenitor cells (NPCs), cerebral organoids (COs), and thalamus organoids (ThOs) models were used. We detected the dysplasia via histological examination and immunofluorescence staining, omics analysis, and loss/gain of function analysis.

Results

At embryonic day 14.5, c-Jun knockout (KO) mice exhibited sparseness of fibers in the brain ventricular parenchyma and malformation of the thalamus in the diencephalon. The absence of c-JUN accelerated the induction of NPCs but impaired the extension of fibers in human neuronal cultures. COs lacking c-JUN displayed a robust PAX6+/NESTIN+ exterior layer but lacked a fibers-connected core. Moreover, the subcortex-like areas exhibited defective thalamus characteristics with transcription factor 7 like 2-positive cells. Notably, in guided ThOs, c-JUN KO led to inadequate thalamus patterning with sparse internal nerve fibers. Chromatin accessibility analysis confirmed a less accessible chromatin state in genes related to the thalamus. Overexpression of c-JUN rescued these defects. RNA-seq identified 18 significantly down-regulated genes including RSPO2, WNT8B, MXRA5, HSPG2 and PLAGL1 while 24 genes including MSX1, CYP1B1, LMX1B, NQO1 and COL2A1 were significantly up-regulated.

Conclusion

Our findings from in vivo and in vitro experiments indicate that c-JUN depletion impedes the extension of nerve fibers and renders the thalamus susceptible to dysplasia during early mouse embryonic development and human ThO patterning. Our work provides evidence for the first time that c-JUN is a key transcription regulator that play important roles in the thalamus/diencephalon development.
Minimum carbon dioxide is a key predictor of the respiratory health of pigs in climate-controlled housing systems
Authors: Lagua Eddiemar Baguio , Mun Hong-Seok , Ampode Keiven Mark Bigtasin , Park Hae-Rang , Sharifuzzaman Md , Hasan Md Kamrul , Kim Young-Hwa , Yang Chul-Ju
Published: December 2024

Background

Respiratory disease is an economically important disease in the swine industry. Housing air quality control is crucial for maintaining the respiratory health of pigs. However, maintaining air quality is a limitation of current housing systems. This study evaluated the growth and health parameters of pigs raised under different environmental conditions and identified key environmental variables that determine respiratory health. Eighty (Largewhite × Landrace) × Duroc crossed growing pigs (31.71 ± 0.53 kg) were equally distributed into two identical climate-controlled houses with distinct environmental conditions (CON = normal conditions and TRT = poor conditions). Two-sample tests were performed to compare the means of the groups, and a random forest algorithm was used to identify the importance scores of the environmental variables to respiratory health.

Results

Pigs in the TRT group were significantly exposed to high temperatures (28.44 vs 22.78 °C, p < 0.001), humidity (88.27 vs 61.86%, p < 0.001), CO2 (2,739.93 vs 847.91 ppm, p < 0.001), NH3 (20.53 vs 8.18 ppm, p < 0.001), and H2S (14.28 vs 6.70 ppm, p < 0.001). Chronic exposure to these factors significantly reduced daily feed intake (1.82 vs 2.32 kg, p = 0.002), resulting in a significant reduction in average daily gain (0.72 vs 0.92 kg, p = 0.026), increased oxidative stress index (3.24 vs 1.43, p = 0.001), reduced cortisol levels (2.23 vs 4.07 mmol/L, p = 0.034), and deteriorated respiratory health status (74.41 vs 97.55, p < 0.001). Furthermore, a random forest model identified Min CO2, Min NH3, and Avg CO2 as the best predictors of respiratory health, and CO2 was strongly correlated with NH3 and H2S concentrations.

Conclusions

These findings emphasize the critical importance of proper environmental management in pig farming and suggest that regular monitoring and control of either CO2 or NH3, facilitated by environmental sensors and integration into intelligent systems, can serve as an effective strategy for improving respiratory health management in pigs.
Real-World Treatment Patterns After Discontinuation of Venetoclax or BTKis in the Frontline Setting Among Older Adults With Chronic Lymphocytic Leukemia
Authors: Huntington Scott F. , Rhodes Joanna M. , Manzoor Beenish S. , Jawaid Dureshahwar , Puckett Justin T. , Emechebe Nnadozie , Ravelo Arliene , Kamal-Bahl Sachin , Marx Steven E. , Doshi Jalpa A.
Published: December 2024

PURPOSE

Venetoclax and Bruton's tyrosine kinase inhibitors (BTKis) are key treatment options for patients with chronic lymphocytic leukemia (CLL) in the frontline setting. This study characterized postdiscontinuation treatment patterns and hospitalization of frontline venetoclax and BTKis in a national sample of older adults with CLL.

METHODS

We identified 1,770 Medicare beneficiaries 66 years and older with CLL initiating venetoclax with obinutuzumab (VEN-O, n = 193) or BTKi treatment (n = 1,577) in the frontline setting between June 01, 2019, and June 30, 2020. Discontinuation was defined as a consecutive 90-day gap in treatment at any point over an 18-month follow-up. BTKi patients were expected to receive treatment continuously; VEN-O patients were expected to complete 11 months of treatment (12 cycles × 28 days = 336 days). The rates of subsequent CLL treatment and all-cause/CLL-related hospitalization were assessed.

RESULTS

Over an 18-month follow-up, 102 (52.8%) VEN-O patients discontinued after completing the fixed-duration period; 597 (37.9%) BTKi and 57 (29.5%) VEN-O patients discontinued treatment prematurely. The median time to discontinuation was 11.9 months (VEN-O) and 4.0 months (BTKi patients), respectively. Few patients (n < 11) who discontinued VEN-O initiated another CLL treatment over a median postdiscontinuation follow-up period of 6.1 months. By contrast, 39.0% of discontinuers in the BTKi group had evidence of subsequent CLL treatment over a median 13.8-month postdiscontinuation follow-up period. Post-BTKi regimens included BCL-2 (35.6%), subsequent BTKi (31.8%), chemotherapy (14.6%), anti-CD20 monotherapy (9.9%), and other (8.2%). The rate of postdiscontinuation all-cause and CLL-related hospitalization per 100 patient-months was 2.0 and 1.5 for the VEN-O group and 3.3 and 2.9 for the BTKi group, respectively.

CONCLUSION

In this real-world study, early discontinuation was more common in patients initiating a BTKi in contrast to VEN-O. Patients who initiated a BTKi also had high rates of subsequent treatment and hospitalization.
Optimal ion shuttling for a noisy trap
Authors: Lu Xiao-Jing , Muga J. G.
Published: December 2024

We find continuous optimal trap trajectories to shuttle one ion with minimal excitation, when the trap spring constant is affected by white noise. The Euler-Lagrange method gives a lower bound for the dynamical (trajectory-dependent) energy sensitivity to the noise. Using a trigonometric ansatz for the state trajectories, the optimal trap trajectories are found for a given shuttling time and a fixed number of terms in the ansatz. The corresponding dynamical sensitivity tends to the lower bound as the number of terms increases. While the dynamical sensitivity increases by shortening the shuttling times, the static (trajectory-independent) one decreases, so we also find optimal shuttling times that minimize the global (static plus dynamical) sensitivity.
Effectiveness of Ventilation via an Endotracheal Tube in Pharynx Versus a Facemask in Patients With Potentially Difficult Airway: A Randomized, Crossover, and Blind Trial
Authors: Markham Travis , AlFarra Abraham S. , Tejani Mubeen , Tate Daniel J. , Barrera Jose E. , Paladugu Sreelekha , Saroukhani Sepideh , Jiang Yandong
Published: December 2024

BACKGROUND:

The difficult airway is frequently encountered across many scenarios. The extreme form is a “cannot intubate and cannot oxygenate” scenario, which lacks a reliable rescue technique. Previous case reports or studies with small sample sizes indicate the feasibility and efficiency of an endotracheal tube in the pharynx (TTIP) to ventilate patients. We hypothesize that ventilation via TTIP is an effective rescue technique for failed mask ventilation.

METHOD:

One hundred forty-seven patients with potentially difficult airways were randomly assigned to the sequence (Tube first) of tube first ventilation via TTIP for 1 minute after induction, followed by via mask ventilation for 1 minute or in reverse sequence (Mask first). The ventilation was done with pressure control mode, a peak inspiratory airway pressure of 20 cmH2O, an inspiratory to expiratory time ratio of 1:2, and a respiratory rate of 10 breaths/min.

RESULTS:

A total of 136 patients underwent final analysis. The overall success rate (primary outcome) of ventilation via TTIP and mask, defined as the presence of expired carbon dioxide, was 93.4% (127/136) and 84.6% (115/136), respectively (P = .02). The success rate, 85.7% (6/7), of mask ventilation rescuing a failed TTIP ventilation and 100% (13/13) of TTIP rescuing a failed mask ventilation were comparable (P = .35).

CONCLUSIONS:

The success rates of TTIP and mask ventilation are comparable. Ventilation via TTIP could be an alternative rescue technique for managing a difficult airway.
Association Between Arterial Hyperoxia and Mortality in Pediatric and Adult Patients Undergoing Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis
Authors: Gu Wan-Jie , Shi Rui , Cen Yun , Ye Ying-Ying , Xie Xu-Dong , Yin Hai-Yan
Published: December 2024

BACKGROUND:

In patients receiving extracorporeal membrane oxygenation (ECMO) support, the association between arterial hyperoxia and outcomes is unclear. We performed a systematic review and meta-analysis to determine the association between arterial Po
2 (Pao
2) and mortality in patients with ECMO.

METHODS:

The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and registered in International Prospective Register of Systematic Reviews (PROSPERO; CRD42023467361). We systematically searched PubMed and Embase databases up to September 2023 for randomized trials or observational studies that investigated the association between Pao
2 and mortality in pediatric and adult patients receiving venovenous ECMO (VV-ECMO), venoarterial ECMO (VA-ECMO), and extracorporeal cardiopulmonary resuscitation (ECPR). The predefined outcome was 28-day mortality. We synthesized the data using a random-effects model, calculating odds ratios (OR) and corresponding 95% confidence intervals (CI).

RESULTS:

Thirteen cohort studies (17,766 participants) were included. All studies used categorical Pao
2 cutoff, with varying thresholds ranging from ≥100 mm Hg to ≥300 mm Hg. When compared with patients with normoxia, elevated Pao
2 levels at all studied thresholds were consistently associated with increased mortality (≥300 mm Hg: OR 1.56, 95% CI, 1.31–1.85, P < .01; ≥200 mm Hg: OR 1.43, 95% CI, 1.10–1.87, P < .01; ≥150 mm Hg: OR 1.51, 95% CI, 1.15–1.98, P < .01; and ≥100 mm Hg: OR 1.44, 95% CI, 1.03–2.02, P = .03). A sensitivity analysis focusing on studies reporting adjusted OR yielded similar results. We observed this association in both adult and pediatric populations.

CONCLUSIONS:

In critically ill patients on VV- or VA-ECMO, increased Pao
2 values were associated with increased 28-day mortality in ECMO patients. Our results should be interpreted with caution given observational nature of included studies. Further randomized trials are warranted to validate these results.
Comparative Effectiveness of Analgesia for Early Pain Management After Pediatric Tonsillectomy: A Systematic Review and Network Meta-Analysis
Authors: Deng Xialin , Zhao Shishun , Guo Wenlai , Wan Xiao , You Di
Published: December 2024

BACKGROUND:

Timely and effective analgesia after tonsillectomy in children is crucial, but there is currently no consensus on the optimal analgesics. This analysis aimed to identify the most effective for this surgery.

METHODS:

We conducted a systematic review and network meta-analysis (random-effects model) of randomized controlled trials comparing analgesics for pediatric tonsillectomy. We searched relevant studies in PubMed, Embase, Cochrane Library, and Web of Science databases from database inception until June 30, 2023. Children (≤18 years old) who underwent tonsillectomy with or without adenoidectomy were eligible for inclusion. Primary outcomes encompassed pain score and postoperative complications; secondary outcomes included postoperative supplementary analgesia, functional evaluation, and sedation score.

RESULTS:

In total 82 randomized controlled trials involving 6110 patients were included, forming the primary network that comprised comparative data for 16 different interventions (including placebo) across 6 types of analgesics. The integrated analysis revealed that nonsteroidal anti-inflammatory drugs except ketoprofen had no significant effects in relieving postoperative pain (mean difference [MD], −2.96; 95% confidence interval [CI], −5.59 to −0.32; P = .10). Local anesthetic infiltration (bupivacaine: MD, −2.76; 95% CI, −3.88 to −1.64, P = .01; ropivacaine: MD, −2.49; 95% CI, −4.25 to −0.73, P = .02; lidocaine: MD, −1.86; 95% CI,-3.52 to −0.2, P = .02; levobupivacaine: MD, −1.06; 95% CI, −2.00 to −0.12, P = .01), analgesics (morphine: MD, −2.07; 95% CI, −3.14 to −1.00; P = .02), and glucocorticoids (dexamethasone: MD, −0.45; 95% CI, −0.73 to −0.16; P = .01) were effective in relieving pain after pediatric tonsillectomy. In reducing incidence of postoperative complications, dexamethasone was superior to bupivacaine (relative risk [RR], 0.60; 95% CI, 0.43–0.83; P = .02). Regarding the number of patients needing rescue analgesic, levobupivacaine was superior to lidocaine (RR, 0.51; 95% CI, 0.32–0.81; P = .01). In rescue analgesia requirement, morphine outperformed lidocaine (RR, 0.44; 95% CI, 0.25–0.75; P = .01) and ropivacaine (RR, 0.54; 95% CI, 0.32–0.91; P = .01) in efficacy but not different from bupivacaine (P = .10) and levobupivacaine (P = .12).

CONCLUSIONS:

Based on these results, we would recommend local bupivacaine infiltration or local levobupivacaine infiltration for older children and dexamethasone injection for younger children for early analgesia after tonsillectomy. However, clinicians should choose the optimal analgesic based on the individual child’s condition and clinical situation.
Paule Marshall, Urban Crisis, and the Bildungsroman in a Totalitarian Age
Authors: Morrison Spencer
Published: December 2024

This article presents Paule Marshall's Brown Girl, Brownstones (1959) as a novel whose aesthetic engagements with totalitarianism disclose broader ideological ambivalences within 1950s-era Black antiracist thought and art. Marshall, like other midcentury Black authors, refashions a language of totalitarianism commonly wielded by cold warriors, directing it toward an anticolonial critique of Western racism. A central facet of this critique is Marshall's representation of inner-city America as an internal colony whose race-based oppression resonates with overseas colonial injustices. However, in Marshall's novel, this critique unfolds through the Bildung of a protagonist whose rebellious growth ultimately connotes the geopolitical value of freedom trumpeted abroad by the US state at midcentury. The political energies the article's reading discerns in the novel are thus at once liberal and radical, nationalist and internationalist. Brown Girl, Brownstones contains residues of a radical internationalist critique of globalized racism articulated by Black anticolonial activists of 1940s; however, its major antiracist currents reflect the ascension among 1950s activists of a liberal narrative foregrounding the struggle for civil rights within America itself, one in which the nation-state struggled to actualize its democratic potential. Marshall's novel, that is, ultimately dissents from midcentury US liberalism while never quite entirely disavowing its tenets.
Prison Writing Anthologies in the United States
Authors: Lockard Joe
Published: December 2024

Prison writing anthologies have provided a defining presence in US prison literature. They have served as a vehicle for incarcerated writers to communicate with outside readers, even though early anthologies frequently relied on patronizing or obsequious language to gain publication. The late 1960s and early 1970s witnessed a surge in prison writing anthologies, a development that responded to rising social consciousness of prisons as sites created by and expressing racial, gender, and class inequalities. Sections of the present article address prison anthologies as a mobilization genre; an editorial typology of these anthologies; a brief history of this subgenre in the United States; and political consciousness and prison anthology production. The article discusses the emergence of prison anthologies as a coherent democratic publishing movement that has supported the twenty-first-century renaissance in US prison writing, and it theorizes this subgenre.
Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study
Authors: Bakshi Poorva , Shetty Sharanya B. , Bera Shreya , D'Souza Priyanka Renita , Pai Keshava
Published: December 2024

Background Rational prescription writing is an important skill to master during internship. This Quality Improvement (QI) project aimed to understand the state of prescription writing among interns posted in the Department of Psychiatry, analyze the causes responsible for errors in prescription writing and bring about a change in the current practice. Methods The MBBS interns are posted in the Department of Psychiatry for 15 days. During day 1 to day 5 of their posting, a pre intervention phase was conducted wherein prescriptions written by interns in the Department of Psychiatry were collected. The prescriptions were scored based on 14 criteria which were selected based on World Health Organization (WHO) guidelines and Medical Council of India (MCI) ideal prescription format. During PDSA (Plan Do Study Act) Cycle 1, an educational handout was distributed to the interns containing the MCI ideal prescription format and WHO guidelines regarding prescription writing. The brochure was also verbally explained to the interns. From day 7 to day 15 of their posting, prescriptions written by the interns were collected. The prescriptions were scored using the same criteria. Results During the pre intervention phase the mean total score of prescriptions was 9.54 ± 1.003. There was a significant improvement in the mean total score to 10.26 ± 0.746. There was a 7.54% improvement. There was also a significant improvement in several individual criteria. Conclusions The first PDSA cycle was successful in improving the quality of prescription writing among interns posted in the Department of Psychiatry. There is a need to implement more PDSA cycles to improve the quality still further.
Developing treatments for cerebral small vessel disease: a scoping review of licensed interventions for potential repurposing
Authors: M Bath Philip , P Phan Elizabeth , Clay Gwynneth , Dawson Jesse , Malhotra Paresh , Howard Rob , Pal Suvankar , M Wardlaw Joanna , Quinn Terry , Macleod Malcolm
Published: December 2024

Background Cerebral small vessel disease (cSVD) is a progressive neurovascular-degenerative condition without specific treatment that causes lacunar stroke, most intracerebral haemorrhage, vascular cognitive impairment (VCI) and several neuropsychiatric conditions. Objectives To conduct a rapid multi-stage scoping review to identify licensed interventions that could be repurposed for testing in cSVD at phase-3. Methods First, we screened preclinical studies of potential relevance to cSVD and used a drug dictionary to identify studies of potential interventions. Separately, we screened clinical studies of relevance to cSVD and VCI. Following merging, we removed drugs that were unsuitable or impractical to assess long-term in the UK. We then performed mini-meta-analyses for shortlisted interventions assessing effects on cognition and scored these for their relevance to cSVD. Results The preclinical review created a long-list of 1,757 deduplicated interventions. Those that were not available in the UK, not expensive or impractical to administer long-term were merged with 62 interventions identified from 75 relevant clinical studies to create a medium-list of 52 interventions. Focussed literature review short-listed ten interventions for review by an independent scientific advisory group; they ranked three as most suitable for immediate testing: metformin, tadalafil and isosorbide mononitrate. Conclusion This rapid review identified three interventions that are suitable for testing in a late phase-3 (platform) trial involving patients with cSVD. The approach could be improved with partial automation, text mining and generative pre-trained transformer approaches which would help manage the large data volumes. Further, our data-driven approach could be combined with genetic or other mechanistic methods to further de-risk future trials.
Conflict between freedom and health in the COVID-19 pandemic: An appraisal of China's zero-COVID-19 policy
Authors: Zhu Ke-Wei
Published: December 2024

Background The Chinese dynamic zero-COVID-19 policy was a very strict policy for COVID-19 response in the Chinese mainland, with the overarching goal of preventing imported infections and domestic flare-ups. Policy and implications The dynamic zero-COVID-19 policy has long been criticized by European and American politicians for the issue of human rights. There are some points that need to be considered with regard to these criticisms: Firstly, the dynamic zero-COVID-19 policy protected millions of Chinese people from death, the outcomes of China’s COVID-19 response demonstrated the correctness and suitability of the dynamic zero-COVID-19 policy, and the policy benefited the world. Secondly, freedom and health were generally conflicted and extremely difficult to be compatible in the COVID-19 pandemic, and the dynamic zero-COVID-19 policy indeed exhibited several advantages in the fight against COVID-19. Thirdly, China struggled to spare no effort to save lives all the time during the COVID-19 pandemic under the dynamic zero-COVID-19 policy. Recommendations Appropriate restrictions on freedom and human rights are justified to protect public health and prevent harm to others in the COVID-19 pandemic, and an important premise is that the implement of these restrictions are based on law. Conclusions In summary, it is biased to censure the Chinese dynamic zero-COVID-19 policy or abandonment of the Chinese dynamic zero-COVID-19 policy based on human rights, and the great achievement of the policy and China’s efforts to fight against the COVID-19 pandemic should not be ignored.
CONTEMPORARY CHALLENGES AS CATALYSTS FOR THE FORMATION OF NEW PHILOSOPHICAL VALUES
Authors: Saralaev N. K. , Murzalieva Z. K. , Sadykova B. A.
Published: December 2024

In the modern world, we face a complex of challenges, including globalization, climate change, technological progress, social inequality, and pandemics. These factors not only change people’s daily lives, but also cause a rethinking of traditional philosophical values ​​and the need to reassess them in the context of new realities. This article examines the mechanisms through which modern challenges act as catalysts for the formation of new philosophical values, and examines the consequences of these changes for human life and society as a whole.
A STUDY OF INSTALLATION ART AS A SOCIOCULTURAL PHENOMENON
Authors: Rui Zhang
Published: December 2024

As a modern art form, installation art has become an important component of contemporary art, embodying rich social and cultural connotations. This paper explores the interactive relationship between installation art and social culture, cultural identity and expression, as well as its application and value in public spaces. Firstly, installation art reflects social phenomena through the emotions and thoughts of the artist, revealing the living conditions and cultural perceptions of people in different historical contexts. Secondly, installation art serves as a vessel for cultural identity, expressing the social identities of specific individuals and groups, and reflecting the differences and commonalities among various cultures in the context of globalization. Finally, the application of installation art in public spaces promotes the popularization of art, becoming an essential part of urban cultural development and fostering cultural dialogue and public participation. Through the study of installation art, we can gain a deeper understanding of its significant role in contemporary social and cultural development and its potential for future growth.
PECULARITIES OF LISTENING COMPREHENSION DEVELOPMENT
Authors: Kudinova O. A. , Kudinova V. I.
Published: December 2024

The research presented in this article is aimed at studying the competence of listening comprehension, which should be formed among postgraduate students studying a foreign language within their specialty. The goals and content of academic listening training can be defined within the framework of interdisciplinary language integration, which will contribute to achieving a certain level of professional communicative competence of students.
Yoga e a fadiga relacionada ao câncer durante o tratamento do câncer de mama: protocolo de um ensaio clínico randomizado
Authors: Acosta Iamara Rodrigues , Alberton Cristine Lima , Petrarca Cristiane Rios , Pinto Stephanie Santana
Published: December 2024

A fadiga relacionada ao câncer é um dos sintomas que mais impacta a qualidade de vida de pacientes em tratamento para o câncer de mama. A prática de Yoga vem sendo utilizada como intervenção não farmacológica para atenuar os sintomas durante o tratamento para o câncer de mama. No entanto, são necessários mais estudos, a fim de elucidar e preencher possíveis lacunas acerca dos efeitos da prática de Yoga nesta população. Este artigo descreve o protocolo de um ensaio clínico randomizado que tem como objetivo analisar os efeitos de um programa de Yoga, em comparação com um grupo controle, sobre desfechos físicos e psicológicos de pacientes diagnosticadas com câncer de mama em tratamento pelo Sistema Único de Saúde (SUS) na cidade de Pelotas-Rio Grande do Sul. Trinta mulheres serão randomizadas em grupo Yoga ou controle. As participantes do grupo Yoga serão submetidas a um programa de Yoga, associado com educação em saúde, duas vezes por semana durante oito semanas, com duração de 60 minutos cada sessão. O grupo controle participará apenas de encontros de educação em saúde, uma vez por semana, também durante oito semanas e com encontros de 60 minutos. Serão realizadas avaliações da fadiga relacionada ao câncer, qualidade de vida, dor, capacidade funcional e nível de atividade física no lazer pré e pós intervenção. Para analisar os dados será utilizado o teste Generalized Estimating Equations e post-hoc de Bonferroni (α = 0,05). O protocolo do estudo está registrado no Registro Brasileiro de Ensaios Clínicos sob o número RBR-6vk2vjr.
Monograph review: Kolіesnik L.Ya. Variation of nominations of human in the Pokuttia-Bukovyna dialects. K.: Dmytro Burago Publishing House, 2018. 640 p.
Authors: Lesnova Valentyna
Published: December 2024

The review has analyzed the monograph "Variation of nominations of human in the Pokuttia-Bukovyna dialects" which expands the empirical base of the Ukrainian dialectology, deepens the theory of nomination and spatial variation of the language.In the peer-reviewed work the researcher’s highlighted the history of the formation of Pokuttia-Bukovyna dialects, substantiated the priority areas of dialect vocabulary research; considered the complex of qualifying and evaluative nominations of a person in the aspect of variation of the dialect vocabulary.The empirical value is provided in the monograph Materials for the Lexical Atlas of the Ukrainian Language: the nomination of a person in the Pokuttia-Bukovyna dialects; the atlas "Nomination of a person in the Pokuttia-Bukovyna dialects" that includes 71 maps, and the Glossary of nominative units.