bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunotherapy for Pulmonary Arterial Hypertension: From the Pathogenesis to Clinical Management
Authors: Zhang Yihan , Li Xing , Li Shang , Zhou Yu , Zhang Tiantai , Sun Lan
Published: August 2024

Pulmonary hypertension (PH) is a progressive cardiovascular disease, which may lead to severe cardiopulmonary dysfunction. As one of the main PH disease groups, pulmonary artery hypertension (PAH) is characterized by pulmonary vascular remodeling and right ventricular dysfunction. Increased pulmonary artery resistance consequently causes right heart failure, which is the major reason for morbidity and mortality in this disease. Although various treatment strategies have been available, the poor clinical prognosis of patients with PAH reminds us that further studies of the pathological mechanism of PAH are still needed. Inflammation has been elucidated as relevant to the initiation and progression of PAH, and plays a crucial and functional role in vascular remodeling. Many immune cells and cytokines have been demonstrated to be involved in the pulmonary vascular lesions in PAH patients, with the activation of downstream signaling pathways related to inflammation. Consistently, this influence has been found to correlate with the progression and clinical outcome of PAH, indicating that immunity and inflammation may have significant potential in PAH therapy. Therefore, we reviewed the pathogenesis of inflammation and immunity in PAH development, focusing on the potential targets and clinical application of anti-inflammatory and immunosuppressive therapy.
α-Tocotrienol Protects Neurons by Preventing Tau Hyperphosphorylation via Inhibiting Microtubule Affinity-Regulating Kinase Activation
Authors: Liu Yuhong , Chen Yunxi , Fukui Koji
Published: August 2024

In the pathological process of Alzheimer’s disease, neuronal cell death is closely related to the accumulation of reactive oxygen species. Our previous studies have found that oxidative stress can activate microtubule affinity-regulating kinases, resulting in elevated phosphorylation levels of tau protein specifically at the Ser262 residue in N1E-115 cells that have been subjected to exposure to hydrogen peroxide. This process may be one of the pathogenic mechanisms of Alzheimer’s disease. Vitamin E is a fat-soluble, naturally occurring antioxidant that plays a crucial role in biological systems. This study aimed to examine the probable processes that contribute to the inhibiting effect on the abnormal phosphorylation of tau protein and the neuroprotective activity of a particular type of vitamin E, α-tocotrienol. The experimental analysis revealed that α-tocotrienol showed significant neuroprotective effects in the N1E-115 cell line. Our data further suggest that one of the mechanisms underlying the neuroprotective effects of α-tocotrienol may be through the inhibition of microtubule affinity-regulated kinase activation, which significantly reduces the oxidative stress-induced aberrant elevation of p-Tau (Ser262) levels. These results indicate that α-tocotrienol may represent an intriguing strategy for treating or preventing Alzheimer’s disease.
RiboScreenTM Technology Delivers a Ribosomal Target and a Small-Molecule Ligand for Ribosome Editing to Boost the Production Levels of Tropoelastin, the Monomeric Unit of Elastin
Authors: Wimmer Bjoern , Schernthaner Jan , Edobor Genevieve , Friedrich Andreas , Poeltner Katharina , Temaj Gazmend , Wimmer Marlies , Kronsteiner Elli , Pichler Mara , Gercke Hanna , Huber Ronald , Kaefer Niklas , Rinnerthaler Mark , Karl Thomas , Krauß Jan , Mohr Thomas , Gerner Christopher , Hintner Helmut , Breitenbach Michael , Bauer Johann W. , Rakers Christin , Kuhn Daniel , von Hagen Joerg , Müller Norbert , Rathner Adriana , Breitenbach-Koller Hannelore
Published: August 2024

Elastin, a key structural protein essential for the elasticity of the skin and elastogenic tissues, degrades with age. Replenishing elastin holds promise for anti-aging cosmetics and the supplementation of elastic activities of the cardiovascular system. We employed RiboScreenTM, a technology for identifying molecules that enhance the production of specific proteins, to target the production of tropoelastin. We make use of RiboScreenTM in two crucial steps: first, to pinpoint a target ribosomal protein (TRP), which acts as a switch to increase the production of the protein of interest (POI), and second, to identify small molecules that activate this ribosomal protein switch. Using RiboScreenTM, we identified ribosomal protein L40, henceforth eL40, as a TRP switch to boost tropoelastin production. Drug discovery identified a small-molecule hit that binds to eL40. In-cell treatment demonstrated activity of the eL40 ligand and delivered increased tropoelastin production levels in a dose-dependent manner. Thus, we demonstrate that RiboScreenTM can successfully identify a small-molecule hit capable of selectively enhancing tropoelastin production. This compound has the potential to be developed for topical or systemic applications to promote skin rejuvenation and to supplement elastic functionality within the cardiovascular system.
Integration of Immunology in a Systems-Based Osteopathic Medical Curriculum
Authors: Shabbir Zian , Mazdeyasnan Layla , Iqbal Naila , Kadavakollu Samuel , Qureshi Mahboob , Lamichhane-Khadka Reena
Published: August 2024

Immunology is an important component of the medical curriculum. It provides a foundation for understanding the cellular and molecular processes by which the body protects itself from external substances and the immunological responses that contribute to the development of many illnesses. The inclusion of immunology in an osteopathic medical curriculum is essential to understanding the body’s defense systems as well as the alignment of osteopathic concepts with immunology. By encompassing innate and adaptive immunity, immunology reflects the interconnectedness of the body’s systems and the foundation for self-regulation inherent in osteopathy. A problem facing medical educators is determining how to facilitate students’ learning of immunological concepts in a way that will help them retain and apply the material throughout their clinical years and beyond. This paper aims to provide an immunology education framework designed to effectively integrate immunology topics across the preclinical courses of an osteopathic medical curriculum. Drawing insights from an extensive review of the literature and current medical curricula, we propose an integrative curriculum model that broadly incorporates fundamental concepts of immunology across multiple disciplines and systems-based courses horizontally as well as vertically over the preclinical years using clinical presentations and laboratory findings and further connecting them to osteopathic principles. This integrative curriculum will augment medical students’ understanding of immunology, making them better able to connect core concepts with clinical applications and enhance their application of immunological concepts in osteopathic patient care in alignment with the NBOME guidelines. Using the proposed integrative medical curriculum may better prepare medical students for providing holistic medical care and guidance to their future patients.
Solutions to Address the Low-Capacity Utilization Issue in Singapore’s Precast Industry
Authors: Chen Chen , Tiong Robert
Published: August 2024

Singapore has established six Integrated Construction and Prefabrication Hubs with the goal of meeting ambitious productivity targets and building a resilient precast supply chain by 2024. These factories are equipped with high levels of mechanization and automation. However, they are currently operating far below their designed capacity due to a storage bottleneck. In land-scarce Singapore, finding large spaces for precast storage is a challenge. One possible solution is to implement a just-in-time approach. To achieve this, a systematic approach is required to plan, monitor, and control the entire supply chain effectively, utilizing various strategies, methods, and tools. This paper aims to conduct a comprehensive literature review in related areas, believing that knowledge transfer is a faster way to develop solutions to new problems. The main idea of the proposed solution is to implement an integrated supply chain system model with a central decision-maker. It is recommended that the factories take a more active role in decision-making. Establishing this integrated system relies on trust and information sharing, which can be facilitated by cutting-edge digital technologies. The results of this paper will provide valuable insights for future research aimed at completely solving this issue.
Health Service Improvement for People with Parkinson’s Disease: A Scoping Review
Authors: Williams Susan , Prior Sarah Jane
Published: August 2024

Parkinson’s disease is a progressive neurological disorder typically beginning in middle or late life, with risk increasing with age. Accessing health services for people living with Parkinson’s disease can be challenging and stressful, often resulting in the worsening of current symptoms, the development of new symptoms, including infection, fatigue, and confusion, or medication changes. This can lead to an increased length of stay in hospital and/or readmission, further worsening symptoms. The aim of this scoping review is to explore how quality improvement and healthcare redesign initiatives have contributed to understanding issues around length of stay and readmission to hospital for people living with Parkinson’s disease. The review was guided by Arksey and O’Malley’s framework and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist. The Excerpta Medica dataBASE (EMBASE), Medline, and Cumulated Index in Nursing and Allied Health Literature (CINAHL) databases were searched for relevant articles published between 2019 and 2023. The included articles were categorised using thematic analysis. Ten articles were included in this review, resulting in the following three major categories: issues contributing to length of stay and readmission, interventions, and recommendations. Quality improvement and healthcare redesign can improve the length of stay and readmission rates for people living with Parkinson’s disease through robust design, delivery, and evaluation.
Optimization of Hypothermic Protocols for Neurocognitive Preservation in Aortic Arch Surgery: A Literature Review
Authors: Llerena-Velastegui Jordan , Velastegui-Zurita Sebastian , Zumbana-Podaneva Kristina , Mejia-Mora Melany , Jesus Ana Clara Fonseca Souza de , Coelho Pedro Moraes
Published: August 2024

Shifts from deep to moderate hypothermic circulatory arrest (HCA) in aortic arch surgery necessitate an examination of their differential impacts on neurocognitive functions, especially structured verbal memory, given its significance for patient recovery and quality of life. This study evaluates and synthesizes evidence on the effects of deep (≤20.0 °C), low-moderate (20.1–24.0 °C), and high-moderate (24.1–28.0 °C) hypothermic temperatures on structured verbal memory preservation and overall cognitive health in patients undergoing aortic arch surgery. We evaluated the latest literature from major medical databases such as PubMed and Scopus, focusing on research from 2020 to 2024, to gather comprehensive insights into the current landscape of temperature management during HCA. This comparative analysis highlights the viability of moderate hypothermia (20.1–28.0 °C), supported by recent trials and observational studies, as a method to achieve comparable neuroprotection with fewer complications than traditional deep hypothermia. Notably, low-moderate and high-moderate temperatures have been shown to support substantial survival rates, with impacts on structured verbal memory preservation that necessitate careful selection based on individual surgical risks and patient profiles. The findings advocate for a nuanced approach to selecting hypothermic protocols in aortic arch surgeries, emphasizing the importance of tailoring temperature management to optimize neurocognitive outcomes and patient recovery. This study fills a critical gap in the literature by providing evidence-based recommendations for temperature ranges during HCA, calling for ongoing updates to clinical guidelines and further research to refine these recommendations. The implications of temperature on survival rates, complications, and success rates underpin the necessity for evolving cardiopulmonary bypass techniques and cerebral perfusion strategies to enhance patient outcomes in complex cardiovascular procedures.
Solanine Inhibits Proliferation and Angiogenesis and Induces Apoptosis through Modulation of EGFR Signaling in KB-ChR-8-5 Multidrug-Resistant Oral Cancer Cells
Authors: Prasad Prathibha , Jaber Mohamed , Alahmadi Tahani Awad , Almoallim Hesham S. , Ramu Arun Kumar
Published: August 2024

Background: The most important factors contributing to multi-drug resistance in oral cancer include overexpression of the EGFR protein and the downstream malignancy regulators that are associated with it. This study investigates the impact of solanine on inflammation, proliferation, and angiogenesis inhibition in multidrug-resistant oral cancer KB-Chr-8-5 cells through inhibition of the EGFR/PI3K/Akt/NF-κB signaling pathway. Methods: Cell viability was assessed using an MTT assay to evaluate cytotoxic effects. Production of reactive oxygen species (ROS), mitochondrial membrane potential (ΔΨM), and AO/EtBr staining were analyzed to assess apoptosis and mitochondrial dysfunction. Western blotting was employed to examine protein expression related to angiogenesis, apoptosis, and signaling pathways. Experiments were conducted in triplicate. Results: Solanine treatment at concentrations of 10, 20, and 30 μM significantly increased ROS production, which is indicative of its antioxidant properties. This increase was associated with decreased mitochondrial membrane potential (ΔΨM) with p < 0.05, suggesting mitochondrial dysfunction. Inhibition of EGFR led to reduced activity of PI3K, Akt, and NF-κB, resulting in decreased expression of iNOS, IL-6, Cyclin D1, PCNA, VEGF, Mcl-1, and HIF-1α and increased levels of the apoptotic proteins Bax, caspase-9, and caspase-3. These changes collectively inhibited the growth of multidrug-resistant (MDR) cancer cells. Conclusions: Solanine acts as a potent disruptor of cellular processes by inhibiting the EGFR-mediated PI3K/Akt/NF-κB signaling pathway. These results suggest that solanine holds promise as a potential preventive or therapeutic agent against multidrug-resistant cancers.
De Novo Biopsy-Proven Glomerular Disease Following COVID-19 Vaccination
Authors: Chen Cheng-Hsu , Chiu Yu-Wei , Chen Bo-Ding , Wu Ming-Ju , Tsai Shang-Feng
Published: August 2024

Background: There is still no consensus about the coronavirus disease 2019 (COVID-19) vaccine-associated glomerular disease (CVAGD). Given the large number of vaccinations administered and the variations in glomerulopathy observed across different countries and regional environments, CVAGD remains an important area of concern. Aim of study: We aimed to elucidate the findings of CVAGD within a Taiwanese cohort using biopsy data. Additionally, we endeavored to clarify the presentation of CVAGD. Methods: We collected data from patients who underwent renal biopsy from June 2021 to October 2022 at Taichung Veterans General Hospital. Two independent nephrologists meticulously reviewed the charts to exclude cases unrelated to vaccination. Results: Initially, a total of 286 patients underwent renal biopsy at our institute. Ultimately, we identified 14 patients with highly suspected CVAGD. All 14 patients exhibited proteinuria and hematuria. The urinary protein-to-creatinine ratio was elevated (median of 2012.1 mg/g; interquartile range (IQR) 25%–IQR 75%: 941.85–3884.1 mg/g) with a median serum creatinine level of 1.71 mg/dL (0.79–5.35). The majority of CVAGD cases were diagnosed as immunoglobulin A (IgA) nephropathy (n = 5, 35.7%), followed by antineutrophil cytoplasmic antibody (ANCA)-related rapidly progressive glomerulonephritis (RPGN) (n = 4, 28.6%). There were only three cases of minimal change disease each: one case of focal segmental glomerulosclerosis, one of membranous glomerulonephritis, and one of lupus nephritis. The culprit of COVID-19 vaccinations was 35.7% (n = 5) of Oxford-AstraZeneca (ChAdOx1-S), 42.9% (n = 6) of Moderna, and 21.4% (n = 3) of BNT162b2. Most patients experienced improvements in renal function. Only two cases of P-ANCA RPGN and one case of IgA nephropathy did not recover. Eighty percent of IgA nephropathy cases had favorable outcomes, but none of the patients with P-ANCA RPGN achieved full recovery. Conclusions: IgA nephropathy and ANCA-related RPGN were the most common CVAGD, and all types of COVID-19 vaccines posed a risk for CVAGD. However, further studies are required to confirm causality.
Data Privacy and Ethical Considerations in Database Management
Authors: Pina Eduardo , Ramos José , Jorge Henrique , Váz Paulo , Silva José , Wanzeller Cristina , Abbasi Maryam , Martins Pedro
Published: August 2024

Data privacy and ethical considerations ensure the security of databases by respecting individual rights while upholding ethical considerations when collecting, managing, and using information. Nowadays, despite having regulations that help to protect citizens and organizations, we have been presented with thousands of instances of data breaches, unauthorized access, and misuse of data related to such individuals and organizations. In this paper, we propose ethical considerations and best practices associated with critical data and the role of the database administrator who helps protect data. First, we suggest best practices for database administrators regarding data minimization, anonymization, pseudonymization and encryption, access controls, data retention guidelines, and stakeholder communication. Then, we present a case study that illustrates the application of these ethical implementations and best practices in a real-world scenario, showing the approach in action and the benefits of privacy. Finally, the study highlights the importance of a comprehensive approach to deal with data protection challenges and provides valuable insights for future research and developments in this field.
Valuation of Medical Innovation Handling with Uncertainty and Risk
Authors: Nuijten Mark , Capri Stefano
Published: August 2024

Background: The purpose of this paper is to address how to handle uncertainty when performing an economic valuation of a medical innovation R&D project in orphan diseases from the perspective of the investor. Methods: We describe the specific uncertainty related to cash flows and the cost of capital for innovation in orphan diseases. The uncertainty in cash flows relates to sales, manufacturing and R&D costs, and probabilities of failure for each phase in the clinical trial program. We consider different net present values (NPVs) and higher standard deviations for orphan drugs compared to non-orphan drugs. Results: Numerical case base examples showed the differences in trade-off by an investor for R&D projects with differences in NPV and level of uncertainty. The investor will transfer the additional uncertainty in cash flows in a higher cost of capital. An alternative approach is the application of an “acceptability curve” based on a probabilistic sensitivity analysis, which displays the cumulative probabilities at a range of different values for the NPV. Finally, we consider uncertainty in the cost of capital itself by applying the Capital Asset Pricing Model (CAPM). Conclusions: In this paper, we described various types of uncertainty and explored various approaches to how to handle uncertainty in the economic valuation of medical innovation in orphan diseases. The bridging of health economics with economic valuation theory in the healthcare market is to our knowledge a novel approach for the valuation of medical innovation by investors.
Optimization and Energy Maximizing Control Systems for Wave Energy Converters II
Authors: Giorgi Giuseppe , Bonfanti Mauro
Published: August 2024

Over the past decade, the renewable energy sector has witnessed remarkable growth, which has been attributed to government support [...]
Effects of Perforations on Internal Cathodic Protection and Recruitment of Marine Organisms to Steel Pipes
Authors: Paluzzi Alexander , Swain Geoffrey , DeFrancisci John , Kuchma Daniel , Hansel Colleen M.
Published: August 2024

Steel monopile support structures for offshore wind turbines require protection from corrosion and consideration with respect to biofouling on their external and internal surfaces. Cathodic protection (CP) works effectively to protect the external surfaces of monopiles, but internally, byproducts from aluminum sacrificial anode CP (SACP) and impressed current CP (ICCP) induce acidification that accelerates steel corrosion. Through an 8-week sea water deployment of four steel pipes, this project investigated the effect of perforations on internal CP systems. Additionally, marine growth on the internal and external surfaces of the pipes was assessed. SACP and ICCP systems inside perforated pipes performed similarly to external systems at a lower current demand relative to internal systems in sealed pipes. The organisms that grew inside of the perforated SACP and ICCP pipes were similar, suggesting that the CP systems did not affect organism recruitment. The results of this study demonstrate the potential benefits of designing perforated monopiles to enable corrosion control while providing an artificial reef structure for marine organisms to develop healthy ecosystems.
Validation of the SCALE/Polaris–PARCS Code Procedure With the ENDF/B-VII.1 AMPX 56-Group Library: Boiling Water Reactor
Authors: Kim Kang Seog , Ward Andrew , Mertyurek Ugur , Asgari Mehdi , Wieselquist William
Published: August 2024

The SCALE/Polaris–PARCS code procedure has been used in the confirmatory analysis for boiling water reactors by the US Nuclear Regulatory Commission. In this study, the SCALE/Polaris v6.3.0–PARCS v3.4.2 code procedure with the Evaluated Nuclear Data File (ENDF)/B-VII.1 AMPX 56-group library was validated by comparing the simulated results with the measured data for operating boiling water reactors, including Peach Bottom Unit 2 cycles 1–3, Hatch Unit 1 cycles 1–3, and Quad Cities Unit 1 cycles 1–3. The uncertainties and biases of the SCALE/Polaris–PARCS code package for boiling water reactor physics analysis were evaluated in the validation for key nuclear parameters such as reactivity and traversing in-core probe data.
Aspergillus in the Indoor Air of Critical Areas of a Tertiary Hospital in Brazil
Authors: Lemos Michele Scardine Corrêa de , Higa Junior Minoru German , Paniago Anamaria Mello Miranda , Melhem Marcia de Souza Carvalho , Takahashi Juliana Possato Fernandes , Fava Wellington Santos , Venancio Fabio Antonio , Martins Nayara Moreno , Chang Marilene Rodrigues
Published: August 2024

Airborne Aspergillus spp. are critical pathogens that cause nosocomial infections in hospitals. Despite their importance, little is known about the distribution of Aspergillus species in the indoor air of hospitals in Brazil. We investigated Aspergillus spp. in the indoor air of critical areas in a tertiary hospital in Brazil. Air samples (n = 238) were collected from the intensive care unit (ICU), medical clinic unit (MCU), and urgency and emergency unit (UEU) using an air sampler (100 L/min). Of the 324 Aspergillus isolates, 322 were identified using phenotypic methods, and 37 were identified using DNA sequencing. Aspergillus spp. was grouped into five sections: Fumigati (29.3%), Nidulantes (27.8%), Nigri (27.5%), Flavi (11.7%), and Terrei (3.1%). The predominant species identified via sequencing were Aspergillus sydowii (n = 9), Aspergillus flavus (n = 7), and Aspergilus fumigatus (n = 6). The number of Aspergillus spp. and their sections varied according to the collection day. A. fumigatus was isolated more frequently during winter and in the ICU. This study is the first to demonstrate the diversity of airborne Aspergillus (saprophytic, allergenic, toxigenic, and potentially pathogenic) strains in a hospital located in the Midwest region of Brazil. It contributes to the knowledge of the diversity of cryptic species in the hospital environment.
In Vivo Antischistosomicidal and Immunomodulatory Effects of Dietary Supplementation with Taraxacum officinale
Authors: Nofal Amany , Shaaban Amal , Ibrahim Hany , Abouelmagd Faten , Mohamed Azza
Published: August 2024

Bilharziasis is a widespread trematode parasite that poses a severe public health burden. Dandelion (Taraxacum officinale) has several pharmacological and traditional properties critical for treating several hepatic disorders. The present study was designed to assess the potential efficacy of T. officinale root (TOR) dietary supplementation with or without praziquantel (PZQ) against liver and intestinal disorders in mice infected with Schistosoma mansoni. This study was conducted on five groups; G1: uninfected control, G2: untreated S. mansoni-infected mice, G3: infected animals treated with 250 mg/kg PZQ for three alternative days, G4: infected animals were orally administered 600 mg/kg bw TOR daily for 10 days, and G5: infected animals that received both PZQ and TOR as previously described. The current findings after different treatments indicated topographical scanning electron microscopy alterations of male adult worms and a critical reduction in worm burden, ova count, granuloma diameter, hepatic and intestinal histological abnormalities, fibrosis, immunohistochemical expression of CD3+ and CD20+ cells, oxidative stress, and interleukin-10, also upregulation of interferon-gamma, and antioxidant enzymes, when compared to the infected untreated mice. The best results were obtained in mice administered PZQ+TOR together because of their antioxidant properties and ability to promote the host immune response to parasitic infection.
Quality of Life of Patients Using Esophageal Speech after Total Laryngectomy: A Systematic Review Study
Authors: Plotas Panagiotis , Mastronikolis Stylianos N. , Papadopoulos Angelos , Zarnomitrou Kiriaki , Pagkalou Marina , Kantanis Anastasios , Alexiou Eleni , Katseri Eygenia , Kyriakopoulou Maria , Reppa Maria , Souka Aggeliki , Christopoulos Alexandros , Trimmis Nikolaos , Mastronikolis Nicholas
Published: August 2024

(1) Background: The present systematic study aimed to assess whether using esophageal speech (ES) as a method of vocal rehabilitation in patients after total laryngectomy enhances their quality of life (QoL) and vocal functionality based on patients’ reports. (2) Methods: Data collection was conducted from PubMed, Google Scholar, and Speech Bite, and the PRISMA Flow Diagram tool was used to record different stages of the literature search process. In the review, nine studies were included, while a bias check was carried out using the Critical Appraisal Skills Programme (CASP) checklists. Survey analysis incorporated quantitative and qualitative data, including standardized questionnaires and audio analyses. (3) Results: A technique’s effectiveness depends on the method’s functionality and the patient’s abilities. Furthermore, the findings revealed that ES use unexpectedly affects quality of life regarding patients. While statistical analysis of the studies showed that some patients reported improvement in quality of life and vocal functionality, others faced challenges such as difficulty in learning the technique, long-term intervention, and unsatisfactory phonetic performance. Some studies observed quantitative measures, such as improved Voice Impairment Index (VHI) scores and Voice-Related Quality of Life (V-RQOL) scores. However, results were not uniformly positive across studies, with a subset of patients reporting minimal improvement. (4) Conclusions: The limited literature on the effect of ES on patients’ QoL appears to influence the results in different ways. However, research data support that patients’ communication and psychological state seem to improve significantly compared to patients who have not been rehabilitated. The final assessment of the technique’s effectiveness on quality of life must depend on many factors.
Detection and Characterization of Extracellular Vesicles in Sputum Samples of COPD Patients
Authors: Kotsiou Ourania S. , Katsanaki Katerina , Tsiggene Aikaterini , Papathanasiou Sophia , Rouka Erasmia , Antonopoulos Dionysios , Gerogianni Irene , Balatsos Nikolaos A. A. , Gourgoulianis Konstantinos I. , Tsilioni Irene
Published: August 2024

Background: Only one study has reported the presence of extracellular vesicles (EVs) in COPD patients’ sputum. Thus, we aimed to isolate and characterize EVs from COPD and healthy individuals’ sputum. Methods: A total of 20 spontaneous sputum samples from COPD patients (m/f: 19/1) and induced sputum samples from healthy controls (m/f: 8/2) were used for EV isolation. The sputum supernatants were resuspended in PBS, precleared by centrifugation at 800× g for 10 min at 4 °C, and passed through a 0.22 μm filter (Millipore, Burlington, MA, USA). EVs were isolated by a standard membrane affinity spin column method (exoEasy maxi kit, Qiagen, Hilden, Germany). The EVs were then characterized by assessing their morphology and size using Transmission Electron Microscopy (TEM) and determining the CD9 and CD81 EV-markers with Western blot analysis. Results: The EVs had a spherical shape and their mean diameter in the COPD patients was significantly greater than in the controls. Enrichment of the EV markers, CD9 and CD81, were detected in both the healthy and COPD individuals. Total EV-associated protein was significantly increased in the COPD patients compared to the controls. ROC analysis showed that total EV-associated protein in the sputum could be used to differentiate between the controls and COPD patients, with a sensitivity of 80% and a specificity of 70% at a cut-off point of 55.59 μg/mL (AUC = 0.8150). Conclusions: EVs were detectable in both the COPD and healthy individuals’ sputum. The ratio of EVs in the 150–200 nm range was twice as high in the COPD patients than in the controls. The COPD patients’ sputum contained increased total EV-associated protein as compared to controls, highlighting their value as a new source of specific exoproteins.
Effects of Risk Committee on Agency Costs and Financial Performance
Authors: Almulhim Abdulateif A. , Aljughaiman Abdullah A. , Al Naim Abdulaziz S. , Alosaimi Abdulmohsen K.
Published: August 2024

This study aimed to explore the influence of risk committee characteristics on agency costs and financial performance as well as investigate whether the attributes of a risk committee moderate the association between the agency costs and financial performance of financial firms listed in the Saudi Stock Market (TASI). We primarily concentrate on six attributes of risk committees (risk committee existence, size, independence, meetings, financial expertise, and busyness) and their impact on agency costs and financial performance. This study employed the ordinary least squares (OLS) and generalized methods of moments (GMM) models to explore these relationships. Using a sample of 455 observations representing the financial corporations listed on the TASI for the period from 2010 to 2022, we found that risk committees’ existence, risk committee independence, and financial expertise have negative and significant associations with agency costs, but a positive influence on financial performance. However, risk committee size and busyness are positively related to agency costs and adversely associated with firms’ financial performance. Furthermore, we showed that agency costs influence banks’ financial performance negatively, yet risk committees oversee this risk and enhance banks’ financial performance. The findings of this study have implications for financial firms, policymakers, and regulators. Beyond making empirical contributions by investigating a relatively unexplored topic in a developing Middle Eastern economy, this analysis provides valuable insights into optimizing risk committee characteristics and structures to improve financial monitoring within the framework of Saudi Arabia. This area of research has been relatively limited compared to studies conducted in developed countries.
Prediction of Currency Exchange Rate Based on Transformers
Authors: Zhao Lu , Yan Wei Qi
Published: August 2024

The currency exchange rate is a crucial link between all countries related to economic and trade activities. With increasing volatility, exchange rate fluctuations have become frequent under the combined effects of global economic uncertainty and political risks. Consequently, accurate exchange rate prediction is significant in managing financial risks and economic instability. In recent years, the Transformer models have attracted attention in the field of time series analysis. Transformer models, such as Informer and TFT (Temporal Fusion Transformer), have also been extensively studied. In this paper, we evaluate the performance of the Transformer, Informer, and TFT models based on four exchange rate datasets: NZD/USD, NZD/CNY, NZD/GBP, and NZD/AUD. The results indicate that the TFT model has achieved the highest accuracy in exchange rate prediction, with an R2 value of up to 0.94 and the lowest RMSE and MAE errors. However, the Informer model offers faster training and convergence speeds than the TFT and Transformer, making it more efficient. Furthermore, our experiments on the TFT model demonstrate that integrating the VIX index can enhance the accuracy of exchange rate predictions.
Does Audit Oversight Quality Reduce Insolvency Risk, Systematic Risk, and ROA Volatility? The Role of Institutional Ownership
Authors: Abraham Rebecca , El-Chaarani Hani , Deari Fitim
Published: August 2024

The board of directors appoints the audit committee to assess the financial performance of the firm. The audit committee uses reports provided by audit firms, such as Form 10Ks, and annual reports to assess firm financial performance. The degree of audit oversight quality is a governance measure, which, if effective, may reduce firm risk. This study measures the effect of three measures of audit oversight quality on insolvency risk, systematic risk, and volatility of return on assets for a sample of U.S. pharmaceutical firms and energy firms from 2010 to 2022. All measures of audit oversight quality reduced firm risk, with the first measure reducing both systematic risk and volatility of return on assets, the second measure reducing systematic risk, and the third measure reducing volatility of return on assets. As institutional ownership is also a governance measure, we tested whether its joint effect with audit oversight quality reduced firm risk. This hypothesis was supported for all three measures of audit oversight quality for systematic risk and for the third audit oversight quality measure for volatility of assets. Robustness was established by replicating the regressions with an alternate governance measure, which yielded similar results. Endogeneity of all audit oversight quality measures was absent due to lack of significance of leverage, firm size, equity multiplier, and firm value in reducing risk through their effect on audit oversight quality.
Study on Spatial Distribution Dispersion Evaluation and Driving Forces of Rural Settlements in the Yellow River Basin
Authors: Li Heying , Zhang Jianchen , Shan Yamin , Wang Guangxia , Tian Qin , Wang Jiayao , Ma Huiling
Published: August 2024

The spatial distribution pattern of rural settlements in the Yellow River Basin is scattered and numerous. It is of great significance to study the discrete distribution of rural settlements for achieving high-quality development and promoting rural revitalization strategy. In this paper, we propose an enhanced evaluation model for assessing the spatial distribution dispersion of rural settlements, incorporating the weight of road grade (the road grade refers to the ranking of traffic capacity and importance of a particular type of road, indicating varying levels of time accessibility). We investigate the dispersion characteristics of rural settlements in the Yellow River Basin in 2020, focusing on both county and city scales. Furthermore, we conduct a comprehensive analysis of the spatial differentiation and scale effects of dispersion evaluation outcomes and their driving forces. Our findings reveal the following insights: (1) The road grade significantly influences the dispersion evaluation. When considering road grade in the dispersion calculation, the results align more closely with the actual situation. (2) The dispersion of rural settlements in the Yellow River Basin exhibits a decreasing trend from west to east. Specifically, the dispersion is higher in the upper reaches compared to the middle and lower reaches. Both city and county scales show spatial autocorrelation in dispersion, with a positive spatial correlation observed. High dispersion values cluster in the west, while low values concentrate in the east. Notably, the agglomeration degree is more pronounced at the county scale than at the city scale, highlighting more localized patterns of agglomeration and dispersion. (3) The multiscale geographically weighted regression model emerges as the optimal model for analyzing the driving forces of dispersion. At the city scale, factors such as river density, road density, and rural economy negatively impact dispersion. However, at the county scale, average elevation and rural economy positively affect dispersion, whereas river density, road density, and rural population density have a negative influence. By incorporating the weight of road grade into our evaluation model, we provide a more nuanced understanding of the spatial distribution dispersion of rural settlements in the Yellow River Basin. Our findings offer valuable insights for policymakers and planners seeking to optimize rural settlement patterns and promote sustainable rural development.
The Disparity of Greenness Accessibility across Major Metropolitan Areas in the United States from 2013 to 2022
Authors: Tang Minmeng , Li Xinwei
Published: August 2024

Urban green space (UGS) is a fundamental infrastructure in modern urban settings, crucial for regulating the urban climate and improving public health. Accessibility to UGS represents a significant environmental justice issue, influencing the sustainable development of local communities. In this work, we comprehensively evaluated the temporal dynamics of UGS accessibility and the disparity in exposure for all 31 metropolitan divisions in the United States from 2013 to 2022. Our findings indicate that there have been no significant changes in both population-weighted UGS exposure and within-city inequality of UGS exposure for all racial/ethnic groups across the study period. Furthermore, a consistent racial/ethnic disparity in UGS exposure was noted throughout the study period, with the White group tending to have higher-than-average UGS accessibility, and all other racial/ethnic groups, including Asian, Black, Hispanic, Native American, and Pacific Islander, experiencing lower-than-average UGS accessibility. These findings underscore the urgency for urban planning and policy-making strategies to address these inequities, promoting healthy and sustainable urban development.
A Comparative Study on the Pain Threshold Experienced by Fibromyalgia Patients Following Acute SARS-CoV-2 Infection
Authors: Matei Daniela , Traistaru Rodica , Amzolini Anca Maria , Ianosi Laura Simona , Neagoe Carmen Daniela , Mitrea Adina , Clenciu Diana , Avramescu Taina Elena
Published: August 2024

Significant gaps remain in the understanding of the etiology and pathogenesis of fibromyalgia (FM), and the COVID-19 pandemic has introduced even more unknowns. Social factors specific to that period, the viral infection itself, and/or vaccination are additional elements that can complicate the progression of the disease or the response to treatment. Aim: The primary hypothesis to be evaluated in this study is that an acute COVID-19 infection, even when considered recovered, may induce changes in the response to non-pharmacological treatment in FM patients, particularly concerning pain. Results: We included 128 patients diagnosed with FM before the pandemic began. The patients were divided based on their history of acute SARS-CoV-2 infection and COVID-19 vaccination status. All patients followed the same rehabilitation program (cognitive therapy, kinesitherapy). Perceived pain: The non-COVID-19 patient groups showed a statistically significant reduction in pain at the final evaluation compared to patients with a history of acute SARS-CoV-2 infection (p < 0.001). Algometric evaluation: Patients without COVID-19 infection and that were vaccinated exhibited the best improvement in pain threshold, both across evaluation times (p < 0.001) and compared to any of the other three groups studied (p < 0.001). Using the WHYMPI questionnaire, the same group of patients (those not having experienced acute COVID-19 and who were vaccinated) was the only group with a statistically significant improvement in pain severity (p = 0.009). In conclusion, to control and improve FM pain symptoms, in addition to appropriate medication, we propose paying additional attention to the history of acute SARS-CoV-2 infection and the COVID-19 vaccination status.
An Update on Mitral Valve Aging
Authors: Opris Carmen Elena , Suciu Horatiu , Opris Cosmin Ioan , Gurzu Simona
Published: August 2024

The aging process can have notable effects on the mitral valve. During life, the mitral valve undergoes various changes that can impact its structure and function. The purpose of this review is to present a comprehensive overview of the literature published up to February 2024 in the Medline database regarding the impact of aging on the mitral valve. The studies were combined with the personal experience of the authors. Until 2024, out of the 12,189 publications that deal with the mitral valve in elderly individuals, 308 refer to mitral valve aging. After reviewing these data, we selected and analyzed the 73 most informative works regarding the age-related transformation of the mitral valve. Understanding the mechanisms driving the aging of the mitral valve is crucial for enhancing diagnostic and therapeutic strategies for reducing age-related valve dysfunction and the subsequent cardiovascular complications.
Usability of Minimal Invasive Surgery for Elbow Dislocation with Coronoid Process Fracture: A Protocol Development Study
Authors: Lin Chun-Cheng , Cheng Ming-Fai , Wang Chien-Shun , Chiang Chao-Ching , Su Yu-Ping
Published: August 2024

Objective: The study aims to explain whether or not minimal invasive surgery (MIS) would be feasible in elbow fracture–dislocation with coronoid process fracture. Methods: At Taipei Veterans General Hospital, patients who had elbow dislocations with coronoid process fractures underwent a single surgeon’s MIS techniques which included the fluoroscopy-guided ulnar anteromedial (FGUAM) approach in the stage of reducing the coronoid process. When there is a proximal ulnar fracture, the posterior incision should be necessary, followed by the incision over the lateral or medial elbow for treating radial fractures or ligament injuries. Results: The Flow Diagram for approach recommendation was established on the basis of defining MIS as that which does not include cross-plane dissection. The importance of anterior rigid fixation for the coronoid process was also emphasized. Conclusions: MIS can be achieved by multiple limited surgical incisions. Although the posterior extensile approach is necessary in situations of ulnar metaphysis or ligament avulsion fracture, the FGUAM approach decreases the cross-plane dissection.
Impact of Stiffness of Quadriceps on the Pedaling Rate of Maximal Cycling
Authors: Ieong Loi , Ni Xindi , Xie Huisong , Liu Ye
Published: August 2024

Propulsive power is one of the factors that determine the performance of sprint cycling. Pedaling rate is related to power output, and stiffness is associated with improving performance in athletic tasks. Purpose: to investigate the relationship between musculoarticular stiffness and pedaling rate. Methods: twenty-two healthy, untrained male volunteers (19 ± 2 years, 175 ± 6 cm, 74 ± 16 kg) were divided into two groups after their musculoarticular (MA) stiffness was tested, and these groups were the stiffness group (SG) and compliant group (CG). A 6-s maximal cycling test was conducted in four cycling modes, which were levels 5 and 10 air-resistance, and levels 3 and 7 magnetic-resistance. Peak and average cadence, peak power output (POpeak), crank force (CFpeak), peak rate of crank force development (RCFD), and the angle of peak crank force were collected. The significance of differences between the two groups for these variables was assessed using an independent samples t-test. Pearson product–moment correlations were calculated to analyze the relationship between MA stiffness and each performance variable. Results: the SG had significantly higher peak cadence and average cadence at level 3 magnetic-resistance, peak crank force, and peak power output at level 10 air-resistance, peak rate of crank force development at levels 5 air-resistance, 10 air-resistance, and 3 magnetic-resistance (p < 0.05). MA stiffness was significantly correlated with average cadence at levels 5 and 10 air-resistance, peak crank force in all 4 modes, and RCFD and peak power output at level 10 air-resistance. There were no significant relationships between MA stiffness and the angle of peak crank force in each cycling mode. Conclusion: results indicate that participants with relatively higher MA stiffness seemed to have a higher pedaling rate during a 6-s sprint cycling in these conditions. They also performed a superior crank force and rate of crank force development, producing greater power output when sprint cycling. Optimizing cycling resistance or gear ratio to enhance both RCFD and musculotendinous stiffness may be crucial for improving sprint cycling performance.
Impact of Excision Type, Cone Volume, and Dimensions on Persistence/Recurrence of Cervical Intraepithelial Neoplasia 2–3
Authors: Medina Bueno Gonzalo Arturo , Fernández-Montolí Maria Eulalia , Heydari Fatima , Ponce Jordi , Tous Sara , Peñafiel Judith
Published: August 2024

The objective of this study was to evaluate the relationship between the excision type and the persistence/recurrence of CIN2–3. A total of 227 women with CIN2–3 who were treated with LLETZ were evaluated. The types of excision according to the IFCPC 2011, volume, cone dimensions, margins of resection, post-cone high-risk human papillomavirus (HR-HPV) status, and viral load were studied. The time to recurrence was assessed using Kaplan–Meier curves. Persistent/recurrent CIN2–3 was found in 12 cases (5.2%). Type 1 excision was performed in 107 patients, with 7 recurrences (6.5%); type 2 excision in 74 patients, with 4 recurrences (5.4%); and type 3 excision in 46 patients, with 1 recurrence (2.1%). The percentage of clear margins in type 1 excisions was 44.9%, that in type 2 excisions was 59.5%, and that in type 3 excisions was 69.6% (p = 0.008). Type 1 excision was associated with 28.5% post-LLETZ HR-HPV positivity, that in type 2 reached 20.6%, and that in type 3 reached 11.4%; this difference was non-significant (p = 0.24). (4) Conclusions: Type 3 excision was associated with a larger proportion of clear margins and lower post-cone HR-HPV positivity, with a lower incidence of the persistence/recurrence of CIN2–3.