bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomized phase II study of full dose gemcitabine versus reduced dose gemcitabine and nab-paclitaxel in vulnerable patients with non-resectable pancreatic cancer (DPCG-01)
Authors: Rasmussen Louise Skau , Winther Stine B. , Chen Inna M. , Weber Britta , Ventzel Lise , Liposits Gabor , Johansen Julia Sidenius , Detlefsen Sönke , Egendal Ida , Shim Susy , Christensen Signe , Pfeiffer Per , Ladekarl Morten
Published: June 2023

Background

According to current evidence, the best treatment for fit patients with non-resectable pancreatic cancer (PC) is combination chemotherapy, whereas frail patients are recommended gemcitabine (Gem) monotherapy. Randomized controlled trials in colorectal cancer and a post-hoc analysis of gemcitabine and nab-paclitaxel (GemNab) in PC suggest, however, that reduced dose of combination chemotherapy may be feasible and more efficient compared to monotherapy in frail patients. The aim of this study is to investigate whether reduced dose GemNab is superior to full dose Gem in patients with resectable PC, who are not candidates for full dose combination chemotherapy in first line.

Methods

The Danish Pancreas Cancer Group (DPCG)-01 trial is a national multicenter prospective randomized phase II trial. A total of 100 patients in ECOG performance status 0–2 with non-resectable PC, not candidate for full dose combination chemotherapy in first line, but eligible for full dose Gem, will be included. Patients are randomized 1:1 to either full dose Gem or GemNab in 80% of recommended dose.

The primary endpoint is progression-free survival. Secondary endpoints are overall survival, overall response rate, quality of life, toxicity and rate of hospitalizations during treatment. The correlation between blood inflammatory markers, including YKL-40 and IL-6, circulating tumor DNA, and tissue biomarkers of resistance to chemotherapy and outcome will be explored. Finally, the study will include measures of frailty (G8, modified G8, and chair-stand-test) to assess whether scoring would enable a personalized allocation to different treatments or indicates a possibility for interventions.

Discussion

Single-drug treatment with Gem has for frail patients with non-resectable PC been the main treatment option for more than thirty years, but the impact on outcome is modest. If improved results and sustained tolerability with reduced dose combination chemotherapy can be shown, this could change the future practice for this increasing group of patients.

Trial registration

ClinicalTrials.gov Identifier: NCT05841420.

Secondary Identifying No: N-20210068.

EudraCT No: 2021–005067-52.

Protocol version: 1.5, 16-MAY-2023.
Factors associated with acute kidney injury among preterm infants administered vancomycin: a retrospective cohort study
Authors: Shin Baek Sup , Shin Seung Han , Park Seul Gi , Kim Ee-Kyung , Kim Han-Suk
Published: June 2023

Background

Vancomycin (VCM) is a widely used antibiotic for the treatment of gram-positive microorganisms, with some nephrotoxic effects. Recent studies have suggested that piperacillin-tazobactam (TZP) aggravates VCM-induced nephrotoxicity in adults and adolescents. However, there is a lack of research investigating these effects in the newborn population. Therefore, this study investigates whether the concomitant use of TZP with VCM use increases the risk of acute kidney injury (AKI) and to explore the factors associated with AKI in preterm infants treated with VCM.

Methods

This retrospective study included preterm infants with birth weight < 1,500 g in a single tertiary center who were born between 2018 and 2021 and received VCM for a minimum of 3 days. AKI was defined as an increase in serum creatinine (SCr) of at least 0.3 mg/dL and an increase in SCr of at least 1.5 times baseline during and up to 1 week after discontinuation of VCM. The study population was categorized as those with or without concomitant use of TZP. Data on perinatal and postnatal factors associated with AKI were collected and analyzed.

Results

Of the 70 infants, 17 died before 7 postnatal days or antecedent AKI and were excluded, while among the remaining participants, 25 received VCM with TZP (VCM + TZP) and 28 VCM without TZP (VCM—TZP). Gestational age (GA) at birth (26.4 ± 2.8 weeks vs. 26.5 ± 2.6 weeks, p = 0.859) and birthweight (750.4 ± 232.2 g vs. 838.1 ± 268.7 g, p = 0.212) were comparable between the two groups. There were no significant differences in the incidence of AKI between groups. Multivariate analysis showed that GA (adjusted OR: 0.58, 95% CI: 0.35–0.98, p = 0.042), patent ductus arteriosus (PDA) (adjusted OR: 5.23, 95% CI: 0.67–41.05, p = 0.115), and necrotizing enterocolitis (NEC) (adjusted OR: 37.65, 95% CI: 3.08–459.96, p = 0.005) were associated with AKI in the study population.

Conclusions

In very low birthweight infants, concomitant use of TZP did not increase the risk of AKI during VCM administration. Instead, a lower GA, and NEC were associated with AKI in this population.
Say it right: measuring the impact of different communication strategies on the decision to get vaccinated
Authors: Avelino-Silva Vivian I. , Ferreira-Silva Sofia Natalia , Soares Maria Eduarda Muniz , Vasconcelos Ricardo , Fujita Luiz , Medeiros Tainah , Barbieri Carolina Luisa Alves , Couto Marcia Thereza
Published: June 2023

Background

Vaccine hesitancy is a concerning menace to the control of vaccine-preventable diseases. Effective health communication could promote an overall understanding of the importance, risks, and benefits of vaccination and reduce vaccine hesitancy.

Methods

In this survey, four fictitious newspaper articles addressing an emerging bogus disease and its vaccine were randomly assigned to participants. The first version focused on information about the disease; the second was akin to the first, including a case description and image. The third version focused on vaccine safety/efficacy; the fourth version was like the third, including a case description and image. After reading a single version of the article, participants responded if they would take the vaccine and if they would vaccinate their children. We used chi-squared tests for comparisons and investigated interactions with vaccine-hesitant attitudes.

Results

We included 5233 participants between August/2021 and January/2022; 790 were caregivers of a child ≤ 5 years old, and 15% had prior vaccine hesitancy. Although most declared intention to take the vaccine, the percentage was highest among those exposed to the newspaper article focusing on the vaccine safety/efficacy with the case description and picture (91%; 95% confidence interval 89–92%), and lowest among participants exposed to the article focusing on the disease with no case description (84%; 95% confidence interval 82–86%). Similar trends were observed in the intention of offspring vaccination. We found evidence of effect modification by vaccine-hesitant attitudes, with a higher impact of communication focusing on vaccine safety/efficacy compared to that focusing on disease characteristics among hesitant participants.

Conclusion

Communication strategies focusing on different aspects of the disease-vaccine duet may impact vaccine hesitancy, and storytelling/emotive imagery descriptions may improve risk perception and vaccine uptake. Moreover, the effect of message framing strategies may differ according to previous vaccine hesitant attitudes.
Scientific creativity and innovation ability and its determinants among medical postgraduate students in Fujian province of China: a cross sectional study
Authors: Liu Fengqiong , Qu Shuming , Fan Yi , Chen Fa , He Baochang
Published: June 2023

Background

Graduate education is the main approach to training high-level innovative elites. With the expansion of the scale of graduate education in China, it has gradually emerged that the lack of innovation ability of graduate students is recognized as the primary problem in graduate education. How to comprehensively improve the quality of postgraduate teaching has become the core task of educational reform and development. However, data about the current cultivation and development of the innovative ability of graduate students in China is limited.

Methods

A questionnaire survey was conducted among medical postgraduate students. Descriptive statistics and multiple regression analysis methods were used to analyze the data to describe the current innovation ability in advanced medical education and potential influence factors.

Results

A total of 1241 medical students were surveyed, according to the results of questionnaire data analysis. The proportion of subjects who participated in the College Student’s Entrepreneurship and Innovation program or any other scientific research programs are fairly high which are 46.82% and 29.20% respectively. Most of the participants are observed with high levels of self-motivation and active learning and have good performance in creative thinking. However, only a small number of participants (16.6%) reported academic achievements such as publications. Most of the students are satisfied with the current scientific research environment and think that the current postgraduate training system is qualified for the cultivation of innovation ability, and expects the inclusion of course specialized in systemic medicine and medical informatics in the curricula. Multiple logistic regression results showed that among the factors studied, gender, medical specialties, and types of master’s degrees are associated with cognition & skills, academic performance, and creativity.

Conclusions

It will be important to incorporate more techniques for creating and improving creativity in the curricula of the current postgraduate education, especially for courses such as systemic medicine and informatics. Guidance in earlier school life can stimulate creativity and an early introduction to scientific research work will facilitate innovative thinking and behavior. Scientific research programs such as the National Innovation and Entrepreneurship Training for the universities of PRC have been widely implemented in the undergraduate education system throughout the country. However, the training effectiveness of the current scientific research programs is worth improving.
Nursing, midwifery, and allied health professions research capacities and cultures: a survey of staff within a university and acute healthcare organisation
Authors: Palmer S. , Coad J. , Gamble J. , Jones C. , Lees-Deutsch L. , McWilliams D. , Murphy E. , Kneafsey R.
Published: June 2023

Background

There is an increasing focus on the development of research capacity and culture in Nursing, Midwifery and Allied Health Professions (NMAHP). However, better understanding of the existing research success and skills, motivators, barriers, and development needs of NMAHP professionals is required to inform this development. This study sought to identify such factors within a university and an acute healthcare organisation.

Methods

An online survey, incorporating the Research Capacity and Culture tool, was administered to NMAHP professionals and students at a university and an acute healthcare organisation in the United Kingdom. Ratings of success/skill levels of teams and individuals were compared between professional groups using Mann–Whitney U tests. Motivators, barriers, and development needs were reported using descriptive statistics. Descriptive thematic analysis was used for open-ended text responses.

Results

A total of 416 responses were received (N&M n = 223, AHP n = 133, Other n = 60). N&M respondents were more positive than their AHP counterparts about the success/skill levels of their teams. There were no significant differences between N&M and AHP in their ratings of individual successes/skills. Finding and critically reviewing relevant literature were identified as specific individual strengths; with weaknesses in securing research funding, submitting ethics applications, writing for publication, and advising less experienced researchers. The main motivators for research were to develop skills, increased job satisfaction, and career advancement; whilst barriers included lack of time for research and other work roles taking priority. Key support needs identified included mentorship (for teams and individuals) and in-service training. Open-ended questions generated main themes of ‘Employment & staffing’, ‘Professional services support’, ‘Clinical & academic management’, ‘Training & development’, ‘Partnerships’ and ‘Operating principles’. Two cross-cutting themes described issues common to multiple main themes: ‘Adequate working time for research’ and ‘Participating in research as an individual learning journey’.

Conclusions

Rich information was generated to inform the development of strategies to enhance research capacity and culture in NMAHP. Much of this can be generic but some nuances may be required to address some specific differences between professional groups, particularly related to perceived team success/skills and priorities identified for support and development.
Identification of miR-143-3p as a diagnostic biomarker in gastric cancer
Authors: Ju Yeongdon , Choi Go-Eun , Lee Moon Won , Jeong Myeongguk , Kwon Hyeokjin , Kim Dong Hyeok , Kim Jungho , Jin Hyunwoo , Lee Kyung Eun , Hyun Kyung-Yae , Jang Aelee
Published: June 2023

Background

Gastric cancer (GC) is among the most common types of gastrointestinal cancers and has a high incidence and mortality around the world. To suppress the progression of GC, it is essential to develop diagnostic markers. MicroRNAs regulate GC development, but a clearer insight into their role is needed before they can be applied as a molecular markers and targets.

Methods

In this study, we assessed the diagnostic value of differentially expressed microRNAs as potential diagnostic biomarkers for GC using data for 389 tissue samples from the Cancer Genome Atlas (TCGA) and 21 plasma samples from GC patients.

Results

The expression of hsa-miR-143-3p (also known as hsa-miR-143) was significantly downregulated in GC according to the TCGA data and plasma samples. The 228 potential target genes of hsa-miR-143-3p were analyzed using a bioinformatics tool for miRNA target prediction. The target genes correlated with extracellular matrix organization, the cytoplasm, and identical protein binding. Furthermore, the pathway enrichment analysis of target genes showed that they were involved in pathways in cancer, the phosphoinositide 3-kinase (PI3K)–protein kinase B (Akt) signaling pathway, and proteoglycans in cancer. The hub genes in the protein–protein interaction (PPI) network, were matrix metallopeptidase 2 (MMP2), CD44 molecule (CD44), and SMAD family member 3 (SMAD3).

Conclusions

This study suggests that hsa-miR-143-3p may be used as a diagnostic marker for GC, contributing via the pathways involved in the development of GC.
CTNNB1 p.D32A (c.95A > C) somatic mutation in stage I grade 1 endometrioid endometrial carcinoma with lung metastasis: a case report
Authors: Zhong Lan , Jiang Wei , RutieYin  , Liu Hui , Song Liang
Published: June 2023

Background

Most endometrial cancers are of low histological grade and uterine-confined, with a high 5-year survival rate. However, a small subset of women with low-grade and early-stage endometrioid endometrial cancer experience recurrence and death; thus, a more precise risk-stratification is needed.

Case presentation

A 29-year-old woman presented with abnormal vaginal bleeding and was diagnosed with FIGO grade 1 endometrioid endometrial carcinoma by curettage. Comprehensive cancer staging including pelvic and para-aortic lymphadenectomy was then performed. Postoperative pathological findings suggested an FIGO grade 1 endometrioid endometrial carcinoma infiltrating the superficial muscle layer. The patient did not receive adjuvant therapy. After 4 years of follow-up, the patient returned to our institution with lung metastasis. She underwent thoracoscopic resection of the affected lobes, followed by six cycles of combined chemotherapy of paclitaxel and carboplatin. Next-generation sequencing showed that the primary and lung metastatic tumors shared 4 mutations: PTEN (p.P248Lfs*8), CTNNB1 (p.D32A), BCOR (p.N1425S) and CBL (p.S439N). Immunohistochemistry revealed nuclear location of β–catenin in the primary and lung metastatic tumor samples, indicating abnormal activation of β–catenin.

Conclusion

CTNNB1p.D32A (c.95A > C) mutation may be related to lung metastasis in this patient with low-grade early-stage endometrioid endometrial carcinoma.
Accelerated mineral bio-carbonation of coarse residue kimberlite material by inoculation with photosynthetic microbial mats
Authors: Jones Thomas Ray , Poitras Jordan , Gagen Emma , Paterson David John , Southam Gordon
Published: June 2023

Microbiological weathering of coarse residue deposit (CRD) kimberlite produced by the Venetia Diamond Mine, Limpopo, South Africa enhanced mineral carbonation relative to untreated material. Cultures of photosynthetically enriched biofilm produced maximal carbonation conditions when mixed with kimberlite and incubated under near surface conditions. Interestingly, mineral carbonation also occurred in the dark, under water-saturated conditions. The examination of mineralized biofilms in ca. 150 µm-thick-sections using light microscopy, X-ray fluorescence microscopy (XFM) and backscatter electron—scanning electron microscopy-energy dispersive x-ray spectrometry demonstrated that microbiological weathering aided in producing secondary calcium/magnesium carbonates on silicate grain boundaries. Calcium/magnesium sulphate(s) precipitated under vadose conditions demonstrating that evaporites formed upon drying. In this system, mineral carbonation was only observed in regions possessing bacteria, preserved within carbonate as cemented microcolonies. 16S rDNA molecular diversity of bacteria in kimberlite and in natural biofilms growing on kimberlite were dominated by Proteobacteria that are active in nitrogen, phosphorus and sulphur cycling. Cyanobacteria based enrichment cultures provided with nitrogen & phosphorus (nutrients) to enhance growth, possessed increased diversity of bacteria, with Proteobacteria re-establishing themselves as the dominant bacterial lineage when incubated under dark, vadose conditions consistent with natural kimberlite. Overall, 16S rDNA analyses revealed that weathered kimberlite hosts a diverse microbiome consistent with soils, metal cycling and hydrocarbon degradation. Enhanced weathering and carbonate-cemented microcolonies demonstrate that microorganisms are key to mineral carbonation of kimberlite.
Cardiovascular mortality in patients with advanced chronic kidney disease with and without diabetes: a nationwide cohort study
Authors: Kofod Dea Haagensen , Carlson Nicholas , Ballegaard Ellen Freese , Almdal Thomas Peter , Torp-Pedersen Christian , Gislason Gunnar , Svendsen Jesper Hastrup , Feldt-Rasmussen Bo , Hornum Mads
Published: June 2023

Background

Cardiovascular mortality and the impact of cardiac risk factors in advanced chronic kidney disease (CKD) remain poorly investigated. We examined the risk of cardiovascular mortality in patients with advanced CKD with and without diabetes as well as the impact of albuminuria, plasma hemoglobin, and plasma low-density lipoprotein (LDL) cholesterol levels.

Methods

In a Danish nationwide registry-based cohort study, we identified persons aged ≥ 18 years with an estimated glomerular filtration rate < 30 mL/min/1.73m2 between 2002 and 2018. Patients with advanced CKD were age- and sex-matched with four individuals from the general Danish population. Cause-specific Cox regression models were used to estimate the 1-year risk of cardiovascular mortality standardized to the distribution of risk factors in the cohort.

Results

We included 138,583 patients with advanced CKD of whom 32,698 had diabetes. The standardized 1-year risk of cardiovascular mortality was 9.8% (95% CI 9.6–10.0) and 7.4% (95% CI 7.3–7.5) for patients with and without diabetes, respectively, versus 3.1% (95% CI 3.1–3.1) in the matched cohort. 1-year cardiovascular mortality risks were 1.1- to 2.8-fold higher for patients with diabetes compared with those without diabetes across the range of advanced CKD stages and age groups. Albuminuria and anemia were associated with increased cardiovascular mortality risk regardless of diabetes status. LDL-cholesterol was inversely associated with cardiovascular mortality risk in patients without diabetes, while there was no clear association in patients with diabetes.

Conclusions

Diabetes, albuminuria, and anemia remained important risk factors of cardiovascular mortality whereas our data suggest a limitation of LDL-cholesterol as a predictor of cardiovascular mortality in advanced CKD.
Mesenchymal stem cell-derived exosomal miR-27b-3p alleviates liver fibrosis via downregulating YAP/LOXL2 pathway
Authors: Cheng Fang , Yang Fuji , Wang Yanjin , Zhou Jing , Qian Hui , Yan Yongmin
Published: June 2023

Lysyl oxidase-like 2 (LOXL2) is an extracellular copper-dependent enzyme that plays a central role in fibrosis by catalyzing the crosslinking and deposition of collagen. Therapeutic LOXL2 inhibition has been shown to suppress liver fibrosis progression and promote its reversal. This study investigates the efficacy and underlying mechanisms of human umbilical cord-derived exosomes (MSC-ex) in LOXL2 inhibition of liver fibrosis. MSC-ex, nonselective LOX inhibitor β-aminopropionitrile (BAPN), or PBS were administered into carbon tetrachloride (CCl4)-induced fibrotic livers. Serum LOXL2 and collagen crosslinking were assessed histologically and biochemically. MSC-ex’s mechanisms on LOXL2 regulation were investigated in human hepatic stellate cell line LX-2. We found that systemic administration of MSC-ex significantly reduced LOXL2 expression and collagen crosslinking, delaying the progression of CCl4-induced liver fibrosis. Mechanically, RNA-sequencing and fluorescence in situ hybridization (FISH) indicated that miR-27b-3p was enriched in MSC-ex and exosomal miR-27b-3p repressed Yes-associated protein (YAP) expression by targeting its 3ʹ untranslated region in LX-2. LOXL2 was identified as a novel downstream target gene of YAP, and YAP bound to the LOXL2 promoter to positively regulate transcription. Additionally, the miR-27b-3p inhibitor abrogated the anti-LOXL2 abilities of MSC-ex and diminished the antifibrotic efficacy. miR-27b-3p overexpression promoted MSC-ex mediated YAP/LOXL2 inhibition. Thus, MSC-ex may suppress LOXL2 expression through exosomal miR-27b-3p mediated YAP down-regulation. The findings here may improve our understanding of MSC-ex in liver fibrosis alleviation and provide new opportunities for clinical treatment.
Bone mineral density in egyptian children with juvenile idiopathic arthritis: possible correlation to serum RANKL / osteoprotegerin (OPG) ratio and OPG gene polymorphisms
Authors: Eid Riham , Abdelsalam Maha , Fathy Aya Ahmed , Abolenein Hadil M. , Elmarghany Eman Bakr , El-Hanafy Aya Ahmed , Hamdy Nashwa , Abd-Elmagid Dina Salama , Niazy Nermeen A. , Abd-El Ghaffar Dina M.
Published: June 2023

Background

Children with juvenile idiopathic arthritis (JIA) are at higher risk of decreased bone mineral density (BMD) compared with healthy children due to genetic, disease and medication-related causes. This study aims to investigate the possible effects of osteoprotegerin (OPG) gene polymorphisms and serum levels of osteoprotegerin (OPG) and receptor activator of nuclear factor κB-ligand (RANKL) and RANKL/OPG ratio on BMD in children with JIA.

Methods

OPG gene rs2073617, rs3134069, serum RANKL, OPG and RANKL/OPG ratio were evaluated in 60 JIA children and 100 matched healthy controls. BMD was evaluated by lumbar dual energy X-ray absorptiometry (DEXA) according to which patients were classified in 2 groups (DEXA z-score above and below − 2). Composite disease activity was measured using the Juvenile Arthritis Disease Activity Score (JADAS) 27-joints. Articular damage was scored using the juvenile arthritis damage index (JADI).

Results

Patients aged 12.05 ± 3.2 years, included 38 females and 31% had BMD z-score below-2. Systemic-onset JIA was the most frequent phenotype (38%). Genotypes and alleles frequencies of the 2 studied polymorphisms did not differ between patients and controls (p > 0.05 for all) while serum RANKL and RANKL/OPG ratio were significantly higher in patients compared to controls (p = < 0.001 and 0.03 respectively). Patients with BMD < -2 had significantly greater frequencies of rs2073617 TT genotype and T allele (p < 0.001), higher serum RANKL, RANKL/OPG ratio (p = 0.01, 0.002), female predominance (p = 0.02), higher articular and extra-articular damage index (p = 0.008,0.009) and more frequent steroid usage (p = 0.02) compared to patients with BMD z-score >-2. Multivariate analysis showed rs2073617 TT genotype, RANKL/OPG ratio, long disease duration (above 36 months) and use of steroid to be associated with decreased BMD (p = 0.03,0.04,0.01,0.01 respectively) in JIA children.

Conclusions

Egyptian children with JIA have decreased BMD. rs2073617 TT genotype and T allele, RANKL/OPG ratio are possible determinants of reduced BMD in JIA. Our results underline the importance of frequent monitoring of BMD in JIA children and trying to control disease activity to preserve long term bone health.
A review of Duhuo Jisheng decoction mechanisms in intervertebral disc degeneration in vitro and animal studies
Authors: Zhou Daqian , Song Chao , Mei Yongliang , Cheng Kang , Liu Fei , Cai Weiye , Gao Silong , Wang Zhenlong , Liu Zongchao
Published: June 2023

Intervertebral disc degeneration (IVDD) has become a serious public health problem, placing a heavy burden on society and the healthcare system. Its pathogenesis is not completely clear and may be closely related to mechanical damage, inflammatory factors, oxidative stress and death of nucleus pulposus cells (NPCs). The treatment of IVDD mainly includes conservative treatment and surgery. Conservative treatment is based on hormonal and anti-inflammatory drugs and massage techniques, which can relieve the pain symptoms to a certain extent, but cannot solve the problem from the root cause. Surgical treatment is mainly by removing the herniated nucleus pulposus, but it is more traumatic for IVDD patients, expensive and not suitable for all patients. Therefore, it is extremely important to clarify the pathogenesis of IVDD, to find an effective and convenient treatment and to further elaborate its mechanism of action. The effectiveness of traditional Chinese medicine in the treatment of IVDD has been well demonstrated in clinical medical research. We have been working on the Chinese herbal formula Duhuo Jisheng Decoction, which is a common formula for the treatment of degenerative disc disease. Not only does it have significant clinical effects, but it also has few adverse effects. At present, we found that its mechanism of action mainly involves regulation of inflammatory factors, reduction of apoptosis and pyroptosis of NPCs, inhibition of extracellular matrix degradation, improvement of intestinal flora, etc. However, a few relevant articles have yet comprehensively and systematically summarized the mechanisms by which they exert their effect. Therefore, this paper will comprehensively and systematically explain on it. This is of great clinical significance and social value for elucidating the pathogenesis of IVDD and improving the symptoms of patients, and will provide a theoretical basis and scientific basis for the treatment of IVDD with traditional Chinese medicine.
Scarf osteotomy for hallux valgus surgery: determining indications for an additional Akin osteotomy
Authors: Thever Yogen , Yongqiang Jerry Chen , Chuin Toh Rong , Meng Nicholas Yeo Eng
Published: June 2023

Introduction

There is a lack of clear indications to carrying out an Akin osteotomy in addition to scarf osteotomy. Recent studies have shown that a proximal distal phalangeal articular angle (PDPAA) of > 8° as an indication to carrying out additional Akin osteotomy correlates with better radiological outcomes with lesser risk of recurrence. Our study aimed to validate carrying out the additional Akin osteotomy at a PDPAA > 8° while looking into functional outcomes which have not been studied.

Methods

Patients who underwent scarf and combined scarf and Akin osteotomy in our institutional registry was identified. Patient reported outcome measures were compared between patients who underwent scarf and combined scarf and Akin osteotomy. The Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), Short Form-36 Physical Component Score (PCS) and Mental Component Score (MCS) were measured pre-operatively and across a follow up period of 2 years.

Results

A total of 212 cases were identified. At a PDPAA > 8, there was no difference in VAS, AOFAS, PCS and MCS between patients that had isolated scarf osteotomy and those that received combined scarf and Akin osteotomy pre-operatively, and at 6 months. However, at 2 years post-operatively, patients that received scarf and Akin osteotomy had a significantly better AOFAS score as compared to patients with isolated scarf osteotomy (82.3 ± 15.3 vs 88.4 ± 13.0, p = 0.0224). On the contrary, at a PDPAA < 8, patients who underwent combined scarf and Akin osteotomy had a significantly lower VAS score at 6 months (1.16 ± 2.16 vs 0.321 ± 1.09, p = 0.00633) and 2 years (0.698 ± 1.73 vs 0.333 ± 1.46, p = 0.0466). They also had a higher AOFAS score at 6 months (80.7 ± 14.3 vs 85.4 ± 12.5, p = 0.0123) and 2 years (83.0 ± 14.0 vs 90.7 ± 9.9, p < 0.0001).

Conclusion

PDPAA > 8° can serve as a valid indication to carrying out additional Akin on top of scarf osteotomy based on functional outcomes. However, further studies should investigate a PDPAA threshold that is lower than 8°, which can potentially allow more patients to receive the additional Akin osteotomy that can bring better functional outcomes.
AXL in cancer: a modulator of drug resistance and therapeutic target
Authors: Tang Yaoxiang , Zang Hongjing , Wen Qiuyuan , Fan Songqing
Published: June 2023

AXL is a member of the TAM (TYRO3, AXL, and MERTK) receptor tyrosine kinases family (RTKs), and its abnormal expression has been linked to clinicopathological features and poor prognosis of cancer patients. There is mounting evidence supporting AXL's role in the occurrence and progression of cancer, as well as drug resistance and treatment tolerance. Recent studies revealed that reducing AXL expression can weaken cancer cells' drug resistance, indicating that AXL may be a promising target for anti-cancer drug treatment. This review aims to summarize the AXL's structure, the mechanisms regulating and activating it, and its expression pattern, especially in drug-resistant cancers. Additionally, we will discuss the diverse functions of AXL in mediating cancer drug resistance and the potential of AXL inhibitors in cancer treatment.
Anti N-Methyl-D-Aspartate receptor antibody associated Acute Demyelinating Encephalomyelitis in a patient with COVID-19: a case report
Authors: Naidu Kuven , Tayler Rory
Published: June 2023

Background

Anti N-Methyl-D-Aspartate (NMDA) receptor antibody associated ADEM is a diagnosis that was first described relatively recently in 2007 by Dalmau et al. The recent COVID-19 pandemic has resulted in multiple neurological complications being reported. However, there is limited data on Anti-NMDA receptor antibody associated ADEM in COVID-19 patients. Furthermore, the MRI findings in these patients have not been fully elucidated. This case report adds to the growing body of knowledge of neurological complications in COVID-19 patients.

Case presentation

A 50 year old Caucasian female with no previous medical co-morbidities presented with symptoms of COVID-19 and subsequently developed neurological symptoms which included confusion, limb weakness and seizures. The patient developed marked behavioural abnormalities which required attention. She was found to have anti NMDA receptor antibodies present in a significant titres, an elevated total protein on lumbar puncture and cytotoxic magnetic resonance imaging (MRI) changes in the brain and spinal cord and was subsequently diagnosed with an anti-NMDA Receptor Antibody associated ADEM. The bilateral symmetric involvement of the corticospinal tract on MRI was considered unusual in our case. She was treated with a combination of corticosteroids and plasmapheresis which halted disease progression. Thereafter she was commenced on intravenous immunoglobulin as maintenance therapy and she has shown continuous improvement with ongoing physiotherapy.

Conclusion

The recognition of COVID 19 neurological complications may be difficult in the initial disease as early symptoms of lethargy, weakness and confusion may be very nondescript. However, it is imperative that these complications are sought for as they are imminently treatable. Early institution of therapy is imperative in decreasing long term neurological consequences.
Retention time and fix acquisition rate of glued-on GPS transmitters in a semi-aquatic species
Authors: Pitman John B. , Bastille-Rousseau Guillaume
Published: June 2023

Background

Movement is a core mechanism through which animals interact with their environment. GPS telemetry is a popular approach used to investigate animal movement, providing access to both the spatial and temporal behavioral patterns exhibited by an individual or population. However, while some species are easily tracked through traditional GPS attachment methods (such as GPS collars or backpacks), other species such as the North American beaver (Castor canadensis) present unique challenges given their fusiform shape and tapered neck.

Results

We tested three different GPS transmitter attachment methods (tail-mounted, lower back glued-on, and upper back glued-on) for beavers over two seasons to determine which treatment was most effective in terms of retention time (RT, total number of days a transmitter remains attached) and GPS fix success rate (FSR, % of successful fixes vs. attempted) and investigated to what degree various factors (season, sex, and age class) affected these results. We then evaluated whether the data collected were sufficient for identifying home-ranging behavior (when an individual begins to display restricted space use and range residency). We found transmitters attached to the lower back during the fall to be the top performing treatment, having a similar mean FSR (51.59%) to upper back attachments in fall, but a significantly greater average RT (42.8 days). Of the 23 individuals included in the home-ranging behavior analysis, all but two had sufficient data for identifying home-ranging behavior.

Conclusions

Our tests show that glued-on GPS tags can provide up to 2 months of fine-scale relocation data in a safe and effective manner. This allows the opportunity to answer novel questions regarding movement patterns of beavers and other semi-aquatic mammals.
Patients’ well-being during the transition period after psychiatric hospitalization to school: insights from an intensive longitudinal assessment of patient–parent–teacher triads
Authors: Finkbeiner Marlene , Wahl Lena-Marie , Kühnhausen Jan , Schmid Johanna , Hellwig Leona , Brenner Vera , Dürrwächter Ute , Conzelmann Annette , Kelava Augustin , Renner Tobias J. , Gawrilow Caterina
Published: June 2023

Background

The transition period after psychiatric hospitalization back to school is accompanied by various challenges, including a substantial risk for rehospitalization. Self-efficacy and self-control, as transdiagnostic variables and important predictors of coping with school demands, should be crucial factors for successful adaptation processes as well as an overall high well-being during school reentry. The present study therefore investigates how patients’ well-being develops during this period, and how it is related to patients’ self-control and academic self-efficacy, as well as parents’ and teachers’ self-efficacy in dealing with the patient.

Methods

In an intensive longitudinal design, daily ambulatory assessment measures via smartphone were collected with self-reports from the triadic perspective of 25 patients (Mage = 10.58 years), 24 parents, and 20 teachers on 50 consecutive school days, starting 2 weeks before discharge from a psychiatric day hospital (mean compliance rate: 71% for patients, 72% for parents and 43% for teachers). Patients answered daily questions between five and nine o'clock in the evening about their well-being, self-control, academic self-efficacy and about positive and negative events at school, as well as parents and teachers about their self-efficacy in dealing with the patient.

Results

Multilevel modeling revealed that on average, patients’ well-being and self-control decreased during the transition period, with trends over time differing significantly between patients. While patients’ academic self-efficacy did not systematically decrease over time, it did show considerable intra-individual fluctuation. Importantly, patients experienced higher well-being on days with higher self-control and academic self-efficacy as well as with higher parental self-efficacy. Daily teacher self-efficacy did not show a significant within-person relationship to daily patients’ well-being.

Conclusions

Well-being in the transition period is related to self-control and self-efficacy of patients and their parents. Thus, addressing patients’ self-control and academic self-efficacy, as well as parental self-efficacy, seems promising to enhance and stabilize well-being of patients during transition after psychiatric hospitalization.

Trial registration Not applicable, as no health care intervention was conducted.
Three-dimensional changes of a porcine collagen matrix and free gingival grafts for soft tissue augmentation to increase the width of keratinized tissue around dental implants: a randomized controlled clinical study
Authors: Ramanauskaite Ausra , Obreja Karina , Müller Katharina Melissa , Schliephake Carla , Wieland Johanna , Begic Amira , Dahmer Iulia , Parvini Puria , Schwarz Frank
Published: June 2023

Background

Emerging clinical data points to the relevance of the presence of keratinized tissue (KT). Although apically positioned flap/vestibuloplasty along with free gingival graft (FGG) is considered as a standard intervention for augmenting KT, substitute materials appear to be a viable treatment alternative. So far, there is a lack of data investigating the dimensional changes at implant sites treated with soft-tissue substitutes or FGG.

Aim

The present study aimed at comparing three-dimensional changes of a porcine derived collagen matrix (CM) and FGG for increasing KT at dental implants over a 6-month follow-up period.

Materials and Methods

The study enrolled 32 patients exhibiting deficient KT width (i.e., < 2 mm) at the vestibular aspect who underwent soft tissue augmentation using either CM (15 patients/23 implants) or FGG (17 patients/31 implants). The primary outcome was defined as tissue thickness change (mm) at treated implant sites between 1- (S0), 3- (S1), and 6-months (S2). Secondary outcomes considered changes of KT width over a 6-month follow-up period, surgical treatment time, and patient-reported outcomes.

Results

Dimensional analyses from S0 to S1 and from S0 to S2 revealed a mean decrease in tissue thickness of − 0.14 ± 0.27 mm and − 0.04 ± 0.40 mm in the CM group, and − 0.08 ± 0.29 mm and − 0.13 ± 0.23 mm in the FGG group, with no significant differences noted between the groups (3 months: p = 0.542, 6 months: p = 0.659). Likewise, a comparable tissue thickness decrease was observed from S1 to S2 in both groups (CM: − 0.03 ± 0.22 mm, FGG: − 0.06 ± 0.14 mm; p = 0.467). The FGG group exhibited a significantly greater KT gain after 1, 3 and 6 months compared to the CM group (1 month: CM: 3.66 ± 1.67 mm, FGG: 5.90 ± 1.58 mm; p = 0.002; 3 months: CM: 2.22 ± 1.44; FGG: 4.91 ± 1.55; p = 0.0457; 6 months: CM: 1.45 ± 1.13 mm, FGG: 4.52 ± 1.40 mm; p < 0.1). Surgery time (CM: 23.33 ± 7.04 min.; FGG: 39.25 ± 10.64 min.; p = 0.001) and postoperative intake of analgesics were significantly lower in the CM group (CM: 1.2 ± 1.08 tablets; FGG: 5.64 ± 6.39 tablets; p = 0.001).

Conclusions

CM and FGG were associated with comparable three-dimensional thickness changes between 1 and 6 months. While a wider KT band could be established with FGG, the use of CM significantly reduced surgical time and patients´ intake of analgesics.

Graphical abstract
Childhood Obesity, Diabetes, and Cardiovascular Disease Risk
Authors: Salama Mostafa , Balagopal Babu , Fennoy Ilene , Kumar Seema
Published: June 2023

This mini-review aims to briefly summarize the pathophysiology of childhood obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) risk in children and adolescents. Recent data on efficacy of lifestyle interventions, medications, and metabolic surgery for obesity, T2DM, and CVD risk factors are also reviewed. We conducted a PubMed search of English-language original and review articles relevant to childhood obesity, T2DM, and CVD risk factors, and biomarkers in children with an emphasis on recent publications. Childhood obesity arises from an intricate interaction between genetic, physiologic, environmental, and socioeconomic factors. The rise in the prevalence of childhood obesity is associated with the development of comorbidities including T2DM and CVD at an early age. A multipronged approach is central to the detection, monitoring, and management of childhood obesity and associated adverse metabolic consequences.
Η παρωδία στην τέχνη της Βοιωτίας κατά την αρχαϊκή και κλασική περίοδο
Authors: Αγωγιάτη Αγγελική
Published: June 2023

Με τη διατριβή αυτήν εξετάζεται στο σύνολό του το βοιωτικό εικονιστικό χιούμορ των αρχαϊκών και κλασικών χρόνων. Η συνάρτησή του με τη θεωρία του καρναβαλιού του Μπαχτίν επιτρέπει τη βαθύτερη κατανόηση του και από ανθρωπολογικής πλευράς. Η πρωτότυπη για τα δεδομένα της κλασικής αρχαιολογίας αυτή ώσμωση ενώνει και τον κρίκο μεταξύ της κωμαστικής παράδοσης και των καβιρικών μορφών, που γενικώς και αορίστως θεωρούνταν πως σχετίζονταν. Ο χαρακτήρας και τα τεχνοτροπικά στοιχεία των καβιρικών εργαστηρίων σκιαγραφούνται μέσα από καινούργιες για την έρευνα αναγωγές και αποδόσεις. Νέες προσθήκες αγγείων στον μακρύ κατάλογο των καβιρικών καταδεικνύουν πως το εργαστήριο του Ζ. του Καβίρου χρησιμοποιούσε πολλές τεχνικές, όπως την ερυθρόμορφη, τη Σιξ και την ημιμελανόμορφη, ενώ μέχρι πρότινος πιστευόταν πως μόνο τη μελανόμορφη και εν μέρει την ημιμελανόμορφη κατείχε και εφάρμοζε. Αμφισβητούμενες για τη γνησιότητά τους παραστάσεις αναλύονται εικονογραφικά και αποδεικνύονται αρχαίες. Για πρώτη φορά στην έρευνα της βοιωτικής αγγειογραφίας και ειδωλοπλαστικής καταγράφονται παραμυθικά μοτίβα. Αυτά μαζί με την μπαχτινική θεωρία συντελούν στη διαγραφή του σχετικού με τους εφήβους λατρευτικού τυπικού του Καβιρίου των Θηβών, στο οποίο, όπως ποτέ πριν, προτείνεται με βάσιμα επιχειρήματα πως σημαντικό ρόλο έπαιζαν οι μυθικοί πρόγονοι. Ο εκτεταμένος παραλληλισμός καβιρικών και αττικών σε χόες παραστάσεων επιβεβαιώνει τη γνωστή από παλαιότερες μελέτες σχέση των δύο, η οποία δηλώνει τον παραπλήσιο χαρακτήρα των εορτών του Καβιρίου και των αττικών Ανθεστηρίων. Με την εικονιστική εξέταση των καβιρικών αγγείων και ειδωλίων, που βρέθηκαν στο ιερό, δίνονται, επιπλέον, απαντήσεις αναφορικά με τον αν στο Καβίριο υπήρχαν μυστηριακά και θεατρικά δρώμενα την κλασική περίοδο.
Integrated Management of Corn Marigold (Glebionis segetum) in Tef Field at Western and Southwestern Shewa Zones in Ethiopia
Authors: Hundessa Niguse , Dechassa Nagassa , Bedada Shashitu , Bekele Getachew , Duguma Mosisa
Published: June 2023

Background: Corn marigold (Glebionis segetum (L.) Frourr.) is a serious weed species of agricultural crops in many parts of Ethiopia. However, there is a lack of information on its management in tef fields in the country. Therefore, the current work was designed with the objectives of evaluating integrated management of the weed and determining the most economical integrated weed management options in tef fields.

Methods: The field experiments were conducted in naturally corn marigold infested fields of Cheliya and Woliso districts of West and Southwest Shewa Zones in Ethiopia, respectively, during 2020 to 2021 cropping seasons.

Results: Different corn marigold management practices exhibited different responses to different parameters of the target weed and the test crop differently. Application of Pyroxsulam 45g L-1 at a rate of 0.40 l ha -1 supplemented with once-hand weeding and Halauxifen-methyl 100g kg-1 + Florasulam 100g kg-1 sprayed at a rate of 50 g ha -1 supplemented with once-hand weeding increased grain yield by about 70 and 50%, respectively, over the weedy check. The marginal revenue and benefit-cost ratio obtained from the marketing of goods for the application of Pyroxsulam 45g L-1 with one supplementary hand weeding of corn marigold increased by110 89%, respectively, as compared to the weedy check.

Conclusions: The present study revealed the role of integrated management of corn marigold in improving tef production and productivity by combating the weed. Future research should be directed towards scaling up and popularizing these technologies among the growers.
El arte y la Capoeira en el alumnado de 6º de primaria de una escuela de Barcelona.
Authors: Moneo Benítez Sergio
Published: June 2023

El presente estudio parte de una premisa vinculada al arte y la Capoeira. Respecto al arte, se plantea la problemática de su indefinición para tratar de saber si la Capoeira puede ser considerada arte. Ésta es una actividad física que posee un importante componente histórico en Brasil. Sus movimientos se efectúan a partir de ritmos que proceden de diversos instrumentos y que tocan capoeiristas de más alto nivel. Esta actividad es trasladada a alumnos y alumnas situados en 6º curso de la etapa de primaria (entre 10 y 12 años de edad). El primer objetivo del estudio pretende conocer la opinión de 2 grupos-clase con respecto al concepto del arte. Consecuentemente, el segundo objetivo tiene como propósito conocer la opinión de los participantes en cuanto a determinar a la Capoeira un arte. Para responder al segundo objetivo se desarrolla una propuesta didáctica de 27 sesiones, realizándose 24 de ellas en el área de Educación Física y 3 en el área de Música. La metodología se centra en un estudio de casos, en el que los resultados determinan que gran parte del alumnado considera la Capoeira como arte debido a la dificultad de efectuar movimientos de manera rápida y cercana al compañero, y siguiendo cada ritmo musical. La docente del área de Música expone ideas similares. En conjunto, se haya posible identificar la Capoeira como manifestación artística debido al carácter subjetivo del término, así como por ser una expresión humana y creativa.
Repatriacja amerykańskich jeńców wojennych i cywilów z radzieckich jednostek repatriacyjnych na terenie Polski w latach 1944-1945
Authors: Arkusz Aleksandra
Published: June 2023

World War II drastically changed the previous international balance of power. It also resulted in far-reaching changes in the bilateral relations between the United States of America and the Soviet Union. Their alliance, forced by wartime circumstances, involved collaboration in the diplomatic, military, political and economic scope. One of the areas of the American-Soviet collaboration was also the mutual repatriation of prisoners of war and civilian internees liberated from German captivity. The problem emerged already in 1944 along with the Allied offensive and forced the Allies to take specific measures. It became a priority to develop mechanisms for concentrating the prisoners and internees, keeping their records, protecting them, providing them with appropriate living, medical and sanitary conditions (until they were transferred to the representatives of their states) as well as preparing specific repatriation procedures both in terms of transferring contingents and organizing means of transport and evacuation routes. Months of negotiations led to the agreement signed at the conference in Yalta on 11 February 1945.