bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting first-line VEGFR-TKI resistance and survival in metastatic clear cell renal cell carcinoma using a clinical-radiomic nomogram
Authors: Wang Yichen , Zhang Xinxin , Wang Sicong , Shi Hongzhe , Zhao Xinming , Chen Yan
Published: November 2024

Background

This study aims to construct predicting models using radiomic and clinical features in predicting first-line vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI) early resistance in metastatic clear cell renal cell carcinoma (mccRCC) patients. We also aim to explore the correlation of predicting models with short and long-term survival of mccRCC patients.

Materials and methods

In this retrospective study, 110 mccRCC patients from 2009 to 2019 were included and assigned into training and test sets. Radiomic features were extracted from tumor 3D-ROI of baseline enhanced CT images. Radiomic features were selected by Lasso method to construct a radiomic score. A combined nomogram was established using the combination of radiomic score and clinical factors. The discriminative abilities of the radiomic, clinical and combined nomogram were quantified using ROC curve. Cox regression analysis was used to test the correlation of nomogram score with progression-free survival (PFS) and overall survival (OS). PFS and OS were compared between different risk groups by log-rank test.

Results

The radiomic, clinical and combined nomogram demonstrated AUCs of 0.81, 0.75, and 0.83 in training set; 0.79, 0.77, and 0.88 in test set. Nomogram score ≥ 1.18 was an independent prognostic factor of PFS (HR 0.22 (0.10, 0.47), p < 0.001) and OS (HR 0.38 (0.20, 0.71), p = 0.002), in training set. PFS in low-risk group were significantly longer than high-risk group in training (p < 0.001) and test (p < 0.001) set, respectively. OS in low-risk group were significantly longer than high-risk group in training (p = 0.003) and test (p = 0.009) set, respectively.

Conclusion

A nomogram combining baseline radiomic signature and clinical factors helped detecting first-line VEGFR-TKI early resistance and predicting short and long-term prognosis in mccRCC patients.
Assessing the intracranial metabolic score as a novel prognostic tool in primary CNS lymphoma with end of induction-chemotherapy 18F-FDG PET/CT and PET/MR
Authors: Mo Yiwen , Li Yongjiang , Huang Yuqian , Chen Mingshi , Zhou Chao , Li Xinling , Wei Yuan , Li Ruping , Fan Wei , Zhang Xu
Published: November 2024

Background

The metabolic response of primary central nervous system lymphoma (PCNSL) patients has yet to be evaluated. This study aimed to assess the prognostic value of a novel scoring scale, the intracranial metabolic score (IMS), in PCNSL patients receiving end-of-therapy 18F-FDG PET/CT (EOT-PCT) and PET/MR (EOT-PMR).

Methods

The IMS was determined based on the metabolism of normal intracranial structures, including gray matter, white matter, and cerebrospinal fluid. The EOT-PCT cohort was evaluated using the IMS and commonly used Deauville score (DS). Another cohort of patients who underwent the EOT-PMR was used to validate the accuracy of the IMS.

Results

In total, 83 patients were included in the study (38 in PET/CT cohort, and 45 in PET/MR cohort). The area under the curve (AUC) values of the IMS for predicting PFS and OS were superior to those of the DS. When patients in the PET/CT cohort were stratified into five groups (respectively labeled IMS 1–5), three groups (IMS1-2, IMS 3–4, and IMS 5), or two groups (IMS1-3 and IMS4-5; IMS 1–4 and IMS 5), a higher IMS score was significantly correlated with poorer PFS and OS (p < 0.001). Similar results were observed for PFS in the PET/MR cohort (p < 0.001). The IMS and DS scale were found to be independent prognostic indicators for PFS and OS in the PET/CT cohort, and the IMS was identified as the sole independent prognostic indicator for PFS in the PET/MR cohort.

Conclusion

The IMS as a novel and effective prognostic tool for PCNSL patients, showing superior predictive value for patients’ outcomes compared to the DS when assessed with EOT-PET scans.
Compatibility of hypokalaemia caused by low-dose prednisolone plus abiraterone acetate therapy for metastatic castration-resistant prostate cancer
Authors: Torii Shota , Torii-Goto Aya , Tanizawa Tamaki , Sakakibara Takashi , Oguri Ryosuke , Nagase Haruka , Nakao Yuri , Hirashita Tomoyuki , Tanaka Kuniaki , Takimoto Norio , Hayashi Takahiro
Published: November 2024

Background

This study aimed to investigate the relationship between low-dose prednisolone (PSL) and the incidence of hypokalaemia at abiraterone acetate (abiraterone) plus PSL combination therapy targeting Japanese patients with metastatic castration-resistant prostate cancer (mCRPC).

Methods

This retrospective observational study included 153 Japanese patients treated with abiraterone and PSL for mCRPC at Kariya Toyota General Hospital and Gifu General Medical Center between September 2014 and October 2022. The incidence of grade ≥ 2 hypokalaemia as well as serum potassium level variations and the continuous combination therapy duration were compared between the low-dose (5 mg/day of PSL) and the standard-dose (10 mg/day of PSL) groups.

Results

This study included 153 patient of which 95 were matched to establish the analysis population. The low-dose and the standard-dose groups consisted of 13 and 82 patients, respectively. No significant difference in the incidence of grade ≥ 2 hypokalaemia was observed between the two groups [15.4% (2/13 patients) in the low-dose group and 12.2% (10/82 patients) in the standard-dose group, P = 0.667]. The low-dose group exhibited a decrease in serum potassium levels from 4.63 on day − 7 − 0 to 4.16 mmol/L on day 84 ± 10 (n = 7, P = 0.066), and serum potassium levels from day − 7 − 0 to 84 ± 10 in the low-dose group appeared to be great in the standard-dose group (n = 37, P = 0.475). The Kaplan–Meier curves for continuity of abiraterone and PSL therapy were not significantly different between the low-dose group (n = 13) and standard-dose group (n = 82, P = 0.427).

Conclusion

Combination therapy with abiraterone and 5 mg/day of PSL in Japanese patients with mCRPC did not change the incidence of grade ≥ 2 hypokalaemia. However, although not significant, 5 mg/day of PSL demonstrated a decreasing trend in serum potassium levels with a larger degree of change than that of 10 mg/day of PSL. Therefore, the combination of abiraterone and 5 mg/day PSL can be administered to Japanese patients with mCRPC. The patients must be monitored for hypokalaemia through measurement of serum potassium levels and observation of subjective symptoms such as muscle weakness, convulsion etc. In addition, the doctor or the pharmacist must explain these symptoms to the patient and instruct them to consult their medical staff immediately in the event of development of such symptoms.
Left-sided portal hypertension caused by a solid pseudopapillary neoplasm of pancreas tail: a pediatric case report
Authors: Sihnkai Toko , Masumoto Kouji , Sanmoto Yohei , Kawami Akio , Ishikawa Miki , Fujii Shunsuke , Saida Tsukasa , Ishiguro Toshitaka , Sakamoto Noriaki
Published: November 2024

Background

Solid pseudopapillary neoplasm (SPN) is a low-grade malignant tumor that occurs in 60% of all pediatric pancreas tumors. Radical tumor resection is essential; however, spleen preservation is also crucial to prevent overwhelming post-splenectomy infection. In contrast, spleen preservation is not always possible, because left-sided portal hypertension (LSPH) can cause splenic vein stenosis or occlusion induced by pancreatic tumor. We herein report on a pediatric patient of LSPH due to SPN in the pancreatic tail.

Case presentation

A 12-year-old girl was admitted to our hospital with left upper quadrant abdominal pain. A solid mass was palpated in the left costal region. The patient showed slight anemia (Hb: 11.8 g/dL) and elevation of inflammatory reaction (CRP: 5.98 mg/dL) without positive tumor markers. A radiological examination revealed that a 9 cm-sized mass with hemorrhagic necrosis in the pancreatic tail. Splenic venous flow was not detected and collateral draining into the left gastric vein and left renal veins were developed with splenomegaly. LSPH was involved at the time of diagnosis. The tumor was diagnosed with SPN, hence tumor resection with spleen preservation was performed. Six months after surgery, the patient developed a left quadrant abdominal pain that worsened during exercise. There was no improvement of splenic venous flow and splenomegaly. LSPH remained with splenomegaly, which possibly triggered the patient’s abdominal pain. The patient underwent splenectomy 9 months after the tumor resection. After the splenectomy, the patient’s abdominal pain disappeared without any recurrence 8-year post-surgery.

Conclusions

LSPH has not been a major focus in previous SPN pediatric patients, although most symptomatic LSPH patients required splenectomy. Careful post-operative observation for LSPH is important for pediatric SPN patients.
Supplementation of glutamine in a short-term boar semen extender during 17°C holding time enhances post-thaw sperm quality for cryopreservation
Authors: Nuntapaitoon Morakot , Tummaruk Padet , Suwimonteerabutr Junpen
Published: November 2024

Background

Glutamine is a nonessential amino acid and the most abundant amino acid found in the seminal plasma and sperm-rich fraction of boar semen. Glutamine plays an important role in enhancing glutathione (GSH) synthesis. It acts as an effective antioxidant in semen and provides intracellular defense to sperm against oxidative stress. This study aimed to improve the quality of frozen-thawed boar semen by using glutamine supplementation in a short-term semen extender during the holding time at 17 °C before cryopreservation.

Results

The results indicate that the total motility, progressive motility, LIN, STR, and WOB were the highest in the 20 mM supplementation group at the 2 h timepoint after thawing. Thus, the optimal concentration for glutamine supplementation in short-term boar semen extender during the holding time at 17 °C was 20 mM. Interestingly, at all of the time points after thawing, 20 mM glutamine supplementation exhibited the highest level of sperm viability and membrane integrity when compared to the CONTROL (0 mM) and other experimental dilution groups. Moreover, the acrosome integrity, mitochondrial activity, and capacitation status (F pattern) were significantly greater in the 20 mM supplementation group than the other groups at the 2 h timepoint after thawing.

Conclusion

Supplementation of glutamine at a concentration of 20 mM in a short-term semen extender (Bio Pig®) during the 17 °C holding time before cryopreservation, which had a standard freezing extender (9.0% glycerol and 1.9% Equex paste), could enhance the post-thaw sperm motility and quality parameters of cryopreservation.
Building trust and inclusion with under-served groups: a public involvement project employing a knowledge mobilisation approach
Authors: Anderson Anna M. , Brading Lucy , Swaithes Laura , Evans Nicola , Fedorowicz Sophia E. , Murinas Darren , Atkinson Elizabeth , Moult Alice , Yip Tatum , Ayub Parveen , Dziedzic Krysia , Conaghan Philip G. , McHugh Gretl A. , Rebane Amy , Kingsbury Sarah R.
Published: November 2024

Background

Certain groups are commonly under-served by health research due to exclusionary models of research design/delivery. Working in partnership with under-served groups is key to improving inclusion. This project aimed to explore the use of a knowledge mobilisation approach to start building partnerships with under-served groups based on trust and mutual understanding.

Methods

This co-produced public involvement project employed a knowledge mobilisation approach. The project team involved public contributors from four community organisations and staff from two Universities. A series of ‘community conversations’ were co-produced. These involved open discussions with local people in community settings. The conversations provide an informal space to engage in a multi-directional dialogue about health research and incorporated approaches such as prompt questions, live illustrations, and themed boards. The findings were reviewed collectively. Dissemination/feedback activities and lessons learned for future engagement with community organisations and under-served groups were also co-produced.

Results

Over 100 people attended the community conversations. Attendees varied widely in their sociodemographic characteristics (e.g., socioeconomic status and ethnicity) and brought diverse lived experiences (e.g., experiences of homelessness and disability). A strong appetite for change and desire to mobilise public knowledge were evident. Attendees reported wide-ranging barriers to inclusion in health research and suggested ways to address them. Three inter-related take-home messages were identified: ensure relevance, appreciation, and trust; prioritise language and accessibility needs; and maximise flexibility in all research-related activities. Feedback about the community conversations and dissemination activities was largely positive, with all parties planning to continue the partnership building. The lessons learned provide practical suggestions for promoting inclusion in research and highlight the importance of addressing research teams’ training/support needs.

Conclusions

Knowledge mobilisation was a valuable approach for facilitating multi-directional dialogues and relationship building between local communities and university teams. This approach enabled co-creation of new knowledge related to inclusion and partnership working in health research. The project has provided a firm foundation to build upon. However, creating sustainable, inclusive public partnerships is likely to require systemic changes, such as weighting of fundings schemes to projects that prioritise inclusion of under-served groups throughout the research cycle.
Factors associated with postoperative shivering in patients with maintained core temperature after surgery
Authors: Shirozu Kazuhiro , Asada Masako , Shiraki Ryotaro , Hashimoto Takuma , Yamaura Ken
Published: November 2024

Background

Postoperative shivering is mainly associated with low body temperature. However, postoperative shivering can develop even at normal or high core temperatures. This study aimed to investigate the factors associated with postoperative shivering in patients with maintained core temperature after surgery.

Methods

This retrospective study involved 537 patients who had undergone radical surgery for pancreatic cancer under general anesthesia from January 2013 to December 2023. The final analysis included 441 patients whose core temperatures after surgery were ≥ 36.5℃. Logistic regression analysis was performed to estimate the odds ratio (OR) of the incidence of postoperative shivering.

Results

Postoperative shivering occurred in 119 patients. After multivariable-adjusted logistic regression, postoperative shivering was significantly associated with patient age (per 1 year increase; OR = 0.98; 95% confidence interval [CI]: 0.96–0.996; p = 0.02), operation time (per 30 min increase; OR = 1.10; 95% CI: 1.01–1.19; p = 0.03), postoperative core temperature (restricted cubic spline, p = 0.001), postoperative peripheral temperature (restricted cubic spline, p = 0.001), effect site fentanyl concentration at extubation (OR = 0.66; 95% CI: 0.24–0.99; p = 0.049), and acetaminophen use (OR = 0.32; 95% CI: 0.18–0.58; p < 0.001).

Conclusions

Low peripheral temperature was a risk factor for the occurrence of shivering, even if the core temperature was maintained postoperatively. Peripheral temperature monitoring could be utilized to prevent postoperative shivering. In addition, fentanyl and acetaminophen reduced the occurrence of shivering in patients with maintained core temperature after surgery.
Parental separation penalties among university students in Italy
Authors: Pesando Luca Maria , Stranges Manuela
Published: November 2024

This paper addresses the long-standing question of whether parental separation shapes offspring school performance drawing on retrospective data from a group of university students in Italy, a country that has historically had very low separation rates yet has experienced an important rise in family dissolution over the last two decades. Using survey data from 1st-year enrollees in undergraduate courses in Economics and Statistics at two points in time (2000 and 2017), we explore whether the association between parental separation and children’s school performance (i) is observed both at the level of middle school (MS) and high school (HS); (ii) varies according to the age at which students experienced separation, and (iii) varies by parental socio-economic status (SES). Our results suggest that students whose parents separated before MS completion score on average 2 points less on the end-of-middle-school exam relative to students whose parents did not separate or separated after MS completion. Similarly, students whose parents separated before HS completion score 1 point less on the end-of-high-school exam relative to their counterpart. As such, we document a parental separation penalty both at the level of MS and HS, yet lower by half when separation occurs later in students’ life course. Moreover, for HS grade parental separation is associated with more negative consequences when students experience it at very young ages (0–5), while for MS grade heterogeneity by age is less clear-cut. Such penalties are concentrated among children of low-educated mothers, particularly for HS, providing support to the “compensatory advantage” hypothesis predicting smaller penalties for children of high-SES parents. Overall, findings from this study corroborate existing evidence suggesting that the consequences of parental separation vary depending on a combination of social background and the “selectivity” of the educational outcome considered.
Cicer arietinum phytosome ameliorates hepatosteatosis via downregulation of fatty acid synthase and stearoyl-CoA desaturase 1 in rats
Authors: Sayed Amany A. , Soliman Amel M. , Elshall Alaa S. , Marzouk Mohamed
Published: November 2024

Background

Hepatosteatosis is considered a universal problematic health due to bad lifestyle. Thereby, the current study evaluates the influence of the Cicer arietinum polyunsaturated fatty acids (CAP) and newly synthesized C. arietinum polyunsaturated fatty acids phytosome (CAPP) against non-alcoholic fatty liver disease (NAFLD) persuaded through a high-fat diet (HFD) in addition to tamoxifen (TAM) in male albino rats. Forty-eight rats were separated into eight groups (6 rats/group). Rats of the control group were administered distilled water for 45 consecutive days, while phosphatidyl choline (PC), CAP, and CAPP groups administered distilled water (15 days), afterward administered PC, CAP, and CAPP, respectively (500 mg/kg b.wt), orally for 30 days. All the previous groups fed normal diet for the 45 days, while NAFLD rats feed HFD for 45 days and receive TAM (200 mg/kg b.wt, i.p) daily for 15 days, followed by administration of vehicle, PC, CAP, and CAPP orally for another 30 days.

Results

Hepatosteatosis was appraised biochemically by significant increase in the concentrations of serum AST, ALT, γGT, LDH, ALP, total bilirubin, total lipid, triglycerides, fatty acid synthase (FAS), stearoyl-CoA desaturase 1 (SCD-1), and LDL-cholesterol, as well as hepatic total lipids and triglycerides. In addition, a significant decline in serum total protein, albumin, and HDL-cholesterol concentrations was observed in comparison with the control group. NAFLD induces oxidative stress by noteworthy increase in hepatic MDA, H2O2, and meaningful reduction in hepatic GSH, SOD, GST, GRD, and CAT levels as compared with the corresponding control group. Liver histological changes were noted in the NAFLD group as compared to the control. Interestingly, CAP and CAPP treatments modulate the abnormal effects of NAFLD in all the previous parameters. For the histological changes caused by NAFLD, the liver tissue appeared nearly normal after the treatment with CAP and CAPP.

Conclusion

CAP and CAPP administration may have a potential role in alleviating hepatosteatosis. This may relate to its downregulation against FAS, SCD-1, and oxidative stress.
Morphological and molecular characterization of Purpureocillium lilacinum along with its biopesticidal effect against fall armyworm (Spodoptera frugiperda) in Southern Taiwan
Authors: Riaz Muhammad , Chen Wen-Hua , Kafle Lekhnath , Tseng Min-Nan
Published: November 2024

Background

Fall armyworm (FAW), Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae), a key agricultural pest, impacts a broad spectrum of crop species, such as cotton, maize, rice, sorghum, and a range of vegetables. Chemical pesticides and transgenic maize are commonly used to protect crops against this major pest. However, biological control offers a safer and more sustainable solution for long-term FAW management. Entomopathogenic fungi (EPF), a substitute for synthetic insecticides, have been proven to be an effective biocontrol agent for managing pest populations. The present study objective is to isolate and identify the EPF, Purpureocillium lilacinum from soil using morphological and molecular techniques and evaluate its pathogenicity against FAW eggs and various larval stages under different spore concentrations.

Results

The micro-morphological characteristics fluctuated in growth behavior, appearance, and color under diverse growth media and temperatures. Molecular analysis, which involved constructing a phylogenetic tree from ITS and TEF gene regions, confirmed that PT-02 was P. lilacinum. The pathogenicity of the fungus was tested on FAW eggs, neonates, and larvae at multiple concentrations (1 × 108, 1 × 107, and 1 × 106 spores/ml), resulting in variation mortality. The egg mortality rate at 1 × 108, 1 × 107, and 1 × 106 spores/ml was 98, 98 and 96%, respectively. The neonate mortality rate was 100%, while first and second instars larvae mortality ranged from 10–36% across three concentrations, seven days after treatment (DAT). The median lethal concentration (LC50) values of P. lilacinum PT-02 against FAW eggs, first and second instars, were 3.02 × 107, 1.38 × 108, and 2.56 × 108 spore/ml, respectively.

Conclusions

The findings revealed that the native strain of P. lilacinum exhibited strong virulence against FAW, suggesting its potential use as an effective biocontrol agent for managing field pest populations.
Exploring non-canonical targets in Alzheimer’s disease: a departure from the norm
Authors: Jain Smita , Chauhan Neha
Published: November 2024

Alzheimer’s disease (AD), a progressive neurodegenerative disorder, is characterized by neurological impairments such as visual and sensory difficulties, motor dysfunction, sphincter issues, incoordination, gait abnormalities, and cognitive decline. Despite advances in understanding AD pathophysiology and the expansion of therapeutic options over the past three decades, the disease remains incurable. Current therapies, even those specifically targeting AD, often fail to significantly alter its progression, underscoring the need for innovative treatment approaches beyond symptomatic relief. This calls for a re-examination of AD pathology to identify potential therapeutic targets that go beyond conventional strategies. This review highlights four of the most promising non-canonical therapeutic targets: oligodendrocytes, the blood–brain barrier (BBB), neuroimmunometabolism, and the coagulation system. These components are crucial for maintaining the integrity and proper function of neurons and the brain, playing key roles in the progression of AD. Oligodendrocytes, for example, are essential for myelination and neuronal support, while BBB dysfunction can lead to impaired clearance of toxic proteins. Neuroimmunometabolism offers insights into how metabolic processes influence immune responses in the brain and dysregulation of the coagulation system has been linked to increased neuroinflammation and vascular abnormalities in AD. Recent discoveries in these fields provide new avenues for understanding the disease and identifying potential therapeutic targets. By exploring these non-canonical pathways, future research may offer breakthroughs in treating AD, moving beyond symptomatic management towards disease-modifying strategies.
Relationship between plasma fibrinogen level and obstructive sleep apnea
Authors: El-Razek Reda Abd , Elnahriry Tarek , Hashish Abdullah , Shehab Osama
Published: November 2024

Background

Obstructive sleep apnea (OSA), which causes recurring hypoxemia owing to upper airway closure, is one of the most frequent sleep disorders. OSA patients are more prone to suffer cardiovascular disease (CVD) and stroke. One primary mechanism connecting OSA with cardiovascular problems is the prothrombotic state. Our goal in this research is to confirm the relationship between plasma fibrinogen levels and OSA.

Results

A case–control study involved 20 adults, non-obese participants who had been recently diagnosed with OSA, had never been treated for OSA before, and did not have any other preexisting conditions, and 20 controls underwent measurement of plasma fibrinogen levels following whole night polysomnography. The patient's plasma fibrinogen levels were substantially more significant than the controls' (399.8 ± 54.7 versus 309.8 ± 26.7 mg/dL, respectively), with a p-value of less than 0.001. Plasma fibrinogen levels in moderate and severe OSA (383.6 ± 20.6 mg/dL and 454.4 ± 25.6 mg/dL, respectively) were significantly higher than in controls (309.8 ± 26.7 mg/dL) (p < 0.001 and p < 0.001) and mild OSA patients (335 ± 27.8 mg/dL) (p = 0.013 and p < 0.001). Plasma fibrinogen levels were not significantly different between the controls and patients with mild OSA (p = 0.219). Apnea–hypopnea index, arousal index, and oxygen desaturation index showed positive correlations with plasma fibrinogen (r = 0.953, 0.888, and 0.894, p =  < 0.001, < 0.001, and < 0.001, respectively). The total sleep time, sleep efficiency, N3%, REM%, and lowest oxygen saturation showed negative correlations (r = − 0.860, − 0.877, − 0.611, − 0.844, and − 0.745, p =  < 0.001, < 0.001, < 0.001, and < 0.001, respectively).

Conclusion

Elevated levels of plasma fibrinogen in individuals with moderate-to-severe OSA may be attributed to sleep apnea and these increased levels could serve as a significant risk factor that establishes a connection between OSA and pathology of the cardiovascular and cerebrovascular systems. These results could significantly affect OSA diagnosis, therapy monitoring, and outcome.
Takayasu’s arteritis associated with tuberculosis: a retrospective study
Authors: Souza Pedreira Ana Luisa , de Oliveira Figueiroa Maria de Lourdes Castro , Miranda Mariana Oliveira , de Santana Alisson Regis , Mattos Victor Pereira , da Paz Adriane Sousa , Duran Camila Cendon , Santiago Mittermayer Barreto
Published: November 2024

Background

Takayasu arteritis (TA) and tuberculosis (TB) share similar histopathological and immunological characteristics. Studies comparing patients with TA with or without active or latent TB infection (LTBI) have revealed some differences in clinical and angiographic profiles. Patient with TA and history of TB exhibited more constitutional symptoms and structural damage to the aorta. This study compared the clinical and radiological features of patients with TA with and without active TB or LTBI.

Methods

We retrospectively analyzed the data of patients with TA at a public tertiary referral outpatient clinic in northeast Brazil from January 2017 to June 2022. Comparisons of clinical features were made according to the presence of TB.

Results

Fifty patients met the eligibility criteria, and a association with TB was identified in 20 (40%) patients (active TB in six and LTBI in 14). There was a predominance of females, and the average age of patients was 40 years. Weight loss was more common in patients with TA and TB (p = 0.005). No significant intergroup differences were noted in terms of comorbidities, medications, erythrocyte sedimentation rates, or C-reactive protein levels. Significant differences were found in abdominal aortic involvement (25% of patients with TA and TB vs. 11.4% in subjects with TA without TB; p = 0.013). Dilations and aneurysms were significantly more common in patients with TA and TB (p = 0.009 and p = 0.027, respectively).

Conclusion

Patients with TA and TB have a higher prevalence of dilatation and aneurysms, most commonly in the abdominal aorta.
Molecular characterization of Ebola virus, immune response, and therapeutic challenges: a narrative review
Authors: Ndayambaje Martin , Yadufashije Callixte , Habyarimana Thierry , Niyonsaba Theogene , Wahnou Hicham , Iradukunda Patrick Gad , Izere Cedrick , Uwishema Olivier , Ndishimye Pacifique , Oudghiri Mounia
Published: November 2024

The Ebola virus (EBOV) remains a major public health challenge due to its complex structure and the lack of appropriate and effective vaccines and therapies. This review characterizes the Ebola virus, its immune response, and its therapeutic challenges. Structural EBOV proteins include the envelope glycoprotein, nucleoprotein, RNA polymerase L, and viral proteins VP30, VP24, VP35, and VP40. The proteins play a role in the virus’s pathogenesis by evading the host's immune response. The immune system evasion mechanisms of EBOV are critical in its pathogenesis. Some vaccines, such as the recombinant vesicular stomatitis virus-Zaire Ebola virus (RVSV-ZEBOV), have proven to be very effective and have been approved by the Food and Drug Administration (FDA) additionally, four other vaccines have been approved including Gam Evac-Combi (licensed in Russia), ad5-EBOV (approved in China), Zabdeno and Mvabea (approved in Europe). However, some challenges remain in developing effective vaccines, such as the selection of immunogens, cross-protecting immunity, long-term protection, mechanism of protection, and rapid response vaccination. Despite the progress made, there is still a need for an effective vaccine that offers durable and broad protection against multiple strains of the Ebola virus. This will be achieved through the collaboration of various organizations and government and Non-Governmental Organization (NGO) agencies.
Novel RP-HPLC method for simultaneous determination of dapagliflozin and teneligliptin in tablet formulation and identification of degradation products by LC-MS/MS
Authors: Kashyap Thummar , Honey Kevat , Priyanka Vadher , Mihir Jesur
Published: November 2024

Background

Diabetes mellitus affects millions globally, necessitating effective management strategies. Glenmark Pharmaceutical Limited introduced a fixed-dose combination of teneligliptin and dapagliflozin in 2022 to address this need. However, existing methods for their simultaneous detection are limited, lacking forced degradation studies essential for assessing drug stability.

Results

A stability-indicating RP-HPLC method was developed for the simultaneous determination of dapagliflozin and teneligliptin in pharmaceutical formulations. The separation was efficiently achieved employing a Zorbax Eclipse Plus C18 column (150 mm × 4.6 mm, 5 µm). The mobile phase comprised a mixture of 10 mM ammonium acetate buffer in water, methanol, and acetonitrile in a suitable proportion and delivered at a flow rate of 0.6 mL/min. Detection of the isocratic eluents was performed at 224 nm using a photodiode array (PDA) detector. Validation against various stress conditions, as per ICH guidelines, revealed significant degradation of teneligliptin primarily under acidic, basic, and oxidative stress. Moreover, liquid chromatography tandem mass spectrometry (LC-MS/MS)-based characterization was conducted for the primary degradation products of teneligliptin generated under acidic, basic, and oxidative conditions.

Conclusions

The developed RP-HPLC method with a stability-indicating approach provides an efficient means for the simultaneous determination of dapagliflozin and teneligliptin in pharmaceutical formulations. The significant degradation was observed under various stress conditions and also successfully separated the degradation products by this method. The proposed method directly applied for the characterization of degradation products and based on LC-MS/MS data the structure of degradation products was generated and also degradation pathways under various stress conditions were predicted. The proposed method ensured accurate and precise results in quality control process in pharmaceutical industry, and adherence to ICH validation guidelines affirms its reliability in assessing the stability of these compounds.
Prevalence of anxiety and depression and the influence of correlates in acute coronary syndrome patients: a cross-sectional analysis
Authors: Nicola Miran , Nicola Mina , Zarif Bassem , Ghalid Ahmed El , Abdelrahim Mohamed E. A. , Hadidi Seif El
Published: November 2024

Background

Acute coronary syndrome (ACS) patients are vulnerable to anxiety and depression. This study aimed to assess the mental health burden among Egyptian ACS patients by assessing the prevalence and associates of these conditions. This study enrolled 212 patients who underwent coronary angiogram. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Demographic, psychosocial, and clinical data were collected. Univariate and multivariate logistic regression analyses identified factors associated with anxiety and depression.

Results

The mean age of the participants was 54.1 years, and 80.7% were males. More than half (58.1%) exhibited anxiety, depression, or both, with depression being more prevalent than anxiety (48.1% vs 38.2%). Past major depressive disorder was strongly correlated with both anxiety and depression. Higher anxiety scores increased the odds of depression (OR = 1.234, p < 0.001), and vice versa (OR = 1.55, p < 0.001). Hypertension and the use of antihypertensive medications were associated with increased depression. Significant associates of anxiety included increased heart rate, past use of furosemide and enoxaparin, and current polypharmacy.

Conclusions

A substantial proportion of ACS patients experience comorbid anxiety and depression. Polypharmacy, past depression, and hypertension are key risk factors. Targeted interventions addressing these factors are essential for improving mental health in this vulnerable population.
Neurorehabilitation in multiple sclerosis: evaluating the efficacy of the Bobath Concept on motor and balance outcomes
Authors: Tedeschi Roberto
Published: November 2024

Background

Multiple sclerosis (MS) is a progressive neurodegenerative disorder, that presents unique challenges for rehabilitation. The Bobath Concept, an individualized physiotherapy approach, has been explored for its potential benefits in addressing these challenges.

Main body of the abstract

Five distinct MS studies were reviewed. These encompassed a range of interventions based on the Bobath Concept, targeting various symptoms and functional domains in MS. Subjects varied from individual cases to larger cohort studies, with differing eligibility criteria, treatment periods, and assessment tools. Additionally, some studies incorporated innovative techniques, such as tear biomarker evaluation, to assess therapy outcomes.

In smaller samples, MS patients exhibited improvements in postural stability, balance, and mobility after undergoing Bobath-based physiotherapy. Larger cohorts showcased enhancements in balance, cognitive functions, and reductions in depression scores post-treatment. Moreover, the reflex locomotion and Bobath Concept potentially led to symptom improvements correlating with tear biomarkers indicating disease progression. However, results varied across studies, with some showing no significant difference between Bobath and traditional rehab methods.

Short conclusion

The Bobath Concept emerges as a promising avenue for MS rehabilitation, emphasizing individualized treatment and active patient participation. Nevertheless, while potential benefits are evident, further extensive research is required to establish its long-term efficacy and its place in comprehensive MS care.
Cognitive, adaptive and daily life functioning in adults with 22q11.2 deletion syndrome
Authors: Vingerhoets Claudia , Ruiz-Fernandez Julia , von Scheibler Emma , Vergaelen Elfi , Volbragt Nele , Soons Nele , Serrarens Chaira , Vogels Annick , Boot Erik , van Amelsvoort Therese , Swillen Ann
Published: November 2024

Background

22q11.2 deletion syndrome (22q11.2DS) is associated with cognitive impairments and an increased risk of psychopathology. Most of the research has been conducted in children and adolescents, although the majority of affected individuals live well into adulthood. Hence, limited data are available on functional outcomes in adults.

Aims

To provide more insight in cognitive and adaptive abilities, and daily life functioning (marital status, living situation and work situation) in adults with 22q11.2DS.

Method

This retrospective study included 250 Dutch-speaking adults (16–69 years) with 22q11.2DS from three sites in The Netherlands and Belgium. Data on full-scale IQ (FSIQ) scores (assessed with the Wechsler Adult Intelligence Scale), adaptive functioning (assessed with the Vineland Adaptive Behavior Scale II), and functional outcomes including marital status, living and work situation were systematically collected from clinical files. In addition, we examined predictors of adaptive functioning.

Results

The majority of individuals in our adult sample demonstrated a low level of adaptive functioning (65%). In contrast to previous findings in children and adolescents, the majority functioned at an intellectual disability level (56%). Male sex, lower FSIQ and autism spectrum disorder were predictors of lower adaptive functioning (P = 0.016, P < 0.001 and P = 0.16, respectively).

Conclusions

These results suggest that low levels of cognitive and adaptive functioning are common in adults with 22q11.2DS. Future longitudinal and multicentre studies including older patients (>40 years) are needed to further investigate cognitive and adaptive trajectories and their interactions with physical and psychiatric comorbidities.
Depression in childhood to early adulthood and respiratory health in early adulthood
Authors: Wang Gang , Hallberg Jenny , Hernandez-Pacheco Natalia , Ekström Sandra , Vercalsteren Ellen , Brew Bronwyn K. , Almqvist Catarina , Janson Christer , Kull Inger , Bergström Anna , Melén Erik , Lu Donghao
Published: November 2024

Background

Both depression and respiratory disease are common today in young populations. However, little is known about the relationship between them.

Aims

This study aims to explore the association between depression in childhood to early adulthood and respiratory health outcomes in early adulthood, and the potential underlying mechanisms.

Method

A prospective study was conducted based on the Swedish BAMSE (Barn, Allergi, Miljö, Stockholm, Epidemiologi [Children, Allergy, Milieu, Stockholm, Epidemiology]) birth cohort (n = 4089). We identified clinically diagnosed depression through the dispensation of antidepressants, using national register data confirmed by self-reported diagnosis. At the 24-year follow-up, respiratory health was assessed via questionnaires and clinical evaluation. Metabolic and inflammatory profiles were analysed to explore potential mechanisms.

Results

Among the 2994 participants who provided study data, 403 (13.5%) had depression at any time point from around age 10 to 25 years. Depression was associated with higher risks of any chronic bronchitis symptoms (odds ratio = 1.58, 95% CI 1.21–2.06) and respiratory symptoms (odds ratio = 1.41, 95% CI 1.11–1.80) in early adulthood, independent of body mass index (BMI) and smoking status. Compared to individuals without depression, those with depression had a higher fat mass index (FMI (β = 0.48, 95% CI 0.22–0.74)) and increased blood levels of fibroblast growth factor 21 and Interleukin-6 in early adulthood. These markers together with FMI were found to partly mediate the association between depression and respiratory symptoms (total mediation proportion: 19.8 and 15.4%, respectively, P < 0.01).

Conclusions

Depression in childhood to early adulthood was associated with an increased risk of respiratory ill-health in early adulthood, independently of smoking. Metabolic and inflammatory dysregulations may underlie this link.
Emergency hospital admissions for stress-related presentations among secondary school-aged minoritised young people in England
Authors: Ní Chobhthaigh Sorcha , Jay Matthew A. , Blackburn Ruth
Published: November 2024

Background

Minoritised young people face a double burden of discrimination through increased risk of stress and differential treatment access. However, acute care pathways for minoritised young people with urgent mental health needs are poorly understood.

Aims

To explore variation in stress-related presentations (SRPs) to acute hospitals across racial-ethnic groups in England.

Method

We examined rates, distribution, duration and types of SRPs across racial-ethnic groups in a retrospective cohort of 11- to 15-year-olds with one or more emergency hospital admissions between April 2014 and March 2020. SRPs were defined as emergency admissions for potentially psychosomatic symptoms, self-harm and internalising, externalising and thought disorders.

Results

White British (8–38 per 1000 births) and Mixed White–Black (9–42 per 1000 births) young people had highest rates of SRPs, whereas Black African (5–14 per 1000 births), Indian (6–19 per 1000 births) and White other (4–19 per 1000 births) young people had the lowest rates of SRPs. The proportion of readmissions were highest for Pakistani (47.7%), White British (41.4%) and Mixed White–Black (41.3%) groups. Black Other (36.4%) and White Other (35.8%) groups had the lowest proportions of readmissions. The proportion of admission durations ≥3 days was higher for Black Other (16.6%), Bangladeshi (16.3%), Asian Other (15.9%) and Black Caribbean (15.8%) groups than their White British (11.9%) and Indian (11.8%) peers. The type of SRPs varied across racial-ethnic groups.

Conclusions

Patterns of SRP admissions systematically differed across racial-ethnic groups, indicative of inequitable triage, assessment and treatment processes. These findings highlight the need for implementation of race equality frameworks to address structural racism in healthcare pathways.
Light Walking Patterns and Postprandial Cardiometabolic Responses in Young Obese Adults: A Randomized Crossover Study
Authors: Wongpipit Waris , Dempsey Paddy C , Zhang Xiaoyuan , Poon Eric Tsz-Chun , Darumas Nattapak , Miyashita Masashi , Kulaputana Onanong
Published: November 2024

Context

Recent studies suggest that light-intensity physical activity may enhance cardiometabolic health and reduce mortality risk in adults. However, more information is required to understand the patterns of light-intensity physical activity and postprandial cardiometabolic health.

Objective

This study examined the effects of different light-intensity walking patterns on postprandial cardiometabolic responses in young obese adults.

Design

A randomized crossover trial was conducted.

Setting

The study was conducted in the laboratory.

Participants

The study analyzed baseline (fasting) and 6-hour postprandial concentrations of glucose, insulin, triglycerides, and blood pressure (BP) in 16 young obese adults.

Interventions

Participants underwent 4 7-hour experimental conditions with a 7- to 20-day washout period: uninterrupted sitting (SIT), 30-minute light-intensity walking (EX + SIT), 3-minute light-intensity walking every 30 minutes (BR), and 30-minute light-intensity walking with 3-minute light-intensity walking every 30 minutes (EX + BR).

Main Outcome Measures

Incremental areas under the curve (iAUC) for each outcome and average BP were compared between SIT and walking conditions.

Results

Compared with SIT, all walking conditions reduced iAUCs for glucose and average diastolic BP (all P < .05). Only EX + SIT and EX + BR reduced iAUCs for insulin (P < .05). No significant differences were found for triglycerides iAUC and systolic BP between the 4 conditions (all P > .05).

Conclusion

All patterns of light-intensity walking reduced postprandial glucose concentrations and diastolic BP in young obese adults, suggesting benefits for glycemic control. Continuous 30-minute light-intensity walking alone or combined with brief 3-minute bouts also attenuated postprandial insulin concentrations, highlighting light-intensity walking as a promising strategy for improving cardiometabolic health in young obese adults.

Clinical Trial Registration

TCTR20220311001, Thaiclinicaltrials.org
Predictive Value of Neurosurgery Applicant Metrics on Resident Academic Productivity
Authors: Banko Lauren , Riesenburger Nathan , Patel Ruchit V. , Gilligan Courtney , Cosgrove G. Rees , Chiocca E. Antonio , Proctor Mark R. , Patel Akash J. , Bi Wenya Linda
Published: November 2024

BACKGROUND AND OBJECTIVES:

Scholarship has been critical to neurosurgery. As grades and board examinations become pass-fail, finding metrics to distinguish applicants coupled with an emphasis on research has led to growth of reported academic output among neurosurgery applicants. We aimed to evaluate applicant factors that associate with an academically productive neurosurgery resident.

METHODS:

Applicant characteristics were extracted from Electronic Residency Application Service archives from 2 geographically distinct neurosurgical programs for the 2014 to 2015 match cycle. Publications during residency were quantified, and residency careers were examined. Factors associated with residency publications were examined using univariate and multivariate regressions.

RESULTS:

A total of 228 United States (US) applicants to neurosurgery were assessed (89% of US neurosurgery applicants), with 173 matching across 93 programs. The average publication number of matched applicants was higher at 6.6 (median: 4, range: 0-43) that of than unmatched applicants (mean: 2.9, median: 1, range: 0-51). A total of 93.1% of publications were substantiated on PubMed review. Matched candidates published 19.3 manuscripts (median: 13, range: 0-120) on average during residency. On univariate analysis, factors associated with higher residency publications included taking a non–degree-granting extra year for research in medical school, consistently high clerkship grades, depth of preresidency research involvement, number of coresidents, program R25 status, and academic output of neurosurgery department leadership. After multivariate correction, the training environment played an outsized role in predicting resident academic output, with program R25 status significantly associated with resident academic output (odds ratio: 1.25, P = .012). Taking an extra research year in medical school approached but was not significant (odds ratio: 1.19, P = .099). Twelve matched international medical school graduates (IMGs) were also assessed (75% of matched IMG neurosurgery applicants). IMGs exhibited higher total publications and conference abstracts than US matched applicants and also published more during residency.

CONCLUSION:

Cultivating an environment that promotes research endeavors is critical for neurosurgical resident academic growth. Preresidency publication number does not predict publication potential during residency.