bluuebunny/crossref_metadata_2025 huggingface dataset:
A nomogram model based on SII, AFR, and NLR to predict infectious complications of laparoscopic hysterectomy for cervical cancer
Authors: Xing Hailin , Yuan Donglan , Zhu Yabin , Jiang Lin
Published: July 2024

Background

This study aimed to investigate the potential risk factors associated with postoperative infectious complications following laparoscopic hysterectomy for cervical cancer and to develop a prediction model based on these factors.

Methods

This study enrolled patients who underwent selective laparoscopic hysterectomy for cervical cancer between 2019 and 2024. A multivariate regression analysis was performed to identify independent risk factors associated with postoperative infectious complications. A nomogram prediction model was subsequently constructed and evaluated using R software.

Results

Out of 301 patients were enrolled and 38 patients (12.6%) experienced infectious complications within one month postoperatively. Six variables were independent risk factors for postoperative infectious complications: age ≥ 60 (OR: 3.06, 95% confidence interval (CI): 1.06–8.79, P = 0.038), body mass index (BMI) ≥ 24.0 (OR: 3.70, 95%CI: 1.4–9.26, P = 0.005), diabetes (OR: 2.91, 95% CI: 1.10–7.73, P = 0.032), systemic immune-inflammation index (SII) ≥ 830 (OR: 6.95, 95% CI: 2.53–19.07, P < 0.001), albumin-to-fibrinogen ratio (AFR) < 9.25 (OR: 4.94, 95% CI: 2.02–12.07, P < 0.001), and neutrophil-to-lymphocyte ratio (NLR) ≥ 3.45 (OR: 7.53, 95% CI: 3.04–18.62, P < 0.001). Receiver operator characteristic (ROC) curve analysis indicated an area under the curve (AUC) of this nomogram model of 0.928, a sensitivity of 81.0%, and a specificity of 92.1%.

Conclusions

The nomogram model, incorporating age, BMI, diabetes, SII, AFR, and NLR, demonstrated strong predictive capabilities for postoperative infectious complications following laparoscopic hysterectomy for cervical cancer.
IRF8 deficiency-induced myeloid-derived suppressor cell promote immune evasion in lung adenocarcinoma
Authors: Gao Zhen , Liu Shang , Xiao Han , Li Meng , Ren Wan-gang , Xu Lin , Peng Zhong-min
Published: July 2024

Background

Patients with lung adenocarcinoma (LUAD) have a low response rate to immune checkpoint blockade. It is highly important to explore the tumor immune escape mechanism of LUAD patients and expand the population of patients who may benefit from immunotherapy.

Methods

Based on 954 bulk RNA-seq data of LUAD patients and 15 single-cell RNA-seq data, the relationships between tumor immune dysfunction and exclusion (TIDE) scores and survival prognosis in each patient were calculated and evaluated, and the immune escape mechanism affecting the independent prognosis of LUAD patients was identified. Functional enrichment analysis explored the antitumour immune response and biological behavior of tumor cells among different LUAD groups. Single-cell annotation and pseudotemporal analysis were used to explore the target molecules and immune escape mechanisms of LUAD.

Results

Myeloid-derived suppressor cells (MDSCs) and IRF8 were identified as risk and protective factors for the independent prognosis of LUAD patients, respectively. In the tumor microenvironment of patients with high infiltration of MDSCs, the antitumor immune response is significantly suppressed, while tumor cell division, proliferation, and distant metastasis are significantly enhanced. Single-cell RNA-seq analysis revealed that IRF8 is an important regulator of MDSC differentiation in LUAD myeloid cells. In addition, IRF8 may regulate the differentiation of MDSCs through the IL6-JAK-STAT3 signalling pathway.

Conclusions

IRF8 deficiency impairs the normal development of LUAD myeloid cells and induces their differentiation into MDSCs, thereby accelerating the immune escape of LUAD cells. IRF8-targeted activation to inhibit the formation of MDSCs may be a new target for immunotherapy in LUAD.
The prevalence and correlates of unintended pregnancy among female sex workers in South China: a cross-sectional study
Authors: Liang Peng , Zhao Peizhen , Shi Yijia , Huang Shujie , Wang Cheng
Published: July 2024

Background

Female sex workers (FSW) are particularly vulnerable to unintended pregnancy. Research examining the experience of unintended pregnancy due to commercial sex among Chinese FSW, however, is limited. This study aimed to examine the prevalence and correlates of unintended pregnancy due to commercial sex among FSW in China.

Methods

In 2021, a cross-sectional study was conducted among 1257 FSW in five cities from Guangdong provinces in South China. Data were collected on social-demographic characteristics, sexual behaviors, experience of unintended pregnancy due to commercial sex and its pregnancy outcome, as well as experience of abortion in lifetime. Multivariable logistic regression analysis was employed to identify factors associated with unintended pregnancy.

Results

Among the 1257 FSW, 19.3% reported having at least one unintended pregnancy due to commercial sex. Of those, 96.7% chose to terminate the pregnancy through induced abortion, and 40.5% reported undergoing multiple induced abortions in their lifetime. Multivariable logistic regression indicated that FSW working in current location over one year (adjusted Odds Ratio (aOR): 2.82, 95% CI 1.71–4.64) and having more than seven clients in the past week (aOR: 4.53, 95% CI 2.74–7.51) were more likely to have had unintended pregnancy due to commercial sex. Working in high tier (aOR: 0.21, 95% CI 0.14–0.30) and consistent condom use with clients in the past month (aOR: 0.16, 95% CI 0.10–0.23) were associated with a lower proportion of FSW having ever had unintended pregnancy.

Conclusions

Unintended pregnancy are prevalent among FSW in South China. Interventions aimed at reducing the prevalence of unintended pregnancy and enhancing post-abortion care could be necessary among Chinese FSW.
The Digital Atlas of Ancient Rare Diseases (DAARD) and its relevance for current research
Authors: Gresky Julia , Frotscher Melina , Dorn Juliane , Scheelen-Nováček Kristina , Ahlbrecht Yannick , Jakob Tina , Schönbuchner Toni , Canalejo José , Ducke Benjamin , Petiti Emmanuele
Published: July 2024

Background

The history of rare diseases is largely unknown. Research on this topic has focused on individual cases of prominent (historical) individuals and artistic (e.g., iconographic) representations. Medical collections include large numbers of specimens that exhibit signs of rare diseases, but most of them date to relatively recent periods. However, cases of rare diseases detected in mummies and skeletal remains derived from archaeological excavations have also been recorded. Nevertheless, this direct evidence from historical and archaeological contexts is mainly absent from academic discourse and generally not consulted in medical research on rare diseases.

Results

This desideratum is addressed by the Digital Atlas of Ancient Rare Diseases (DAARD: https://daard.dainst.org), which is an open access/open data database and web-based mapping tool that collects evidence of different rare diseases found in skeletons and mummies globally and throughout all historic and prehistoric time periods. This easily searchable database allows queries by diagnosis, the preservation level of human remains, research methodology, place of curation and publications. In this manuscript, the design and functionality of the DAARD are illustrated using examples of achondroplasia and other types of stunted growth.

Conclusions

As an open, collaborative repository for collecting, mapping and querying well-structured medical data on individuals from ancient times, the DAARD opens new avenues of research. Over time, the number of rare diseases will increase through the addition of new cases from varied backgrounds such as museum collections and archaeological excavations. Depending on the research question, phenotypic or genetic information can be retrieved, as well as information on the general occurrence of a rare disease in selected space–time intervals. Furthermore, for individuals diagnosed with a rare disease, this approach can help them to build identity and reveal an aspect of their condition they might not have been aware of. Thus, the DAARD contributes to the understanding of rare diseases from a long-term perspective and adds to the latest medical research.
Spared nerve injury leads to reduced activity of neurons projecting from the ventrolateral periaqueductal gray to the locus coeruleus
Authors: Yu Wing Lam , Zhang Zizhen , Zamponi Gerald W.
Published: July 2024

The ventrolateral periaqueductal gray (vlPAG) serves as a central hub for descending pain modulation. It receives upstream projections from the medial prefrontal cortex (mPFC) and the ventrolateral orbitofrontal cortex (vlOFC), and projects downstream to the locus coeruleus (LC) and the rostroventral medulla (RVM). While much research has focused on upstream circuits and the LC-RVM connection, less is known about the PAG-LC circuit and its involvement in neuropathic pain. Here we examined the intrinsic electrophysiological properties of vlPAG-LC projecting neurons in Sham and spared nerve injury (SNI) operated mice. Injection of the retrotracer Cholera Toxin Subunit B (CTB-488) into the LC allowed the identification of LC-projecting neurons in the vlPAG. Electrophysiological recordings from CTB-488 positive cells revealed that both GABAergic and glutamatergic cells that project to the LC exhibited reduced intrinsic excitability after peripheral nerve injury. By contrast, CTB-488 negative cells did not exhibit alterations in firing properties after SNI surgery. An SNI-induced reduction of LC projecting cells was confirmed with c-fos labeling. Hence, SNI induces plasticity changes in the vlPAG that are consistent with a reduction in the descending modulation of pain signals.
Synthesis of sodium alginate / polyvinyl alcohol / polyethylene glycol semi-interpenetrating hydrogel as a draw agent for forward osmosis desalination
Authors: Zewail Taghreed Mohamed Mohamed , Saad Menatalla Ashraf , AbdelRazik Shrouk Medhat , Eldakiky Basma Mohamed , Sadik Eman Radi
Published: July 2024

Typically, hydrogels are described as three-dimensional networks of hydrophilic polymers that are able to capture a certain mass of water within their structure. Recently, hydrogels have been widely used as drawing agents in forward osmosis (FO) desalination processes. The major aim of this study is to prepare a novel semi-interpenetrating hydrogel by crosslinking sodium alginate (SA) and polyvinyl alcohol (PVA) by using the epichlorohydrin (ECH) crosslinker and polyethylene glycol (PEG) interpenetrated within the hydrogel’s network as a linear polymer. Based on the optimum composition of SA/PVA composite hydrogel obtained from our earlier research, the effect of various percentages of PEG on the response of the hydrogel was investigated. The optimal composition of SA/PVA/PEG hydrogel was characterized by scanning electron microscopy (SEM), compression strength testing, Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). The morphological and mechanical properties of the SA/PVA/PEG semi-interpenetrating hydrogel were also compared to those of the SA/PVA composite hydrogel. Moreover, the performance of the optimal SA/PVA/PEG hydrogel in a FO batch unit as a drawing agent was investigated based on the optimal operation conditions from our previous experiments. The results showed that the optimal PEG/polymer blend mass ratio was 0.25, which increased the swelling ratio (SR) (%) of the hydrogel from 645.42 (of the neat SA/PVA hydrogel) to 2683. The SA/PVA/PEG semi-interpenetrating hydrogel was superior to the SA/PVA copolymer hydrogel in pore structure and mechanical properties. Additionally, in terms of FO desalination, the achieved water flux by SA/PVA/PEG hydrogel is higher than that accomplished by SA/PVA hydrogel.
Recombinant porcine interferon delta 8 inhibits swine acute diarrhoea syndrome coronavirus infection in vitro and in vivo
Authors: Zhang Teng , Yao Jiale , Yang Zhuan , Wang Jucai , Yang Kankan , Yao Lunguang
Published: July 2024

Swine acute diarrhoea syndrome coronavirus (SADS-CoV), which originates from zoonotic transmission of bat coronaviruses in the HKU2 lineage, causes severe illness in pigs and carries a high risk of spreading to humans. At present, there are no licenced therapeutics for the treatment of SADS-CoV. In this study, we examined the effectiveness of recombinant porcine interferon delta 8 (IFN-δ8) against SADS-CoV both in vitro and in vivo. In vitro experiments showed that IFN-δ8 inhibited SADS-CoV proliferation in a concentration-dependent manner, with complete inhibition occurring at a concentration of 5 μg/mL. In vivo experiments demonstrated that two 50 μg/kg doses of IFN-δ8 injected intraperitoneally protected piglets against lethal challenge, blocked viral shedding, attenuated intestinal damage, and decreased the viral load in the jejunum and ileum. Further findings suggested that IFN-δ8 inhibited SADS-CoV infection by increasing the expression of IFN-stimulated genes. These results indicate that IFN-δ8 shows promise as a biological macromolecule drug against SADS-CoV infection.
Implementing a nutrition education intervention in Eastern Norwegian Kindergartens: barriers and facilitators
Authors: Løvik Brandvik Caroline , Meshkovska Biljana , Schultz Gry Irene Granli , Garnweidner-Holme Lisa
Published: July 2024

Background

Implementations to improve healthy eating in kindergartens may play a pivotal role in shaping children’s dietary behaviors. There is limited research on the implementation and key implementation determinants (barriers and facilitators) of interventions in kindergarten settings. The aim of this study was to explore kindergarten staff members’ experiences with the implementation of a nutrition education intervention to identify implementation barriers and facilitators.

Methods

We interviewed 12 employees from five different kindergartens in an Eastern Norwegian municipality between 2019 until 2020. The individual interviews were guided by the consolidated framework for implementation research. The interviews were recorded, transcribed verbatim, and analyzed inductively, inspired by Braun and Clarke’s reflexive thematic analysis.

Results

Implementation facilitators were satisfactory planning and presentation execution, including tailoring to kindergarten and staff needs, food and meals being a kindergarten/staff priority, and confidence-building of staff. Barriers included unsatisfactory planning and presentation execution, the presentation as a one-time event, non-tailoring to kindergarten and staff needs, and kindergartens/staff not prioritizing food and meals.

Conclusions

When developing and implementing similar kindergarten interventions, the following should be considered: a participatory approach, active engagement of staff, the physical learning environment, and the frequency of opportunities to revisit topics.
Are first-trimester pregnant women consuming adequate and diverse diet? A hospital-based cross-sectional study in Karachi, Pakistan
Authors: Vadsaria Khadija , Mohammed Nuruddin , Aamir Shelina , Nuruddin Rozina
Published: July 2024

Background

Maintaining a healthy and diverse diet during pregnancy is crucial for maternal well-being and fetal development. The first trimester marks the beginning of vital developmental processes influenced by maternal nutritional status. Therefore, we aimed to determine dietary adequacy and diversity among first-trimester pregnant women.

Methods

In this cross-sectional study, we recruited 306 first-trimester pregnant women from the antenatal clinics of Aga Khan University Hospital, Karachi (January 2020 to September 2021). Eligible women possessed smartphones (for the mHealth intervention trial) and reported no major comorbidities or medication use. Data about socio-demographic, obstetric, and dietary history were collected through interviews using a structured questionnaire. Booking weight, height, blood pressure, and haemoglobin levels were extracted from medical records. An aggregate dietary risk score (DRS) was calculated separately for quantity and quality by summing the DRS for each of the six major food groups. A score of 0 was assigned to adequate, 1.5 to intermediate, and 3 to inadequate quantity or quality categories. Data were analysed using STATA 14.0.

Results

The mean ± SD for DRS quantity and quality were 10.6 ± 2.4 and 7.5 ± 2.5, respectively. Adequate dietary quantity and quality per week for starch-based food were reported by 14.4% and 21.2%, for vegetables by 0.3% and 49%, for fruits by 41.2% and 88.6%, for animal and plant protein by 19% and 0%, for milk and milk products by 1% and 37.6% and for oils and fats by 90.5% and 8.8%, respectively. Sweet and savoury snacks were eaten by 74.8% and 53.9%, respectively. Ready-made meals, carbonated beverages, packaged juices, and additional salt were consumed by 55.2%, 46.4%, 34.3%, and 7.5%, respectively. The median (IQR) water intake was 6 (4–8) glasses/day.

Conclusions

During the early stages of pregnancy, women enrolled for antenatal care at an urban private tertiary care hospital report inadequate dietary intake for various food groups, except for the quantity of oils/fats and the quality of fruit consumption. Poor dietary practices underscore the need for focused and impactful dietary counselling during the initial stages of pregnancy.
MGMT promoter methylation is a strong prognostic factor for survival after progression in high-grade gliomas
Authors: Zhang Jing , Qiu Xiaoguang , Feng Jin , Liu Yanwei
Published: July 2024

Background

High-grade gliomas (HGGs) have a rapid relapse and short survival. Studies have identified many clinical characteristics and biomarkers associated with progression-free survival (PFS) and over-survival (OS). However, there has not yet a comprehensive study on survival after the first progression (SAP).

Methods

From CGGA and TCGA, 319 and 308 HGGs were confirmed as the first progression. The data on clinical characteristics and biomarkers were analyzed in accordance with OS, PFS, and SAP.

Results

Analysis of 319 patients from CGGA, significant predictors of improved OS/PFS/SAP were WHO grade, MGMT promoter methylation, and Ki-67 expression in univariate analysis. Further multivariate analysis showed MGMT promoter methylation and Ki-67 expression were independent predictors. However, an analysis of 308 patients from TCGA found MGMT promoter methylation is the only prognostic marker. A longer SAP was observed in patients with methylated MGMT promoter after standard chemoradiotherapy. In our data, HGGs could be divided into low, intermediate, and high-risk groups for SAP by MGMT methylation and Ki-67 expression.

Conclusions

Patients with MGMT promoter methylation have a prolonger SAP after standard chemoradiotherapy. HGGs could be divided into low, intermediate, and high-risk groups for SAP according to MGMT status and Ki-67 expression.
Low-contrast lesion detection in neck CT: a multireader study comparing deep learning, iterative, and filtered back projection reconstructions using realistic phantoms
Authors: Bellmann Quirin , Peng Yang , Genske Ulrich , Yan Li , Wagner Moritz , Jahnke Paul
Published: July 2024

Background

Computed tomography (CT) reconstruction algorithms can improve image quality, especially deep learning reconstruction (DLR). We compared DLR, iterative reconstruction (IR), and filtered back projection (FBP) for lesion detection in neck CT.

Methods

Nine patient-mimicking neck phantoms were examined with a 320-slice scanner at six doses: 0.5, 1, 1.6, 2.1, 3.1, and 5.2 mGy. Each of eight phantoms contained one circular lesion (diameter 1 cm; contrast -30 HU to the background) in the parapharyngeal space; one phantom had no lesions. Reconstruction was made using FBP, IR, and DLR. Thirteen readers were tasked with identifying and localizing lesions in 32 images with a lesion and 20 without lesions for each dose and reconstruction algorithm. Receiver operating characteristic (ROC) and localization ROC (LROC) analysis were performed.

Results

DLR improved lesion detection with ROC area under the curve (AUC) 0.724 ± 0.023 (mean ± standard error of the mean) using DLR versus 0.696 ± 0.021 using IR (p = 0.037) and 0.671 ± 0.023 using FBP (p < 0.001). Likewise, DLR improved lesion localization, with LROC AUC 0.407 ± 0.039 versus 0.338 ± 0.041 using IR (p = 0.002) and 0.313 ± 0.044 using FBP (p < 0.001). Dose reduction to 0.5 mGy compromised lesion detection in FBP-reconstructed images compared to doses ≥ 2.1 mGy (p ≤ 0.024), while no effect was observed with DLR or IR (p ≥ 0.058).

Conclusion

DLR improved the detectability of lesions in neck CT imaging. Dose reduction to 0.5 mGy maintained lesion detectability when denoising reconstruction was used.

Relevance statement

Deep learning enhances lesion detection in neck CT imaging compared to iterative reconstruction and filtered back projection, offering improved diagnostic performance and potential for x-ray dose reduction.

Key Points

Low-contrast lesion detectability was assessed in anatomically realistic neck CT phantoms.

Deep learning reconstruction (DLR) outperformed filtered back projection and iterative reconstruction.

Dose has little impact on lesion detectability against anatomical background structures.

Graphical Abstract
Prevalence and patterns of multidrug-resistant bacteria isolated from sputum samples of patients with bacterial pneumonia at a tertiary hospital in Tanzania
Authors: Kamori Doreen , Renatus Dominic , Mwandigha Ambele M. , Emmanuel Edgar , Masoud Salim S. , Shedura Vulstan , Kibwana Upendo O. , Manyahi Joel , Joachim Agricola , Majigo Mtebe
Published: July 2024

Background

Antimicrobial resistance affects the treatment of several bacterial infections, including pneumonia. This subsequently increased the morbidity and mortality rates of patients with bacterial pneumonia, especially in resource-limited settings. In this study, we aimed to determine the patterns of multidrug-resistant (MDR) bacteria isolated from the sputum samples of patients with bacterial pneumonia attending a tertiary hospital in Tanzania.

Methodology

A retrospective cross-sectional study was conducted. It involved reviewing the laboratory sputum data in the laboratory information system at Muhimbili National Hospital in Tanzania. The sputum samples were previously processed using standard methods (culture, Gram staining, and biochemical tests) to isolate and identify the bacteria. At the same time, antibiogram profiles were determined using antimicrobial susceptibility tests. Bacterial isolates that expressed MDR patterns were identified. Demographic information was collected from patients' medical records. We used the chi-square test to determine factors associated with MDR. A p-value < 0.05 was considered significant.

Results

We retrieved and analysed 169 laboratory records of patients with a provisional clinical diagnosis of bacterial pneumonia confirmed in the microbiology laboratory. Nearly 98% of the records were from adult patients. The patients’ mean age was 48.3 years and 17.3 standard deviations. About 84% of the isolated bacteria were Gram-negative; the most predominant was Klebsiella pneumoniae (59/142; 41.5%). The predominant Gram-positive bacteria was Staphylococcus aureus (25/27; 92.6%). Furthermore, 80 out of 169 (47.3%) bacteria were MDR; Klebsiella pneumoniae (32.5%) was predominant. In addition, 50% of Staphylococcus aureus was methicillin resistance. MDR bacterial pneumonia was highly observed in patients admitted to the Intensive Care Unit (p < 0.05).

Conclusions

Although our study was limited by variations in the number of bacterial isolates subjected to the same antibiotic drugs and a lack of information on risk factors such as occupation, smoking history, and marital status, we observed that a high proportion of bacterial pneumonia is caused by MDR Gram-negative bacteria in our local setting. These results inform the need to improve infection prevention control measures in hospitals to reduce the burden of MDR bacteria in our settings and other similar resource-limited settings.
What works in implementing shared medical appointments for patients with diabetes in primary care to enhance reach: a qualitative comparative analysis from the Invested in Diabetes study
Authors: Holtrop Jodi Summers , Gurfinkel Dennis , Nederveld Andrea , Reedy Julia , Rubinson Claude , Kwan Bethany Matthews
Published: July 2024

Background

Diabetes is a serious public health problem affecting 37.3 million Americans. Diabetes shared medical appointments (SMAs) are an effective strategy for providing diabetes self-management support and education in primary care. However, practices delivering SMAs experience implementation challenges. This analysis examined conditions associated with successful practice implementation of diabetes SMAs in the context of participation in a pragmatic trial.

Methods

Mixed methods study using qualitative and quantitative data collected from interviews, observations, surveys, and practice-reported data, guided by the practical, robust implementation and sustainability model (PRISM). Data were analyzed using qualitative comparative analysis (QCA). Successful implementation was defined as meeting patient recruitment targets (Reach) during the study period. Participants were clinicians and staff members from 22 primary care practices in Colorado and Missouri, USA.

Results

The first necessary condition identified from the QCA was the presence of additional resources for patients with diabetes in the practice. Within practices that had these additional resources, we found that a sufficiency condition was the presence of an effective key person to make things happen with the SMAs. A second QCA was conducted to determine conditions underlying the presence of the effective key person (often performing functions of an implementation champion), which revealed factors including low or managed employee turnover, a strong baseline practice culture, and previous experience delivering SMAs.

Conclusions

Identification of key factors necessary and sufficient for implementation of new care processes is important to enhance patient access to evidence-based interventions. This study suggests that practice features and resources have important implications for implementation of diabetes SMAs. There may be opportunities to support practices with SMA implementation by enabling the presence of skilled implementation champions.

Trial registration

Registered at clinicaltrials.gov under trial ID NCT03590041, registered on July 18, 2018.
The moderating role of board gender diversity on the association between audit committee attributes and integrated reporting quality
Authors: El-Deeb Mohamed Samy , Mohamed Lana
Published: July 2024

Purpose

The main objective of the research is to examine the influence of audit committee attributes on the integrated reporting quality (IRQ) and to investigate whether this association is moderated by board gender diversity in the manufacturing and non-manufacturing sectors. The study specifically investigates the association between audit committee independence, meetings frequency, financial expertise, audit committee size, and integrated reporting quality.

Design/methodology/approach

The data collection was from the financial statements and corporate governance reports of 54 Egyptian firms listed on the stock market [EGX100] for the period of 2018–2022. The study used pooled effect modelling and performed data analysis using the STATA software.

Findings

For the manufacturing sector, the results showed a significant impact of audit committee independence and meetings frequency on IRQ, while audit committee size and financial expertise showed insignificant association with IRQ. Board gender diversity moderates the association between audit committee meetings only and IRQ. In contrast, audit committee financial expertise and meetings frequency significantly impact IRQ, while audit committee independence and size showed an insignificant impact on IRQ in the non-manufacturing sector. Also, board gender diversity moderates the association between audit committee and IRQ. The findings highlight the significance of AC attributes and provide guidance to firms to strengthen their audit committees in order to provide high quality of integrated reports to increase investor trust in the Egyptian business environment as it is now mandatory by the government.

Originality/value

This research offers unique perspectives on the association between variables in Egypt. This study is one of the first investigations on the impact of audit committee attributes and board diversity on integrated reporting quality within the context of Egyptian listed companies. Comprehending the ways in which audit committee attributes impact the integrated reporting quality in the manufacturing and non-manufacturing sectors can enable organizations to devise focused approaches that comply to the unique operational, regulatory, and investor demands in each sector.
Prevalence of hearing loss among patients attending the private otolaryngology clinic, Ramadi city, Anbar, Iraq
Authors: Al-Ani Raid M. , Jamal Karrar Khalid , Fakhri Fatima Wadhah , Muhamed Sabaa Haitham , Muhamed Nabaa Haitham , Ali Omar Fadhil
Published: July 2024

Background

Hearing loss is a common problem worldwide with a global prevalence of 20%. There is no local relevant study from Iraq about the prevalence of hearing loss.

Objective

To assess the prevalence of hearing loss among patients attending the otolaryngology clinic, Ramadi city, Iraq.

Method

This retrospective study was conducted at the otolaryngology clinic, Ramadi city, Anbar government, Iraq. Patients with hearing loss were enrolled in the current study. Data were gathered from patients record regarding the age, sex, type, side, and severity of hearing loss. Additionally, the number of cases were registered for each month during the study period.

Results

Out of 8497, there were 2165 (25.48%) patients with hearing loss. The highest number of cases was registered in April (n = 246, 11.4%). The highest age group affected was 18–60 years (n = 1125) with slight male predominance (51.64%). The main cause of hearing loss was secretary otitis media (n = 762, 35.19/5). The vast majority of cases were with conductive hearing impairment (n = 2051, 94.73%). Unilateral hearing loss (50.76%) was slightly more than bilateral one. Mild hearing loss has outnumbered (n = 1905, 88%) the other severities.

Conclusion

The prevalence of hearing loss was 25.48%. Hearing loss could affect any age with slight male predominance. The majority of the cases were with conductive type and mild severity.
Sinonasal anatomical findings associated with revision functional endoscopic sinus surgery in chronic rhinosinusitis
Authors: Khalil Mohamed Fat-hy , Khalifa Mohamad Adel , Gamea Ahmad Moawad , Erfan Fatthe Ali , Ebeid Kamal
Published: July 2024

Background

Functional endoscopic sinus surgery (FESS) is a crucial additional procedure employed in the management of chronic rhinosinusitis (CRS). It has mostly overtaken the external methods for managing CRS that do not respond to medicinal treatment. Over the years, several instruments have been created to eliminate anatomical obstructions and restore proper function in the sinus drainage pathways. The purpose of this work was to reflect on various anatomical findings after primary functional endoscopic sinus surgery and their relationship with sinus surgery revision.

Methods

This is a prospective cohort study conducted on 40 participants with CRS. The Sino-Nasal Outcome Test version 22 (SNOT-22) was utilized as a measure of results and was filled out by participants both prior to and following their operation (at the 6-month and 12-month intervals).

Results

There were multiple anatomical findings encountered in CRS persistence and subsequent need for revision FESS; the most common was incomplete ethmoidectomy (both anterior and posterior) 62.5% (N = 25), and the least common was misplaced antrostomy and partial or full resection of the middle turbinate 7.5% (N = 3). Preoperative total SNOT-22 scoring ranged from 42 to 86 with mean 58.83 ± 12.08, while 6-month postoperative scoring ranged from 10 to 32 with mean 21.48 ± 5.12, and 12-month postoperative scoring ranged from 15 to 37 with mean 28.83 ± 5.52. There was significant improvement (P = 0.001). The ages of patients range between 18 and 62 years.

Conclusions

Several common anatomical findings are often found during revision surgeries by analysis of CT scans and endoscopic examination of participants who underwent revision FESS for recurrent or persistent CRS, and this often shows persisting anatomical features or incompletely excised cells that correspond to persistent symptoms and signs of CRS, and the most common was incomplete ethmoidectomy. Also, there was significant improvement regarding outcome measure SNOT-22, 6-month and 12-month period postoperative as contrasted with preoperative scoring.
A source of entangled photons based on a cavity-enhanced and strain-tuned GaAs quantum dot
Authors: Rota Michele B. , Krieger Tobias M. , Buchinger Quirin , Beccaceci Mattia , Neuwirth Julia , Huet Hêlio , Horová Nikola , Lovicu Gabriele , Ronco Giuseppe , Covre da Silva Saimon F. , Pettinari Giorgio , Moczała-Dusanowska Magdalena , Kohlberger Christoph , Manna Santanu , Stroj Sandra , Freund Julia , Yuan Xueyong , Schneider Christian , Ježek Miroslav , Höfling Sven , Basso Basset Francesco , Huber-Loyola Tobias , Rastelli Armando , Trotta Rinaldo
Published: July 2024

A quantum-light source that delivers photons with a high brightness and a high degree of entanglement is fundamental for the development of efficient entanglement-based quantum-key distribution systems. Among all possible candidates, epitaxial quantum dots are currently emerging as one of the brightest sources of highly entangled photons. However, the optimization of both brightness and entanglement currently requires different technologies that are difficult to combine in a scalable manner. In this work, we overcome this challenge by developing a novel device consisting of a quantum dot embedded in a circular Bragg resonator, in turn, integrated onto a micromachined piezoelectric actuator. The resonator engineers the light-matter interaction to empower extraction efficiencies up to 0.69(4). Simultaneously, the actuator manipulates strain fields that tune the quantum dot for the generation of entangled photons with corrected fidelities to a maximally entangled state up to 0.96(1). This hybrid technology has the potential to overcome the limitations of the key rates that plague QD-based entangled sources for entanglement-based quantum key distribution and entanglement-based quantum networks.
From an idea to the marketplace: identifying and addressing ethical and regulatory considerations across the digital health product-development lifecycle
Authors: Largent Emily A. , Karlawish Jason , Wexler Anna
Published: July 2024

Widespread adoption of digital health tools has the potential to improve health and health care for individuals and their communities, but realizing this potential requires anticipating and addressing numerous ethical and regulatory challenges. Here, we help digital health tool developers identify ethical and regulatory considerations – and opportunities to advance desirable outcomes – by organizing them within a general product-development lifecycle that spans generation of ideas to commercialization of a product.
Patterns of digital health access and use among US adults: a latent class analysis
Authors: Hegeman Phillip C. , Vader Daniel T. , Kamke Kristyn , El-Toukhy Sherine
Published: July 2024

Background

Digital technologies allow users to engage in health-related behaviors associated with positive outcomes. We aimed to identify classes of US adults with distinct digital technologies access and health use patterns and characterize class composition. Data came from Health Information National Trends Survey Wave 5 Cycles 1–4, a nationally representative cross-sectional survey of US adults (N = 13,993). We used latent class analysis to identify digital technologies access and health use patterns based on 32 ternary variables of behaviors and access to requisite technologies and platforms, including the internet, internet-enabled devices, health monitors, and electronic health records (EHRs). We ran a multinomial logistic regression to identify sociodemographic and health correlates of class membership (n = 10,734).

Results

Ten classes captured patterns of digital technology access and health use among US adults. This included a digitally isolated, a mobile-dependent, and a super user class, which made up 8.9%, 7.8%, and 13.6% of US adults, respectively, and captured access patterns from only basic cellphones and health monitors to near complete access to web-, mobile-, and EHR-based platforms. Half of US adults belonged to classes that lacked access to EHRs and relied on alternative web-based tools typical of patient portals. The proportion of class members who used digital technologies for health purposes varied from small to large. Older and less educated adults had lower odds of belonging to classes characterized by access or engagement in health behaviors. Hispanic and Asian adults had higher odds of belonging to the mobile-dependent class. Individuals without a regular healthcare provider and those who had not visited a provider in the past year were more likely to belong to classes with limited digital technologies access or health use.

Discussion

Only one third of US adults belonged to classes that had near complete access to digital technologies and whose members engaged in almost all health behaviors examined. Sex, age, and education were associated with membership in classes that lacked access to 1 + digital technologies or exhibited none to limited health uses of such technologies. Results can guide efforts to improve access and health use of digital technologies to maximize associated health benefits and minimize disparities.
On the Strength of a Recommendation
Authors: Sanatani Michael
Published: July 2024

Can an oncologist doing shared decision making connect with patients via treatment recommendations?
Introduction: Toward a Radical International Thought
Authors: Sajed Alina , Adalet Begüm
Published: July 2024

Bringing together political theorists of empire with critical scholars of international relations who have interrogated the methodological nationalism (indeed the fetish of the nation-state) of their disciplines, this special issue examines the multifaceted dimensions (including political, ideological, and psycho-affective) of a radical international thought. Going beyond articulations of anti-colonial struggle at the national level, the issue charts radical theories and praxes of insurgency and revolutionary violence and brings an internationalist framework to bear on historical moments like the Spanish Civil War, the rise of anti-imperial development alternatives, and the Civil Rights Movement in the United States, and others. In doing so, the issue spotlights thinkers who are rarely read in a global register, such as Martin Luther King Jr., James Baldwin, Jalāl Āl-e Ahmad, Ghassan Kanafani, and Eqbal Ahmad, among others. Furthermore, the introduction argues, the essays track these understudied articulations of radical international thought in the context of the traveling projects of imperial domination to which they responded. These radical figures’ political thought and action, in turn, inspired further imperial responses, such as political assassinations in the Third World, counterrevolutionary tactics, and other modes of violence in the service of empire.
On Left Internationalism
Authors: Çubukçu Ayça
Published: July 2024

This essay offers reflections on how contemporary left internationalism could think through—and beyond—both “humanity” and “nation” when positioning its struggles. With this aim, it first turns to philosophy and then to history to distinguish unsettled questions that animate dilemmas of left internationalism today. The essay is not, in a straightforward way, an attempt to draw the boundaries, offer the definitions, and determine the strategies of left internationalism. Ultimately, it is an invitation to a partisan “we” who claims sides within humanity and nation. This “we” is an open question and permanent problem of left internationalism.
Mechanisms of regeneration: to what extent do they recapitulate development?
Authors: Aztekin Can
Published: July 2024

One of the enduring debates in regeneration biology is the degree to which regeneration mirrors development. Recent technical advances, such as single-cell transcriptomics and the broad applicability of CRISPR systems, coupled with new model organisms in research, have led to the exploration of this longstanding concept from a broader perspective. In this Review, I outline the historical parallels between development and regeneration before focusing on recent research that highlights how dissecting the divergence between these processes can uncover previously unreported biological mechanisms. Finally, I discuss how these advances position regeneration as a more dynamic and variable process with expanded possibilities for morphogenesis compared with development. Collectively, these insights into mechanisms that orchestrate morphogenesis may reshape our understanding of the evolution of regeneration, reveal hidden biology activated by injury, and offer non-developmental strategies for restoring lost or damaged organs and tissues.
Roles of collagen cross-links and osteon collagen/lamellar morphotypes in equine third metacarpals in tension and compression tests
Authors: Skedros John G. , Dayton Michael R. , Cronin John T. , Mears Chad S. , Bloebaum Roy D. , Wang Xiaodu , Bachus Kent N.
Published: July 2024

Many bones experience bending, placing one side in net compression and the other in net tension. Because bone mechanical properties are relatively reduced in tension compared with compression, adaptations are needed to reduce fracture risk. Several toughening mechanisms exist in bone, yet little is known of the influences of secondary osteon collagen/lamellar ‘morphotypes’ and potential interplay with intermolecular collagen cross-links (CCLs) in prevalent/predominant tension- and compression-loaded regions. Paired third metacarpals (MC3s) from 10 adult horses were prepared for mechanical testing. From one MC3/pair, 5 mm cubes were tested in compression at several mid-shaft locations. From contralateral bones, dumbbell-shaped specimens were tested in tension. Hence, habitual/natural tension- and compression-loaded regions were tested in both modes. Data included: elastic modulus, yield and ultimate strength, and energy absorption (toughness). Fragments of tested specimens were examined for predominant collagen fiber orientation (CFO; representing osteonal and non-osteonal bone), osteon morphotype score (MTS, representing osteonal CFO), mineralization, porosity and other histological characteristics. As a consequence of insufficient material from tension-tested specimens, CCLs were only examined in compression-tested specimens (HP, hydroxylysylpyridinoline; LP, lysylpyridinoline; PE, pentosidine). Among CCLs, only LP and HP/LP correlated significantly with mechanical parameters: LP with energy absorption, HP/LP with elastic modulus (both r=0.4). HP/LP showed a trend with energy absorption (r=−0.3, P=0.08). HP/LP more strongly correlated with osteon density and mineralization than CFO or MTS. Predominant CFO more strongly correlated with energy absorption than MTS in both testing modes. In general, CFO was found to be relatively prominent in affecting regional toughness in these equine MC3s in compression and tension.
Induction of torpor in response to a common chronic food restriction paradigm: implications for behavioural research using mice
Authors: Wilcox Sian L. , Bannerman David M. , Peirson Stuart N. , Vyazovskiy Vladyslav V.
Published: July 2024

Background Many behavioural, pharmacological, and metabolic studies in mice require fasting, yet the possibility of fasting-induced torpor affecting data is rarely considered. Torpor is a state characterised by depressed metabolism and profound alterations in physiology and behaviour. In this study, we aimed to determine whether a chronic food restriction paradigm, common in behavioural studies, was sufficient to induce torpor in mice. Methods Mice were food restricted to ~85-90% of their bodyweight, as is typically done, and monitored using continuous thermal imaging. Results We observed that body temperature significantly decreased over days of food restriction, and it was significantly related to the drop in bodyweight (r2=0.8989, p<0.0001). All mice reliably entered torpor daily from day 8 of food restriction which coincided with bodyweight stabilisation at ~85%. We found a strong positive relationship between the magnitude of the decrease of bodyweight and the proportion of mice entering torpor each day (r2=0.8715, p<0.0001). Conclusions Overall, we found that torpor is readily induced in response to food restriction. Considering that hunger is frequently used as a motivational drive in behavioural tasks, it is likely that torpor occurrence is common in such studies, while remaining undetected and unaccounted for. Due to the profound effect of torpor on physiology, it is possible that torpor induction may be confounding subsequent data and represents an important source of variation. We recommend that body temperature is always monitored noninvasively in studies where food restriction is employed, to determine when torpor is occurring, and that torpor history is appropriately controlled for within and across experimental groups.
Adjusting for covariates representing potential confounders, mediators, or competing predictors in the presence of measurement error: Dispelling a potential misapprehension and insights for optimal study design with nutritional epidemiology examples
Authors: Zoh Roger S. , Thomas Diana M. , Tekwe Carmen D. , Yu Xiaoxin , Vorland Colby J. , Dhurandhar Nikhil V. , Klurfeld David M. , Allison David B.
Published: July 2024

Background Variables such as dietary intake are measured with error yet frequently used in observational epidemiology. Although this limitation is sometimes noted, these variables are still often modeled as covariates without formal correction or sincere dialogue about measurement unreliability potentially weakening the validity of statistical conclusions. Further, larger sample sizes increase power (bias) to detect spurious correlations. Counterintuitively, recent work suggested a non-monotonic relationship between confounder unreliability and how much controlling for the confounder reduces (or induces) bias when testing for an exposure-outcome association. If true, such non-monotonicity would be especially concerning for applications such as nutrition, where measurement reliability varies substantially, and large sample sizes are common. Methods We offer a detailed derivations of the square partial correlation between the outcome and exposure, controlling for the confounder. In our derivation, the measurement reliabilities of exposures and confounders are not arbitrarily constrained to be equal. Further, our theoretical results are investigated using simulations. Results Reassuringly, these derivations and simulations show that the counterintuitive non-monotonicity relationship between confounder unreliability and how much controlling for the confounder reduces (or induces) bias when testing for an exposure-outcome association is an artifact of the arbitrary constraint which forces the measurement reliabilities of exposures and confounders to be equal, which that does not always hold. Conclusions The profound and manifold effects of measurement error on estimation and statistical conclusion validity in realistic scenarios indicate that merely mentioning measurement error as a limitation and then dispensing with it is not an adequate response. We also explore questions for optimal study design subject to resource constraints when considering reliability of exposures, covariates, and outcomes.