bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of CPTED Principles on Intention to Burgle in High-Density Low-Rise Residential Areas of South Korea: A Virtual Reality Experiment
Authors: Son Dongpil , Im Boyeong , Her Jaeseok , Kim Seung-Nam
Published: November 2024

This study aimed to analyze the impact of Crime Prevention Through Environmental Design (CPTED) principles on burglary intentions in high-density low-rise residential areas in South Korea using a virtual reality (VR) experiment. An ordered logistic regression model was developed based on data from a VR-aided survey involving 100 young adults. The findings revealed that the installation of security features, such as barred windows and signs indicating a security system, significantly reduced the intention to commit burglary in single-family houses and walk-up apartments. In contrast to studies conducted in Western contexts, the results indicated that higher fences were associated with a lower intention to burgle in these high-density low-rise residential areas. Territoriality was found to have no significant effect on burglary intentions. These results suggest that CPTED strategies should be tailored to local environmental contexts and community atmospheres.
A Unique Case of a Mildly Symptomatic Patient With Severe Hypokalemia Secondary to Furosemide
Authors: Dao Kevin Trong , Dhillon Amrit , Uddin Syed Saad , Eppanapally Sabitha , Lai Hobart
Published: November 2024

Hypokalemia is a common condition that has been well studied. In most patients, mild hypokalemia is asymptomatic, while those with moderate-to-severe hypokalemia tend to show more prominent symptoms. In patients with a potassium level of 2.5 milliequivalents/liter (mEq/L) or lower, symptoms such as muscle cramps or weakness, rhabdomyolysis, and myoglobinuria tend to arise. These manifestations can lead to more debilitating consequences, such as renal failure secondary to rhabdomyolysis or respiratory failure secondary to muscle weakness. Other symptoms such as ileus, nausea, and vomiting, as well as cardiac arrhythmia and abnormalities, are also associated. Here we would like to present a patient with a potassium level of 1.4 mEq/L secondary to furosemide who presents to the emergency department with only complaints of muscle spasms for the past few days.
The Impact of Early Colleges on Postsecondary Performance and Completion
Authors: Edmunds Julie A. , Unlu Fatih , Phillips Brian , Glennie Elizabeth J. , Mulhern Christine
Published: November 2024

Early colleges are a model of schooling that combines the high school and college experiences, providing students the opportunity to simultaneously earn a high school diploma and an associate degree or 2 years of college credit. This article updates findings from a 17-year longitudinal experimental study of the model, examining the impact of the model on postsecondary performance and completion. The study found positive impacts on overall degree completion, with very large impacts on associate degree completion. There were also positive impacts on bachelor’s degree completion for low-income students and first-generation college-goers. For students who enrolled in a public 4-year institution, the study found positive impacts on advanced coursetaking. There was no difference between treatment and comparison students on final college GPA or on the percentage of students who double-majored. Treatment students who earned a bachelor’s degree did so more quickly than comparison students.
A Boy with an Itch: A Case Report of Genital Nodular Scabies
Authors: Bruno Tony F. , Seo David J.
Published: November 2024

Scabies is an enormous global public health problem and one of the World Health Organization’s 20 most neglected tropical diseases. Scabies affects all groups with children and elderly, particularly in resource scarce countries, among the most vulnerable in terms of prevalence, morbidity, and preventable sequalae. The medical community now recognizes the preventable life-threatening secondary complications attributable to scabies. Nodular scabies occurs in more than 10% of patients despite successful treatment of primary scabies and is particularly easy to misdiagnose. We report a case of nodular scabies in a 6-year-old child. He presented with severe deformity to the head of the penis and severe pruritis lasting for many months. Our case highlights the importance of understanding the differences in disease pathophysiology between scabietic infestation and hypersensitivity to its retained products to better direct effective treatment. Proper diagnosis and treatment of nodular scabies will undoubtedly curb secondary complications on a global scale.
The Fragility of Statistically Significant Binary Outcomes for Treating Achilles Tendinopathy: A Systematic Review of Randomized Trials
Authors: Anaspure Omkar S. , Patel Shiv , Baumann Anthony N. , Newsom Andrew , Anastasio Albert T. , Amendola Annunziato
Published: November 2024

Background:

Randomized controlled trials (RCTs) are the gold standard for treatment efficacy, but foot and ankle RCTs are often small or inconsistent. The Fragility Index (FI) evaluates the stability of significant findings. This study assessed the fragility of RCT outcomes for Achilles tendon pathology (ATP) interventions.

Methods:

This systematic review queried PubMed up to May 14, 2024, for RCTs on ATP interventions. RCTs with significant binary outcomes were included. Two reviewers assessed eligibility, extracted data, calculated FIs, and evaluated risk of bias. Frequency-weighted means were used for narrative synthesis.

Results:

Eleven RCTs with 4506 patients (mean cohort size: 409.64 ± 160.54) and a mean age of 36.97 ± 13.51 years (n = 4356; 96.67%) were included, covering 24 binary outcomes. The median FI across all outcomes was 3 (interquartile range 1-4; mean 3.92), indicating that changing the outcome of just a few patients could shift a study’s results from statistically significant to nonsignificant. Trials having an FI ≤3 comprised 58.33%. Three outcomes (12.5%) had an FI of zero after recalculating P values using the two-sided Fisher exact test. Half of the outcomes were robust. No RCT reported FIs or adjusted significance for multiple testing. Most studies (81.82%) performed 2 or more statistical tests, with an average of 30.81 ± 41.28 P values reported per study. The overall risk of bias was low in 1 study (9.09%) and moderate in 7 (63.64%). Most studies had low risk of bias in randomization (72.73%) and missing outcome data (90.91%).

Conclusion:

The FI assesses the fragility of statistically significant binary results, revealing that many ATP RCTs have fragile outcomes due to small sample sizes. A median FI of 3 means that changing the outcome of 3 patients could shift a study’s results from statistically significant to nonsignificant.
Etiology and Clinical Profile of Pediatric Acquired Demyelination Syndromes of the Central Nervous System: An Ambispective Longitudinal Study from South India
Authors: Sugumar Kiruthiga , Chidambaram Aakash Chandran , Ramamoorthy Jaikumar Govindaswamy
Published: November 2024

Background

Pediatric acquired demyelinating disorders (pADS) are diverse disorders with varied clinical presentations and literature regarding them is far and few.

Materials and methods

This ambispective study included 46 children with pADS who presented between 2016 and 2021 to our institution.

Results

The most common form was acute demyelinating encephalomyelitis (ADEM) (41.3%). The most common symptom was limb weakness (45.6%). During follow-up, regression of milestones was observed in 3(7.5%) children, and seizures were seen in 4(10%) children. Except for two children, all others could perform activities of daily living. Residual weakness was seen in six children. Recurrence of pADS was seen in five children.

Conclusion

ADEM was the most common pADS, and 20% had residual deficits. Though mortality is rare in these groups of conditions, morbidity is significantly high, which can be reduced with proper and early treatment with immunosuppressants.
Piano at the Center: Reimagining Music Education
Authors: Eldridge Emily G.
Published: November 2024

Many scholars and pedagogues have noted the various benefits that class piano can offer to student development, but few have noted the great potential for the piano class to address current prevailing issues in music education. The most pressing of these issues has centered on preparing students for the future through building 21st century skills, democratizing education through social justice, and increasing opportunities for student socialization post-pandemic. As interest in piano classes grows, it is vital to begin discussing ways that musical learning can occur in these settings. This article will provide examples of how the piano can be used in the piano technology lab, the piano ensemble, and the general classroom to address these current gaps in music education through project-based learning and student collaboration.
Hyperoside induces ferroptosis in chronic myeloid leukemia cells by targeting NRF2
Authors: Wei Junyi , Chai Quanyou , Qin Yuqiao , Li Long , Guo Chunling , Lu Zhaoyang , Liu Huimin
Published: November 2024

Background

Hyperoside (quercetin-3-O-β-D-galactopyranoside) is a flavonol glycoside compound derived from plants in the Hypericum and Crataegus genera that reportedly exhibits an array of anti-inflammatory, antioxidant, and antitumor properties such that it has been used to treat various diseases. Whether it can serve as an effective treatment for chronic myeloid leukemia (CML) cells, however, has yet to be established. The present study was thus devised to assess the therapeutic effects of hyperoside on CML cells and to clarify the underlying mechanism of action.

Methods

Cellular viability, proliferative activity, migration, and apoptotic death were respectively analyzed through CCK-8, EDU, transwell, and flow cytometry assays. RNA-seq and bioinformatics approaches were further employed to evaluate the mechanisms through which hyperoside influences CML cells, while analyses of reactive oxygen species (ROS) and free iron were detected with commercial kits. Transmission electron microscopy was used to assess mitochondrial morphology. Molecular docking, cellular thermal shift assay (CETSA), and drug affinity responsive target stability (DARTS) approaches were also used to explore the ability of hyperoside to target NRF2.

Results

From a mechanistic perspective, hyperoside was able to inhibit SLC7A11/GPX4 signaling in a manner that was abrogated by the ferroptosis inhibitor ferrostatin-1. NRF2 was also closely associated with the inactivation of the SLC7A11/GPX4 axis mediated by hyperoside such that overexpressing NRF2 ablated the benefits associated with hyperoside treatment.

Conclusions

The present analyses indicate that hyperoside can target the NRF2/SLC7A11/GPX4 axis to induce ferroptotic CML cell death.
Novel Multipoint-drive Rotary Actuator for Extraterrestrial Celestial Ultrasonic Driller
Authors: Deng Naiwen , Han Guangchao , Zhu Shuqi , Zhang Xingwang , Pang Yong , Bai Wei
Published: November 2024

Ultrasonic drilling has emerged as a prominent technique in extraterrestrial environments due to its advantageous features. However, its application in extraterrestrial sampling missions is constrained by challenges such as drilling, chip removal efficiency, and high and low temperature adaptability. Addressing these limitations, this study introduces a novel multi-point driven rotary helical longitudinal torsion horn. The initial phase involved a detailed analysis of the actuator’s structure and operational principle. Subsequently, the actuator’s vibration mode and elliptical motion trajectory were validated through finite element simulation. The study further explores a methodology for adjusting the parameters of the helical groove and the displacement amplitude of the impact head. Following the theoretical analysis, prototypes of the actuator and drill were fabricated. Their adaptability to high and low temperatures, as well as their output characteristics, were rigorously tested. Experimental results demonstrate that with an increase in temperature, the dynamic impedance of the actuator initially rises before decreasing, while the mechanical quality factor exhibits the opposite trend. Notably, the concurrent activation of points P1 and P2 significantly enhances the no-load speed, achieving a maximum of 506 revolutions per minute (r/min). Under conditions of power below 35 W and a drilling pressure of 10 N, the drilling speed achieved in basalt is 6.2 millimeters per minute (mm/min). The proposed multipoint-driven actuator can effectively improve the drilling and chip removal efficiency of the driller, which is an important application prospect in future extraterrestrial drilling missions.
Prevalence and uptake of vaping among people who have quit smoking: a population study in England, 2013-2024
Authors: Jackson Sarah E. , Brown Jamie , Kock Loren , Shahab Lion
Published: November 2024

Background

Vaping prevalence has increased rapidly in England since 2021. This study estimated trends between 2013 and 2024 in vaping among ex-smokers, overall and among those who did not use e-cigarettes to support their quit attempt.

Methods

Data were collected via nationally-representative, monthly cross-sectional surveys in England, October 2013 to May 2024. We analysed data from 54,251 adults (≥ 18y) who reported having tried to stop smoking in the past year or having stopped smoking more than a year ago. Logistic regression estimated associations between time and e-cigarette use.

Results

Across the period, there were increases in the use of e-cigarettes to support attempts to stop smoking (from 26.9% [24.0–30.0%] in October 2013 to 41.4% [37.7–45.2%] in May 2024), in current vaping among ≥ 1y ex-smokers (1.9% [1.5–2.5%] to 20.4% [18.7–22.2%]), and in late uptake of vaping after smoking cessation (i.e., current vaping among people who quit smoking before e-cigarettes started to become popular in 2011; 0.4% [0.2–0.8%] to 3.7% [2.8–4.9%]). These increases were non-linear, with much of the difference occurring since mid-2021, and were greatest at younger ages (e.g., current vaping among ≥ 1y ex-smokers reached 58.9% among 18-year-olds vs. 10.7% among 65-year-olds).

Conclusions

Vaping prevalence increased substantially among adult ex-smokers in England over the past decade, particularly at younger ages. While this is likely to have been largely driven by increased use of e-cigarettes in quit attempts and continued use thereafter, there was also evidence of increased uptake of vaping among those who had been abstinent from smoking for many years.
Characteristics of helicopter hoist operations with intubated patients: a retrospective analysis of a Norwegian physician staffed SAR helicopter service
Authors: Skaiaa Sven Christjar , Roslin André , Heggland Torfinn , Heian Sigurd , Elden Trond , Åreskjold Øivind , Iversen Hanne Rikstad , Jakobsen Dag Stian , Sabel Mads , Berve Per Olav
Published: November 2024

Background

Timely medical management and evacuation of critically ill or injured patients from austere environments or maritime vessels is often achieved by helicopter hoist operations. When indicated, intubation is performed onsite to restore and sustain patient physiology and to facilitate safe transport. We aimed to describe the characteristics of helicopter hoist operations (HHOs) with intubated patients in a physician staffed SAR helicopter service and to identify learning points for future missions.

Methods

The Norwegian national SAR database and local medical journal systems on six SAR helicopter bases were searched for data on hoisted intubated patients from January 2011 to April 2024.

Results

From a total of 18,710 missions, we registered 2,423 helicopter hoist operations with patients as human external cargo. In 54 hoist operations (2%) the patients were intubated prior to hoisting. We observed an increasing number of both HHOs in general and HHOs with intubated patients over time. The intubated HHO patients were in an overall critical state, with a median NACA score of 6 and a median GCS of 3 before intubation. Trauma was the main cause of intubation (n = 32). Twenty-five patients presented with cardiac arrest, 13 of whom were hoisted with an ongoing mechanical chest compression device. During the hoist operation, 34 patients were ventilated manually, and 20 patients were connected to an automatic ventilator. Monitoring of vital parameters during hoisting varied from none to fully monitored patients including invasive arterial blood pressure. Twenty-eight patients, seven of whom presented with initial cardiac arrest, survived to hospital discharge.

Conclusions

HHOs with intubated patients are rare but increasingly occurring events in our service. Owing to the infrequency, complexity and risk factors involved, these operations should be governed by specific operating procedures and trained regularly to be performed safely. HHOs with intubated patients represents a favourable alternative in situations where terrestrial transport is associated with significant time delay or additional risk to the patient or the rescuers.
Self-assessed performance-based function test versus patient-reported outcome measures for knee and hip osteoarthritis
Authors: Kiadaliri Ali , Sirard Paulina , Dahlberg Leif E. , Lohmander L. Stefan
Published: November 2024

Background

Physical function constitutes a key component of outcome assessment for almost all osteoarthritis interventions. The aim was to compare physical function measured using a self-assessed performance-based test versus self-reported function using questionnaires among individuals with knee or hip osteoarthritis (OA) participating in a digital exercise and education therapy.

Methods

We analysed data from individuals aged 40 + years participating in the digital program. We extracted data on the self-assessed 30-second chair stand test (30s CST) and the function subscales of Knee injury/Hip disability and Osteoarthritis Outcome Score 12 (KOOS-12/HOOS-12) at enrolment and 3- (n = 10884) and 12-month (n = 3554) follow-ups. Participants completed Numeric Rating Scale (NRS) pain, EQ-5D-5L, and an external anchor: global rating of change scale. Correlations were assessed using the Spearman correlation coefficient, responsiveness using standardized response mean (SRM) and receiver operating characteristic (ROC) curves, and agreement using weighted percent of agreement and weighted Gwet’s agreement coefficient.

Results

Correlations were weak between the 30s CST and KOOS-12/HOOS-12 function (r < 0.35 for raw and r < 0.20 for change scores). Correlations with NRS pain and EQ-5D-5L were stronger for the KOOS-12/HOOS-12 function subscale than for 30s CST. Greater internal (SRM > 1 vs. SRM < 0.5) and lower external responsiveness were observed for the 30s CST versus the KOOS-12/HOOS-12 function, even though external responsiveness was generally inadequate for both (the area under the ROC curves < 0.7). The direction of change was similar for the two function measures for about 70% of subjects with moderate agreement between them (weighted Gwet’s agreement coefficient range 0.45 to 0.50).

Conclusion

Weak correlations and moderate agreements between function measured using performance-based test and self-reported using KOOS-12/HOOS-12 in people with knee or hip OA suggest that they may capture different aspects of functional abilities in this population.
Comparative analysis of regulations and studies on stem cell therapies: focusing on induced pluripotent stem cell (iPSC)-based treatments
Authors: Song Seohyun Jennie , Nam Yoojun , Rim Yeri Alice , Ju Ji Hyeon , Sohn Yeowon
Published: November 2024

Stem cell therapies have emerged as a promising approach in regenerative medicine, demonstrating potential in personalized medicine, disease modeling, and drug discovery. Therapies based on induced pluripotent stem cells (iPSCs) particularly stand out for their ability to differentiate into various cell types while avoiding ethical concerns. However, the development and application of these therapies are influenced by varying regulatory frameworks across countries. This study provides a comparative analysis of regulations and research on stem cell therapies in key regions: The European Union (EU), Switzerland, South Korea, Japan, and the United States. First, the study reviews the regulatory frameworks on stem cell therapies. The EU and Switzerland maintain rigorous guidelines that prioritize safety and ethical considerations, which can hinder innovation. In contrast, the United States adopts a more flexible regulatory stance, facilitating the rapid development of stem cell therapies. South Korea and Japan take a balanced approach by incorporating practices from both regimes. These regulatory differences reflect each country’s unique priorities and impact the pace and scope of stem cell therapy development. Moreover, the study examines global trends in clinical trials on stem cell treatments based on data obtained from two sources: ClinicalTrials.gov and ICTRP. Findings indicate a significant growth in the number of clinical trials since 2008, particularly in that involving iPSCs. Therapeutic studies involving iPSCs predominantly target conditions affecting the cardiovascular and nervous systems which are considered vital. The results put emphasis on the safety of stem cell treatments. Meanwhile, the number of such trials also varies by country. The United States and Japan, where relatively flexible guidelines on stem cell research are adopted, are in a leading position. However, countries in the EU fall behind with rigorous regulations imposed. This reflects the need for more flexible regulatory guidance for active development of stem cell therapies. The findings underscore the importance of legal frameworks in facilitating innovation while ensuring safety. Regulatory agencies in different countries should collaborate to achieve a balanced global standard to ensure the safe and efficient advancement of stem cell therapies. Global regulatory convergence will promote international collaboration in research and the applicability of new treatments.
A Novel Analytical Bond Model for ETS FRP Bars in Shear Rehabilitation of Concrete Members
Authors: Mofidi Amir , Mirzabagheri Sara , Doyle Andrew Kevin Kenneth , Chaallal Omar
Published: November 2024

In this article, an unprecedented fracture mechanics-based bond model for embedded through-section (ETS) fibre-reinforced polymer (FRP) bars installed in concrete blocks is proposed. Various methods have emerged for rehabilitating substandard and deteriorated concrete structures. The ETS FRP bar method provides numerous advantages over existing shear strengthening methods, but no reliable and comprehensive bond–slip model exist to predict the method’s bond behaviour. In this study, a state-of-the-art analytical bond model is derived for determining the debonding force of the ETS FRP bars from concrete blocks using a newly proposed bi-linear bond–slip relationship that is expressed as a function of the maximum shear stress and its corresponding slip. The accuracy of the results predicted by the proposed model is verified with the existing push–pull data of ETS FRP/concrete joints in the literature. The results show that the newly proposed model can be used for both carbon FRP (CFRP) and glass FRP (GFRP) ETS bars with an average Pexp/Pmax ratio of 1.04 with superior statistical accuracy measures when compared to the existing bond models’ predictions.
Urinary pentosidine as a potential biomarker of muscle and physical performance in young adult men
Authors: Nishimura Takayuki , Loh Ping Yeap , Tomita Yoshihito , Ng Ted K. S. , Maeda Takafumi
Published: November 2024

Pentosidine is representative of the cross-linked structure of advanced glycation end products (AGEs) and has been suggested as a biomarker to assess bone and muscle quality. As studies on pentosidine in young adult men remain limited, we aimed to clarify the associations of urinary pentosidine with musculoskeletal status and physical performance in young men. Participants in this study comprised 32 men (age range: 19–39 years). Anthropometric measurements (body composition by InBody 430; stiffness index by ultrasound), muscle performance (grip strength by dynamometer, thigh muscle thickness by ultrasound), physical performance (functional reach test, 30-s chair stand test, and timed up and go test), and urinary biomarkers (pentosidine, N-telopeptide of type I collagen, and creatinine) were measured. In partial correlation analysis adjusted for age and height, higher urinary pentosidine levels were significantly associated with lower fat-free mass index (rho = − 0.368, p = 0.046), grip strength (rho = − 0.433, p = 0.017), rectus femoris thickness (rho = − 0.393, p = 0.032), and anterior thigh thickness (rho = − 0.416, p = 0.022), and a marginally inverse correlation was noted between urinary pentosidine levels and functional reach test (rho = − 0.327, p = 0.078). Our findings suggest that pentosidine correlates inversely with a few muscle and physical performance indicators. Pending future validations, urinary pentosidine may be a biomarker of AGEs in young men.
The Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): an Italian validation using confirmatory factor analysis and Rasch analysis
Authors: Soraci Paolo , Bevan Nadia , Griffiths Mark D. , Pisanti Renato , Servidio Rocco , Ferrari Ambra , Di Bernardo Carla , Pakpour Amir H.
Published: November 2024

The present study examined the psychometric properties of the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). A total of 742 Italian participants (84.6% female), with a mean age of 33.08 years (SD = 12.44) took part in a cross-sectional survey study. Confirmatory factor analysis and Rasch analysis were used to examine the psychometric properties. The CFA showed that the SWEMWBS had a unidimensional structure with robust psychometric properties and showed good internal consistencies (Cronbach’s alpha 0.88; McDonald’s omega 0.91). Overall, most items showed no substantial differential item functioning in the Rasch analysis, except for Item 7, indicating that female participants reported more difficulty with this item than the male participants. The SWEMWBS was positively associated with life satisfaction and negativity associated with general psychological distress (i.e., anxiety, stress, and depression). In sum, the SWEMWBS showed robust psychometric properties capable of assessing positive aspects of mental health and well-being among Italian-speaking adults.
Impact of cell geometry, cellular uptake region, and tumour morphology on 225Ac and 177Lu dose distributions in prostate cancer
Authors: Miller Cassandra , Klyuzhin Ivan , Chaussé Guillaume , Brosch-Lenz Julia , Koniar Helena , Shi Kuangyu , Rahmim Arman , Uribe Carlos
Published: November 2024

Background

Radiopharmaceutical therapy with 225Ac- and 177Lu-PSMA has shown promising results for the treatment of prostate cancer. However, the distinct physical properties of alpha and beta radiation elicit varying cellular responses, which could be influenced by factors such as tumour morphology. In this study, we use simulations to examine how cell geometry, region of pharmaceutical uptake within the cell to model different internalization fractions, and the presence of tumour hypoxia and necrosis impact nucleus absorbed doses and dose heterogeneity with 225Ac and 177Lu. We also develop nucleus absorbed dose kernels for application to autoradiography images.

Methods

We used the GATE Monte Carlo software to simulate three geometries of LNCaP prostate cancer cells (spherical, cubic, and ovoid) with activity of 225Ac or 177Lu internalized in the cytoplasm or bound to the extracellular membrane. Nucleus S-values were calculated for each geometry, source region, and isotope. The cell models were used to create nucleus absorbed dose kernels for each source region describing the dose to each nucleus in a cell layer, which were applied to simulated tumours composed of normoxic, hypoxic, or necrotic cancer cells to obtain dose rate maps. Absorbed doses within the tumours and dose heterogeneity were analyzed for each tumour morphology and isotope. Cell geometry made a minimal impact on S-values to the nucleus, however internalization resulted in higher nucleus doses. Applying the kernels to the simulated tumour maps showed that doses to each cell type varied between 225Ac and 177Lu depending on tumour morphology. Dose heterogeneity within tumours was slightly higher with 225Ac, however the tumour morphology made a larger impact on dose heterogeneity compared to the choice of isotope, with hypoxic and necrotic tumours having very heterogeneous dose distributions.

Conclusions

Cell geometry simplifications may still allow robust results in simulation studies. Furthermore, the morphology of the tumour itself may make a larger impact on treatment response compared to other variables such as ratio of internalization. Finally, nucleus absorbed dose kernels were created that could enable microdosimetric studies with autoradiography.
A case report of porcine circovirus 3 (PCV3) reproductive disease in Iberian semi-outdoor reared sows
Authors: Cobos Àlex , Sibila Marina , Huerta Eva , Pérez Mónica , Marcos Marcial , Menjón Rut , Jiménez Marta , Gálvez Laura , Segalés Joaquim
Published: November 2024

Background

Porcine circovirus 3 (PCV3) is a recently discovered swine pathogen associated with reproductive disease. To date, clinical problems linked to PCV3 have been described in intensive rearing pig farms. The present case describes an Iberian semi-outdoors sow farm affected by PCV3 reproductive disease.

Case presentation

The affected farm was composed of 420 self-replaced Iberian sows, working in 3-week batches (60 sows per batch). The farm was free from porcine reproductive and respiratory syndrome virus (PRRSV) and had been previously affected by porcine circovirus 2 (PCV2) reproductive disease, which was successfully managed through sow vaccination. In spring 2022, reproductive disease was noticed with a high increase in the number of mummified foetuses and stillborn piglets from gilts as the most remarkable finding; multiparous sows were not affected. A first analysis with pooled stillborn tissues ruled out most swine reproductive pathogens and revealed detection of PCV3. To further elucidate PCV3 implication in the reproductive disease, a complete post-mortem examination of stillborn and mummified foetuses from two affected litters was conducted. Pooled tissue samples yielded high PCV3 loads by quantitative PCR. Grossly, one (out of 5) stillborn had an enlarged, flaccid heart. Histopathological evaluation revealed PCV3 lesions consisting of lymphohistiocytic and systemic periarteritis (3/5). The grossly affected heart had lymphohistiocytic myocarditis with fibrosis and lymphohistiocytic endocarditis. By in situ hybridization, high amounts of PCV3 genome were observed within histological lesions. Moreover, immunohistochemistry against PRRSV and PCV2 resulted negative in the same tissues.

Conclusions

This is the first report of PCV3 reproductive disease in a semi-extensive production Iberian pig farm, affecting exclusively gilts. Moreover, this is the first description of grossly apparent myocarditis associated to PCV3 infection. Therefore, PCV3 should be considered within the differential diagnostic list of swine reproductive problems in non-intensive pig rearing production.
Defensive medicine practice among physicians in Egypt versus Saudi Arabia: causes and associated factors
Authors: Adel Rana , Gaballah Mohammed Hassan , Sehsah Radwa , Sayed Sara Ibrahim , Asem Mostafa Mohammed , Yousri Nada A.
Published: November 2024

Background

Defensive medicine (DM) is an international dilemma affecting developed and developing countries. Most research studies were conducted in high-income countries. Thus, the current study aimed to compare the attitudes and practices of DM among different specialty physicians practicing in Egypt and Saudi Arabia (KSA). Associated factors and causes of DM practice were also examined. This survey study is based on a self-administered online questionnaire consisting of seven domains that targeted physicians with different specialties and workplaces in Egypt and KSA.

Results

A total of 829 physicians completed the questionnaire. Physicians practicing in Egypt (31.4%) exhibited significantly higher rates of DM practice than those in KSA (13.2%). Regarding types of DM practice, 47% and 40% of all studied physicians practiced positive and negative DM, respectively, with significantly higher rates in Egypt than in KSA. Factors that predict DM practice were different among both countries; however, legal concerns are the basic factors that are significantly associated with positive and negative DM practice in both countries. Fear of legal concern is the main reason physicians practicing in Egypt use DM practice while following clinical standards and ethics is the main cause reported by those practicing in KSA.

Conclusion

Defensive medicine practices are prevalent among physicians in Egypt and KSA, with some differences between both countries in associated factors. Addressing physicians' legal concerns, improving medical education, and implementing evidence-based practices may help reduce unnecessary DM.
Numerical simulation of turbulent airflow around a tall telecommunication tower model
Authors: Moradi Alireza , Salajegheh Eysa , Tavakol Mohammad Mehdi , Heidari Ali , Ahmadi Goodarz
Published: November 2024

In this study, wind flow around a telecommunication tower (Milad Tower) model was numerically simulated. Several computational fluid dynamics (CFD) simulations were performed using the Reynolds Averaged Navier–Stokes (RANS) and the Delayed Detached Eddy Simulation (DDES) models. Two cases resembling the tower head with different inlet turbulence intensity profiles were considered, and computational results for wind flow and pressure distributions on various sections around the tower head and structure were presented and compared with the available wind tunnel data. Good agreement of the simulated pressure coefficient distributions around the head section in the windward and leeward sides of the tower with the wind tunnel data was observed. The regions with positive and negative pressures on the tower surface were identified based on the pressure coefficient distributions. In addition, the airflow characteristics around a model of the entire Milad Tower were studied. The simulation results for the airflow and the drag and lift coefficients acting on the tower for the high and low-intensity winds were evaluated and discussed. It was demonstrated that the DDES model was preferred for the simulation of mean pressure coefficients over the tower; however, the RNG k–ε model results, which were obtained at lower computational costs, were also satisfactory. In addition, the DDES showed better performance in simulating the maximum and minimum pressure coefficients on different tower levels and predicting the mean aerodynamics drag and lift coefficients. The results of the DDES model illustrated the higher power spectral density of velocity fluctuations on the leeward side of the tower compared with the windward side.
Cross-Sectional National Survey of Practice Patterns in Radiotherapy for Rectal Cancer: A Snapshot of India
Authors: Krishnatry Rahul , Mathew Ashwathy , Das Sayan , Misra Shagun , Khosla Divya , Ramireddy Jeba Karunya , Lewis Shirley
Published: November 2024

PURPOSE

The information on the practice of radiotherapy, including intensity-modulated radiotherapy (IMRT) use for rectal cancer in India, is lacking. This national survey was planned to understand the current status of knowledge, attitudes, and practice among radiation oncologists, specifically concerning the practice of IMRT for rectal cancers.

MATERIALS AND METHODS

A national survey was sent to radiation oncologists through e-mail or a WhatsApp message, where feasible, with a request letter containing the link to the survey questionnaire. The survey questionnaire was adapted from the UK IMRT survey with permission from the authors. It explored rectal cancer management, IMRT use, reasons for nonadoption, total neoadjuvant therapy (TNT), dose fractionation schedules and radiotherapy processes like radiotherapy simulation, target volume/organ at risk definition, and treatment planning, evaluation, and verification. Descriptive statistics is used to present the results.

RESULTS

Over 300 radiation oncologists were approached, and 182 (60.6%) of the 153 institutes responded. Around 88% (160 of 182) indicated using IMRT or volumetric modulated arc therapy (VMAT) to treat rectal cancer, of whom 32% used exclusively IMRT/VMAT in all their patients. The reasons for not adopting IMRT were affordability/lack of insurance, resource constraints, and lack of guidelines. Long-course chemoradiation (capecitabine-based) followed by surgery was the most common neoadjuvant approach, with short course and TNT in less than a third of patients. Daily verification feasibility was reported by 60%. Seventy-three percent emphasized the need for a national IMRT guidance document.

CONCLUSION

This national survey from India indicates a scope of routine implementation of IMRT in rectal cancer, highlighting the urgent need for a national IMRT guidance document, which could significantly enhance the quality of care for patients with rectal cancer in India.
Against Inevitability
Authors: Ben-Yishai Ayelet
Published: November 2024

Emergency situations around the world have always presented a complicated and ostensibly paradoxical mix of crisis and continuity. This essay builds on the author's research into the cultural and literary history of the Emergency in India (1975 – 77) and on a reading of Paul Lynch's 2023 novel Prophet Song to address the ongoing and horrific crisis of 2023–24 in Palestine and Israel. Turning to genre as a way to look at emergencies and the ways in which we comprehend them, the article argues that once identified and declared, an emergency brings about an array of generically determined actions and reactions that seem inevitable and necessary. The crisis becomes disconnected from its historical origins, attendant only to the immanent logic of its genre. The logic of inevitability does not then allow a recognition of those strands of reality that are not embedded in the genres through which the world is already understood. Paying attention to the genres in which the current emergency is narrated, the article argues that the deadly violence in the Middle East is not, in fact, just a singular moment of crisis, nor is it just “more of the same,” or an inevitable result of a two-sided “conflict.” Shifting genres, one can recognize that the deadly violence today, and the occupation of which it is part, has a history and a politics that are human-made and can thus be unmade.
External Validation of the ARISE Prediction Models for Aneurysmal Rebleeding After Aneurysmal Subarachnoid Hemorrhage
Authors: Mijderwijk Hendrik-Jan , de Winkel Jordi , Nieboer Daan , Abdelaal Ahmed , Germans Menno R. , Karadag Cihat , Cornelius Jan F. , Sorteberg Angelika , Roozenbeek Bob , Lingsma Hester F. , Boogaarts Hieronymus D. , van Lieshout Jasper H.
Published: November 2024

BACKGROUND AND OBJECTIVES:

To externally validate the Aneurysmal RebleedIng after Subarachnoid hEmorrhage (ARISE) prediction models that predict preinterventional aneurysmal rebleeding within 24 and 72 hours after aneurysmal subarachnoid hemorrhage (aSAH).

METHODS:

We pooled data from two international hospital registries from University Hospital Oslo, Norway, and University Hospital Rotterdam, The Netherlands, to validate the ARISE base model (including patient age, sex, hypertension, World Federation of Neurological Surgeons grade, Fisher grade, aneurysm size, and cerebrospinal fluid diversion) and the ARISE extended model (adding aneurysm irregularity to the base model). Model performance was assessed with discrimination (Harrell c-statistic, model-based c-statistic) and calibration (calibration-in-the-large, calibration slope, and calibration plots). After validation, we updated the ARISE models as appropriate.

RESULTS:

The combined cohort consisted of 1467 patients, of whom 143 (10%) suffered preinterventional rebleeding. In the University Hospital Oslo, Norway cohort, the externally validated c-statistics were 0.75 (95% CI: 0.71-0.80) for the ARISE base model and 0.71 (0.66-0.76) for the ARISE extended model. In the University Hospital Rotterdam, The Netherlands cohort, the c-statistics were 0.70 (0.64-0.76) for the ARISE base model and 0.64 (0.57-0.72) for the ARISE extended model. Calibration-in-the-large was poor; the average predicted risks were lower than the average observed risk for both models in both centers. After updating the baseline hazard, the base model calibrated excellently over the range of clinically relevant probabilities of rebleeding.

CONCLUSION:

The ARISE base model had good discriminative ability for the prediction of preinterventional rebleeding in patients suffering from aSAH. Updating the baseline hazard for each center was needed to improve calibration. After local validation and adjustment of the baseline hazard if required, the ARISE baseline model may well be used for risk prediction in patients with aSAH in other settings. The ARISE extended model needs further modification before reliable application can take place.
Safety and Efficacy of Tiny (≤3 mm) Unruptured Middle Cerebral Artery Aneurysm Treatment: An Analysis of the NeuroVascular Quality Initiative-Quality Outcomes Database Cerebral Aneurysm Registry
Authors: Padmanaban Varun , Harbaugh Thaddeus , Zhu Junjia , Zhou Shouhao , Ansari Sameer A. , Howington Jay U. , Sahlein Daniel H. , Tejada Juan G. , Wilkinson D. Andrew , Simon Scott D. , Cockroft Kevin M. , Church Ephraim W. ,   on behalf of the NVQI-QOD Registry Investigators
Published: November 2024

BACKGROUND AND OBJECTIVES:

Improved imaging modalities have led to an increased detection of intracranial aneurysms, many of which are small. There is uncertainty in the appropriate management of tiny aneurysms. The objective of this study was to use a large, multi-institutional NeuroVascular Quality Initiative-Quality Outcomes Database (NVQI-QOD) to assess the frequency, safety, and efficacy of treatment of tiny, unruptured middle cerebral artery (MCA) aneurysms.

METHODS:

The NeuroVascular Quality Initiative-Quality Outcomes Database registry was queried for patients with tiny unruptured MCA aneurysms who underwent treatment. Tiny size was defined as an aneurysm with a maximum dimension of ≤3 mm. Demographics, aneurysm characteristics, and treatment safety were queried. Outcomes included modified Rankin Score (mRS) at discharge and the last follow-up as well as aneurysm occlusion status at discharge.

RESULTS:

Of 674 treated, unruptured MCA aneurysms, 57 (8.5%) were tiny. The mean aneurysm width was 2.2 mm, and the mean patient age was 55.9 years. Most aneurysms were treated with microsurgery (61.4%, 35/57). The overall intraoperative complication rate was 5.3% (3/57), and the postoperative complication rate was 10.5% (6/57). 10.5% (6/57) of patients were discharged to rehabilitation. At discharge, 42 (87.5%) of the treated aneurysms had complete occlusion. In the subgroup of patients with recorded follow-up data, 48.3% (14/29) had a mRS of 0 at discharge and 46.9% (15/32) had an mRS of 0 at the last follow-up (median follow-up 166 days).

CONCLUSION:

Treatment of tiny, unruptured MCA aneurysms is efficacious but may have a high rate of complications. Physicians should be cautious when deciding to treat tiny, unruptured MCA aneurysms.
So the Bone Flap Hit the Floor, Now What? An In Vitro Comparison of Cadaveric Bone Flap Decontamination Procedures
Authors: Marion Alexis , Lévesque Simon , Touchette Charles , Villeneuve Samuelle-Ariane , Huppé-Gignac Béatrice , Martin Philippe , Arsenault Christine , Iorio-Morin Christian
Published: November 2024

BACKGROUND AND OBJECTIVES:

Over the course of their career, 66% of neurosurgeons will witness someone accidentally dropping a bone flap on the floor during a craniotomy procedure. Although this event is rare, it can have significant consequences for the patient, and little literature is available to guide management of this complication. Our objective was to compare 5 bone flap decontamination protocols for efficacy in reducing bacterial load, with the goal of safely reimplanting the dropped flap.

METHODS:

Cadaveric human bone flaps were contaminated with common operating room (OR) contaminant bacteria. The bone flaps were then subject to 1 of 5 decontamination protocols: washing in saline, mechanical debridement, washing in antibiotics, washing in alcoholic chlorhexidine antiseptic, and flash decontamination in autoclave. Inoculum from the flaps was then used to grow bacteria in petri dishes, and bacterial load after decontamination was assessed. Some flaps were physically dropped on an OR floor to simulate and evaluate a real-life contamination.

RESULTS:

The observed contamination from a flap dropped on an OR floor can be significant (up to 1070 colony-forming units cultured per flap). All protocols tested decreased bacterial load of the bone flaps to different degrees: saline by 95.7%, mechanical debridement by 97.5%, antibiotic bath by 99.5%, alcoholic chlorhexidine by 99.9%, and flash sterilization by 100.0%. Flash sterilization led to significant alterations in the flap's physical appearance.

CONCLUSION:

In the event of the accidental fall of a bone flap, decontamination by rinsing in an alcohol–chlorhexidine solution followed by 3 successive washes in saline seemed to provide the best balance between effectiveness, safety, and complexity of the method.
Biphasic DNA damage and non-canonical replication stress response govern radiation-induced senescence in glioblastoma
Authors: Ghorai Atanu , Singh Bhawna , Dutt Shilpee
Published: November 2024

Therapy-induced senescence (TIS) in glioblastoma (GBM) residual disease and escape from TIS account for resistance and recurrence, but the mechanism of TIS manifestation remains obscure. Here, we demonstrate that replication stress (RS) is critical for the induction of TIS in residual cells by employing an in vitro GBM therapy-resistance cellular model. Interestingly, we found a ‘biphasic’ mode of DNA damage after radiation treatment and reveal that the second phase of DNA damage arises majorly in the S phase of residual cells due to RS. Mechanistically, we show that persistent phosphorylated ATR is a safeguard for radiation resilience, whereas the other canonical RS molecules remain unaltered during the second phase of DNA damage. Importantly, RS preceded the induction of senescence, and ATR inhibition resulted in TIS reduction, leading to apoptosis. Moreover, ATR inhibition sensitized PARP-1 inhibitor-induced enhanced TIS-mediated resistance, leading to cell death. Our study demonstrates the crucial role of RS in TIS induction and maintenance in GBM residual cells, and targeting ATR alone or in combination with a PARP-1 inhibitor will be an effective strategy to eliminate TIS for better treatment outcomes.