bluuebunny/crossref_metadata_2025 huggingface dataset:
PredATW: Predicting the Asynchronous Time Warp Latency For VR Systems
Authors: Dixit Akanksha , Sarangi Smruti R.
Published: July 2024

With the advent of low-power ultra-fast hardware and GPUs, virtual reality (VR) has gained a lot of prominence in the past few years and is being used in various areas, such as education, entertainment, scientific visualization, and computer-aided design. VR-based applications are highly interactive, and one of the most important performance metrics for these applications is the motion-to-photon-delay (MPD). MPD is the delay from the user’s head movement to the time at which the image gets updated on the VR screen. Since the human visual system can even detect an error of a few pixels (very spatially sensitive), the MPD should be as small as possible.

Popular VR vendors use the GPU-accelerated Asynchronous Time Warp (ATW) algorithm to reduce the MPD. ATW reduces the MPD if and only if the warping operation finishes just before the display refreshes. However, due to the competition between the different constituent applications for the single, shared GPU, the GPU-accelerated ATW algorithm suffers from an unpredictable ATW latency, making it challenging to find the ideal time instance for starting the time warp and ensuring that it completes with the least amount of lag relative to the screen refresh. Hence, the state-of-the-art is to use a separate hardware unit for the time-warping operation. Our approach,
PredATW
, uses an ML-based hardware predictor to predict the ATW latency for a VR application, and then schedule it as late as possible while running the time-warping operation on the GPU itself. As far as we know, this is the first work to do so. Our predictor achieves an error of only 0.22 ms across several popular VR applications for predicting the ATW latency. As compared to the baseline architecture, we reduce deadline misses by 80.6%.
Maternal AMPK pathway activation with uterine artery blood flow and fetal growth maintenance during hypoxia
Authors: Moore Lorna G. , Lorca Ramón A. , Gumina Diane L. , Wesolowski Stephanie R. , Reisz Julie A. , Cioffi-Ragan Darleen , Houck Julie A. , Banerji Sarah , Euser Anna G. , D’Alessandro Angelo , Hobbins John C. , Julian Colleen G.
Published: July 2024

Fetal growth restriction (FGR) is increased and uterine artery (UtA) blood flow is lower at high altitudes (HA) but not all HA pregnancies have FGR. Here we show that greater UtA diameter and blood flow at week 20 are positively correlated with higher expression of the gene encoding the α1-catalytic subunit of AMP protein kinase, PRKAA1, suggesting that increased AMPK activation may help to prevent the detrimental effects of chronic hypoxia on fetal growth.
Quality of Life After Endovascular Thrombectomy for Acute Ischemic Stroke in Northern Finland
Authors: Junttola Ulla , Liisanantti Janne , Isokangas Juha-Matti , Kaakinen Timo , Vakkala Merja , Lahtinen Sanna
Published: July 2024

Objectives: Endovascular thrombectomy has demonstrated a major therapeutic improvement in the treatment of acute ischemic stroke. The benefit of endovascular thrombectomy is commonly reported by determining the functional outcome using the modified Rankin Scale (mRS). There is a lack of knowledge concerning the quality of life (QoL) and factors impacting the QoL after endovascular thrombectomy. The aim of this study was to assess the QoL of stroke survivors who underwent endovascular thrombectomy and to determine the variables associated with QoL.

Methods: Prospective single‐center analysis of 98 patients who underwent endovascular thrombectomy between 2015 and 2019. QoL was assessed by using the Rand 36‐Item Health Survey (RAND‐36), Beck’s Depression Inventory (BDI), Stroke Impact Scale‐16 (SIS‐16), and Alcohol Use Disorders Identification Test (AUDIT) questionnaires.

Results: Of the 98 patients, 53 (54.1%) reported poor QoL. According to the logistic regression analysis, the National Institutes of Health Stroke Scale (NIHSS) score > 6 on the first postprocedural day, right hemispheric infarction, and depression were independently associated with poor QoL. Depression was reported by 40.8% of all the respondents. QoL scores of the patients treated with endovascular thrombectomy were impaired in physical functioning, physical and emotional role functioning, social functioning, and general health compared to the age‐adjusted values of the Finnish general population.

Conclusion: Endovascular thrombectomy (EVT)‐treated stroke survivors experience disability in multiple levels. More than half of the patients report poor QoL. Neurological disability, functional dependence, depression, and comorbidities are associated with poor QoL. Social capability is impaired and the difficulties are more distinct among individuals with age above 65 years.
Psychometric Properties of a Russian Version of the Comprehensive Scale of Intellectual Humility
Authors: Zhdanova Yulia A. , Shchebetenko Sergei A.
Published: July 2024

Background. Intellectual humility (IH) can be defined as an awareness of one's intellectual fallacy that does not threaten the Ego. The Comprehensive Scale of Intellectual Humility (CIHS; Krumrei-Mancuso & Rouse, 2016) measures four aspects of IH: Openness to Revising One’s Viewpoint, Lack of Intellectual Overconfidence, Independence of Intellect and Ego, and Respect for Others’ Viewpoints. Objectives. The purpose of this study was to develop and evaluate psychometric properties of a Russian version of CIHS. Study Participants. The participants were 300 respondents, including 186 women and 144 men aged 18 to 70 years. Methods. The items of CIHS were translated from English to Russian using the back-translation method. We next examined the CIHS factor structure, its internal consistency, and a nomological network of CIHS assessing its correlations with the HEXACO-PI-R, which measures six basic personality traits. Results. The Velicer’s minimum average partial index revealed a four-factor solution turned out to be optimal, which corresponded to our theoretical expectations. Principal component analysis supported a four-component structure suited to the original IH model. CIHS (α = 0.72) and its subscales (0.65 < α < 0.82) showed acceptable internal consistency. The subscales were positively correlated with HEXACO’s Conscientiousness, Agreeableness (vs. Anger), Openness to Experience, and Honesty-Humility, evidencing convergent validity of the test. Conclusions. As a preliminary corollary, the Russian adaptation of CIHS has shown satisfactory psychometric properties, which makes the questionnaire acceptable for research purposes and for further testing its practical implications.
Cultural Life Scenario in Generations: an Instrument to Study “the Changing in the Unchanged”
Authors: Rikel Alexander M. , Dorokhov Egor A.
Published: July 2024

Background. Increasing social attention to the problem of expanding contradictions in social attitudes among the younger and older generations and, as a consequence of a possible generational conflict, causes an increase in the number of social-psychological studies of intergenerational differences. However, most of these studies do not seek to distinguish between the factor of belonging to generational and age groups, which causes methodological confusion in the results. Objectives. The aim is to identify and describe the role of the factor of belonging to a generation in the cultural life scenarios (CLS) in different generations of modern Russians in relation to the age factor. Methods. An empirical study (N = 951) was carried out using a modified ‘Lifeline’ technique. The Age-Period-Cohort (APC) analysis was applied to process results showing differences between generation and age factors. Results. The revealed features of CLS in four generational groups were described in detail. Also, the possibilities of studying CLS in the context of generational and age-psychological factors were analyzed. In particular, it was noted that it was the so-called generation Z that demonstrated the greatest number of differences in CLS from other generations, as well as a trend towards individualization of life scenarios. Conclusions. A conclusion was made and mathematically substantiated about the importance of continuing the study of generations in their socio-psychological understanding (separately from the age factor). A theoretical proposal was made to revise the boundaries of generations with the subsequent division of generations into subgroups.
Surgical Care Through a Community Free Clinic-Ambulatory Surgical Center Partnership
Authors: Park Flora S. , Pang Jonathan C. , Yang Christopher D. , Breziner Dalia , Manzanarez-Felix Karlos O. , Hoyos Juan Pablo , Ruiz Andres M. , Alvarez Claudia A. , Swentek Lourdes Y. , Chin Theresa L.
Published: July 2024

Background

Disparities secondary to underinsurance present throughout the surgical care continuum. Community free clinics are uniquely capable to provide health care services to the medically underserved, but surgery often falls outside their scope of care.

Methods

Retrospective chart review was conducted on consecutive community free clinic patients receiving free surgical services via referral to a partnering ambulatory surgery center between March 2016 and September 2021. Those with documented contact information were recruited 1-3 years post-procedure for long-term quality-of-life (LTQOL) outcomes assessment via modified Veterans RAND 12-item health survey.

Results

Of 142 included patients, 95.7% identified as Hispanic/Latino and 75.6% were uninsured. Twelve patients had cancerous or precancerous lesions detected and/or removed through diagnostic or definitive procedures. 3.5% experienced postoperative complication including bacterial (n = 2) or fungal (n = 1) surgical site infection and wound dehiscence (n = 2). With a 48.9% response rate, no significant differences in sociodemographic or clinical characteristics were found between surveyed vs non-surveyed patients. Of surveyed patients, 59.7% and 52.2% reported pre-/post-operative improvement in physical health and emotional health, respectively.

Discussion

Free diagnostic screening procedures provided timely diagnoses while free definitive surgeries safely and positively impacted long-term patient-reported physical health. Longitudinal, multidisciplinary follow-up and social support may be warranted to concurrently improve emotional and mental health in similarly underinsured populations.
Creating and enacting culturally responsive assessment for First Nations students in higher education settings
Authors: Steele Carly , Gower Graeme , Bogachenko Tetiana
Published: July 2024

In this article, we argue that current assessment practices in higher education require urgent examination and should be re-imagined in culturally responsive ways to ensure fairness for all. From sociocultural and social justice perspectives, we highlight examples of cultural and linguistic bias in assessment that disadvantages many First Nations students. Incorporating a constructivist viewpoint, we argue that assessment practices must keep pace with culturally responsive pedagogical practices to improve assessment validity for First Nations students and to maintain constructive alignment between learning, teaching, and assessment. Based on qualitative interviews with stakeholders in the On Country Teacher Education program, we describe how university lecturers changed their approaches to assessment and modified their assessment tasks to enact and create culturally responsive assessments. These practices, whilst beneficial for First Nations students, are viewed as being ‘responsive’ rather than ‘proactive’. Recommendations include shifting to a ‘proactive’ stance by evaluating the validity of student learning outcomes and assessment design from the onset.
Coordination Rights, Competition Law and Varieties of Capitalism
Authors: Foster Chase , Thelen Kathleen
Published: July 2024

Competition law is a constitutive institution in capitalist markets, establishing the rules for when interfirm coordination is allowed and where competition is required (Paul, 2020). Yet comparativists have spent decades debating the varieties of capitalism framework—which places the issue of coordination at the center of the distinction between capitalist types—while paying virtually no attention to cross-national variation in antitrust rules. This article develops an original theoretical framework to conceptualize the relationship between competition law and the organization of capitalism. We go beyond the usual binaries (coordinated vs. liberal market economies, “restrictive” vs. “permissive” antitrust regimes) to disentangle two dimensions of the law that fundamentally shape patterns of coordination and competition both across regulatory jurisdictions and over time. Applying our framework to analyze the evolution of American and European competition law, we show how a comparative coordination rights framework can be used to conceptualize key institutional changes within contemporary capitalist systems.
The impact of ankle movements on venous return flow: A comparative study
Authors: Cao Yun , He JinFeng , Chen Xufeng , Jing Lei , Qiu JiaWen , Geng YuJuan , Chen Feng , Sun GuoZhen , Ji XueLi
Published: July 2024

Objective

To compare the haemodynamic effects of different ankle movements combined ankle and toe movements on the femoral vein of the lower extremity.

Methods

28 healthy volunteers participated in the study. Doppler ultrasound was used to measure peak systolic velocity and time-averaged mean velocity of the common femoral vein during ankle dorsiflexion, ankle dorsiflexion with simultaneous toe extension, ankle plantarflexion, and ankle plantarflexion with simultaneous toe flexion.

Results

In comparison to the resting state, both ankle alone or ankle combined with toe movement showed statistically significant differences ( p < .01). However, there were no significant difference in the velocity of the common femoral vein between ankle alone and ankle combined with toe movement ( p > .05). It is noteworthy that dorsiflexion of the ankle resulted in the highest peak velocity of blood flow.

Conclusion

The impact of ankle movement, with or without toe movement, the velocity of the common femoral vein is not significantly correlated.
Exploring the potential of CuO nanoneedles and CNT/PVC nanocomposites in medium voltage cable technology
Authors: Elbasiony A. M. , Alkhursani Sheikha A. , Ghobashy Mohamed Mohamady , Madani Mohamed , Al-Gahtany Samera Ali , Sharshir A. I.
Published: July 2024

This study focuses on the development of CuO nanoneedle and multi wall carbon nanotube (CNT) reinforced poly (vinyl chloride) (PVC) nanocomposites for medium voltage cable applications. CuO nanoneedles were synthesized using a pulsed wire evaporation technique and integrated with CNTs to create CuO/CNT nanocomposites. The nanocomposites were then used to reinforce PVC films through a solution casting method. Microstructural characterization confirmed the uniform dispersion of CuO nanoneedles and CNTs concentrations (0–0.4 wt%) within the PVC matrix. Microstructural characterization by XRD, SEM, and TEM confirmed the formation of CuO nanoneedles (diameter ∼4 nm, length 200–250 nm) and their uniform dispersion within the PVC matrix along with CNTs. Optical studies revealed reduced optical bandgap and Urbach tail width in PVC/CuO/CNT nanocomposites compared to neat PVC/CuO. Electrical characterization showed significantly improved AC conductivity (up to eight orders of magnitude) with increasing CNT loading, attributed to the formation of efficient charge transport networks. Dielectric studies revealed concurrent improvements in dielectric permittivity and losses with CNT addition. Simulations demonstrated a more uniform electric field distribution in PVC/CuO/CNT nanocomposites, mitigating hotspots. The synergetic effects of CuO nanoneedles and CNTs led to excellent improvements in the electric properties of PVC, underscoring their potential in medium voltage cable applications.
The Renaissance and Refashioning of Skills-Based Pay for the 2020s: Learning From the UK
Authors: Brown Duncan , Armstrong Michael
Published: July 2024

Skill-based pay (SBP) has had a long but chequered history. However, interest in it has intensified recently in the UK, largely as a result of labour shortages and increasing and often unsatisfied demands for skills, which prevailing market-driven approaches to compensation have failed to address. It has become evident that SBP can provide a useful means of supporting organisations to attract, retain, develop and engage the increasing numbers and range of skilled people they need to grow and succeed. In this article we describe the current context within which SBP is being developed; review the historical development of the approach and then illustrate the increasingly varied range of methods now being taken to how SBP is being applied in the UK; and draw some tentative conclusions from our analysis for SBP’s practical application, along with implications for future research.
Optimal control for helicopter/turboshaft engine system based on hybrid variable speed
Authors: Wang Yong , Song Jie , Li Shancheng , Zhang Haibo
Published: July 2024

In order to address the limitation of fixed-ratio transmission (FRT), which compromises the attainment of both optimal main rotor speed and optimal power turbine speed, an optimal speed control method based on hybrid variable speed (HVS) is proposed. Firstly, based on the integrated performance calculation model of helicopter/turboshaft engine system, the distribution factors of variable speed are applied, and the integrated optimization method of optimal speed is proposed based on the minimum engine fuel flow. Subsequently, an online estimation technique employing a high-order filter is devised and engineered to achieve superior cascaded control of turboshaft engines. Finally, a novel real-time optimal speed control method based on hybrid variable speed is proposed. The simulation results under different operation conditions demonstrate that regardless of whether it is FRT or HVS, the optimal main rotor speed increases with forward velocity. In the case of HVS, turboshaft engine degradations have a significant impact on the optimal power turbine speed rather than optimal main rotor speed. Adopting an estimation method based on high-order filtering for gas turbine rotational acceleration proves more advantageous in mitigating high-frequency oscillation and continuous saltation of estimated values. Moreover, in comparison with the optimal speed control method of FRT, HVS-based approach enables simultaneous attainment of the optimal main rotor speed and power turbine speed, thereby enhancing the overall efficiency of the integrated helicopter/turboshaft engine system and significantly decreasing engine fuel consumption by over 2%. Consequently, there has been a remarkable enhancement in the overall performance of the integrated helicopter/turboshaft engine system.
Exploring the impact of giving free food samples and loyalty cards on sustainable food choices: A stepped wedge trial in workplace food outlets
Authors: Gold Natalie , Cornel Pieter , Zhuo Shi , Thornton Katie , Riddle Rupert , McPhedran Robert
Published: July 2024

Free samples and loyalty cards are frequently used, but there is little rigorous empirical testing of their effects. We conducted a stepped wedge trial in 29 workplace food outlets to investigate their effects on sales of plant-based meals. Outlets were randomly assigned to three sequences that entered the intervention in the first, second, or third week of August 2022. Free samples of plant-based meals were given out in the first week of the intervention; loyalty cards were available throughout, entitling the bearer to a free meal after they had bought three. The intervention period ended in the last week of August for all outlets. The free meal could be redeemed until one month later. We did not find statistically significant effects of the interventions compared to the baseline period. Our process evaluation indicated that many participants preferred to eat their habitual meal or were unaware of the loyalty cards.
Practicing Embodied Listening for Transformation: The Transformative Listening Protocol
Authors: Romano Alessandra , Kramlich Deborah J. , Marsick Victoria , Cotter Zakrzewski Tes , Anderson-Sathe Laurie , Brunstein Janette , Cunliff Ed , Longmore Anne-Liisa
Published: July 2024

In this article, we explore the process of creating spaces for the practice and inquiry of transformative listening through the development of the Transformative Listening Protocol (TLP). Our premise is that embodied listening opens doors to transformations via a process to improve listening and safe spaces where people may engage with each other in storytelling and story listening. The organization of our paper flows from research design to relevance for transformative learning theory. We begin with a description of the practice led research design for the project (Candy, 2006), we follow that with the historical development of the TLP including sections on both the theoretical and methodological background. After this section we describe the practice-ing of transformative listening with three applications of listening in practice we documented. In the final paragraphs we explore the limitations and conclusions of the research design and of TLP. We conclude the paper with the relevance of practicing transformative listening for the evolution of transformative learning theory.
Efficacy and safety of atogepant, a small molecule CGRP receptor antagonist, for the preventive treatment of migraine: a systematic review and meta-analysis
Authors: Hou Min , Luo Xiaofeng , He Shuangshuang , Yang Xue , Zhang Qing , Jin Meihua , Zhang Pan , Li Yang , Bi Xiaoting , Li Juan , Cheng Caiyi , Xue Qiang , Xing Haiyan , Liu Yao
Published: July 2024

Background

Migraine is one of the most common diseases worldwide while current treatment options are not ideal. New therapeutic classes of migraine, the calcitonin gene-related peptide (CGRP) antagonists, have been developed and shown considerable effectiveness and safety. The present study aimed to systematically evaluate the efficacy and safety of atogepant, a CGRP antagonist, for migraine prophylaxis from the results of randomized controlled trials (RCTs).

Methods

The Cochrane Library, Embase, PubMed and https://www.clinicaltrials.gov/ were searched for RCTs that compared atogepant with placebo for migraine prophylaxis from inception of the databases to Feb 1, 2024. Outcome data involving efficacy and safety were combined and analyzed using Review Manager Software version 5.3 (RevMan 5.3). For each outcome, risk ratios (RRs) or standardized mean difference (SMD) were calculated.

Results

4 RCTs with a total of 2813 subjects met our inclusion criteria. The overall effect estimate showed that atogepant was significantly superior to placebo in terms of the reduction of monthly migraine (SMD − 0.40, 95% CI -0.46 to -0.34) or headache (SMD − 0.39, 95% CI -0.46 to -0.33) days, the reduction of acute medication use days (SMD − 0.45, 95% CI -0.51 to -0.39) and 50% responder rate (RR 1.66, 95% CI 1.46 to 1.89), while no dose-related improvements were found between different dosage groups. For the safety, significant number of patients experienced treatment-emergent adverse events (TEAEs) with atogepant than with placebo (RR 1.10, 95% CI 1.02–1.21) while there was no obvious difference between the five dosage groups. Most TEAEs involved constipation (RR 2.55, 95% CI 1.91–3.41), nausea (RR 2.19, 95% CI 1.67–2.87) and urinary tract infection (RR 1.49, 95% CI 1.05–2.11). In addition, a high dosage of atogepant may also increase the risk of treatment-related TEAEs (RR 1.64, 95% CI 1.02–2.63) and fatigue (RR 3.07, 95% CI 1.13–8.35).

Conclusions

This meta-analysis suggests that atogepant is effective and tolerable for migraine prophylaxis including episodic or chronic migraine compared with placebo. It is critical to weigh the benefits of different doses against the risk of adverse events in clinical application of atogepant. Longer and multi-dose trials with larger sample sizes are required to verify the current findings.
Traversed dynamics of climate change and One Health
Authors: Shafique Muhammad , Khurshid Mohsin , Muzammil Saima , Arshad Muhammad Imran , Malik Imran Riaz , Rasool Muhammad Hidayat , Khalid Aimen , Khalid Rabia , Asghar Rubab , Baloch Zulqarnain , Aslam Bilal
Published: July 2024

Climate change, caused by both natural and human activities, poses significant threats to global health, including rising temperatures, extreme weather events, and environmental disruptions. The One Health concept, emphasizing the interconnectedness of human, animal, and environmental health, is crucial in addressing these challenges. Climate change is linked to the emergence and resurgence of infectious diseases, resulting in substantial economic losses worldwide due to outbreaks, floods, and disrupted trade, among other factors. Therefore, it is crucial to adapt to this changing climate to safeguard One Health. By implementing a One Health approach, we can effectively address the consequences of climate change and make substantial contributions to health and food safety. This approach also holds the potential to mitigate economic losses, particularly in low and middle-income countries. Additionally, in the future, research interventions based on the One Health framework may offer sustainable solutions to combat climate change.
TopoDoE: a design of experiment strategy for selection and refinement in ensembles of executable gene regulatory networks
Authors: Bouvier Matteo , Zreika Souad , Vallin Elodie , Fourneaux Camille , Gonin-Giraud Sandrine , Bonnaffoux Arnaud , Gandrillon Olivier
Published: July 2024

Background

Inference of Gene Regulatory Networks (GRNs) is a difficult and long-standing question in Systems Biology. Numerous approaches have been proposed with the latest methods exploring the richness of single-cell data. One of the current difficulties lies in the fact that many methods of GRN inference do not result in one proposed GRN but in a collection of plausible networks that need to be further refined. In this work, we present a Design of Experiment strategy to use as a second stage after the inference process. It is specifically fitted for identifying the next most informative experiment to perform for deciding between multiple network topologies, in the case where proposed GRNs are executable models. This strategy first performs a topological analysis to reduce the number of perturbations that need to be tested, then predicts the outcome of the retained perturbations by simulation of the GRNs and finally compares predictions with novel experimental data.

Results

We apply this method to the results of our divide-and-conquer algorithm called WASABI, adapt its gene expression model to produce perturbations and compare our predictions with experimental results. We show that our networks were able to produce in silico predictions on the outcome of a gene knock-out, which were qualitatively validated for 48 out of 49 genes. Finally, we eliminate as many as two thirds of the candidate networks for which we could identify an incorrect topology, thus greatly improving the accuracy of our predictions.

Conclusion

These results both confirm the inference accuracy of WASABI and show how executable gene expression models can be leveraged to further refine the topology of inferred GRNs. We hope this strategy will help systems biologists further explore their data and encourage the development of more executable GRN models.
Circulating microRNAs as potential biomarkers of physical activity in geriatric patients with HCV
Authors: Al-Rawaf Hadeel A. , Gabr Sami A. , Iqbal Amir , Alghadir Ahmad H.
Published: July 2024

Background

Circulating microRNAs have been implicated in a diverse array of biological and pathological phenomena. Their potential utility as noninvasive biomarkers for screening and diagnosing various diseases has been proposed.

Objective

This study aimed to explore the potential role of the miRNAs miR-122 and miR-486 as molecular biomarkers in the pathogenesis of hepatitis C virus (HCV) infection. Thus, miR-122 and miR-486 were detected in the serum of HCV patients and healthy controls. Moreover, the potential correlations of miR-122 and miR-486 with viral complications, such as physical activity, pain, muscle fatigue, and HCV infection, were identified.

Methods

A total of 150 subjects aged 30 to 66 years were included in this study. The patients were classified as patients with chronic hepatitis C virus (CHC) (n = 110) or healthy controls (n = 40). Real-time polymerase chain reaction (PCR) analyses were performed to determine miR-122 and miR-486 expression. Physical activity (PA), pain score, HCV genotyping, viral overload, aspartate transaminase (AST), alanine transaminase (ALT), lactic acid dehydrogenase (LDH), creatine kinase (CK), and antioxidant status were also estimated by using prevalidated questionnaires, PCR, and spectrophotometric analyses.

Results

Compared with those in normal controls, significant increases in the serum levels of miR-122 and miR-486 were reported in patients with CHC. In physically active CHC patients, there was a significant correlation between the expression of miRNAs and increased alanine transaminase (ALT), aspartate transaminase (AST), fibrosis scores, and inflammation activity, but no association was reported for hepatitis C virus (HCV) RNA or viral load. Additionally, significant decreases in LDH, CK, GSSG, and pain scores and increases in TAC, GSH, and the GSH/GSSG ratio were reported. Moreover, the expression of miR-122 and miR-486 was positively correlated with changes in body mass index (BMI) and liver fibrosis stage, as well as negatively correlated with sex, PA, TAC, GSH, GSSG, and the GSH/GSSG ratio.

Conclusion

MiR-122 and miR-486 expression levels were strongly correlated with physical activity, pain perception, and muscle fatigue biomarkers in HCV-infected patients. These miRNA levels were associated with elevated AST, ALT, fibrosis scores, LDH, CK, and antioxidant status, thus suggesting their potential as biomarkers for disease severity and oxidative stress. However, no correlation was observed with viral load or HCV-RNA expression, thus implying that these miRNAs may impact disease progression and symptoms through host factors, rather than directly affecting viral replication. In summary, the results demonstrated that molecular studies of miR-22 and miR-468 and their associations with PA, pain, adiposity, sex differences, and muscle fatigue, as well as routine biomarkers, could be useful as prognostic nanoninvasive biomarkers, thus providing novel therapeutic targets for CHC infection.
The reverse TRBV30 gene of mammals: a defect or superiority in evolution?
Authors: Wu Fengli , Wu Yingjie , Yao Yuanning , Xu Yuanyuan , Peng Qi , Ma Long , Li Jun , Yao Xinsheng
Published: July 2024

At the 3’ end of the C2 gene in the mammalian TRB locus, a distinct reverse TRBV30 gene (named TRBV31 in mice) has been conserved throughout evolution. In the fully annotated TRB locus of 14 mammals (including six orders), we observed noteworthy variations in the localization and quality of the reverse V30 genes and Recombination Signal Sequences (RSSs) in the gene trees of 13 mammals. Conversely, the forward V29 genes and RSSs were generally consistent with the species tree of their corresponding species. This finding suggested that the evolution of the reverse V30 gene was not synchronous and likely played a crucial role in regulating adaptive immune responses. To further investigate this possibility, we utilized single-cell TCR sequencing (scTCR-seq) and high-throughput sequencing (HTS) to analyze TCRβ CDR3 repertoires from both central and peripheral tissues of Primates (Homo sapiens and Macaca mulatta), Rodentia (Mus musculus: BALB/c, C57BL/6, and Kunming mice), Artiodactyla (Bos taurus and Bubalus bubalis), and Chiroptera (Rhinolophus affinis and Hipposideros armige). Our investigation revealed several novel observations: (1) The reverse V30 gene exhibits classical rearrangement patterns adhering to the ‘12/23 rule’ and the ‘D-J rearrangement preceding the V-(D-J) rearrangement’. This results in the formation of rearranged V30-D2J2, V30-D1J1, and V30-D1J2. However, we also identified ‘special rearrangement patterns’ wherein V30-D rearrangement preceding D-J rearrangement, giving rise to rearranged V30-D2-J1 and forward Vx-D2-J. (2) Compared to the ‘deletional rearrangement’ (looping out) of forward V1-V29 genes, the reverse V30 gene exhibits preferential utilization with ‘inversional rearrangement’. This may be attributed to the shorter distance between the V30 gene and D gene and the ‘inversional rearrangement’ modes. In summary, in the mammalian TRB locus, the reverse V30 gene has been uniquely preserved throughout evolution and preferentially utilized in V(D)J recombination, potentially serving a significant role in adaptive immunity. These results will pave the way for novel and specialized research into the mechanisms, efficiency, and function of V(D)J recombination in mammals.
Legionella pneumophila cell surface RtxA release by LapD/LapG and its role in virulence
Authors: Kanaan Hussein , Chapalain Annelise , Chokr Ali , Doublet Patricia , Gilbert Christophe
Published: July 2024

Background

Legionella pneumophila is a Gram-negative intracellular bacillus and is the causative agent of a severe form of pneumonia called Legionnaires’ disease which accounts for 2-9% of cases of community acquired pneumonia. It produces an extremely large protein belonging to the RTX (Repeats in ToXin) family, called RtxA, and we previously reported that RtxA is transported by a dedicated type 1 secretion system (T1SS) to the cell surface. RTX proteins have been shown to participate in the virulence or biofilm formation of various bacteria, the most studied models being the pore forming hemolysin A (HlyA) of Escherichia coli and the biofilm associated protein LapA of P. fluorescens. LapA localization depends on the enzymatic release by LapD/LapG complex activity. This study aimed to elucidate the dual localization (cell surface associated or released state) of L. pneumophila RTX protein (RtxA) and whether this released versus sequestered state of RtxA plays a role in L. pneumophila virulence.

Results

The hereby work reveals that, in vitro, LapG periplasmic protease cleaves RtxA N-terminus in the middle of a di-alanine motif (position 108–109). Consistently, a strain lacking LapG protease maintains RtxA on the cell surface, whereas a strain lacking the c-di-GMP receptor LapD does not exhibit cell surface RtxA because of its continuous cleavage and release, as in the LapA-D-G model of Pseudomonas fluorescens. Interestingly, our data point out a key role of RtxA in enhancing the infection process of amoeba cells, regardless of its location (embedded or released); therefore, this may be the result of a secondary role of this surface protein.

Conclusions

This is the first experimental identification of the cleavage site within the RTX protein family. The primary role of RtxA in Legionella is still questionable as in many other bacterial species, hence it sounds reasonable to propose a major function in biofilm formation, promoting cell aggregation when RtxA is embedded in the outer membrane and facilitating biofilm dispersion in case of RtxA release. The role of RtxA in enhancing the infection process may be a result of its action on host cells (i.e., PDI interaction or pore-formation), and independently of its status (embedded or released).
Awake fiberoptic intubation of a patient with severe multiple trauma in prone position: a case report
Authors: Yang Jingli , Zou Feng , Ma Guoping
Published: July 2024

Background

Fiberoptic-guided intubation is considered as “gold standard” of difficult airway management. Management of the airway in prone position in patients with severe trauma presenting with penetrating waist and hip injury poses a major challenge to the anesthesiologist.

Case presentation

A man presented with severe multiple trauma and hemorrhagic shock as a result of an industrial accident with several deformed steel bars penetrating the left lower waist and hip. It was decided to schedule an exploratory laparotomy following extracting the deformed steel bars. Successful administration of awake fiberoptic nasotracheal intubation, performed in a prone position under airway blocks and appropriate sedation, allowed for the procedure. The exploratory laparotomy revealed damage to multiple organs, which were repaired sequentially during a 7-hour surgical operation. The patient’s recovery was uneventful, and he was discharged from the hospital one month after the surgery.

Conclusions

Awake fiberoptic nasotracheal intubation, along with airway blocks and appropriate sedation, can be a viable option in patients with severe multiple trauma in the prone position.
Targeted nanopore sequencing using clinical specimens for the rapid diagnosis of extrapulmonary tuberculosis
Authors: Yu Guocan , Fang Likui , Shen Yanqin , Zhong Fangming , Xu Xudong
Published: July 2024

Background

The clinical presentation of extrapulmonary tuberculosis (EPTB) is atypical and it is easily confused with other diseases such as common infections, making prompt diagnosis a great challenge. This study aimed to evaluate the accuracy of targeted nanopore sequencing (TNS) in the diagnosis of EPTB. The diagnostic accuracy of TNS using different types of extrapulmonary specimens was also evaluated.

Methods

We reviewed the clinical data of patients with suspected EPTB for whom TNS was conducted and who were hospitalized at our center. The true positive, false positive, false negative, and true negative values were determined. Indices of diagnostic accuracy were computed, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for TNS and acid-fast bacilli (AFB) culture, and compared with those from clinical diagnosis.

Results

149 patients were included in the analysis. The overall sensitivity, specificity, PPV, NPV, and AUC of TNS for the diagnosis of EPTB were 86.4%, 87.5%, 97.3%, 55.3%, and 0.87, respectively. For diagnosis by AFB culture, these values were 25.6%, 100.0%, 100.0%, 20.5%, and 0.63, respectively. The most common specimens used were lymph node tissue, cerebrospinal fluid, pleural effusion, and pleural tissue. The diagnostic accuracy of TNS using all types of extrapulmonary specimens was good.

Conclusions

TNS demonstrates good diagnostic accuracy in the rapid diagnosis of EPTB and this was true across different types of extrapulmonary specimens.
Salvage radiotherapy for locally recurrent cervical and endometrial carcinoma: clinical outcomes and toxicities
Authors: Cong Hui , Yang Xiaojing , Li Zhaobin , Li Zhen , Lin Shuchen , Jiang Wei , Fu Jie
Published: July 2024

Background

The management of locally recurrent gynecological carcinoma remains a challenge due to the limited availability of data. This study aims to share our institutional experience in using definitive radiotherapy (RT) for the treatment of locally recurrent cervical and endometrial carcinoma.

Methods

The study retrospectively reviewed 20 patients in our hospital completing salvage 3D image-based HDR brachytherapy, with or without EBRT, for locally recurrent cervical and endometrial carcinoma after surgery. The Kaplan–Meier method was applied to estimate the disease-free survival (DFS) and overall survival (OS). The toxicities were assessed by CTCAEv5.

Results

During a median observation period of 21 months, the study reported a tumor objective response rate of 95%. The 3-year DFS and OS rates were 89.4% and 90.9%, respectively. The EBRT combined with brachytherapy achieved a median cumulative dose of 88 Gy to CTV D90. 14 patients received concurrent and/or systemic chemotherapy. Two patients suffered locoregional recurrence after salvage treatment, one of whom only received salvage brachytherapy for prior RT history. The analysis identified significant predictors for DFS, including tumor histology and FIGO stage. 5 patients observed acute grade 1–2 rectal (15%) or genitourinary (10%) toxicities. Late toxicities including grade 1–2 rectal bleeding (10%) and grade 2 pelvic fracture (5%) were seen in 3 patients.

Conclusions

3D image-guided brachytherapy combined with EBRT shows effective tumor control and acceptable toxicity profile for women with locally recurrent gynecologic cancer. The success in managing vaginal recurrence is notably influenced by histologic subtype and FIGO staging.
Mediation of depressive symptoms in the association between blood urea nitrogen to creatinine ratio and cognition among middle-aged and elderly adults: evidence from a national longitudinal cohort study
Authors: Feng Qiaoduan , Yang Shaokun , Ye Shaohua , Wan Can , Wang Hongjian , You Jinsong
Published: July 2024

Background

The relationships between BUNCr (blood urea nitrogen and creatinine ratio) and cognitive function, as well as depressive symptoms, remain unclear. We aim to investigate the association between BUNCr and cognition, as well as depressive symptoms, and to identify the mechanisms underlying these relationships.

Methods

We utilized data from the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2020. Cognitive function was assessed using the Telephone Interview of Cognitive Status (TICS) scale, while depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). We employed multivariate linear regression models to examine the association between BUNCr and cognitive function, as well as depressive symptoms. Additionally, causal mediation analysis was conducted to identify potential mediation effects of depressive symptoms between BUNCr and cognition.

Results

We observed a negative association between BUNCr and cognitive function (coefficient: -0.192; 95% confidence interval [CI]: -0.326 ∼ -0.059) and a positive relationship between BUNCr and depressive symptoms (coefficient: 0.145; 95% CI: 0.006 ∼ 0.285). In addition, the causal mediation analysis revealed that depressive symptoms (proportion mediated: 7.0%) significantly mediated the association between BUNCr and cognition.

Conclusion

Our study has unveiled that BUNCr is inversely associated with cognitive function and positively linked to depressive symptoms. Moreover, we found that depressive symptoms significantly mediated the association between BUNCr and cognition. These findings provide new evidence and insights for the prevention and management of cognitive function and dementia.
Collaborative goal setting in palliative rehabilitation: a case report
Authors: Hwee Heng Charlotte Siew
Published: July 2024

Background

Palliative rehabilitation amalgamates the principles of palliative care and rehabilitation to enhance patients’ quality of life by optimizing physical function and maximizing autonomy despite advancing illness. Alongside providing non-pharmacological symptom management, it emphasizes personalized goal-setting tailored to individual needs. This case illustrates the transformative impact targeted physiotherapy interventions can have on patients’ physical function, morale and motivation in spite of their expected deterioration.

Case presentation

An 85-year-old male with angioimmunoblastic T cell lymphoma was admitted to home hospice care. He was referred for physiotherapy to optimize his function and mobility despite his short prognosis. A conversation guide was used throughout the duration of therapy to identify personal goals, prescribe and review the use of appropriate interventions, and discuss future therapeutic plans. Within a month he achieved his functional goals, experienced reduced physical dependency, and had increased satisfaction in his ability to participate more actively in self-care. This also resulted in significant improvements in his confidence, mood, and overall well-being. Engaging the patient actively in his care and management journey provided him with significant motivation and hope.

Conclusion

The case study highlights the vital role of physiotherapists in facilitating transparent communication among patients, healthcare providers, and caregivers throughout palliative rehabilitation. Through open dialogue and utilizing conversation guides, physiotherapists help understand patient preferences, goals, and motivation. This patient-centred approach ensures that therapeutic interventions align with individual needs, enhancing overall patient care and the provision of holistic palliative care.
What are the perceptions of faculty and academic leaders regarding the impact of accreditation on the continuous quality improvement process of undergraduate medical education programs at Caribbean medical schools?
Authors: Arja Sateesh B. , White Bobbie Ann Adair , Kottathveetil Praveen , Thompson Anne
Published: July 2024

Background

Accreditation and regulation are meant for quality assurance in higher education. However, there is no guarantee that accreditation ensures quality improvement. The accreditation for Caribbean medical schools varies from island to island, and it could be mandatory or voluntary, depending on local government requirements. Caribbean medical schools recently attained accreditation status to meet the Educational Commission for Foreign Medical Graduates (ECFMG) requirements by 2024. Literature suggests that accreditation impacts ECFMG certification rates and medical schools’ educational processes. However, no such study has examined accreditation’s impact on continuous quality improvement (CQI) in medical schools. This study aims to gather the perceptions and experiences of faculty members and academic leaders regarding the impact of accreditation on CQI across Caribbean medical schools.

Methods

This qualitative phenomenological study inquiries about the perceptions and experiences of faculty and academic leaders regarding accreditation’s impact on CQI. Purposive and snowball sampling techniques were used. Participants were interviewed using a semi-structured interview method. Fifteen participants were interviewed across ten Caribbean medical schools representing accredited medical schools, accreditation denied medical schools, and schools that never applied for accreditation. Interviews were audio recorded, and thematic data analysis was conducted.

Results

Thematic analysis yielded six themes, including accreditation and CQI, CQI irrespective of accreditation, faculty engagement and faculty empowerment in the CQI process, collecting and sharing data, ECFMG 2024 requirements, and organizational structure of CQI.

Conclusions

There is ongoing quality improvement at Caribbean medical schools, as perceived by faculty members and academic leaders. However, most of the change process is happening because of accreditation, and the quality improvement is due to external push such as accreditation rather than internal motivation. It is recommended that Caribbean medical schools promote internal quality improvement irrespective of accreditation and embrace the culture of CQI.