bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain computer interface training with motor imagery and functional electrical stimulation for patients with severe upper limb paresis after stroke: a randomized controlled pilot trial
Authors: Brunner Iris , Lundquist Camilla Biering , Pedersen Asger Roer , Spaich Erika G. , Dosen Strahinja , Savic Andrej
Published: January 2024

Background

Restorative Brain–Computer Interfaces (BCI) that combine motor imagery with visual feedback and functional electrical stimulation (FES) may offer much-needed treatment alternatives for patients with severely impaired upper limb (UL) function after a stroke.

Objectives

This study aimed to examine if BCI-based training, combining motor imagery with FES targeting finger/wrist extensors, is more effective in improving severely impaired UL motor function than conventional therapy in the subacute phase after stroke, and if patients with preserved cortical-spinal tract (CST) integrity benefit more from BCI training.

Methods

Forty patients with severe UL paresis (< 13 on Action Research Arm Test (ARAT) were randomized to either a 12-session BCI training as part of their rehabilitation or conventional UL rehabilitation. BCI sessions were conducted 3–4 times weekly for 3–4 weeks. At baseline, Transcranial Magnetic Stimulation (TMS) was performed to examine CST integrity. The main endpoint was the ARAT at 3 months post-stroke. A binominal logistic regression was conducted to examine the effect of treatment group and CST integrity on achieving meaningful improvement. In the BCI group, electroencephalographic (EEG) data were analyzed to investigate changes in event-related desynchronization (ERD) during the course of therapy.

Results

Data from 35 patients (15 in the BCI group and 20 in the control group) were analyzed at 3-month follow-up. Few patients (10/35) improved above the minimally clinically important difference of 6 points on ARAT, 5/15 in the BCI group, 5/20 in control. An independent-samples Mann–Whitney U test revealed no differences between the two groups, p = 0.382. In the logistic regression only CST integrity was a significant predictor for improving UL motor function, p = 0.007. The EEG analysis showed significant changes in ERD of the affected hemisphere and its lateralization only during unaffected UL motor imagery at the end of the therapy.

Conclusion

This is the first RCT examining BCI training in the subacute phase where only patients with severe UL paresis were included. Though more patients in the BCI group improved relative to the group size, the difference between the groups was not significant. In the present study, preserved CTS integrity was much more vital for UL improvement than which type of intervention the patients received. Larger studies including only patients with some preserved CST integrity should be attempted.
The quest for Homer’s moly: exploring the potential of an early ethnobotanical complex
Authors: Molina-Venegas Rafael , Verano Rodrigo
Published: January 2024

The Homeric plantmolyis a mysterious herb mentioned in Book 10 of theOdyssey. In the early 1980s, a pharmacological thesis to identify the plant was put forward for the first time, regarding the snowdrop (Galanthus nivalisL.) as candidate species. The proposal was inspired by the snowdrop’s acetylcholinesterase (AChE)-inhibiting properties and its alleged morphological reminiscence to other plants calledmolyby ancient Greek herbalists. Here, we draw from a compilation of literature from various disciplines, together with an understanding of the Homeric epic as a repository of information based on oral traditions, to (i) show that the assimilation of Homer’smolytoGalanthus nivalisis, at the very least, questionable and (ii) frame and support a new synthesis of the pharmacological thesis. We suggest that the uncertainty that revolves around the identity of Homer’smolycan be tied to an unnamed phylogenetic clade of closely related Mediterranean native species with AChE-inhibiting properties. Further, we speculate that Homer’smolymight represent an early record of an ethnobotanical complex, a sort of cultural taxon resulting from the cognitive crossbreeding of closely related taxonomic species that could have been interchangeably used due to their rough resemblance and common AChE-inhibiting properties. Such cultural taxon would have referred to the phytonymmolyby the centuries-old oral traditions that ultimately crystallized in the poem. We also venture that sea daffodils (Pancratiumspp.) could have greatly contributed to shaping the botanical archetype in the myth as we know it today.
Trans-apical catheter ablation of ventricular tachycardia in a patient with metallic aortic and mitral valves
Authors: Bozorgi Ali , Sadeghian Saeed , Mehrabi Nasab Entezar
Published: January 2024

We present a patient with a history of heart failure and metallic aortic and mitral valves surgeries, who required ablation for a drug-refractory left ventricular tachycardia. But the metallic valves prohibited the insertion of catheters via retrograde or via trans-septal approaches. Therefore, we decided to perform catheter ablation by direct left ventricle puncture through a minithoracotomy. The arrhythmia was successfully ablated via of trans-apical approach and did not recur at six months follow-up.
Rapid expansion of a left atrial myxoma caused by acute multiple internal hemorrhages: a case report and literature review
Authors: Kato Takayoshi , Umeda Etsuji , Suzui Natsuko , Fujii Ryo , Ogura Hiroki , Sakai Osamu , Shimabukuro Katsuya , Doi Kiyoshi
Published: January 2024

Background

Left atrial myxoma is the most common benign tumor, with the growth rate remaining unknown because specific symptoms do not present until the tumor grows to a certain size. Early surgical management is performed in most cases once it is detected by physicians. Despite cardiac myxomas commonly being perceived as slow-growing tumors, rapid enlargement of myxomas has been reported.

Case presentation

A 64-year-old woman was referred to our hospital with a diagnosis of a left atrial tumor. The pointed tumor changed morphologically in a few hours, and her respiratory condition, which had been normal at admission, suddenly deteriorated. Emergent surgery was performed, and the diagnosis was myxoma with multiple intratumor massive hematomas. The patient recovered uneventfully and was discharged on postoperative day 12 without any complications.

Conclusions

We report an extremely rare case of left atrial myxoma rapidly expanded due to acute multiple hemorrhages within itself. Massive internal hemorrhage alters the size, shape, and fragility of the tumor. We should recognize the potential risk of internal hemorrhage that may lead to acute deterioration of the so-called “slow-growing benign” tumors, such as myxomas.
Late-onset methylmalonic acidemia and homocysteinemia (cblC disease): systematic review
Authors: Arhip Loredana , Brox-Torrecilla Noemi , Romero Inmaculada , Motilla Marta , Serrano-Moreno Clara , Miguélez María , Cuerda Cristina
Published: January 2024

Introduction

Combined methylmalonic acidemia and homocystinuria, cblC type is an inborn error of intracellular cobalamin metabolism and the most common one. The age of onset ranges from prenatal to adult. The disease is characterised by an elevation of methylmalonic acid (MMA) and homocysteine and a decreased production of methionine. The aim is to review existing scientific literature of all late onset cblC patients in terms of clinical symptoms, diagnosis, and outcome.

Methods

A bibliographic database search was undertaken in PubMed (MEDLINE) complemented by a reference list search. We combined search terms regarding cblC disease and late onset. Two review authors performed the study selection, data extraction and quality assessment.

Results

Of the sixty-five articles included in this systematic review, we collected a total of 199 patients. The most frequent clinical symptoms were neuropathy/myelopathy, encephalopathy, psychiatric symptoms, thrombotic microangiopathy, seizures, kidney disease, mild to severe pulmonary hypertension with heart failure and thrombotic phenomena. There were different forms of supplementation used in the different studies collected and, within these studies, some patients received several treatments sequentially and/or concomitantly. The general outcome was: 64 patients recovered, 78 patients improved, 4 patients did not improve, or the disease progressed, and 12 patients died.

Conclusions

Most scientific literature regarding the late onset cblC disease comes from case reports and case series. In most cases treatment initiation led to an improvement and even recovery of some patients. The lack of complete recovery underlines the necessity for increased vigilance in unclear clinical symptoms for cblC disease.
Unraveling the complexity of STAT3 in cancer: molecular understanding and drug discovery
Authors: Hu Yamei , Dong Zigang , Liu Kangdong
Published: January 2024

Signal transducer and activator of transcription 3 (STAT3) is a transcriptional factor involved in almost all cancer hallmark features including tumor proliferation, metastasis, angiogenesis, immunosuppression, tumor inflammation, metabolism reprogramming, drug resistance, cancer stemness. Therefore, STAT3 has become a promising therapeutic target in a wide range of cancers. This review focuses on the up-to-date knowledge of STAT3 signaling in cancer. We summarize both the positive and negative modulators of STAT3 together with the cancer hallmarks involving activities regulated by STAT3 and highlight its extremely sophisticated regulation on immunosuppression in tumor microenvironment and metabolic reprogramming. Direct and indirect inhibitors of STAT3 in preclinical and clinical studies also have been summarized and discussed. Additionally, we highlight and propose new strategies of targeting STAT3 and STAT3-based combinations with established chemotherapy, targeted therapy, immunotherapy and combination therapy. These efforts may provide new perspectives for STAT3-based target therapy in cancer.
Enhanced exclusive enteral nutrition delivery during the first 7 days is associated with decreased 28-day mortality in critically ill patients with normal lactate level: a post hoc analysis of a multicenter randomized trial
Authors: Chen Yizhe , Liu Zirui , Wang Qiuhui , Gao Fei , Xu Hongyang , Ke Lu , Lee Zheng-Yii , Stoppe Christian , Heyland Daren K. , Liang Fengming , Lin Jiajia ,   for the Chinese Critical Care Nutrition Trials Group (CCCNTG)
Published: January 2024

Background and aims

Exclusive enteral nutrition (EN) is often observed during the first week of ICU admission because of the extra costs and safety considerations for early parenteral nutrition. This study aimed to assess the association between nutrition intake and 28-day mortality in critically ill patients receiving exclusive EN.

Methods

This is a post hoc analysis of a cluster-randomized clinical trial that assesses the effect of implementing a feeding protocol on mortality in critically ill patients. Patients who stayed in the ICUs for at least 7 days and received exclusive EN were included in this analysis. Multivariable Cox hazard regression models and restricted cubic spline models were used to assess the relationship between the different doses of EN delivery and 28-day mortality. Subgroups with varying lactate levels at enrollment were additionally analyzed to address the potential confounding effect brought in by the presence of shock-related hypoperfusion.

Results

Overall, 1322 patients were included in the analysis. The median (interquartile range) daily energy and protein delivery during the first week of enrollment were 14.6 (10.3–19.6) kcal/kg and 0.6 (0.4–0.8) g/kg, respectively. An increase of 5 kcal/kg energy delivery was associated with a significant reduction (approximately 14%) in 28-day mortality (adjusted hazard ratio [HR] = 0.865, 95% confidence interval [CI]: 0.768–0.974, P = 0.016). For protein intake, a 0.2 g/kg increase was associated with a similar mortality reduction with an adjusted HR of 0.868 (95% CI 0.770–0.979). However, the benefits associated with enhanced nutrition delivery could be observed in patients with lactate concentration ≤ 2 mmol/L (adjusted HR = 0.804 (95% CI 0.674–0.960) for energy delivery and adjusted HR = 0.804 (95% CI 0.672–0.962) for protein delivery, respectively), but not in those > 2 mmol/L.

Conclusions

During the first week of critical illness, enhanced nutrition delivery is associated with reduced mortality in critically ill patients receiving exclusive EN, only for those with lactate concentration ≤ 2 mmol/L.

Trial registration: ISRCTN12233792, registered on November 24, 2017.
Increasing transcultural competence in clinical psychologists through a web-based training: study protocol for a randomized controlled trial
Authors: Studer Selina , Kleinstäuber Maria , von Lersner Ulrike , Weise Cornelia
Published: January 2024

Background

In mental health care, the number of patients with diverse cultural backgrounds is growing. Nevertheless, evaluated training programs for transcultural competence are missing. Barriers for engaging in transcultural therapy can be identified in patients as well as in therapists. Besides language barriers, clinical psychologists report insecurities, for example, fear of additional expenses when involving a language mediator, ethical concerns such as power imbalances, or fear of lack of knowledge or incorrect handling when working with patients from other cultures. Divergent values and concepts of disease, prejudices, and stereotyping are also among the issues discussed as barriers to optimal psychotherapy care. The planned study aims to empower clinical psychologists to handle both their own as well as patients’ barriers through a web-based training on transcultural competence.

Methods

The training includes 6 modules, which are unlocked weekly. A total of N = 174 clinical psychologists are randomly assigned to two groups: the training group (TG) works through the complete training over 6 weeks, which includes a variety of practical exercises and self-reflections. In addition, participants receive weekly written feedback from a trained psychologist. The waitlist control group (WL) completes the training after the end of the waiting period (2 months after the end of the TG’s training). The primary outcome is transcultural competence. Secondary outcomes consist of experiences in treating people from other cultures (number of patients, satisfaction and experience of competence in treatment, etc.). Data will be collected before and after the training as well as 2 and 6 months after the end of the training.

Discussion

This randomized controlled trial tests the efficacy of and satisfaction with a web-based training on transcultural competence for German-speaking clinical psychologists. If validated successfully, the training can represent a time- and place-flexible training opportunity that could be integrated into the continuing education of clinical psychologists in the long term.

Trial registration

DRKS00031105. Registered on 21 February 2023.
Effectiveness of an 11-week exercise intervention for patients with hip or knee osteoarthritis: results of a quasi-experimental pragmatic trial
Authors: Krauss Inga , Roesel Inka , Martus Peter , Giurgiu Marco , Mueller Gerhard
Published: January 2024

Objective

To assess the effectiveness of exercise and education in addition to standard care (SC) compared to SC alone in patients with hip or knee osteoarthritis (OA) during 24 months follow-up.

Design

We conducted a quasi-experimental pragmatic clinical trial in care centers of a health insurance company. Overall, 1,030 subjects with hip and/or knee OA were included. The intervention group was recruited from clients participating in a hip/knee training (HKT, n = 515) in addition to SC. The control group (CO, n = 515) receiving SC only was recruited from the insurance database. HKT comprised 8 group sessions (1/week) of exercise and education, complemented by a 11-week structured home-exercise program (2/week). Primary endpoints were change of joint-related pain and function (WOMAC Index, score 0–10) after 3 months. Secondary endpoints related to follow-ups at 6, 12 and 24 months. All patient reported outcome measures were analyzed using linear mixed models (LMMs) investigating a time x treatment effect. A multivariable cox proportional hazards regression model was used to identify differences of joint replacement during follow-up between groups.

Results

LMMs revealed statistically significant differences in favor of HKT for the primary outcomes WOMAC pain = 0.47 (CI 0.27–0.66; Effect Size (ES) = 0.22, p < 0.001) and WOMAC function = 0.27 (CI 0.11–0.44; ES = 0.13, p < 0.001). HKT was superior to CO for 6, 12, and 24 months as well (ES < 0.2, p ≤ 0.006). HKT was inferior regarding the first incidence of hip or knee AJR during follow-up in comparison to CO (adjusted hazard ratio, HR = 1.57; CI 1.08—2.30; p = 0.020).

Conclusions

This trial demonstrated short-, mid- and long-term superiority of exercise versus control. However, differences were smaller than those reported in previous efficacy trials, raising questions regarding clinical importance. Responder analysis will follow to identify possible predictors for patient responsiveness on an individual level. Further studies should investigate the frequency and reasons for joint replacement following exercise therapy.

Trial registration

German Clinical Trial Register (DRKS00009251). Registered 10 September 2015.
Improving the quality of counseling and clinical supervision in opioid treatment programs: how can technology help?
Authors: Peavy K. Michelle , Klipsch Angela , Soma Christina S. , Pace Brian , Imel Zac E. , Tanana Michael J. , Soth Sean , Ricardo-Bulis Esther , Atkins David C.
Published: January 2024

Background

The opioid epidemic has resulted in expanded substance use treatment services and strained the clinical workforce serving people with opioid use disorder. Focusing on evidence-based counseling practices like motivational interviewing may be of interest to counselors and their supervisors, but time-intensive adherence tasks like recording and feedback are aspirational in busy community-based opioid treatment programs. The need to improve and systematize clinical training and supervision might be addressed by the growing field of machine learning and natural language-based technology, which can promote counseling skill via self- and supervisor-monitoring of counseling session recordings.

Methods

Counselors in an opioid treatment program were provided with an opportunity to use an artificial intelligence based, HIPAA compliant recording and supervision platform (Lyssn.io) to record counseling sessions. We then conducted four focus groups—two with counselors and two with supervisors—to understand the integration of technology with practice and supervision. Questions centered on the acceptability of the clinical supervision software and its potential in an OTP setting; we conducted a thematic coding of the responses.

Results

The clinical supervision software was experienced by counselors and clinical supervisors as beneficial to counselor training, professional development, and clinical supervision. Focus group participants reported that the clinical supervision software could help counselors learn and improve motivational interviewing skills. Counselors said that using the technology highlights the value of counseling encounters (versus paperwork). Clinical supervisors noted that the clinical supervision software could help meet national clinical supervision guidelines and local requirements. Counselors and clinical supervisors alike talked about some of the potential challenges of requiring session recording.

Conclusions

Implementing evidence-based counseling practices can help the population served in OTPs; another benefit of focusing on clinical skills is to emphasize and hold up counselors’ roles as worthy. Machine learning technology can have a positive impact on clinical practices among counselors and clinical supervisors in opioid treatment programs, settings whose clinical workforce continues to be challenged by the opioid epidemic. Using technology to focus on clinical skill building may enhance counselors’ and clinical supervisors’ overall experiences in their places of work.
Postoperative and postdischarge nausea and vomiting following ambulatory eye, head, and neck surgeries: a retrospective cohort study comparing incidence and associated factors
Authors: Xiao Mark , Yao Dongdong , Fields Kara G. , Sarin Pankaj , Macias Alvaro Andres , Eappen Sunil , Juang Jeremy
Published: January 2024

Background

Ambulatory surgery is often followed by the development of nausea and/or vomiting (N/V). Although risk factors for postoperative nausea and vomiting (PONV) are frequently discussed, the distinction between PONV and postdischarge nausea and vomiting (PDNV) is unclear. This is especially troublesome given the potential consequences of postdischarge nausea and vomiting (PDNV), which include major discomfort and hospital readmission.

Methods

In this retrospective cohort study, data from 10,231 adult patients undergoing ambulatory ophthalmology or otolaryngology procedures with general anesthesia were collected and analyzed. Binary and multinomial logistic regression was used to assess the association between patient and anesthetic characteristics (including age, body mass index (BMI), American Society of Anesthesiologists Physical Status (ASA P/S) classification, current smoker status, and intra- and postoperative opioid usage) and the odds ratios of experiencing only PDNV, only PONV, or both PONV and PDNV, as compared to not experiencing N/V at all.

Results

We found that 17.8% of all patients developed N/V (PONV and/or PDNV). Patients who experienced PONV had a 2.79 (95% confidence interval 2.24–3.46) times greater risk of reporting PDNV. Binary logistic regression found that younger age, opioid use, and female sex were associated with an increased likelihood of experiencing any N/V. Increased use of nitrous oxide and a higher ASA P/S class was associated with elevated likelihood of PONV, but not PDNV or PONV plus PDNV.

Conclusions

Patients experiencing N/V in the PACU are observed to develop PDNV disproportionately by a factor of 2.79. The patients have distinct predictors, indicating important opportunities for care improvements beyond current guidelines.
Salidroside protects RGC from pyroptosis in diabetes-induced retinopathy associated with NLRP3, NFEZL2 and NGKB1, revealed by network pharmacology analysis and experimental validation
Authors: Zhang Lan-Chun , Li Na , Xu Min , Chen Ji-Lin , He Hua , Liu Jia , Wang Ting-Hua , Zuo Zhong-Fu
Published: January 2024

Objective

To investigate the effect of salidroside (SAL) in protecting retinal ganglion cell (RGC) from pyroptosis and explore associated molecular network mechanism in diabetic retinapathy (DR) rats.

Methods

HE, Nissl and immunofluorescence staining were used to observe the retinal morphological change, and the related target genes for salidroside, DR and pyroptosis were downloaded from GeneCard database. Then Venny, PPI, GO, KEGG analysis and molecular docking were used to reveal molecular network mechanism of SAL in inhibiting the pyroptosis of RGC. Lastly, all hub genes were confirmed by using qPCR.

Results

HE and Nissl staining showed that SAL could improve the pathological structure known as pyroptosis in diabetic retina, and the fluorescence detection of pyroptosis marker in DM group was the strongest, while they decreased in the SAL group(P < 0.05)). Network pharmacological analysis showed 6 intersecting genes were obtained by venny analysis. GO and KEGG analysis showed 9 biological process, 3 molecular function and 3 signaling pathways were involved. Importantly, molecular docking showed that NFE2L2, NFKB1, NLRP3, PARK2 and SIRT1 could combine with salidroside, and qPCR validates the convincible change of CASP3, NFE2L2, NFKB1, NLRP3, PARK2 and SIRT1.

Conclusion

Salidroside can significantly improve diabetes-inducedRGC pyrotosis in retina, in which, the underlying mechanism is associated with the NLRP3, NFEZL2 and NGKB1 regulation.
Amifostine ameliorates bleomycin-induced murine pulmonary fibrosis via NAD+/SIRT1/AMPK pathway-mediated effects on mitochondrial function and cellular metabolism
Authors: Guo Feng , Xu Feng , Li Shujuan , Zhang Yun , Lv Dan , Zheng Lin , Gan Yongxiong , Zhou Miao , Zhao Keyu , Xu Shuling , Wu Bin , Deng Zaichun , Fu Panfeng
Published: January 2024

Background

Idiopathic pulmonary fibrosis (IPF) is a devastating chronic lung disease characterized by irreversible scarring of the lung parenchyma. Despite various interventions aimed at mitigating several different molecular aspects of the disease, only two drugs with limited clinical efficacy have so far been approved for IPF therapy.

Objective

We investigated the therapeutic efficacy of amifostine, a detoxifying drug clinically used for radiation-caused cytotoxicity, in bleomycin-induced murine pulmonary fibrosis.

Methods

C57BL6/J mice were intratracheally instilled with 3 U/kg of bleomycin. Three doses of amifostine (WR-2721, 200 mg/kg) were administered intraperitoneally on days 1, 3, and 5 after the bleomycin challenge. Bronchoalveolar lavage fluid (BALF) was collected on day 7 and day 21 for the assessment of lung inflammation, metabolites, and fibrotic injury. Human fibroblasts were treated in vitro with transforming growth factor beta 1 (TGF-β1), followed by amifostine (WR-1065, 1–4 µg/mL) treatment. The effects of TGF-β1 and amifostine on the mitochondrial production of reactive oxygen species (ROS) were assessed by live cell imaging of MitoSOX. Cellular metabolism was assessed by the extracellular acidification rate (ECAR), the oxygen consumption rate (OCR), and the concentrations of various energy-related metabolites as measured by mass spectrum (MS). Western blot analysis was performed to investigate the effect of amifostine on sirtuin 1 (SIRT1) and adenosine monophosphate activated kinase (AMPK).

Results

Three doses of amifostine significantly attenuated lung inflammation and pulmonary fibrosis. Pretreatment and post-treatment of human fibroblast cells with amifostine blocked TGF-β1-induced mitochondrial ROS production and mitochondrial dysfunction in human fibroblast cells. Further, treatment of fibroblasts with TGF-β1 shifted energy metabolism away from mitochondrial oxidative phosphorylation (OXPHOS) and towards glycolysis, as observed by an altered metabolite profile including a decreased ratio of NAD + /NADH and increased lactate concentration. Treatment with amifostine significantly restored energy metabolism and activated SIRT1, which in turn activated AMPK. The activation of AMPK was required to mediate the effects of amifostine on mitochondrial homeostasis and pulmonary fibrosis. This study provides evidence that repurposing of the clinically used drug amifostine may have therapeutic applications for IPF treatment.

Conclusion

Amifostine inhibits bleomycin-induced pulmonary fibrosis by restoring mitochondrial function and cellular metabolism.
SOX9 gene shows association with adolescent idiopathic scoliosis predisposition in Northwest Indians
Authors: Singh Hemender , Shipra  , Gupta Manish , Gupta Nital , Gupta Geetanjali , Pandita Ajay K. , Sharma Rajesh , Pandita Sarla , Singh Vinod , Garg Bhavuk , Rai Ekta , Sharma Swarkar
Published: January 2024

Background

Adolescent idiopathic scoliosis (AIS) is a common structural deformity of the spine affecting adolescent individuals globally. The disorder is polygenic and is accompanied by the association of various genetic loci. Genetic studies in Chinese and Japanese populations have shown the association of genetic variants of SOX9 with AIS curve severity. However, no genetic study evaluating the association of SRY-Box Transcription Factor 9 (SOX9) variants with AIS predisposition has been conducted in any Indian population. Thus, we aimed to investigate the association of the genetic variants of the SOX9 along with 0.88 Mb upstream region with AIS susceptibility in the population of Northwest India.

Methods

In total, 113 AIS cases and 500 non-AIS controls were recruited from the population of Northwest India in the study and screened for 155 genetic variants across the SOX9 gene and 0.88 Mb upstream region of the gene using Global Screening Array-24 v3.0 chip (Illumina). The statistical significance of the Bonferroni threshold was set at 0.000322.

Result

The results showed the association of 11 newly identified variants; rs9302936, rs7210997, rs77736349, rs12940821, rs9302937, rs77447012, rs8071904, rs74898711, rs9900249, rs2430514, and rs1042667 with the AIS susceptibility in the studied population. Only one variant, rs2430514, was inversely associated with AIS in the population, while the ten variants were associated with the AIS risk. Moreover, 47 variants clustered in the gene desert region of the SOX9 gene were associated at a p-value ≤ 0.05.

Conclusion

The present study is the first to demonstrate the association of SOX9 enhancer locus variants with AIS in any South Asian Indian population. The results are interesting as rs1042667, a 3' untranslated region (UTR) variant in the exon 3 and upstream variants of the SOX9 gene, were associated with AIS susceptibility in the Northwest Indian population. This provides evidence that the variants in the enhancer region of SOX9 might regulate its gene expression, thus leading to AIS pathology and might act as an important gene for AIS susceptibility.
circNINL facilitates aerobic glycolysis, proliferation, invasion, and migration in lung cancer by sponging miR-3918 to mediate FGFR1 expression
Authors: Li Sai , Qiu Chun , Sun DaTong , Yang ShengHui , Wang Lin
Published: January 2024

Previously characterized as an oncogenic player in breast cancer, the function of circular RNA NINL (circNINL) in lung cancer (LC) remained elusive. This study aimed to delineate the biological role of circNINL in LC and to unveil its potential molecular mechanisms. We discovered elevated expression levels of circNINL and Fibroblast Growth Factor Receptor 1 (FGFR1) concomitant with diminished expression of microRNA-3918 (miR-3918) in LC specimens. Knockdown of circNINL led to a marked decrease in cell proliferation, migration, invasion, and aerobic glycolysis, alongside an upsurge in apoptosis in LC cells. Either downregulation of miR-3918 or overexpression of FGFR1 mitigated the suppressive impact of circNINL knockdown on LC pathogenesis. Mechanistic studies validated that circNINL served as a competitive endogenous RNA for miR-3918, thus influencing FGFR1 expression. Further, in vivo experiments using nude mouse xenograft models underscored that silencing circNINL substantially curtailed tumor growth in LC. Collectively, these findings illuminate that circNINL exacerbates LC malignancy via the miR-3918/FGFR1 axis, a process integrally linked with the activation of aerobic glycolysis.

Graphical Abstract
Multidisciplinary-derived clinical score for accurate prediction of long-term mortality in fibrotic lung disease patients
Authors: Liao Yu-Wan , Chen Yi-Ming , Liu Ming-Cheng , Wu Yu-Cheng , Hsu Chiann-Yi , Fu Pin-Kuei , Huang Wen-Nan , Chen Yi-Hsing
Published: January 2024

Background

Idiopathic pulmonary fibrosis (IPF) stands out as one of the most aggressive forms of interstitial lung diseases (ILDs), currently without a definitive cure. Multidisciplinary discussion (MDD) is now considered a cornerstone in diagnosing and differentiating ILD subtypes. The Gender-Age-Physiology (GAP) score, developed to assess IPF prognosis based on sex, age, forced vital capacity, and diffusion capacity for carbon monoxide (DLCO), is limited in not considering dyspnea and functional impairment during the walking test. We proposed a MDD-based clinical score for mortality prediction among those patients.

Methods

From December 2018 to December 2019, we enrolled ILD patients with IPF and non-IPF and followed-up them till December 2020. Based on DLCO, modified Medical Research Council (mMRC) Dyspnea Scale, and six-minute walking test (6MWT) distance, a functional score was developed for mortality prediction.

Results

We enrolled 104 ILD patients, 12 (11.5%) died by the one-year follow-up. In receiver operating characteristic (ROC) curve analysis, DLCO (% predicted) was the most accurate variable predicting one-year mortality with an area under curve (AUC) of 0.88 (95% confidence interval [CI] = 0.80–0.94), followed by mMRC Dyspnea Score (AUC = 0.82 [95% CI = 0.73–0.89]), 6MWT distance (AUC = 0.80 [95% CI = 0.71–0.88]), and GAP score (AUC = 0.77 [95% CI = 0.67–0.84]). Only the GAP score (hazard ratio [HR] = 1.55, 95% CI = 1.03–2.34,p = 0.0.37) and functional score (HR = 3.45, 95% CI = 1.11–10.73,p = 0.032) were significantly associated with one-year mortality in multivariable analysis.

Conclusion

The clinical score composite of DLCO, mMRC Dyspnea Scale, and 6MWT distance could provide an accurate prediction for long-term mortality in ILD patients, laying out a helpful tool for managing and following these patients.
N-Nitrosomorpholine-induced oncocytic transformation in rat endocrine organs
Authors: Gezer Emre , Özer Cüneyt , Şimşek Turgay , Yaprak Bayrak Büşra , Turan Gupse , Çetinarslan Berrin , Selek Alev , Cantürk Zeynep , Sözen Mehmet , Köksalan Damla
Published: January 2024

Background

N-Nitrosomorpholine (NMO) is one of the most common N-nitroso compounds. An oncocytic transformation has been demonstrated in renal tubules of NMO-treated rats. In our study, we aimed to investigate the potential transformation of oncocytic cells in 6 endocrine organs, i.e., thyroid, adrenal and pituitary glands, pancreas, testis, and bone, of NMO-exposed rats.

Methods

Thirty male rats were born and raised. Fifteen of them were given a single dose of 320 mg NMO per kg body weight, dissolved in drinking water, by a gavage tube. At the end of 52 weeks, the animals in both series were killed. Right after the killing, 6 different endocrine organs (hypophysis, thyroid, pancreas, adrenal gland, bone [femur], and testicles) of each animal were excised.

Results

There was no evidence of oncocytic cell development in the control group. In contrast, oncocytes were observed in 8 out of 13 NMO-treated rats: 2 in the adrenal sections, 1 in the thyroid sections, 3 in the pituitary sections, and 2 in the pancreas sections. Thesticle and bone sections were completely normal.

Conclusions

We showed that NMO induced an oncocytic change in pancreas, thyroid, pituitary, and adrenal glands. To date, no identified specific environmental risk factors that lead to an oncocytic transformation in endocrine glands have been reported previously. Given the increasing prevalence of endocrine-disrupting chemicals in the environment, personal care products, manufactured goods, and food sources, there is a need to advance our understanding of the pathological mechanisms underlying oncocytosis in endocrine organs.
Nafamostat mesylate versus regional citrate anticoagulation for continuous renal replacement therapy in patients at high risk of bleeding: a retrospective single-center study
Authors: Liu Dan , Zhao Jian , Xia Hui , Dong Shi , Yan Songjuan , Zhuang Yugang , Chen Yuanzhuo , Peng Hu
Published: January 2024

Purpose

The choice of continuous renal replacement therapy (CRRT) anticoagulation program for patients at high risk of bleeding has always been a complex problem in clinical practice. Clinical regimens include regional citrate anticoagulation (RCA) and nafamostat mesylate (NM). This study aimed to evaluate the efficacy and safety of these two anticoagulants for CRRT in patients at high risk of bleeding to guide their clinical use better.

Patients and methods

Between January 2021 and December 2022, 307 patients were screened for this study. Forty-six patients were finally enrolled: 22 in the regional citrate anticoagulation group and 24 in the nafamostat mesylate group. We collected patients’ baseline characteristics, laboratory indicators before CRRT, and CRRT-related data. We then performed a statistical analysis of the data from both groups of patients.

Results

In our study, the baseline characteristics did not differ significantly between the two groups; the baseline laboratory indicators before CRRT of patients in the two groups were not significantly different. The duration of CRRT was 600 min in the regional citrate anticoagulation (RCA) group, 615 min in the nafamostat mesylate (NM) group; the success rate was 90.7% in the RCA group, and 85.6% in the NM group, the anticoagulant efficacy between the two groups was comparable. There was no significant difference in the safety of anticoagulation between the two groups. We used Generalized Estimating Equations (GEE) to test whether different anticoagulation methods significantly affected the success rate of CRRT and found no statistical difference between RCA and NM.

Conclusion

Our study suggests that nafamostat mesylate's anticoagulant efficacy and safety are not inferior to regional citrate anticoagulation for continuous renal replacement therapy in patients at high risk of bleeding.
Dementia care pathways in prisons – a comprehensive scoping review
Authors: Treacy Samantha , Martin Steven , Samarutilake Nelum , Phillips Veronica , Underwood Ben R. , Van Bortel Tine
Published: January 2024

Background

The number of older people in prison is growing. As a result, there will also be more prisoners suffering from dementia. The support and management of this population is likely to present multiple challenges to the prison system.

Objectives

To examine the published literature on the care and supervision of people living in prison with dementia and on transitioning into the community; to identify good practice and recommendations that might inform the development of prison dementia care pathways.

Methods

A scoping review methodology was adopted with reporting guided by the PRISMA extension for scoping reviews checklist and explanation.

Results

Sixty-seven papers were included. Most of these were from high income countries, with the majority from the United Kingdom (n = 34), followed by the United States (n = 15), and Australia (n = 12). One further paper was from India.

Discussion

The literature indicated that there were difficulties across the prison system for people with dementia along the pathway from reception to release and resettlement. These touched upon all aspects of prison life and its environment, including health and social care. A lack of resources and national and regional policies were identified as important barriers, although a number of solutions were also identified in the literature, including the development of locally tailored policies and increased collaboration with the voluntary sector.

Conclusion

To our knowledge, this is the most comprehensive and inclusive review of the literature on dementia care pathways in prison to date. It has identified a number of important areas of concern and opportunities for future research across the prison system, and its operations. This will hopefully lead to the identification or adaptation of interventions to be implemented and evaluated, and facilitate the development of dementia care pathways in prisons.
The impact of psychosocial safety climate on public sector job satisfaction: the moderating role of organizational climate
Authors: Lintanga Albert Joseph bin James , Rathakrishnan Balan
Published: January 2024

Background

The purpose of this study is to uncover the effect of psychological safety climate (PSC) on employees’ job satisfaction and organisational climate mediating processes explaining that association. It is posited that the four PSC aspects (management commitment, management priority, organisational participation, and organisational communication) are important for employees’ job satisfaction and organisational climate act as resources to facilitate the enactment of managerial quality.

Methods

This study uses a quantitative approach through a questionnaire survey method involving 340 Kota Kinabalu City Hall employees who were selected through simple random sampling.

Results

The results of linear regression analysis found that organisation participation has a positive significant relationship with job satisfaction. Organisational communication also showed a negative and significant relationship with job satisfaction. Meanwhile, both management commitment and management priority are statistically insignificant. When the organisational climate is included in the relationship as a mediator through Structural Equation Modelling (SEM) to reinforce the role of psychological safety climate in increasing job satisfaction, such mediating role can only strengthen the relationship between management commitment and organisational participation with job satisfaction.

Conclusion

Despite the study being cross-sectional, it contributes to knowledge on the resources facilitating PSC, which is important for employees’ psychological health. From a practical viewpoint, this study contributes to the literature showing that organizations with good PSC should have policies and practices directed towards employee well-being. The implications of the study for DBKK management are to providing knowledge on the types of psychosocial safety climate domains that plays a crucial role in improving the job satisfaction of DBKK employees.
Spatial analyses on pre-earthquake ionospheric anomalies and magnetic storms observed by China seismo-electromagnetic satellite in August 2018
Authors: Liu Jann-Yenq Tiger , Shen Xuhui , Chang Fu-Yuan , Chen Yuh-Ing , Sun Yang-Yi , Chen Chieh-Hung , Pulinets Sergey , Hattori Katsumi , Ouzounov Dimitar , Tramutoli Valerio , Parrot Michel , Chen Wei-Sheng , Liu Cheng-Yan , Zhang Fei , Liu Dapeng , Zhang Xue-Min , Yan Rui , Wang Qiao
Published: January 2024

The China Seismo-Electromagnetic Satellite (CSES), with a sun-synchronous orbit at 507 km altitude, was launched on 2 February 2018 to investigate pre-earthquake ionospheric anomalies (PEIAs) and ionospheric space weather. The CSES probes manifest longitudinal features of four-peak plasma density and three plasma depletions in the equatorial/low-latitudes as well as mid-latitude troughs. CSES plasma and the total electron content (TEC) of the global ionosphere map (GIM) are used to study PEIAs associated with a destructive M7.0 earthquake and its followed M6.5 and M6.3/M6.9 earthquakes in Lombok, Indonesia, on 5, 17, and 19 August 2018, respectively, as well as to examine ionospheric disturbances induced by an intense storm with the Dst index of − 175 nT on 26 August 2018. Anomalous increases (decreases) in the GIM TEC and CSES plasma density (temperature) frequently appear specifically over the epicenter days 1–5 before the M7.0 earthquake and followed earthquakes, when the geomagnetic conditions of these PEIA periods are relatively quiet, Dst: − 37 to 19 nT. In contrast, TEC and CSES plasma parameter anomalies occur globally in the southern hemisphere during the storm days of 26–28 August 2018. The CSES ion velocity shows that the electric fields of PEIAs associated with the M7.0 earthquake are 0.21/0.06 mV/m eastward and 0.11/0.10 mV/m downward at post-midnight/post-noon on 1–3 August 2018, while the penetration electric fields during the storm periods of 26–28 August 2018 are 0.17/0.45 mV/m westward/downward at post-midnight of 02:00 LT and 0.26/0.26 mV/m eastward/upward at post-noon of 14:00 LT. Spatial analyses on CSES plasma discriminate PEIAs from global effects and locate the epicenter of possible forthcoming large earthquakes. CSES ion velocities are useful to derive PEIA- and storm-related electric fields in the ionosphere.
Development and validation of a nomogram model based on pretreatment ultrasound and contrast-enhanced ultrasound to predict the efficacy of neoadjuvant chemotherapy in patients with borderline resectable or locally advanced pancreatic cancer
Authors: Yan Xiaoyi , Fu Xianshui , Gui Yang , Chen Xueqi , Cheng Yuejuan , Dai Menghua , Wang Weibin , Xiao Mengsu , Tan Li , Zhang Jing , Shao Yuming , Wang Huanyu , Chang Xiaoyan , Lv Ke
Published: January 2024

Objectives

To develop a nomogram using pretreatment ultrasound (US) and contrast-enhanced ultrasound (CEUS) to predict the clinical response of neoadjuvant chemotherapy (NAC) in patients with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC).

Methods

A total of 111 patients with pancreatic ductal adenocarcinoma (PDAC) treated with NAC between October 2017 and February 2022 were retrospectively enrolled. The patients were randomly divided (7:3) into training and validation cohorts. The pretreatment US and CEUS features were reviewed. Univariate and multivariate logistic regression analyses were used to determine the independent predictors of clinical response in the training cohort. Then a prediction nomogram model based on the independent predictors was constructed. The area under the curve (AUC), calibration plot, C-index and decision curve analysis (DCA) were used to assess the nomogram’s performance, calibration, discrimination and clinical benefit.

Results

The multivariate logistic regression analysis showed that the taller-than-wide shape in the longitudinal plane (odds ratio [OR]:0.20, p = 0.01), time from injection of contrast agent to peak enhancement (OR:3.64; p = 0.05) and Peaktumor/ Peaknormal (OR:1.51; p = 0.03) were independent predictors of clinical response to NAC. The predictive nomogram developed based on the above imaging features showed AUCs were 0.852 and 0.854 in the primary and validation cohorts, respectively. Good calibration was achieved in the training datasets, with C-index of 0.852. DCA verified the clinical usefulness of the nomogram.

Conclusions

The nomogram based on pretreatment US and CEUS can effectively predict the clinical response of NAC in patients with BRPC and LAPC; it may help guide personalized treatment.
Changing the whole game: effects of the COVID-19 pandemic's accelerated digitalization on European bank staff's data protection capabilities
Authors: van Zeeland Ine , Pierson Jo
Published: January 2024

The COVID-19 pandemic accelerated the acceptance of digital banking services such as online payment and banking apps. As bank clients become more likely to use online services and contactless payment, the amount of consumer data available for banks’ digitalization strategies has increased. This acceleration in digital banking has placed a spotlight on retail banks’ efforts to protect personal data. Bank staff are on the frontlines of both protecting personal data and communicating their banks’ efforts in this respect to maintain consumer trust. Our study aimed to answer the following question: How did the sudden increase in digitalization during the pandemic affect bank staff’s capabilities in protecting personal data? In a two-stage qualitative study, we collected empirical data on bank staff’s data protection efforts during accelerated digitalization. Analyzing our findings from the perspective of technological mediation theory, which focuses on the relationships between technologies, practices, and social arrangements, we found that in banking platformization, bank staff are disempowered in supporting clients, who are responsibilized for protecting themselves from fraud. Competitive pressures push retail banks into using client data in ways beyond sector norms, endangering the contextual integrity of data flows. Further, our findings show that digitalization presents bank clients with new risks, of which they are informed only after changing their banking practices, and it may be difficult to return to former arrangements. The application of mediation theory, combined with contextual integrity theory, clarified the shifting positions of different digital technology users in the infrastructural network of platformized banking and allowed for an in-depth analysis of conflicting interests. By clarifying these interests, difficulties were identified that need to be addressed in public policy and digital innovation projects to prevent loss of trust among bank clients.