bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive value of bronchoscopy combined with CT score for refractory mycoplasma pneumoniae pneumonia in children
Authors: Lu Weihong , Wu Xiangtao , Xu Yali , Wang Tuanjie , Xiao Aiju , Guo Xixia , Xu Yuping , Li Duoduo , Li Shujun
Published: May 2024

Introduction

Mycoplasma pneumoniae pneumonia (MPP) is prevalent in paediatric patients and can progress to refractory mycoplasma pneumoniae pneumonia (RMPP).

Objective

To assess the predictive value of bronchoscopy combined with computed tomography (CT) score in identifying RMPP in children.

Methods

A retrospective analysis was conducted on 244 paediatric patients with MP, categorising them into RMPP and general mycoplasma pneumoniae pneumonia (GMPP) groups. A paired t-test compared the bronchitis score (BS) and CT score before and after treatment, supplemented by receiver operating characteristic (ROC) analysis.

Results

The RMPP group showed higher incidences of extrapulmonary complications and pleural effusion (58.10% and 40%, respectively) compared with the GMPP group (44.60%, p = 0.037 and 18.71%, p < 0.001, respectively). The CT scores for each lung lobe were statistically significant between the groups, except for the right upper lobe (p < 0.05). Correlation analysis between the total CT score and total BS yielded r = 0.346 and p < 0.001. The ROC for BS combined with CT score, including area under the curve, sensitivity, specificity, and cut-off values, were 0.82, 0.89, 0.64, and 0.53, respectively.

Conclusion

The combined BS and CT score method is highly valuable in identifying RMPP in children.
Integration of bioinformatics and machine learning approaches for the validation of pyrimidine metabolism-related genes and their implications in immunotherapy for osteoporosis
Authors: Feng Zichen , Wu Zixuan , Zhang Yongchen
Published: May 2024

Background

Osteoporosis (OP), the “silent epidemic” of our century, poses a significant challenge to public health, predominantly affecting postmenopausal women and the elderly. It evolves from mild symptoms to pronounced severity, stabilizing eventually. Unique among OP’s characteristics is the altered metabolic profile of affected cells, particularly in pyrimidine metabolism (PyM), a crucial pathway for nucleotide turnover and pyrimidine decomposition. While metabolic adaptation is acknowledged as a therapeutic target in various diseases, the specific role of PyM genes (PyMGs) in OP’s molecular response remains to be clarified.

Methods

In pursuit of elucidating and authenticating PyMGs relevant to OP, we embarked on a comprehensive bioinformatics exploration. This entailed the integration of Weighted Gene Co-expression Network Analysis (WGCNA) with a curated list of 37 candidate PyMGs, followed by the examination of their biological functions and pathways via Gene Set Variation Analysis (GSVA). The Least Absolute Shrinkage and Selection Operator (LASSO) technique was harnessed to identify crucial hub genes. We evaluated the diagnostic prowess of five PyMGs in OP detection and explored their correlation with OP’s clinical traits, further validating their expression profiles through independent datasets (GSE2208, GSE7158, GSE56815, and GSE35956).

Results

Our analytical rigor unveiled five PyMGs—IGKC, TMEM187, RPS11, IGLL3P, and GOLGA8N—with significant ties to OP. A deeper dive into their biological functions highlighted their roles in estrogen response modulation, cytosolic calcium ion concentration regulation, and GABAergic synaptic transmission. Remarkably, these PyMGs emerged as potent diagnostic biomarkers for OP, distinguishing affected individuals with substantial accuracy.

Conclusions

This investigation brings to light five PyMGs intricately associated with OP, heralding new avenues for biomarker discovery and providing insights into its pathophysiological underpinnings. These findings not only deepen our comprehension of OP’s complexity but also herald the advent of more refined diagnostic and therapeutic modalities.
“When I do have some time, rather than spend it polishing silver, I want to spend it with my grandkids”: a qualitative exploration of patient values following left ventricular assist device implantation
Authors: Bechthold Avery C. , McIlvennan Colleen K. , Matlock Daniel D. , Ejem Deborah B. , Wells Rachel D. , LeJeune Jesse , Bakitas Marie A. , Odom J. Nicholas
Published: May 2024

Background

Values are broadly understood to have implications for how individuals make decisions and cope with serious illness stressors, yet it remains uncertain how patients and their family and friend caregivers discuss, reflect upon, and act on their values in the post-left ventricular assist device (LVAD) implantation context. This study aimed to explore the values elicitation experiences of patients with an LVAD in the post-implantation period.

Methods

Qualitative descriptive study of LVAD recipients. Socio-demographics and patient resource use were analyzed using descriptive statistics and semi-structured interview data using thematic analysis. Adult (> 18 years) patients with an LVAD receiving care at an outpatient clinic in the Southeastern United States.

Results

Interviewed patients (n = 27) were 30–76 years, 59% male, 67% non-Hispanic Black, 70% married/living with a partner, and 70% urban-dwelling. Three broad themes of patient values elicitation experiences emerged: 1) LVAD implantation prompts deep reflection about life and what is important, 2) patient values are communicated in various circumstances to convey personal goals and priorities to caregivers and clinicians, and 3) patients leverage their values for strength and guidance in navigating life post-LVAD implantation. LVAD implantation was an impactful experience often leading to reevaluation of patients’ values; these values became instrumental to making health decisions and coping with stressors during the post-LVAD implantation period. Patient values arose within broad, informal exchanges and focused, decision-making conversations with their caregiver and the healthcare team.

Conclusions

Clinicians should consider assessing the values of patients post-implantation to facilitate shared understanding of their goals/priorities and identify potential changes in their coping.
The palliative care experience in Irish nursing homes during the COVID-19 pandemic: a survey of residents, family, and staff
Authors: Doody Owen , Lombard John , Delamere Tara , Rabbitte Mary
Published: May 2024

Background

Nursing homes and other long-term care services account for a disparate share of COVID-19 cases and casualties worldwide. During COVID-19 there is a distinct need to preserve a holistic view of the wellbeing of residents of nursing homes, be mindful of their rights as citizens, and to be aware of protecting residents from infection. The delivery of health and social care throughout a pandemic must remain person-centred and adhere to a human rights-based approach.

Methods

This study aimed to capture nursing home residents, their families and staff’s perspective of the nursing homes residents experience, approaches of staff and the nursing home environment. An online survey was distributed via stakeholder networks and online platforms across Ireland. This study was performed and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).

Results

25 residents, 42 family members and 51 staff completed the survey (n = 118). Across the domains measured all but one aspect scored above 50% (residents get up and go to bed when they want 41.5%) with the highest score of 89.1% scored for the nursing home is comfortable and well-kept. Results highlight evidence of positive experiences and endeavours to preserve social connections, residents were in a safe place cared for by staff who did their best in a difficult position and who went above and beyond their duty of care. However, some families reported poor communication, no internet connections, not enough phones or tablets, and that staff were busy and unable at times to assist residents who needed help using phones/tablets.

Conclusion

This study highlights the importance of human rights and how they ought to inform and shape the advancement of public health advice and policy documents. Overall, nursing home residents, their families and staff reported favourably on the study measures. However, issues pertaining to communication are essential and there is a need to address issues such as the provision of accurate timely information, communication infrastructure and resources, and inconsistencies in communications. Of note is that while healthcare professionals have a duty to uphold the rights of nursing home residents, they themselves have human rights which must also be protected and supported.
Infection prevention practice in home healthcare: a mixed-method study in two Swiss home healthcare organisations
Authors: Brockhaus Lisa , Lötscher Claudia , Labhardt Niklaus Daniel
Published: May 2024

Background

Infection prevention and control (IPC) research has long neglected the home healthcare sector with its unique challenges. This study aimed to gain an understanding of the barriers to the implementation of infection prevention practices relevant to this setting, the related attitudes, perceived relevance and priorities from the home healthcare worker perspective in Switzerland.

Methods

The mixed-method study involved semi-structured interviews (n = 18) and an anonymous web-based survey (n = 144) among nursing assistants and nurses from two home healthcare organizations in northwest Switzerland. Questions in both sub-studies focused on perceived challenges to infection prevention practices, perceived relevance, and related attitudes and mitigation strategies. Using an exploratory-sequential design, survey questions were designed to quantify and complement the findings from the interview study.

Results

Healthcare workers in these two organisations felt adequately protected, trained and supported by their organisations regarding IPC (survey agreement rates > 90%). General challenges to IPC in the home environment most agreed on were lack of cleanliness, lack of space, and the priorities of the patient to be respected (survey agreement rates 85.4%, 77.1%, and 70.8%, respectively). Practices and perceived challenges in the case of colonisation with multi-drug resistant organisms (MDRO) and potentially infectious diarrheal or respiratory illnesses varied highly regarding information transfer, use of protective equipment, and use and disinfection practices of multi-use equipment. Challenges to hand hygiene, sharps safety, waste management and decontamination of equipment did not feature as a prominent concern.

Conclusions

This study is the first to characterise the implementation of infection prevention practices and the related challenges in home healthcare in Switzerland. Home healthcare workers describe various challenges related to infection prevention practices as largely manageable in their work routine, and generally show satisfaction with the support provided by their organisations regarding IPC precautions. Key findings regarding challenges amenable to interventions include uncertainty and inconsistency regarding the management of MDRO colonisation and acute illnesses, and gaps in information transfer. Those challenges may benefit from both organisational interventions and further research into the level of precautions that are appropriate to the home healthcare setting.
Enhancing clinical utility: deep learning-based embryo scoring model for non-invasive aneuploidy prediction
Authors: Ma Bing-Xin , Zhao Guang-Nian , Yi Zhi-Fei , Yang Yong-Le , Jin Lei , Huang Bo
Published: May 2024

Background

The best method for selecting embryos ploidy is preimplantation genetic testing for aneuploidies (PGT-A). However, it takes more labour, money, and experience. As such, more approachable, non- invasive techniques were still needed. Analyses driven by artificial intelligence have been presented recently to automate and objectify picture assessments.

Methods

In present retrospective study, a total of 3448 biopsied blastocysts from 979 Time-lapse (TL)-PGT cycles were retrospectively analyzed. The “intelligent data analysis (iDA) Score” as a deep learning algorithm was used in TL incubators and assigned each blastocyst with a score between 1.0 and 9.9.

Results

Significant differences were observed in iDAScore among blastocysts with different ploidy. Additionally, multivariate logistic regression analysis showed that higher scores were significantly correlated with euploidy (p < 0.001). The Area Under the Curve (AUC) of iDAScore alone for predicting euploidy embryo is 0.612, but rose to 0.688 by adding clinical and embryonic characteristics.

Conclusions

This study provided additional information to strengthen the clinical applicability of iDAScore. This may provide a non-invasive and inexpensive alternative for patients who have no available blastocyst for biopsy or who are economically disadvantaged. However, the accuracy of embryo ploidy is still dependent on the results of next-generation sequencing technology (NGS) analysis.
Long-term outcome and fertility results of intraplacental choriocarcinoma: a retrospective study of 14 patients and literature review
Authors: Liu Yang , Song Xiaochen , Zhang Hui , Feng Fengzhi , Zhao Jun , Yang Junjun , Ren Tong , Wan Xirun , Jiang Fang , Li Yuan , Xiang Yang
Published: May 2024

Backgrounds

Intraplacental choriocarcinoma (IC) is an extremely rare subtype of gestational choriocarcinoma. The long-term follow-up and reproductive outcomes of IC patients remain unclear. Here, we report a series of 14 cases and conduct a literature review to assess the fertility and recurrence results of this rare disease.

Results

Fourteen patients with pathologically confirmed IC treated in Peking Union Medical College Hospital between January 2002 and July 2022 were included in this study. Half of them had metastatic IC and were treated by chemotherapy with or without surgery. Only 1 patient had chemoresistant disease, but she achieved complete remission after immunotherapy. The median follow-up time was 45.5 months (range 4-192), and no recurrence occurred. One metastatic IC patient who achieved remission after chemotherapy had a full-term delivery. Among the 5 patients with fertility demands, 3 abandoned their pursuit of pregnancy because of “fear and worry about choriocarcinoma recurrence”. We reviewed a total of 89 cases of IC in English and Chinese literature from 1963 to 2022, and only 5 cases with subsequent pregnancy were reported, all of them were nonmetastatic IC cases.

Conclusions

IC is sensitive to chemotherapy and has good long-term remission and a low recurrence rate. Patients with metastatic or nonmetastatic IC can have good pregnancy results after treatment. Doctors should pay more attention to the psychology of these patients.

Clinical trial registration

N/A.
A first-in-class inhibitor of HSP110 to potentiate XPO1-targeted therapy in primary mediastinal B-cell lymphoma and classical Hodgkin lymphoma
Authors: Durand Manon , Cabaud Gibouin Vincent , Duplomb Laurence , Salmi Leila , Caillot Mélody , Sola Brigitte , Camus Vincent , Jardin Fabrice , Garrido Carmen , Jego Gaëtan
Published: May 2024

Background

Primary mediastinal B-cell lymphoma (PMBL) and classical Hodgkin lymphoma (cHL) are distinct hematological malignancies of B-cell origin that share many biological, molecular, and clinical characteristics. In particular, the JAK/STAT signaling pathway is a driver of tumor development due to multiple recurrent mutations, particularly in STAT6. Furthermore, the XPO1 gene that encodes exportin 1 (XPO1) shows a frequent point mutation (E571K) resulting in an altered export of hundreds of cargo proteins, which may impact the success of future therapies in PMBL and cHL. Therefore, targeted therapies have been envisioned for these signaling pathways and mutations.

Methods

To identify novel molecular targets that could overcome the treatment resistance that occurs in PMBL and cHL patients, we have explored the efficacy of a first-in-class HSP110 inhibitor (iHSP110-33) alone and in combination with selinexor, a XPO1 specific inhibitor, both in vitro and in vivo.

Results

We show that iHSP110-33 decreased the survival of several PMBL and cHL cell lines and the size of tumor xenografts. We demonstrate that HSP110 is a cargo of XPO1wt as well as of XPO1E571K. Using immunoprecipitation, proximity ligation, thermophoresis and kinase assays, we showed that HSP110 directly interacts with STAT6 and favors its phosphorylation. The combination of iHSP110-33 and selinexor induces a synergistic reduction of STAT6 phosphorylation and of lymphoma cell growth in vitro and in vivo. In biopsies from PMBL patients, we show a correlation between HSP110 and STAT6 phosphorylation levels.

Conclusions

These findings suggest that HSP110 could be proposed as a novel target in PMBL and cHL therapy.
One Health monitoring reveals invasive freshwater snail species, new records, and undescribed parasite diversity in Zimbabwe
Authors: Mudavanhu Aspire , Schols Ruben , Goossens Emilie , Nhiwatiwa Tamuka , Manyangadze Tawanda , Brendonck Luc , Huyse Tine
Published: May 2024

Background

Snail-borne trematodes afflict humans, livestock, and wildlife. Recognizing their zoonotic potential and possible hybridization, a One Health approach is essential for effective control. Given the dearth of knowledge on African trematodes, this study aimed to map snail and trematode diversity, focusing on (i) characterizing gastropod snail species and their trematode parasites, (ii) determining infection rates of snail species as intermediate hosts for medically, veterinary, and ecologically significant trematodes, and (iii) comparing their diversity across endemic regions.

Methods

A cross-sectional study conducted in 2021 in Chiredzi and Wedza districts in Zimbabwe, known for high human schistosomiasis prevalence, involved malacological surveys at 56 sites. Trematode infections in snails were detected through shedding experiments and multiplex rapid diagnostic polymerase chain reactions (RD-PCRs). Morphological and molecular analyses were employed to identify snail and trematode species.

Results

Among 3209 collected snail specimens, 11 species were identified, including schistosome and fasciolid competent snail species. We report for the first time the invasive exotic snail Tarebia granifera in Zimbabwe, which was highly abundant, mainly in Chiredzi, occurring at 29 out of 35 sites. Shedding experiments on 1303 snails revealed a 2.24% infection rate, with 15 trematode species identified through molecular genotyping. Five species were exclusive to Chiredzi: Bolbophorus sp., Schistosoma mansoni, Schistosoma mattheei, Calicophoron sp., and Uvulifer sp. Eight were exclusive to Wedza, including Trichobilharzia sp., Stephanoprora amurensis, Spirorchid sp., and Echinostoma sp. as well as an unidentified species of the Plagiorchioidea superfamily. One species, Tylodelphys mashonensis, was common to both regions. The RD-PCR screening of 976 non-shedding snails indicated a 35.7% trematode infection rate, including the presence of schistosomes (1.1%) Fasciola nyanzae (0.6%). In Chiredzi, Radix natalensis had the highest trematode infection prevalence (33.3%), while in Wedza, R. natalensis (55.4%) and Bulinus tropicus (53.2%) had the highest infection prevalence.

Conclusions

Our xenomonitoring approach unveiled 15 trematode species, including nine new records in Zimbabwe. Schistosoma mansoni persists in the study region despite six mass deworming rounds. The high snail and parasite diversity, including the presence of exotic snail species that can impact endemic species and biomedically important trematodes, underscores the need for increased monitoring.

Graphical Abstract
Generative design of compounds with desired potency from target protein sequences using a multimodal biochemical language model
Authors: Chen Hengwei , Bajorath Jürgen
Published: May 2024

Deep learning models adapted from natural language processing offer new opportunities for the prediction of active compounds via machine translation of sequential molecular data representations. For example, chemical language models are often derived for compound string transformation. Moreover, given the principal versatility of language models for translating different types of textual representations, off-the-beaten-path design tasks might be explored. In this work, we have investigated generative design of active compounds with desired potency from target sequence embeddings, representing a rather provoking prediction task. Therefore, a dual-component conditional language model was designed for learning from multimodal data. It comprised a protein language model component for generating target sequence embeddings and a conditional transformer for predicting new active compounds with desired potency. To this end, the designated “biochemical” language model was trained to learn mappings of combined protein sequence and compound potency value embeddings to corresponding compounds, fine-tuned on individual activity classes not encountered during model derivation, and evaluated on compound test sets that were structurally distinct from training sets. The biochemical language model correctly reproduced known compounds with different potency for all activity classes, providing proof-of-concept for the approach. Furthermore, the conditional model consistently reproduced larger numbers of known compounds as well as more potent compounds than an unconditional model, revealing a substantial effect of potency conditioning. The biochemical language model also generated structurally diverse candidate compounds departing from both fine-tuning and test compounds. Overall, generative compound design based on potency value-conditioned target sequence embeddings yielded promising results, rendering the approach attractive for further exploration and practical applications.

Scientific contribution

The approach introduced herein combines protein language model and chemical language model components, representing an advanced architecture, and is the first methodology for predicting compounds with desired potency from conditioned protein sequence data.
Ibragimov–Gadjiev operators preserving exponential functions
Authors: Herdem Serap
Published: May 2024

In this paper, a modification of general linear positive operators introduced by Ibragimov and Gadjiev in 1970 is constructed. It is shown that this modification preserves exponential mappings and also contains modified Bernstein-, Szász- and Baskakov-type operators as special cases. The convergence properties of corresponding operators on $[ 0,\infty ) $
[
0
,
∞
)
and in exponentially weighted spaces are investigated. Finally, the quantitative Voronovskaja theorem in terms of modulus of continuity for functions having exponential growth is examined.
Fredholm integral equation in composed-cone metric spaces
Authors: Hijab Anas A. , Shaakir Laith K. , Aljohani Sarah , Mlaiki Nabil
Published: May 2024

The current paper introduces a novel generalization of cone metric spaces called type I and type II composed cone metric spaces. Therefore, examples of a type I and type II composed cone metric space, which is not a cone metric space, are given. We establish some results of fixed point precisely about Hardy–Rogers type contraction on C2CMS and provide examples. Finally, we present an application of our results and how our results solve the Fredholm integral equation of generalizing several existing and unique fixed point theorems.
A social network analysis approach to assess COVID19-related disruption to substance use treatment and informal social interactions among people who use drugs in Scotland
Authors: McCann Mark , Bianchi Federica , Letina Srebrenka , Stewart Samantha , McLeod Katy , Tranmer Mark
Published: May 2024

Aims

To assess the extent of Coronavirus-related disruption to health and social care treatment and social interactions among people with lived or living experience of substance use in Scotland, and explore potential reasons for variations in disruption.

Design

Cross sectional mixed methods interview, incorporating a social network ‘egonet interview’ approach asking about whether participants had interactions with a range of substance use, health, social care or third sector organisations, or informal social interactions.

Setting

Five Alcohol and Drug Partnership Areas in Scotland.

Participants

57 (42% women) participants were involved in the study, on average 42 years old.

Measurements

Five-point Likert scale reporting whether interactions with a range of services and people had gotten much better, better, no different (or no change), worse, or much worse since COVID19 and lockdown. Ratings were nested within participants (Individuals provided multiple ratings) and some ratings were also nested within treatment service (services received multiple ratings). The nested structure was accounted for using cross classified ordinal logistic multilevel models.

Findings

While the overall average suggested only a slight negative change in interactions (mean rating 2.93), there were substantial variations according to type of interaction, and between individuals. Reported change was more often negative for mental health services (Adjusted OR = 0.93 95% CI 0.17,0.90), and positive for pharmacies (3.03 95% CI 1.36, 5.93). The models found between-participant variation of around 10%, and negligible between-service variation of around 1% in ratings. Ratings didn’t vary by individual age or gender but there was variation between areas.

Conclusions

Substance use treatment service adaptations due to COVID19 lockdown led to both positive and negative service user experiences. Social network methods provide an effective way to describe complex system-wide interaction patterns, and to measure variations at the individual, service, and area level.
Antitumour effects of artesunate via cell cycle checkpoint controls in human oesophageal squamous carcinoma cells
Authors: Mao Linlin , Deng Guodong , Li Mengfan , Lu Shih-Hsin , Jiang Wei , Yu Xiying
Published: May 2024

Artesunate (ART), an effective antimalarial semisynthetic derivative of artemisinin, exhibits antitumour properties, but the mechanism(s) involved remain elusive. In this study, we investigated the antitumour effects of ART on human oesophageal squamous cell carcinoma (ESCC) cell lines. Treatment of ESCC cell lines with ART resulted in the production of excessive reactive oxygen species (ROS) that induced DNA damage, reduced cell proliferation and inhibited clonogenicity via G1-S cell cycle arrest and/or apoptosis in vitro. The administration of ART to nude mice with ESCC cell xenografts inhibited tumour formation in vivo. However, the cytotoxicity of ART strongly differed among the ESCC cell lines tested. Transcriptomic profiling revealed that although the expression of large numbers of genes in ESCC cell lines was affected by ART treatment, these genes could be functionally clustered into pathways involved in regulating cell cycle progression, DNA metabolism and apoptosis. We revealed that p53 and Cdk4/6-p16-Rb cell cycle checkpoint controls were critical determinants required for mediating ART cytotoxicity in ESCC cell lines. Specifically, KYSE30 cells with p53Mut/p16Mut were the most sensitive to ART, KYSE150 and KYSE180 cells with p53Mut/p16Nor exhibited intermediate responses to ART, and Eca109 cells with p53Nor/p16Nor exhibited the most resistance to ATR. Consistently, perturbation of p53 expression using RNA interference (RNAi) and/or Cdk4/6 activity using the inhibitor palbociclib altered ART cytotoxicity in KYSE30 cells. Given that the p53 and Cdk4/6-cyclin D1-p16-Rb genes are commonly mutated in ESCC, our results potentially shed new light on neoadjuvant chemotherapy strategies for ESCC.
Case of functional paraganglioma with intraoperative hypertensive crisis during robot-assisted thoracoscopic resection
Authors: Lachmann Björn , Schweigert Michael , Almeida Ana Beatriz , Spieth Stephanie , Rössel Thomas , Richter Torsten
Published: May 2024

Background

Mediastinal paragangliomas are rare. Their dangerousness may unfold during surgery, especially if hormonal activity was previously unknown. We report our experience with this case in context to the incidence and localization of atypically located mediastinal paragangliomas in the literature.

Case presentation

A 69-year-old female patient who was scheduled for thoracoscopic resection due to a posterior mediastinal tumor that had been progressing in size for several years and increasing symptoms. The induction of anesthesia, the ventilation of the lungs and the gas exchange after lung separation was uneventful. After initially stable circulatory conditions, there was a sudden increase in blood pressure up to 300/130 mmHg and tachycardia up to 130/min. This hypertensive phase was difficult to influence and required a rapid and consistent use of antihypertensive medication to bring down the blood pressure to reasonable values. The patient stabilized after tumor resection. The postoperative course was unremarkable. During the intraoperative blood pressure crisis, blood was drawn for analysis. These samples showed elevated concentrations of normetanephrine and metanephrine. The tumor subsequently presented as a catecholamine-secreting paraganglioma.

Conclusion

In order to avoid life-threatening blood pressure crises, hormone activity should be ruled out preoperatively in the case of mediastinal tumor, in which a paraganglioma could be considered in the differential diagnosis, especially if there are indications of hypertension in the medical history. Robotic-assisted thoracoscopic resection of the posterior mediastinal tumor was a feasible surgical method, even in the case of unexpected functional paraganglioma.
Exploring the role of green hydrogen for distributed energy access planning towards net-zero emissions in Nigeria
Authors: Shari Babajide E. , Moumouni Yacouba , Ohunakin Olayinka S. , Blechinger Philipp , Madougou Saidou , Rabani Adamou
Published: May 2024

Providing sustainable, affordable, and reliable electricity through low-carbon energy development in the Nigerian energy sector is fundamental to ensuring energy security. Currently, efforts to harness the potential of renewable energy, to provide universal electricity access for all have not translated into significant economic development in Nigeria. Investment in green hydrogen could strengthen Nigeria’s net-zero transition plan (NETP) and achieve sustainable energy access. The study explored the role of green hydrogen among five Electricity Distribution Companies (DisCos), from three geopolitical zones in Nigeria—North West, North Central, and North East. A bottom-up optimization linear programming methodology based on an open energy modelling framework (OEMOF) was used as the modelling paradigm. Secondary data mined from the Nigeria Energy Commission, Nigeria Electricity Regulatory Commission, NECAL 2050 report and international reports, and 2020 was used as a reference year to benchmark the model. The basic characteristics of the generation of electricity from green hydrogen, fuel cells, electrolyzers, and hydrogen storage, among other existing generation plants, were modelled till 2060 using modelled daily data obtained from Toktarova et al. (Electrical Power and Energy Systems 111:160–181, 2019). Outcomes from benchmarking led to two planning scenarios; these investigated possible insights that explored green hydrogen in Nigeria. Results showed that an integrated distributed approach would enhance harnessing green hydrogen in Nigeria, that is, electricity distribution among the DisCos. The study also revealed the following (1) the levelized cost of electricity could drop by about 8%, so also the cost of the investment; (2) access to electricity showed an improvement compared to the base year; and (3) emissions were cut in the power sector. To attain sustainable NETP with green hydrogen, the study recommends that a distributed generation approach among DisCos would support the national net-zero transition plan.
The impact of mobile learning in English language classrooms in Pakistan
Authors: Ali Muhammad Mooneeb , Alaa Ahmed M. , Shahnaz Ambreen
Published: May 2024

In the wake of the COVID-19 pandemic, a discernible shift towards mobile learning tools has emerged, supplanting conventional pedagogical methods. Mobile learning (m-learning) constitutes a subset of e-learning, involving the utilization of portable devices for educational purposes. This research undertakes an examination of the impact of m-learning within the context of Pakistani English language classrooms. The study's target population consisted of university students in Pakistan. Five universities in Lahore, Pakistan, were selected using a convenience sampling method. From these universities, a sample of 100 students, enrolled in the first semester of a Bachelor of Science English language learning preparatory year course, were selected based on a simple random sampling technique. Before the experimental phase, the students underwent a pre-test assessment. Subsequently, based on the results, they were evenly divided into a control group and an experimental group. It was ensured that both groups included students of mixed ability levels. The treatment duration spanned 4 months, equivalent to 48 credit hours. The experimental group engaged in learning activities through mobile phones, while the control group adhered to conventional instructional methods. Finally, upon completion of the treatment period, a post-test assessment was administered to the students. Data analysis revealed that the experimental group (Mean: 15.93) exhibited notably superior performance compared to the control group (Mean: 10.12). This outcome highlights the positive influence of m-learning on learners' academic achievements. Furthermore, this enhanced performance reflects learners' favorable reception of mobile phone utilization within the context of English as a second language academic learning.
Empirical analysis of the impact of China’s carbon emissions trading policy using provincial-level data
Authors: Jiang Xiaoguo , Xu Weiwei , Du Lixia
Published: May 2024

Investigating the impact of carbon emissions trading policy and elucidating the underlying mechanisms are crucial for enhancing policy effectiveness and refining related systems. This study examines the impact of carbon emissions trading policy by constructing a difference-in-difference model utilizing unbalanced panel data from China’s provinces spanning the period from 2005 to 2019. Additionally, a mediating effect model is employed to delve into the underlying mechanisms. The key findings are as follows: Firstly, the implementation of carbon emissions trading policy has a notable inhibitory impact on carbon emissions. Secondly, both the upgrading of industrial structure and the reduction of energy intensity play mediating roles in carbon emissions reduction. However, the development of clean energy industries does not exhibit a significant mediating effect. In conclusion, this study offers policy recommendations aimed at facilitating carbon reduction. These include enhancing the market-based trading mechanism for carbon emissions, optimizing and upgrading industrial structures, fostering innovation in green and low-carbon technologies, and promoting the development and utilization of clean energy.
Coral species-specific loss and physiological legacy effects are elicited by an extended marine heatwave
Authors: Strand Emma L. , Wong Kevin H. , Farraj Alexa , Gray Sierra , McMenamin Ana , Putnam Hollie M.
Published: May 2024

Marine heatwaves are increasing in frequency and intensity, with potentially catastrophic consequences for marine ecosystems such as coral reefs. An extended heatwave and recovery time-series that incorporates multiple stressors and is environmentally realistic can provide enhanced predictive capacity for performance under climate change conditions. We exposed common reef-building corals in Hawai‘i, Montipora capitata and Pocillopora acuta, to a 2-month period of high temperature and high PCO2 conditions or ambient conditions in a factorial design, followed by 2 months of ambient conditions. High temperature, rather than high PCO2, drove multivariate physiology shifts through time in both species, including decreases in respiration rates and endosymbiont densities. Pocillopora acuta exhibited more significantly negatively altered physiology, and substantially higher bleaching and mortality than M. capitata. The sensitivity of P. acuta appears to be driven by higher baseline rates of photosynthesis paired with lower host antioxidant capacity, creating an increased sensitivity to oxidative stress. Thermal tolerance of M. capitata may be partly due to harboring a mixture of Cladocopium and Durusdinium spp., whereas P. acuta was dominated by other distinct Cladocopium spp. Only M. capitata survived the experiment, but physiological state in heatwave-exposed M. capitata remained significantly diverged at the end of recovery relative to individuals that experienced ambient conditions. In future climate scenarios, particularly marine heatwaves, our results indicate a species-specific loss of corals that is driven by baseline host and symbiont physiological differences as well as Symbiodiniaceae community compositions, with the surviving species experiencing physiological legacies that are likely to influence future stress responses.
Magnesium ions mitigate metastable states in the regulatory landscape of mRNA elements
Authors: Ding Erdong , Chaudhury Susmit Narayan , Prajapati Jigneshkumar Dahyabhai , Onuchic José N. , Sanbonmatsu Karissa Y.
Published: May 2024

Residing in the 5′ untranslated region of the mRNA, the 2′-deoxyguanosine (2′-dG) riboswitch mRNA element adopts an alternative structure upon binding of the 2′-dG molecule, which terminates transcription. RNA conformations are generally strongly affected by positively charged metal ions (especially Mg2+). We have quantitatively explored the combined effect of ligand (2′-dG) and Mg2+binding on the energy landscape of the aptamer domain of the 2′-dG riboswitch with both explicit solvent all-atom molecular dynamics simulations (99 μsec aggregate sampling for the study) and selective 2′-hydroxyl acylation analyzed by primer extension (SHAPE) experiments. We show that both ligand and Mg2+are required for the stabilization of the aptamer domain; however, the two factors act with different modalities. The addition of Mg2+remodels the energy landscape and reduces its frustration by the formation of additional contacts. In contrast, the binding of 2′-dG eliminates the metastable states by nucleating a compact core for the aptamer domain. Mg2+ions and ligand binding are required to stabilize the least stable helix, P1 (which needs to unfold to activate the transcription platform), and the riboswitch core formed by the backbone of the P2 and P3 helices. Mg2+and ligand also facilitate a more compact structure in the three-way junction region.
Clinical efficacy of a new type of Sports Rehabilitation Therapy Bed
Authors: Yu Duoduo , Luo Xiaobing , Gao Piming
Published: May 2024

Objective: To prove that the “sports rehabilitation bed” is a device aimed at improving the precision of stretching, which can help to reduce the difficulty of rehabilitation therapy, cut down the manpower input of rehabilitation therapy, and shorten the therapy duration as well.
Methods: This was a clinical comparative study. Twenty patients who underwent stretching therapy in Sichuan Province Orthopedic Hospital from June 2020 to August 2020 were randomly selected to carry out a control study on both lower extremities. The experimental group was given sports rehabilitation bed to assist rehabilitation therapy, while the control group was given conventional bare-handed stretching rehabilitation therapy. The stretching angle, stretching value, and the effective rate of stretching therapy between the two groups to analyze the clinical value of the new sports rehabilitation therapy bed.
Results: The stretching angle in the experimental group when using the sports rehabilitation therapy bed for stretching was lower than the conventional bare-handed stretching in the control group (T<0, P=0.05), with a statistically significant difference; the stretching values of the experimental group were lower than those of the control group(P<0.01), with a statistically significant difference. Moreover, the response rate of stretching therapy in the experimental group was lower than that in the control group(P<0.05), with a statistically significant difference.
Conclusion: Sports rehabilitation therapy beds can results in the advantages of effectively preventing iatrogenic injury in the process of stretching, and providing a more accurate and convenient stretching therapy method than the current commonly used bare-handed stretching for sports rehabilitation and intervention.
doi: https://doi.org/10.12669/pjms.40.6.7871
How to cite this: Yu D, Luo X, Gao P. Clinical efficacy of a new type of Sports Rehabilitation Therapy Bed. Pak J Med Sci. 2024;40(6):1180-1184.  doi: https://doi.org/10.12669/pjms.40.6.7871
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of mortality in acute pulmonary embolism: A systematic review and meta-analysis
Authors: Tang Shanshan , Hu Yanhua
Published: May 2024

Objective: The purpose of this review was to examine the association between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and mortality rates in patients with acute pulmonary embolism (PE).
Methods: PubMed Central, Scopus, Web of Science, and Embase were searched for studies reporting the association between NLR and PLR with mortality up to March 17th 2023. Adjusted ratios were sourced from studies and combined to generate pooled outcomes as odds ratio (OR) in a random-effects model. Risk of bias was assessed using the Newcastle Ottawa Scale.
Results: Fifteen studies were included. Meta-analysis showed that NLR was a significant predictor of mortality in patients with PE (OR: 1.42 95% CI: 1.26, 1.61 I2=92%). Results were unchanged on sensitivity analysis and subgroup analysis based on study location, method of diagnosis, sample size, overall mortality rates, cut-offs, and follow-up. Pooled analysis failed to demonstrate PLR as a predictor of mortality in patients with PE (OR: 1.00 95% CI: 1.00, 1.01 I2=57%). Results were unchanged on sensitivity analysis and subgroup analysis based on study location, diagnosis of PE, overall mortality rates, and cut-off.
Conclusion: Current evidence from retrospective studies shows that NLR can independently predict mortality in acute PE. Data on PLR was limited and failed to indicate an independent role in the prognosis of PE patients.
Registration No. PROSPERO (CRD42023407573).
doi: https://doi.org/10.12669/pjms.40.6.8802
How to cite this: Tang S, Hu Y. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of mortality in acute pulmonary embolism: A systematic review and meta-analysis. Pak J Med Sci. 2024;40(6):1274-1279. doi: https://doi.org/10.12669/pjms.40.6.8802
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
A Note on Hobbes’s Thucydides
Authors: Demetriou Kyriakos
Published: May 2024

The aim of this paper is to examine Hobbes’s translation of Thucydides in the post-renaissance philological context and show that it surpasses other existing texts in its syntactical and morphological adherence to the original Greek text. Through this examination, Thomas Hobbes’s understudied Greek scholarship will shine in crystal clear clarity. Furthermore, it is proposed that the similarities between the two authors stem primarily from their shared viewpoint on political matters and human psychology, rather than from Thucydides having a decisive impact on Hobbes.
The role of school leadership in relation to conflict management at school:
Authors: Manolis Kyriakos
Published: May 2024

The role of the manager is decisive in terms of the effective or non-effective management of conflicts, as through the techniques he chooses to use and many times through the leadership style he chooses to apply, he will influence the attitudes and perceptions of teachers towards disagreements and consequent conflicts.
Jerusalem and Athens against Rome Leo Strauss’ critique of Edmund Burke’s political logic
Authors: Christias Panagiotis
Published: May 2024

Leo Strauss never stopped questioning the three great Western traditions. The first was Judaism and the paradox of understanding it in the orthodox way in the modern era. His writings on Moses Maimonides are an attempt to present a coherent version of what he called “moderate Enlightenment”, an intellectual world where Moses and the prophets could be heard and understood for their reason. The second was an immoderate attachment to Plato and Platonism. In Philosophie und Gesetz (1935) he asserts that all great medieval philosophers of Judaism and Islam were platonicians. Strauss establishes a kind of alliance between the Ancients and the Medieval, forged around the profound harmony between Plato and Moses. The third tradition concerns his critique on “radical Enlightenment” and historicism, whose existential translation would be the assimilation of the Jewish people to the West (Die Religionskritik Spinozas, 1930). In his Natural Law and History (1950), he considers Edmund Burke to be the true father of the “historical school”, that lead to Hegelian radical historicism. He sides then with Plato and the Ancients forming an alliance against Cicero, Burke, and Modern political philosophy that defended the historical provenance of the Law. Athens and Jerusalem against Rome is the battle around the fundamental understanding of the Law, its origin and structure.
Book Review The City and the Philosopher:
Authors: Bifis George
Published: May 2024

The objective of The City and the Philosopher: Leo Strauss revisits Plato by Despina Vertzagia – the title counterpoints one of Leo Strauss’s most well-known works that focuses inter alia on Plato, i.e. The City and the Man – is twofold. At first, to familiarize the reader with the thought of Leo Strauss, which is crystallized into – and defined by – three core-issues: a. the conflict between antiquity – or, pre-modern thought in general – and modernity, b. the theologico-political predicament, and c. the distinction between esoteric and exoteric writing. This exposition serves the purpose of convincing the reader about the importance of Strauss as a political philosopher and also, as Vertzagia mentions in the preface, of clearing the mist that surrounds the effect Strauss had on the contemporary political arena in the U.S. The verdict the author arrives to is reached not in the form of any blatant exoneration, but as the fruit of a laborious study of the work of Strauss.