bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of design parameters on the dynamic performance, in-cylinder pressure and electrical power generation of a free piston linear engine
Authors: Hung Nguyen Ba , Lim Ocktaeck
Published: January 2024

Operation of a free piston linear engine is modeled based on the combination of three mathematical models, including a piston dynamic model, a linear alternator model and a thermodynamic model. The simulated in-cylinder pressure, piston velocity, and electric power output are compared with the corresponding experimental results to validate the models mentioned above. The influences of the design parameters, including cylinder dimension ( Le), number of coil turns ( N), and air gap ( g) between the translator and stator, on the dynamic performance, in-cylinder pressure and electric power generation of the free piston linear engine are studied. The study results show that the reduction of Le has a benefit for improving the piston dynamic performance and output electric power, however it also reduced the cylinder pressure. The increase of number of coil turns N results in the reduction of the peak piston velocity, displacement, acceleration, and pressure in the cylinder, however, it increases the output electric power of the free piston linear engine. The peak piston velocity, displacement, acceleration, and pressure in the cylinder are considerably decreased when g is reduced. However, the reduction of g has a benefit to improve the output electric power of the free piston linear engine. The energy conversion efficiency can be maximized when g and Le are reduced, and N is increased.
Novel air duct designs to estimate the windshield demisting issue for a commercial vehicle
Authors: Akgunlu Safak , Özcan Onur , Bacak Aykut , Gonul Alisan , Taner Tolga , Dalkilic Ahmet Selim
Published: January 2024

This study is about the fog on the windshields of passenger buses because it makes it hard for drivers to see, which is dangerous. The goal of the research is to come up with an effective way to spread the produced mist. According to the study, the air duct design, which is connected to the car’s defroster and defrosting system by Kraft hoses, has to be upgraded. The analysis identifies areas in which the current air duct design might be enhanced and then makes design modifications to create a superior design. By conducting climatic chamber experiments on a vehicle equipped with the first air duct design and tracking the actual air velocity values at the nozzle tips, the success of the new technique is assessed. The boundary conditions for the analysis are the observed values. The study involves the utilization of a commercially available software package to conduct investigations on both the original and modified air duct designs. The software package employs a k-ε turbulence model that is known to produce reliable results. The data demonstrate that the adjustments made in light of the comparison produced beneficial effects. The maximum air velocities were increased by 23%, while the pressure loss values of the left and right fans were reduced by 2.5% and 2.9%, respectively, due to the modification of the air duct. Significant energy was saved because of the decrease in fan pressure loss, which led to decreases in the power consumption of the left and right fans of 4.2% and 4.7%, respectively. This comparison shows that the newly built air ducts actually increased the flow rate at the system’s fan outlets by 40%.
The effect of melatonin on capecitabine-induced hepatic and renal toxicity in rats
Authors: Tavakoli Pirzaman Ali , Mansoori Razieh , Hosseini Seyed Mohammad , Abolhosseini Ali , Khosravi Sahar , Moghadamnia Ali Akbar , Kazemi Sohrab
Published: January 2024

Background

Capecitabine (CAPE), an antimetabolite chemotherapy, can induce hepatic and renal toxicity. Melatonin (MEL), a neurohormone, possesses antioxidant, anti-apoptotic and anti-inflammatory effects. This study investigated the impact of MEL on capecitabine-induced hepatic and renal toxicity.

Methods and materials

Twenty-five male Wistar rats were categorized into five groups for the study. The groups included a control group, MEL10 group (rats receiving daily intraperitoneal injections of 5 mg/kg MEL), CAPE 500 group (rats receiving weekly intraperitoneal injections of 500 mg/kg CAPE), CAPE + MEL five group, and CAPE + MEL 10 group. All groups were treated for a duration of 6 weeks. Various hematological, serological, biochemical, and histopathological assessments were conducted to evaluate the objective of the study.

Results

The administration of CAPE led to significant liver and kidney toxicity, as evidenced by elevated levels of malondialdehyde (MDA), myeloperoxidase (MPO), nitric oxide (NO), as well as serological markers including AST, ALT, ALP, BUN, and creatinine. CAPE exposure also resulted in a reduction in total antioxidant capacity (TAC) and glutathione peroxidase (GPx) levels. Histological examination revealed hyperemia in both liver and kidney tissues exposed to CAPE. However, treatment with MEL demonstrated positive effects. MEL administration alleviated oxidative stress, reduced levels of liver enzymes, BUN, and creatinine, and ameliorated histopathological degenerations. MEL also increased GPx and TAC levels. Moreover, MEL treatment aided in restoring the body weight that was lost due to CAPE exposure.

Conclusion

Our findings indicated that the administration of MEL in rats significantly reduced the hepatic and renal toxicity induced by CAPE.
Looking Inward, Looking Forward: Articulating Alternatives to the Current Education System for Adivasis, by Adivasis
Authors: Jayakumar Chinmayi , Sankaran Suganya , Gangadharan P.
Published: January 2024

This article explores the conceptualisation of alternative education based on the lived realities of marginalised indigenous communities. By amplifying the voices of the Bettakurumba, Kattunayakan, Mullakurumba and Paniya communities, the article explores their vision for an alternative education system that promotes equality and justice, and the implications of such an alternative to the larger discourses on alternative education. The study foregrounds the lived experiences and perspectives of community members, utilising qualitative data gathered from focus group discussions and workshops involving 165 participants. The participants demand for an education that enables their children to navigate both their traditional environments and the modern world, fostering knowledge, dignity, character and contentment. Recognising that schools alone are inadequate, the article suggests reclaiming the village as a learning space and strengthening leadership within these communities. Furthermore, it outlines specific educational practices that can facilitate the development of a culturally relevant education system for Adivasi children.
Novel immobilization method of Lactiplantibacillus plantarum in grains for dry food products
Authors: Karwowski Marilia Silva Malvezzi , Sayuri Kassuia Yasmine , Turchenski Daniela Góes , Aust Ana Carolina Camargo de Oliveira , Macedo Renata Ernlund Freitas de
Published: January 2024

This study aimed to assess the potential use of grains (amaranth, millet, and quinoa) as immobilizing matrices on the metabolic activity of Lactiplantibacillus plantarum and evaluate the viability of the probiotic immobilized in millet during simulated oro-gastrointestinal digestion (OGI) and storage. Firstly, different grains, sterilization and immobilization times were assessed. Secondly, Lp. plantarum was immobilized in millet and its viability and metabolic activity were assessed during non-refrigerated long-term storage and OGI. Metabolic activity was higher with 15 min. of grain sterilization and 72 h of immobilization. Lp. plantarum in millet showed the highest count. Millet grains were able to maintain the high population (>7 log CFU/g) and the metabolic activity of Lp. plantarum during up to 150 d of storage and conferred a protective effect on entrapped probiotic cells during OGI. Millet is a promising immobilizing matrix for the addition of probiotics in dry food products.
Impact of Distractors on Sustained Attention and Inhibition in Children With ADHD
Authors: Rivella Carlotta , Bazzurro Alice , Olla Valeria , Potente Cristina , Vio Claudio , Viterbori Paola , Usai Maria Carmen
Published: January 2024

Objective:

This study examines the impact of visual and auditory distractors on attention and inhibition in children with and without ADHD.

Method:

The study used the MOXO d-CPT child version. The sample consisted of 208 children aged 8 to 12 years, including 64 with ADHD and 144 controls.

Results:

Children with ADHD and controls differed in their reaction to distracting stimuli; visual distractors cause a higher decrease in sustained attention and inhibitory control in the ADHD group. Moreover, auditory distractors generate improved performance in the control group but not in the ADHD group. In addition, age-related effects were found in both sustained attention and inhibitory control in all children, regardless of whether the ADHD condition was present.

Conclusions:

The findings indicate that children with ADHD performed poorer compared to controls, and that distractors differently affected the performance of the two groups.
Mullerian Serous Cystadenoma Occurring in the Scrotum Post-Orchidopexy: A Rarely Reported Yet Distinctive Entity
Authors: Champion Benjamin , Foo Tiffany , Kikiros Colin , Charles Adrian
Published: January 2024

Serous cystadenoma is a rare lesion in the para-testicular tissue, with even rarer reports of this entity occurring in the scrotum post-orchidopexy. We present such an occurrence, adding support for its existence as a distinct entity.
A new modelling method for open cell foam structure based on centroidal and capacity constraint power diagram
Authors: Zhou Xin , Yang Jian , Shen Liangliang , Xie Ximing , Tang Jianbo , Zhao Gang , Feng Peifeng , Li Shuxin , Chen Zhenyao , Lai Nai Yeen Gavin , Xu Jian
Published: January 2024

To efficiently establish a finite element model that is highly compatible with the intricate microstructure of foam materials, this study carries out simulation and experimental investigations into open cell foams and explores their compression behavior assuming isotropy. Using an in-house algorithm, we optimize the traditional power diagram model, which is widely used in foam finite element simulation. Specifically, a parameterized geometric foam model is developed based on the centroidal and capacity constrained power diagram (CCCPD), which accurately reflects the internal meso-structure of foam materials. The optimized foam model can restore the typical deformation process of foams under compressive load, thus addressing the limitations of existing foam models. The accuracy of the optimized model is validated by conducting uniaxial Quasi-static compression experiments on foamed thermoplastic polyurethane (TPU) material and comparing the experimental results of the 3D printing model with the simulation results of the optimized model. The improved foam model serves as a basis for future research on open cell foam materials.
Improving transmission loss performance of aluminum extrusion in railway vehicles using lightweight material
Authors: Noh Hee-Min
Published: January 2024

This study developed a method for improving the transmission loss performance of aluminum extrusion by reinforcing the inner space of the extruded material with a lightweight material, such as acrylic plastic. First, the dynamic characteristics of the aluminum extrusion were analyzed, and the characteristics of noise transmission were evaluated through an acoustic mode analysis of the air layer for the inner space of the extruded material. Furthermore, to improve the transmission loss performance of the aluminum extrusion, methods were developed for increasing the vibration stiffness and altering the acoustic mode of the inner space. Additionally, a simulation analysis of the vibration mode and a response analysis based on the excitation of sound were performed to validate the proposed model; the effectiveness of the model for noise and vibration reduction was compared with that of the existing model. This analysis was conducted using models wherein the acrylic plastic was partially and totally inserted into the interior space of aluminum extrusion. The results indicated that the noise performance of the short reinforcement model with the partially inserted acrylic plastic was improved by 3 dB and that of the long reinforcement model with the totally inserted acrylic plastic was degraded by > 4 dB compared with the existing aluminum panel.
Going beyond creativity: Primary headteachers as social intrapreneurs?
Authors: Beresford-Dey Marie , Ingram Richard , Lakin Liz
Published: January 2024

This article presents the details and findings of a mixed-methods study that explored Scottish primary sector headteachers’ enactment of creativity through a Complexity Leadership Theory lens. Although policymakers emphasise the importance of headteachers and their impact on school improvement, there is a growing need for headteachers to enact and effectively nurture school-wide creativity if they are to overcome complex challenges brought about by today's political, social and economic environments. In response to the research question ‘To what extent do primary headteachers perceive their role as being creative?’, this article reports on 23 surveys and 11 semi-structured interviews undertaken as part of a larger study. Whilst our findings suggest that creativity is enacted to some extent by the headteachers, the evidence goes beyond this and identifies social intrapreneurship emerging. The concept of social intrapreneurship within education appears to be unique to this study. We identify social intrapreneurs as individuals who demonstrate creativity, resourcefulness, collaboration and determination and are growth-oriented within bureaucratic constraints. We conclude by discussing how social intrapreneurship is a valuable concept for headteachers and policymakers alike.
Statistical Packages and Algorithms for the Analysis of Continuous Glucose Monitoring Data: A Systematic Review
Authors: Olsen Mikkel Thor , Klarskov Carina Kirstine , Dungu Arnold Matovu , Hansen Katrine Bagge , Pedersen-Bjergaard Ulrik , Kristensen Peter Lommer
Published: January 2024

Background:

Continuous glucose monitoring (CGM) measures glucose levels every 1 to 15 minutes and is widely used in clinical and research contexts. Statistical packages and algorithms reduce the time-consuming and error-prone process of manually calculating CGM metrics and contribute to standardizing CGM metrics defined by international consensus. The aim of this systematic review is to summarize existing data on (1) statistical packages for retrospective CGM data analysis and (2) statistical algorithms for retrospective CGM analysis not available in these statistical packages.

Methods:

A systematic literature search in PubMed and EMBASE was conducted on September 19, 2023. We also searched Google Scholar and Google Search until October 12, 2023 as sources of gray literature and performed reference checks of the included literature. Articles in English and Danish were included. This systematic review is registered with PROSPERO (CRD42022378163).

Results:

A total of 8731 references were screened and 46 references were included. We identified 23 statistical packages for the analysis of CGM data. The statistical packages could calculate many metrics of the 2022 CGM consensus and non-consensus CGM metrics, and 22/23 (96%) statistical packages were freely available. Also, 23 statistical algorithms were identified. The statistical algorithms could be divided into three groups based on content: (1) CGM data reduction (eg, clustering of CGM data), (2) composite CGM outcomes, and (3) other CGM metrics.

Conclusion:

This systematic review provides detailed tabular and textual up-to-date descriptions of the contents of statistical packages and statistical algorithms for retrospective analysis of CGM data.
Effect of Human Capital and Information Capital Readiness on Business Sustainability: Do Market Orientation and Business Performance Matter?
Authors: Tjahjadi Bambang , Soewarno Noorlailie , Anwar Dewi Nabilah , Fairuzi Atika
Published: January 2024

COVID-19 pandemic has been threatening the sustainability of companies in Indonesia. Various policies and restrictions have caused a significant decline in sales and led to bankruptcy. As the major players in the national economy, the micro, small, medium enterprises (MSMEs) are encouraged to focus on their survival and sustainability. Survey method is done to examine the direct effect of human capital readiness and information capital readiness on business sustainability. It investigates whether the relationship is sequentially mediated by market orientation and business performance. Online questionnaires were distributed to 347 owners/managers of Indonesian manufacturing MSMEs in the East Java Province, Indonesia. PLS-SEM equation modeling was employed to test the hypotheses. Result shows that human capital readiness and information capital readiness positively affect business sustainability, and business performance does not mediate the effect of human capital readiness on business sustainability. Most important finding reveals that market orientation and business performance sequentially mediate the human capital readiness-business sustainability relationship. Market orientation and business performance sequentially mediate information capital readiness-business sustainability relationship. This study contributes to the development of resource-based view (RBV) by providing the empirical result on the important internal resources on sustainability. This brings practical awareness to the owners/managers of Indonesian MSMEs on increasing their market orientation to enhance their business performance and to guarantee their business sustainability. Practically, this research has important implications for achieving business sustainability as it offers a way for practitioners to improve business sustainability by utilizing human capital readiness, information capital readiness, market orientation, and business performance.
Corporate Social Responsibility and COVID-19: Doing Good and Doing Well
Authors: Jung SoYeon
Published: January 2024

Since the first case was reported in December 2019, COVID-19 has dramatically disrupted the globe, severely impacting physical and mental health worldwide as well as creating one of the worst economic crises since World War II. Among other industries, the hospitality industry was one of the most severely impacted by the pandemic. Due to the unprecedented economic downturn caused by the nationwide lockdowns and social distancing measures, millions of hospitality employees lost their jobs, and the value of stocks in the hotel, restaurant, casino, airline, and cruise industries plunged sharply. However, despite the severe and challenging economic circumstances, numerous hospitality companies spontaneously initiated a variety of corporate social responsibility (CSR) efforts to help cope with the spread of the COVID-19 pandemic, such as donations to communities and support for employees. Therefore, the objective of this case study is to explore various CSR practices that hospitality companies employed to support their people and communities. The current case study provides unique contributions not only to hospitality literature but also to CSR literature in a timely manner, considering the pandemic as a pivotal point in human history when hospitality companies can provide such beneficial impact to society. This study additionally presents vital insights to hospitality executives in charge of CSR initiatives.
The Popularity Gap: Effects of Social Status on the Visibility of Lifestyle Sports Stars on Instagram
Authors: Woods Joshua , Oldham Leah , House-Niamke Stephanie , Hartwell Matthew
Published: January 2024

Social media provides athletes with opportunities to enhance their personal brands, engage with fans, and access professional opportunities. Several studies have examined how athletes use social media to attract and engage large audiences. Less is known about the social forces that enable and constrain their popularity. Drawing on expectation states theory, this study considers how athletes’ social status affects their follower counts and engagement rates on Instagram. Based on a content analysis of 6240 images posted on Instagram by 112 professional disc golfers, we show that the gender, sport dominance, and physical attractiveness of athletes affect their popularity, controlling for their strategic efforts to self-brand. These findings offer new insight into the ongoing debate over social media’s impact on long-standing inequalities in the media-sport industry.
When are peacekeepers “green?”
Authors: Böhmelt Tobias
Published: January 2024

Although the focus of United Nations (UN) peacekeeping operations (PKOs) remains peace and security, missions may also have an environmental orientation. Such an emphasis is usually based on environmental goals and activities in operation mandates or deployed units on the ground dedicated to environmental matters. A “green” mission orientation can strengthen peacekeepers’ commitment to environmental protection and help promote environmental quality in host countries. However, little is known about what leads to an environmental mission orientation in the first place. This research contributes to addressing this question as I analyze the mission orientation of African PKOs since 1991. Consistent with the general rationale that interventions tend to strategically select themselves into the more difficult cases, I report evidence that peacekeepers are more likely to have a green orientation when host countries are more exposed to climate change and environmental stress. The analysis is complemented by a short qualitative study of UN peacekeeping in Somalia.
Is Early Onset of Nonmedical Prescription Stimulant Use Associated With Cocaine Use During Adolescence? Results From a National Study
Authors: McCabe Sean Esteban , Schepis Ty S. , Schulenberg John E. , Wilens Timothy E. , Veliz Philip T.
Published: January 2024

Background:

To examine the associations between early onset of nonmedical prescription stimulant use (NPSU) and cocaine use.

Methods:

Nationally representative samples of high school seniors were surveyed annually. Data were collected via self-administered questionnaires in nationally representative public and private schools in the United States (1976-2020) as part of the Monitoring the Future Study. The sample consisted of 45 cohorts of 12th grade students (N = 121 909). The main outcome was lifetime, past-year, and past-month cocaine use.

Results:

An estimated one in every 10 (10.1%) individuals reported lifetime NPSU while 8.5% reported any cocaine use. The vast majority of youth (87.2%) initiated NPSU before cocaine among those who reported both substances. Cocaine use was most prevalent among youth who reported early onset of NPSU in 8th grade or earlier (51.7%) followed by those who reported later onset of NPSU in 12th grade (24.7%), and those who never initiated NPSU (3.7%). Binary logistic regression analysis indicated that early onset of NPSU had greater adjusted odds of cocaine use compared to those with later onset of NPSU or those who never reported NPSU. Moreover, the adjusted odds of cocaine use were higher for adolescents who initiated NPSU before or after medical use of prescription stimulants compared to those with no history of medical use or NPSU. Similar results were found for lifetime, past-year, and past-month cocaine use as a function of NPSU onset; this association was stronger among more recent cohorts.

Conclusions:

Early onset of NPSU appears to be a signal of increased risk of cocaine use among US adolescents. NPSU should be included in screening and early prevention strategies among secondary school students. Health professionals, school officials, and families are encouraged to monitor youth for NPSU based on the increased risk of later cocaine use and related consequences.
CRISPR/Cas9 deletion of MIR155HG in human T cells reduces incidence and severity of acute GVHD in a xenogeneic model
Authors: Neidemire-Colley Lotus , Khanal Shrijan , Braunreiter Kara M. , Gao Yandi , Kumar Rathan , Snyder Katiri J. , Weber Margot A. , Surana Simran , Toirov Olimjon , Karunasiri Malith , Duszynski Molly E. , Chi Mengna , Malik Punam , Kalyan Sonu , Chan Wing K. , Naeimi Kararoudi Meisam , Choe Hannah K. , Garzon Ramiro , Ranganathan Parvathi
Published: January 2024

Acute graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic cell transplantation (allo-HCT). Using preclinical mouse models of disease, previous work in our laboratory has linked microRNA-155 (miR-155) to the development of acute GVHD. Transplantation of donor T cells from miR-155 host gene (MIR155HG) knockout mice prevented acute GVHD in multiple murine models of disease while maintaining critical graft-versus-leukemia (GVL) response, necessary for relapse prevention. In this study, we used clustered, regularly interspaced, short palindromic repeats (CRISPR)/Cas9 genome editing to delete miR-155 in primary T cells (MIR155HGΔexon3) from human donors, resulting in stable and sustained reduction in expression of miR-155. Using the xenogeneic model of acute GVHD, we show that NOD/SCID/IL2rγnull (NSG) mice receiving MIR155HGΔexon3 human T cells provide protection from lethal acute GVHD compared with mice that received human T cells with intact miR-155. MIR155HGΔexon3 human T cells persist in the recipients displaying decreased proliferation potential, reduced pathogenic T helper–1 cell population, and infiltration into GVHD target organs, such as the liver and skin. Importantly, MIR155HGΔexon3 human T cells retain GVL response significantly improving survival in an in vivo model of xeno-GVL. Altogether, we show that CRISPR/Cas9–mediated deletion of MIR155HG in primary human donor T cells is an innovative approach to generate allogeneic donor T cells that provide protection from lethal GVHD while maintaining robust antileukemic response.
In vivo measurement of RBC survival in patients with sickle cell disease before or after hematopoietic stem cell transplantation
Authors: Leonard Alexis K. , Furstenau Dana , Inam Zaina , Luckett Christina , Chu Rebecca , Demirci Selami , Essawi Khaled , Gudmundsdottir Bjorg , Hinds Malikiya , DiNicola Julia , Li Quan , Eaton William A. , Cellmer Troy , Wang Xunde , Thein Swee Lay , Macari Elizabeth R. , VanNest Sara , Hsieh Matthew M. , Bonner Melissa , Pierciey Francis J. , Tisdale John F.
Published: January 2024

Stable, mixed-donor–recipient chimerism after allogeneic hematopoietic stem cell transplantation (HSCT) for patients with sickle cell disease (SCD) is sufficient for phenotypic disease reversal, and results from differences in donor/recipient–red blood cell (RBC) survival. Understanding variability and predictors of RBC survival among patients with SCD before and after HSCT is critical for gene therapy research which seeks to generate sufficient corrected hemoglobin to reduce polymerization thereby overcoming the red cell pathology of SCD. This study used biotin labeling of RBCs to determine the lifespan of RBCs in patients with SCD compared with patients who have successfully undergone curative HSCT, participants with sickle cell trait (HbAS), and healthy (HbAA) donors. Twenty participants were included in the analysis (SCD pre-HSCT: N = 6, SCD post-HSCT: N = 5, HbAS: N = 6, and HbAA: N = 3). The average RBC lifespan was significantly shorter for participants with SCD pre-HSCT (64.1 days; range, 35-91) compared with those with SCD post-HSCT (113.4 days; range, 105-119), HbAS (126.0 days; range, 119-147), and HbAA (123.7 days; range, 91-147) (P<.001). RBC lifespan correlated with various hematologic parameters and strongly correlated with the average final fraction of sickled RBCs after deoxygenation (P<.001). No adverse events were attributable to the use of biotin and related procedures. Biotin labeling of RBCs is a safe and feasible methodology to evaluate RBC survival in patients with SCD before and after HSCT. Understanding differences in RBC survival may ultimately guide gene therapy protocols to determine hemoglobin composition required to reverse the SCD phenotype as it relates directly to RBC survival. This trial was registered at www.clinicaltrials.gov as #NCT04476277.
Transfusion needs after CAR T-cell therapy for large B-cell lymphoma: predictive factors and outcome (a DESCAR-T study)
Authors: Vic Samuel , Thibert Jean-Baptiste , Bachy Emmanuel , Cartron Guillaume , Gastinne Thomas , Morschhauser Franck , Le Bras Fabien , Bouabdallah Kamal , Despas Fabien , Bay Jacques-Olivier , Rubio Marie-Thérèse , Mohty Mohamad , Casasnovas Olivier , Choquet Sylvain , Castilla-Llorente Cristina , Guidez Stéphanie , Loschi Michaël , Guffroy Blandine , Carras Sylvain , Drieu La Rochelle Laurianne , Guillet Mathilde , Houot Roch
Published: January 2024

Chimeric antigen receptor (CAR) T-cells targeting CD19 have been approved for the treatment of relapse/refractory large B-cell lymphoma. Hematotoxicity is the most frequent CAR T-cell–related adverse event. Transfusion support is a surrogate marker of severe cytopenias. Transfusion affects patients’ quality of life, presents specific toxicities, and is known to affect immunity through the so-called transfusion-related immunomodulation that may affect CAR T-cell efficacy. We analyzed data from 671 patients from the French DESCAR-T registry for whom exhaustive transfusion data were available. Overall, 401 (59.8%) and 378 (56.3%) patients received transfusion in the 6-month period before and after CAR T-cell infusion, respectively. The number of patients receiving transfusion and the mean number of transfused products increased during the 6-month period before CAR T-cell infusion, peaked during the first month after infusion (early phase), and decreased over time. Predictive factors for transfusion at the early phase were age >60 years, ECOG PS ≥2, treatment with axicabtagene ciloleucel, pre–CAR T-cell transfusions, and CAR-HEMATOTOX score ≥2. Predictive factors for late transfusion (between 1 and 6 months after infusion) were pre–CAR T-cell transfusions, CAR-HEMATOTOX score ≥2, ICANS ≥3 (for red blood cells [RBC] transfusion), and tocilizumab use (for platelets transfusion). Early transfusions and late platelets (but not RBC) transfusions were associated with a shorter progression-free survival and overall survival. Lymphoma-related mortality and nonrelapse mortality were both increased in the transfused population. Our data shed light on the mechanisms of early and late cytopenia and on the potential impact of transfusions on CAR T-cell efficacy and toxicity.
The efficacy of adipose-derived stem cells in burn injuries: a systematic review
Authors: Kohlhauser Michael , Tuca Alexandru , Kamolz Lars-Peter
Published: January 2024

Background

Burn injuries can be associated with prolonged healing, infection, a substantial inflammatory response, extensive scarring, and eventually death. In recent decades, both the mortality rates and long-term survival of severe burn victims have improved significantly, and burn care research has increasingly focused on a better quality of life post-trauma. However, delayed healing, infection, pain and extensive scar formation remain a major challenge in the treatment of burns. ADSCs, a distinct type of mesenchymal stem cells, have been shown to improve the healing process. The aim of this review is to evaluate the efficacy of ADSCs in the treatment of burn injuries.

Methods

A systematic review of the literature was conducted using the electronic databases PubMed, Web of Science and Embase. The basic research question was formulated with the PICO framework, whereby the usage of ADSCs in the treatment of burns in vivo was determined as the fundamental inclusion criterion. Additionally, pertinent journals focusing on burns and their treatment were screened manually for eligible studies. The review was registered in PROSPERO and reported according to the PRISMA statement.

Results

Of the 599 publications screened, 21 were considered relevant to the key question and were included in the present review. The included studies were almost all conducted on rodents, with one exception, where pigs were investigated. 13 of the studies examined the treatment of full-thickness and eight of deep partial-thickness burn injuries. 57,1 percent of the relevant studies have demonstrated that ADSCs exhibit immunomodulatory effects during the inflammatory response. 16 studies have shown improved neovascularisation with the use of ADSCs. 14 studies report positive influences of ADSCs on granulation tissue formation, while 11 studies highlight their efficacy in promoting re-epithelialisation. 11 trials demonstrated an improvement in outcomes during the remodelling phase.

Conclusion

In conclusion, it appears that adipose-derived stem cells demonstrate remarkable efficacy in the field of regenerative medicine. However, the usage of ADSCs in the treatment of burns is still at an early experimental stage, and further investigations are required in order to examine the potential usage of ADSCs in future clinical burn care.
Agronomic and phenotypic plant traits as indicators for environmental risks of genetically modified plants
Authors: Marion Dolezel , Marianne Miklau , Andreas Heissenberger , Mathias Otto
Published: January 2024

Background

For market approval of genetically modified plants (GMPs), the evaluation of agronomic and phenotypic plant traits is a standard requirement and part of the comparative assessment of the GMP and its conventional counterpart. This comparative assessment is a starting point for environmental risk assessment (ERA) and should inform all areas of risk. We scrutinize frequently used approaches to characterize GMPs in EU market applications and discuss their usefulness for drawing conclusions on risks related to the plant’s ability to survive, persist or become invasive.

Results

Our analysis shows that the agronomic and phenotypic characterization of GMPs, although based on guidelines, is confined to plant traits and test designs that are relevant for the quality control and agronomic performance of genetically modified (GM) crops. We provide evidence of how methodological approaches frequently applied during the agronomic and phenotypic characterization of the GMP could be improved and complemented to better inform on potential phenotypic changes relevant to assessing environmental risks. These approaches refer to (i) the assessment of the survival of GM seeds and plants (e.g., volunteers); (ii) the consideration of environmental exposure and (iii) improved methodological approaches for the assessment of biotic and abiotic stress responses for GMPs.

Conclusions

The comparative assessment of agronomic and phenotypic plant traits currently does not provide suitable data to draw conclusions on environmental risks relating to the persistence and invasiveness of the GMP. Ecologically more realistic assessments should be part of the phenotypic characterization of GMPs and need guidance and decision criteria to be implemented in ERA. This is of considerable importance, as new genomic techniques are expected to increase the diversity and complexity of GM plants and traits, particularly stress tolerance, which may affect the survival of GMPs in the environment.
The rumen-derived Lact. mucosae LLK-XR1 exhibited greater free gossypol degradation capacity during solid-state fermentation of cottonseed meal and probiotic potential
Authors: Lv Liangkang , Xiong Fengliang , Liu Yingyi , Pei Shiteng , He Shanshan , Li Shengli , Yang Hongjian
Published: January 2024

Background

This study aimed to isolate the rumen-derived bacteria with the ability to degrade free gossypol (FG), and to evaluate the probiotic potential in vitro for ensuring safe utilization.

Methods

The strains were anaerobically isolated from fresh rumen fluid of sheep with long-term fed cottonseed meal (CSM) with the screening agar medium containing gossypol as the sole carbon source. Afterwards, the isolated strain incubated with CSM was subjected to the determination of the FG degradation and in vitro evaluation of probiotic characteristics.

Results

The target strain labeled Lact. mucosae LLK-XR1 [Accession number: OQ652016.1] was obtained, and its growth on MRS Liquid medium exhibited degradation efficiency of FG up to 69.5% which was significantly greater than its growth on Man-Rogosa-Sharpe medium with glucose free for 24 h (p < 0.01). Meanwhile, LLK-XR1 showed 40.652% degradation rate of FG for unautoclaved, non-pulverized, and no additional nutrients supplementation CSM. Furthermore, LLK-XR1 presented good survivability at pH 3.0 (above 88.6%), and 0.3% bile (78.5%). LLK-XR1 showed sensitivity to broad-spectrum antibiotics except Sulfamethoxazole, Ciprofloxacin and Gentamycin and significantly inhibited E. coli CICC 10,899, Staph. aureus CICC 21,600, and Salmonella. Typhimurium CICC 21,483. LLK-XR1 demonstrated good cell surface hydrophobicity and auto-aggregation ability.

Conclusions

Taken together, this study for the first time noted that rumen-originated Lact. mucosae LLK-XR1 with probiotic properties exhibited substantial FG degradation capacity when it was applied to the solid-state fermentation of CSM.
The dilemma of the split between theory and reality as experienced by primary healthcare professionals: a mixed methods study of evidence-based practice in a primary care context
Authors: Abelsson Tobias , Karlsson Ann-Kristin , Morténius Helena , Baigi Amir , Bergman Stefan
Published: January 2024

Background

Primary care depends upon a good information flow across professional and structural boundaries to provide the best care for patients. Previous research has mainly focused on Evidence-Based Practice (EBP) within specific professions. Mapping of pan-professional experiences of and attitudes to EBP in publicly funded clinical practice is necessary to deepen the understanding of EBP and its implementation. Thus, this study aimed to investigate healthcare professionals’ experiences of and attitudes towards working in accordance with EBP in primary care.

Methods

The study used a convergent mixed methods design divided into two strands: a quantitative enquiry tool (Evidence-Based Practice Attitude Scale, EBPAS) and a set of qualitative interviews analysed by means of qualitative content analysis. Both strands included all primary care employees with patient interaction in the studied county (n = 625), including doctors, nurses, physiotherapists, psychologists and assistant nurses. Out of the original 625 healthcare professionals, 191 finished the first strand and 8 volunteered for the second strand (2 nurses, 2 physiotherapists, 1 psychiatrist and 3 doctors).

Results

The EBPAS value of 2.8 (max 4) indicated a generally positive attitude towards EBP amongst the population, which was also evident in the interviews. However, there were additional experiences of not having the ability or resources to engage in EBP. This was illustrated by the theme that emerged from the qualitative content analysis: “The dilemma of the split between theory and reality”. Due to the organisational and managerial focus on efficiency rather than quality of care, there were few or no incentives for promoting individual educational or research development.

Conclusions

Although the general attitude towards EBP is positive, experiences of practising it differ. There is a need to increase knowledge of EBP concepts, requirements and implementation in the clinical setting. The absence of opportunities to do research and collegial debate about new ways of finding and implementing research-based evidence results might influence the quality of care.
Convergent and discriminant validity of the Minimal Eating Observation Form – version II: a cross-sectional study
Authors: Westergren Albert , Smithard David , Westergaard Mark , Norup Anne , Riis Johannes , Krarup Anne , Hansen Line Elise Møller , Emborg Christina , Melgaard Dorte
Published: January 2024

Background

The Minimal Eating Observation Form – Version II (MEOF-II) is a brief and easy to use screening tool for eating difficulties, that is psychometrically robust. The aim of this study was to explore convergent (measuring similar constructs) and discriminant (measuring somewhat different constructs) validity of the MEOF-II to other validated dysphagia specific, activity and participation related instruments.

Methods

In this cross-sectional study, participants (n = 100, mean age 72, n = 42 women), diagnosed with either chronic pulmonary disease, Parkinson´s disease, Multiple Sclerosis, or stroke were recruited from rehabilitation centres. Patient-reported outcomes and clinical-rated assessments, capturing eating ability in general and swallowing in specific, included: The Dysphagia Handicap Index (DHI), the 4-question test (4QT), the Minimal Eating Observation Form – II, the Volume – Viscosity Swallow Test (V-VST), Flexible Endoscopic Evaluation of Swallowing (FEES) documented according to the Penetration-Aspiration Scale (PAS). Type of oral intake was documented using the Functional Oral Intake Scale (FOIS). Activities in daily living was assessed with Barthel index (BI). Spearman’s correlation coefficient was used to analyze associations. The MEOF-II total score was hypothesised to have moderate correlations (r ≥ 0.3) with the other assessments, besides with PAS and FOIS (weak correlations, r < 0.3).

Results

In total 78 participants had any type of eating difficulties (MEOF-II), 69 reported dysphagia (4QT), 62 had dysphagia according to V-VST, 29 showed evidence of penetration/aspiration (PAS), and 31 participants had decreased oral intake ability (FOIS). The MEOF-II total score had moderate correlations with DHI, BI, 4QT, V-VST volume, and weak correlations with V-VST dysphagia and viscosity, PAS, and FOIS. Comparing a prior hypothesised correlation strengths against empirical findings showed that 83% of the hypothesised correlations were correct.

Conclusions

The MEOF-II is a holistic and objective screening tool that can indicate the need for further assessment and corresponds well with the persons’ subjective experiences. MEOF-II does not specifically assess the risk for penetration/aspiration.
Prevalence of and risk factors for iron deficiency among pregnant women with moderate or severe anaemia in Nigeria: a cross-sectional study
Authors: Babah Ochuwa Adiketu , Akinajo Opeyemi Rebecca , Beňová Lenka , Hanson Claudia , Abioye Ajibola Ibraheem , Adaramoye Victoria Olawunmi , Adeyemo Titilope A. , Balogun Mobolanle Rasheedat , Banke-Thomas Aduragbemi , Galadanci Hadiza S. , Sam-Agudu Nadia A. , Afolabi Bosede Bukola , Larsson Elin C.
Published: January 2024

Background

Anaemia during pregnancy causes adverse outcomes to the woman and the foetus, including anaemic heart failure, prematurity, and intrauterine growth restriction. Iron deficiency anaemia (IDA) is the leading cause of anaemia and oral iron supplementation during pregnancy is widely recommended. However, little focus is directed to dietary intake. This study estimates the contribution of IDA among pregnant women and examines its risk factors (including dietary) in those with moderate or severe IDA in Lagos and Kano states, Nigeria.

Methods

In this cross-sectional study, 11,582 women were screened for anaemia at 20-32 weeks gestation. The 872 who had moderate or severe anaemia (haemoglobin concentration < 10 g/dL) were included in this study. Iron deficiency was defined as serum ferritin level < 30 ng/mL. We described the sociodemographic and obstetric characteristics of the sample and their self-report of consumption of common food items. We conducted bivariate and multivariable logistic regression analysis to identify risk factors associated with IDA.

Results

Iron deficiency was observed among 41% (95%CI: 38 – 45) of women with moderate or severe anaemia and the prevalence increased with gestational age. The odds for IDA reduces from aOR: 0.36 (95%CI: 0.13 – 0.98) among pregnant women who consume green leafy vegetables every 2-3 weeks, to 0.26 (95%CI: 0.09 – 0.73) among daily consumers, compared to those who do not eat it.

Daily consumption of edible kaolin clay was associated with increased odds of having IDA compared to non-consumption, aOR 9.13 (95%CI: 3.27 – 25.48). Consumption of soybeans three to four times a week was associated with higher odds of IDA compared to non-consumption, aOR: 1.78 (95%CI: 1.12 – 2.82).

Conclusion

About 4 in 10 women with moderate or severe anaemia during pregnancy had IDA. Our study provides evidence for the protective effect of green leafy vegetables against IDA while self-reported consumption of edible kaolin clay and soybeans appeared to increase the odds of having IDA during pregnancy. Health education on diet during pregnancy needs to be strengthened since this could potentially increase awareness and change behaviours that could reduce IDA among pregnant women with moderate or severe anaemia in Nigeria and other countries.
Comprehensive reference intervals for white blood cell counts during pregnancy
Authors: Zhu Jinxiu , Li Zexin , Deng Yuguo , Lan Liting , Yang Jinying
Published: January 2024

Background

White blood cell (WBC) count increases during pregnancy, necessitating reliable reference intervals for assessing infections and pregnancy-related complications. This study aimed to establish comprehensive reference intervals for WBC counts during pregnancy.

Methods

The analysis included 17,737 pregnant women, with weekly WBC count measurements from pre-pregnancy to postpartum. A threshold linear regression model determined reference intervals, while Harris and Boyd’s test partitioned the intervals.

Results

WBC count exhibited a significant increase during pregnancy, characterized by a rapid rise before 7 weeks of gestation, followed by a plateau. Neutrophils primarily drove this increase, showing a similar pattern. The threshold regression model and Harris and Boyd’s test supported partitioned reference intervals for WBC counts: 4.0–10.0 × 10^9/L for < = 2 weeks, 4.7–11.9 × 10^9/L for 3–5 weeks, and 5.7–14.4 × 10^9/L for > = 6 weeks of gestation. These reference intervals identified pregnant women with high WBC counts, who had a higher incidence of pregnancy-related complications including placenta previa, oligohydramnios, secondary uterine inertia, and intrauterine growth restriction.

Conclusion

This study establishes comprehensive reference intervals for WBC counts during pregnancy. Monitoring WBC counts is clinically relevant, as elevated levels are associated with an increased risk of infection and pregnancy-related complications.
The protocol of Enhanced Recovery After Cardiac Surgery (ERACS) in congenital heart disease: a stepped wedge cluster randomized trial
Authors: Dou Dou , Jia Yuan , Yuan Su , Wang Yang , Li Yinan , Wang Hongbai , Ding Jie , Wu Xie , Bie Dongyun , Liu Qiao , An Ran , Yan Haoqi , Yan Fuxia
Published: January 2024

Background

The Enhanced Recovery After Cardiac Surgery (ERACS) programs are comprehensive multidisciplinary interventions to improve patients’ recovery. The application of the ERAS principle in pediatric patients has not been identified completely.

Methods

This study is a multicenter, stepwise design, cluster randomized controlled trial. 3030 patients presenting during control and intervention periods are eligible if they are aged from 28 days to 6 years old and awaiting elective correction surgery of congenital heart disease with cardiopulmonary bypass. 5 centers are randomly assigned to staggered start dates for one-way crossover from the control phase to the intervention phase. In the intervention periods, patients will receive a bundle strategy including preoperative, intraoperative, and postoperative approaches. During the control phase, patients receive the usual care. The primary outcome consists of major adverse cardiac and cerebrovascular events (MACCEs), postoperative pulmonary complications (PPCs), and acute kidney injury (AKI).

Discussion

This study aims to explore whether the bundle of ERAS measurements could improve patients’ recovery in congenital heart surgery.

Trial registration

http://www.clinicaltrials.gov. (NCT05914103).