bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety of propofol-assisted deep extubation in the dental treatment of children—a retrospective, observational study
Authors: Zhang Xiang , Wang Xiao-Dong , Cui Wei , Gao Shun-Cai , Yang Xu-Dong , Xia Bin
Published: July 2024

Purpose

Awake extubation and deep extubation are commonly used anesthesia techniques. In this study, the safety of propofol-assisted deep extubation in the dental treatment of children was assessed.

Materials and methods

Children with severe caries who received dental treatment under general anesthesia and deep extubation between January 2017 and June 2023 were included in this study. Data were collected on the following variables: details and time of anesthesia, perioperative vital signs, and incidence of postoperative complications. The incidence of laryngeal spasm (LS) was considered to be the primary observation indicator.

Results

The perioperative data obtained from 195 children undergoing dental treatment was reviewed. The median age was 4.2 years (range: 2.3 to 9.6 years), and the average duration of anesthesia was 2.56 h (range 1 to 4.5 h). During intubation with a videoscope, purulent mucus was found in the pharyngeal cavity of seven children (3.6%); LS occurred in five of them (2.6%), and one child developed a fever (T = 37.8 °C) after discharge. Five children (2.6%) experienced emergence agitation (EA) in the recovery room. Also, 13 children (6.7%) experienced epistaxis; 10 had a mild experience and three had a moderate experience. No cases of airway obstruction (AO) and hypoxemia were recorded. The time to open eyes (TOE) was 16.3 ± 7.2 min. The incidence rate of complications was 23/195 (11.8%). Emergency tracheal reintubation was not required. Patients with mild upper respiratory tract infections showed a significantly higher incidence of complications (P < 0.001).

Conclusions

Propofol-assisted deep extubation is a suitable technique that can be used for pediatric patients who exhibited non-cooperation in the outpatient setting. Epistaxis represents the most frequently encountered complication. Preoperative upper respiratory tract infection significantly increases the risk of complications. The occurrence of EA was notably lower than reported in other studies.
“How difficult it is to change dietary behaviour” experience of older people with sarcopenic obesity: a qualitative study
Authors: Yin Yue-Heng , Liu Justina Yat Wa , Välimäki Maritta
Published: July 2024

Background

Dietary intervention is an important method to manage sarcopenic obesity, but the implementation in real world is difficult to achieve an ideal condition. This study aimed to the experiences of older people with sarcopenic obesity during the implementation of dietary behavioural change (DBC) intervention.

Methods

This study is a semi-structured individual interview embedded within a pilot randomized controlled trial on community-dwelling older people with sarcopenic obesity. Purposive sampling was applied to invite 21 participants who had received a 15-week DBC intervention. The interviews were audio-recorded and transcribed verbatim. Content analysis was performed to analyze the data.

Results

The themes for facilitators included: (a) Attach importance to self’s health; (b) Family’s support; (c) Concern self’s body shape; (d) Instructor’s support; (e) Regular food diary taken. The themes for barriers included: (a) Difficulties of taking food diary; (b) Difficulties of calculating the food amount; (c) Yield to offspring’s appetite; (d) Misjudging self’s or family’s appetite.

Conclusion

Support from family members and instructor, caring about self’s health and body image facilitated the intervention implementation. The complication of food amount estimation and diary record, personal sacrifice for next generations, and previous living experience were barriers for implementing the intervention. Overall, the older people with sarcopenic obesity can accept the design of DBC intervention program and have great willing to join.
Comparison between MRI-negative and positive results and the predictors for a poor prognosis in patients with idiopathic acute transverse myelitis
Authors: Zhou Yu , Chen Qianxi , Gan Weiming , Lin Xiuwen , Wang Bo , Zhou Meihong , Wu Xiaomu , Hong Daojun , Chen Hao
Published: July 2024

Background

Idiopathic acute transverse myelitis (IATM) is a focal inflammatory disorder of the spinal cord that results in motor, sensory, and autonomic dysfunction. However, the comparative analysis of MRI-negative and MRI-positive in IATM patients were rarely reported.

Objectives

The purpose of this study was to compare MRI-negative with MRI-positive groups in IATM patients, analyze the predictors for a poor prognosis, thus explore the relationship between MRI-negative and prognosis.

Methods

We selected 132 patients with first-attack IATM at the First Affiliated Hospital of Nanchang University from May 2018 to May 2022. Patients were divided into MRI-positive and MRI-negative group according to whether there were responsible spinal MRI lesions, and good prognosis and poor prognosis based on whether the EDSS score ≥ 4 at follow-up. The predictive factors of poor prognosis in IATM patients was analyzed by logistic regression models.

Results

Of the 132 patients, 107 first-attack patients who fulfilled the criteria for IATM were included in the study. We showed that 43 (40%) patients had a negative spinal cord MRI, while 27 (25%) patients were identified as having a poor prognosis (EDSS score at follow-up ≥ 4). Compared with MRI-negative patients, the MRI-positive group was more likely to have back/neck pain, spinal cord shock and poor prognosis, and the EDSS score at follow-up was higher. We also identified three risk factors for a poor outcome: absence of second-line therapies, high EDSS score at nadir and a positive MRI result.

Conclusions

Compared with MRI-negative group, MRI-positive patients were more likely to have back/neck pain, spinal cord shock and poor prognosis, with a higher EDSS score at follow-up. The absence of second-line therapies, high EDSS score at nadir, and a positive MRI were risk factors for poor outcomes in patients with first-attack IATM. MRI-negative patients may have better prognosis, an active second-line immunotherapy for IATM patients may improve clinical outcome.
Short stature and vaginal dinoprostone as independent predictors of composite maternal-newborn adverse outcomes in induction of labor after one previous cesarean: a retrospective cohort study
Authors: Tan Sze Ping , Bashirudin Saniyati Badri , Rajaratnam Rajeev Kumar , Gan Farah
Published: July 2024

Background

The rates of labor induction and cesarean delivery is rising worldwide. With the confluence of these trends, the labor induction rate in trials of labor after cesarean can be as high as 27-32.7%. Induction of labor after one previous cesarean (IOLAC) is a high-risk procedure mainly due to the higher risk of uterine rupture. Nevertheless, the American College of Obstetricians and Gynecologists considers IOLAC as an option in motivated and informed women in the appropriate care setting. We sought to identify predictors of a composite of maternal and newborn adverse outcomes following IOLAC.

Methods

The electronic medical records of women who delivered between January 2018 to September 2022 in a Malaysian university hospital were screened to identify cases of IOLAC. A case is classified as a composite adverse outcome if at least one of these 11 adverse outcomes of delivery blood loss ≥ 1000 ml, uterine scar complications, cord prolapse or presentation, placenta abruption, maternal fever (≥ 38 0C), chorioamnionitis, intensive care unit (ICU) admission, Apgar score < 7 at 5 min, umbilical artery cord artery blood pH < 7.1 or base excess ≤-12 mmol/l, and neonatal ICU admission was present. An unplanned cesarean delivery was not considered an adverse outcome as the practical management alternative for a clinically indicated IOLAC was a planned cesarean. Bivariate analysis of participants’ characteristics was performed to identify predictors of their association with composite adverse outcome. Characteristics with crude p < 0.10 on bivariate analysis were incorporated into a multivariable binary logistic regression analysis model.

Results

Electronic medical records of 19,064 women were screened. 819 IOLAC cases and 98 cases with composite adverse outcomes were identified. Maternal height, ethnicity, previous vaginal delivery, indication of previous cesarean, indication for IOLAC, and method of IOLAC had p < 0.10 on bivariate analysis and were incorporated into a multivariable binary logistic regression analysis. After adjustment, only maternal height and IOLAC by vaginal dinoprostone compared to Foley balloon remained significant at p < 0.05. Post hoc adjusted analysis that included all unplanned cesarean as an added qualifier for composite adverse outcome showed higher body mass index, short stature (< 157 cm), not of Chinese ethnicity, no prior vaginal delivery, prior cesarean indicated by labor dystocia, and less favorable Bishop score (< 6) were independent predictors of the expanded composite adverse outcome.

Conclusion

Shorter women and IOLAC by vaginal dinoprostone compared to Foley balloon were independently predictive of composite of adverse outcome.
Loneliness and risky behaviours among mobile fishers in Elmina, Ghana: a convergent parallel mixed-method study
Authors: Kyei-Gyamfi Sylvester , Kyei-Arthur Frank
Published: July 2024

Background

Loneliness affects individuals of all age groups, and mobile fishers are susceptible to loneliness due to the nature of their occupation. However, there is no study examining loneliness and risky behaviours among fishers in Ghana. Therefore, the purpose of this study was to examine fishers’ mobility history, prevalence of loneliness, predictors of loneliness, effects of loneliness on fishers, coping strategies to address loneliness, and prevalence of risky behaviour among fishers in Elmina, Ghana.

Methods

This is a convergent parallel mixed-method study involving 385 fishers in Elmina. A questionnaire and interview guides were used to collect data from respondents. Descriptive statistics, Pearson’s chi-square and Fisher exact tests, and binary logistic regression were used to analyse the quantitative data, while the qualitative data were analysed thematically.

Results

From the quantitative findings, most fishers were mobile (54.5%) and travelled alone (45.7%). Approximately 83% of the fishers experienced loneliness. Male fishers (AOR = 0.049; 95% CI = 0.003–0.741; p-value = 0.030), fishers affiliated with the African Traditionalist religion (AOR = 0.043; 95% CI = 0.002–0.846; p-value = 0.038), and fishers who travelled with their working colleagues (AOR = 0.002; 95% CI = 0.000-0.023; p-value = ≤ 0.001), were less likely to be experience loneliness. Feeling bored, isolated and worried/anxious were the main perceived effects of loneliness. Alcohol consumption and finding a companion to spend time with were the main strategies fishers used to cope with their loneliness. Most male fishers consumed alcohol (92.5%; p-value = ≤ 0.001) and spent time with companions (73.5%; p-value = ≤ 0.001) to cope with their loneliness. The quantitative and qualitative findings showed that fishers engaged in risky behaviours (excessive alcohol consumption, casual sex, and smoking marijuana and tobacco). From the quantitative findings, more male fishers engaged in excessive alcohol consumption (97.6% vs. 74.5%; p-value = ≤ 0.001), casual sex (88.2% vs. 61.7%, p-value = ≤ 0.001), smoking marijuana (43.0% vs. 13.0%, p-value = ≤ 0.001) and tobacco (49.4% vs. 19.1%; p-value = 0.001) than female fishers.

Conclusions

Loneliness and risky behaviours were common among fishers. Therefore, there is an urgent need to design interventions to help reduce loneliness and risky behaviour among fishers.
Employing students’ evaluations and tutors’ perceptions to evaluate a faculty development program on problem-based learning at the Faculty of Medicine, King Abdulaziz University
Authors: Barnawi Ahlam , Sonbol Ahmed M. , Al-Shawwa Lana , Abulaban Alwalla , Asiri Khalil , Bagasi Abdulaziz , Alafari Reem , Alamoudi Aliaa Amr
Published: July 2024

Background

Faculty development programs are crucial for promoting continuous learning, enhancing teaching effectiveness, and encouraging professional growth among medical educators. Problem-based learning was introduced as a teaching strategy in our Faculty of Medicine in 2007. Thereafter, several rounds of a faculty development program were conducted to help teachers recognize their role as facilitators and assess areas for improvement.

Methods

We conducted a mixed-methods study with a sample of 284 third-year medical students answering a questionnaire and 21 faculty members participating in focus groups. A validated 13-item questionnaire was used to investigate the students’ evaluation of their tutors’ performance in problem-based learning. Three sessions were then conducted with faculty members involved in problem-based learning to gain in-depth insights into their experiences and perspectives.

Results

The mean performance ranking for tutors awarded by the students was above halfway. There was a significant positive correlation between tutors’ performance ranking and all five of the learning approaches examined herein: constructive/active learning, self-directed learning, contextual learning, collaborative learning, and intra-personal behavior (p < 0.05). The data from the focus groups were analyzed under five broad themes: tutors’ insights into their strengths and weaknesses, challenges in conducting problem-based learning, tutors’ ways of preparing for problem-based learning, feedback, and suggestions for improving problem-based learning workshops.

Conclusions

This study recommends improvements and future directions for advanced program evaluation. Faculty development programs can be tailored to effectively address students and faculty members’ goals and needs, which can benefit the teaching and learning process and foster a culture of continuous improvement and professional growth.
Nonlinear association between atherogenic index of plasma and type 2 diabetes mellitus in overweight and obesity patients: evidence from Chinese medical examination data
Authors: Sun Yongbing , Li Fengli , Zhou Yang , Liu Ao , Lin Xinbei , Zou Zhi , Lv Xue , Zhou Jing , Li Zhonglin , Wu Xiaoling , Dou Shewei , Zhang Michael , Zhu Jiadong , Chen Yalong , Xiao Xinguang , Hu Yangxi , Li Hao , Li Yongli
Published: July 2024

Background

The atherogenic index of plasma (AIP) is closely associated with the onset of diabetes, with obesity being a significant risk factor for type 2 diabetes mellitus (T2DM). However, the association between the AIP and T2DM in overweight and obese populations has been infrequently studied. Therefore, this study aimed to explore this association in overweight and obese individuals with T2DM.

Methods

This cross-sectional analysis utilized data from 40,633 participants with a body mass index (BMI) ≥ 24 kg/m2 who were screened from January 2018 to December 2023 at Henan Provincial People’s Hospital. Participants were categorized into groups of overweight and obese individuals with and without diabetes according to the T2DM criteria. The AIP, our dependent variable, was calculated using the formula log10 [(TG mol/L)/HDL-C (mol/L)]. We investigated the association between the AIP and T2DM in overweight and obese individuals using multivariate logistic regression, subgroup analysis, generalized additive models, smoothed curve fitting, and threshold effect analysis. Additionally, mediation analysis evaluated the role of inflammatory cells in AIP-related T2DM.

Results

Overweight and obese patients with T2DM exhibited higher AIP levels than those without diabetes. After adjusting for confounders, our results indicated a significant association between the AIP and the risk of T2DM in overweight and obese individuals (odds ratio (OR) = 5.17, 95% confidence interval (CI) 4.69–5.69). Notably, participants with a high baseline AIP (Q4 group) had a significantly greater risk of T2DM than those in the Q1 group, with an OR of 3.18 (95% CI 2.94–3.45). Subgroup analysis revealed that the association between the AIP and T2DM decreased with increasing age (interaction P < 0.001). In overweight and obese populations, the association between AIP and T2DM risk displayed a J-shaped nonlinear pattern, with AIP > – 0.07 indicating a significant increase in T2DM risk. Various inflammatory cells, including neutrophils, leukocytes, and monocytes, mediated 4.66%, 4.16%, and 1.93% of the associations, respectively.

Conclusion

In overweight and obese individuals, the AIP was independently associated with T2DM, exhibiting a nonlinear association. Additionally, the association between the AIP and T2DM decreased with advancing age. Multiple types of inflammatory cells mediate this association.
Serum lipid metabolism characteristics and potential biomarkers in patients with unilateral sudden sensorineural hearing loss
Authors: Chen Xiaoyan , Zheng Zhong , Xie Daoyu , Xia Liang , Chen Yi , Dong Hongjun , Feng Yanmei
Published: July 2024

Background

Glycerophospholipids (GPLs) are essential for cell membrane structure and function. Sphingomyelin and its metabolites regulate cell growth, apoptosis, and stress responses. This study aimed to investigate lipid metabolism in patients experiencing sudden sensorineural hearing loss across all frequencies (AF-SSNHL).

Methods

The study included 60 patients diagnosed with unilateral AF-SSNHL, among whom 30 patients had a level of hearing improvement ≥ 15 dB after 6 months of follow-up. A propensity score-matched (2:1) control group was used. Liquid chromatography‒mass spectrometry based untargeted lipidomics analysis combined with multivariate statistics was performed to investigate the lipids change. The “lipidome” R package and weighted gene co-expression network analysis (WGCNA) were utilised to assess the lipids’ structural features and the association between lipids and hearing.

Results

Lipidomics successfully differentiated the AF-SSNHL group from the control group, identifying 17 risk factors, mainly including phosphatidylcholine (PC), phosphatidylethanolamine (PE), and related metabolites. The ratios of lysophosphatidylcholine/PC, lysophosphatidylethanolamine/PE, and lysodimethylphosphatidylethanolamine/PE were upregulated, while some glycerophospholipid (GPL)-plasmalogens were downregulated in the AF-SSNHL group, indicating abnormal metabolism of GPLs. Trihexosylceramide (d34:1), PE (18:1e_22:5), and sphingomyelin (d40:3) were significantly different between responders and nonresponders, and positively correlated with hearing improvement. Additionally, the results of the WGCNA also suggested that partial GPL-plasmalogens were positively associated with hearing improvement.

Conclusion

AF-SSNHL patients exhibited abnormally high blood lipids and pronounced GPLs metabolic abnormalities. Sphingolipids and GPL-plasmalogens had an association with the level of hearing improvement. By understanding the lipid changes, clinicians may be able to predict the prognosis of hearing recovery and personalize treatment approaches.
Recurrence in isolated distal DVT after anticoagulation: a systematic review and meta-analysis of axial and muscular venous thrombosis
Authors: Yang Wen-Tao , Jin Zhen-Yi , Li Chun-Min , Wen Jia-Hao , Ren Hua-Liang
Published: July 2024

Objective

To identify recurrent venous thromboembolism (VTE) after discontinuation of anticoagulation in patients with isolated distal deep vein thrombosis based on its anatomic localization (axial or muscular veins).

Methods

Data were sourced from PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases in the time period up to October 2023. The study followed PRISMA guidelines using a registered protocol (CRD42023443029). Studies reporting recurrent VTE in patients with axial or muscular DVT were included in the analysis.

Results

Five studies with a total of 1,403 participants were evaluated. The results showed a pooled odds ratio of 1.12 (95% confidence interval 0.77–1.63) between axial and muscular DVT. Heterogeneity was low (I2 = 0%, p = 0.91) and there was no significant difference in the rate of recurrent VTE between axial and muscular DVT in each subgroup.

Conclusions

Muscular and axial DVT showed comparable recurrent VTE rates after anticoagulation. However, uncertainties regarding the possibility of recurrence affecting the popliteal vein or resulting in pulmonary embolism following muscular DVT anticoagulation persisted. Randomized trials in patients with isolated distal DVT are still needed to clarify its prognosis for different anatomical thrombus locations.
Indirect comparisons of traction table versus standard table in total hip arthroplasty through direct anterior approach: a systematic review and frequentist network meta-analysis
Authors: Ramadanov Nikolai , Voss Maximilian , Hable Robert , Prill Robert , Hakam Hassan Tarek , Salzmann Mikhail , Dimitrov Dobromir , Diquattro Emanuele , Ostojic Marko , Królikowska Aleksandra , Becker Roland
Published: July 2024

Background

It remains unclear whether the use of an orthopaedic traction table (TT) in direct anterior approach (DAA) total hip arthroplasty (THA) results in better outcomes. The aim of this systematic review and network meta-analysis was to compare the THA outcomes through DAA on a standard operating table and the THA outcomes through DAA on a TT.

Methods

PubMed, Epistemonikos, and Google Scholar were searched for relevant randomized controlled trials (RCTs) up to 01 January 2024. An indirect comparison in network meta-analysis was performed to assess treatment effects between DAA on a TT and DAA on a standard table, using fixed-effects and random-effects models estimated with frequentist approach and consistency assumption. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated for continuous variables and odds ratios (ORs) with 95% CIs were estimated for binary variables.

Results

The systematic review of the literature identified 43 RCTs with a total of 2,258 patients. DAA with TT had a 102.3 mL higher intraoperative blood loss and a 0.6 mmol/L lower Hb 3 days postoperatively compared with DAA without TT (SMD = 102.33, 95% CI 47.62 to 157.04; SMD = − 0.60, 95% CI  − 1.19 to − 0.00). DAA with TT had a 0.15 lower periprosthetic fracture OR compared with DAA without TT (OR 0.15, 95% CI 0.03 to 0.86). There were no further significant differences in surgical, radiological, functional outcomes and in complication rates.

Conclusion

Based on our findings and taking into account the limitations, we recommend that particular attention be paid to the risk of periprosthetic fracture in DAA on a standard operating table and blood loss in DAA with TT. Since numerous other surgical, radiological, functional outcome parameters and other complication rates studied showed no significant difference between DAA on a standard operating table and DAA with TT, no recommendation for a change in surgical technique seems justified.

Level of evidence

Level I evidence, because this is a systematic review and meta-analysis of randomized controlled trials.
Fenofibrate alleviates the composition and metabolic pathways of gut microbiota in high-fat diet treated hamsters
Authors: Liu Qifeng
Published: July 2024

Background

Fenofibrate is a compound with diverse biological properties that can be utilized to lower blood lipids. Understanding the impact of the gut microbiota in hyperlipidemia is vital for controlling systemic inflammation and improving serum lipid control. Nevertheless, the specific effects of fenofibrate on the phenotype and gene expression of resident gut bacteria, as well as its influence on the transformation of microbial metabolism into functional networks, remain unclear. In this study, our aimed to examine the gene and metabolic pathways of the gut microbiota in a hamster fed a high-fat diet (HFD) and administered fenofibrate.

Results

In this study, we conducted metagenomic analyses on samples from HFD hamsters treated with fenofibrate. The results indicated that fenofibrate treatments significantly reduce the serum lipid levels in hyperlipidemia hamsters. And the group treated with fenofibrate exhibited higher levels of beneficial bacterial species associated with health, including Bacteroides ovatus, Bifidobacterium animalis, Bacteroides intestinalis, Allobaculum stercoricanis, Lactobacillus reuteri, and Bacteroides acidifaciens, in comparison to the HFD group. Additionally, analysis of metabolic pathways demonstrated that dietary fenofibrate significantly enhanced the biosynthesis of unsaturated fatty acids, glycerophospholipid metabolism, and pyrimidine metabolism, while reducing glyoxylate and dicarboxylate metabolism, tyrosine metabolism, tryptophan metabolism, and nonribosomal peptide structures. Furthermore, these metabolic pathway changes were associated with relative alterations in the abundance of genes from the Kyoto Encyclopedia of Genes and Genomes (KEGG) database, namely K01667, K11358, K13953, K04072, K06131, K00655, K04567, K02864, K06409, K05366, K01867, K21071, and K13292. Moreover, significant changes were observed in related to carbohydrate and antibiotic resistance, such as glycosyltransferase family 51 (GT51) as well as adeC, carA, and MexT.

Conclusions

Dietary fenofibrate exerted significant effects on intestinal flora and genes related to lipid, energy, and amino acid metabolism, ultimately promoting a healthier colonic environment for the host. And these findings contribute to a better understanding of the mechanism of action of fenofibrate and provide a valuable foundation for future experimental and clinical studies, aiming to explore its practical applications.
The lived experience of French parents concerning the diagnosis of their children with borderline personality disorder
Authors: Villet Léa , Madjlessi Abtine , Revah-Levy Anne , Speranza Mario , Younes Nadia , Sibéoni Jordan
Published: July 2024

Background

Psychiatrists often hesitate to diagnose borderline personality disorder (BPD). While individuals with BPD have reported both positive and negative experiences upon receiving their diagnosis, no study has specifically explored this issue among parents. Parents of children diagnosed with BPD can benefit from recently developed family-support interventions such as the Family Connections program. Our study aimed to explore the experiences of parents learning about their child’s BPD diagnosis and to investigate the impact of the Family Connections program on their experiences.

Methods

This qualitative study, conducted in France following the five-stage IPSE method, involved parents of children with BPD recruited through the Family Connections association in Versailles. We conducted semi-structured interviews and used purposive sampling for data collection until data saturation was reached. Data analysis was performed using a descriptive and structuring approach with NVivo 12 software to elucidate the structure of lived experiences.

Results

The study included 21 parents. The structure of the lived experiences was characterized by three central axes: (1) the long and difficult road to diagnosis; (2) communicating the BPD diagnosis to parents: a necessary step; (3) the pitfalls of receiving the diagnosis. The Family Connections program provided significant support in these areas, particularly in understanding the diagnosis, enhancing communication with their child, and reducing social isolation.

Conclusion

These findings highlight the challenges parents face when receiving a BPD diagnosis for their child and underscore the need for an early, clear, and detailed explanation of the diagnosis. The specific experiences of receiving the diagnosis are indicative of the broader care experience parents undergo and highlight their need and right to be informed, supported, and guided throughout their child’s treatment.
Development of mADM-collagen wound dressings for mimicking native skin architecture to enhance skin wound healing
Authors: Wang Xiang , Jiang Yujia , Sun Xiaoqin , Yue Chongxia , Li Zhengyong , Wu Yao
Published: July 2024

Acellular dermal matrix (ADM) is one of the most promising scaffold materials due to its ability to retain natural extracellular matrix structure. Micronized acellular dermal matrix (mADM) was prepared with no intact cell nuclei and preserved growth factors by High Hydrostatic Pressure (HHP) approach. And mADM-collagen wound dressings were developed with different proportion of type I collagen and recombinant humanized type III collagen. The porous structure of the mADM-collagen wound dressings made them a good candidate for preventing excessive fluid accumulation, while the collagens with gel-like texture combined with mADM powder to form pasty texture wound dressing, which preserving the moisture at the wound site. Moreover, the paste texture of the mADM-collagen wound dressing was easy to reshape to conform any wound shapes and body contours. Furthermore, the resulted mADM-collagen wound dressings showed good biocompatibility by supporting fibroblasts adhesion and proliferation in vitro. Subsequently, a murine model of full-thickness skin wounds was employed to assess its effects on wound healing. Notably, mADM-75% Col-I exhibited superior effects throughout the wound healing process, specifically it promoted neovascularization, skin appendage growth and new skin regeneration. This formulation closely mimicked the collagen ratio found in healthy skin, facilitating the favorable wound repair. These results indicated the superior performance of this mADM-collagen wound dressing providing an optimal environment for wound healing.

Graphical Abstract
D-limonene supplementation does not alter postprandial metabolism of postmenopausal women challenged with a mixed macronutrient tolerance test: a pilot study
Authors: Vasconcelos Amanda D. , Donado-Pestana Carlos M. , More Tushar H. , Duarte Graziela B. S. , Duarte Stephany G. , Dias Caroline G. , Rodrigues Larissa , Hernandez Guilherme N. , Fock Ricardo , Hiller Karsten , Fiamoncini Jarlei
Published: July 2024

The hormonal decline during menopause increases women's risk of chronic diseases. D-limonene, a monoterpene found in the human diet, possesses biological properties related to hypolipemic, antioxidant, anti-inflammatory, and gut microbiota-modulating activities, primarily observed in preclinical studies. Postprandial responses include physiological adaptations to the stress of a nutrient surplus, providing an opportunity to assess metabolic resilience, being a suitable strategy for exploring post-menopause-associated metabolic alterations. Here, we investigated the effects of D-limonene supplementation (2 g/day) on postprandial metabolism in postmenopausal women (n = 9) challenged with a standardized mixed meal in a 3-week single-arm clinical study. Our findings revealed that D-limonene did not induce marked differences in postprandial responses to the dietary challenge. The supplementation with D-limonene induced no alterations in serum lipid/lipoprotein profile or glycemia/insulinemia. D-limonene supplementation did not affect the transient postprandial inflammatory response regarding changes in gene expression of peripheral blood mononuclear cells (PBMC) and circulating inflammatory markers. Nevertheless, D-limonene reduced postprandial levels of lithocholic acid, a gut microbiota-derived bile acid, and regulated the plasma concentrations of selected amino acids, carbohydrate metabolism-derived metabolites, and organic acids. In conclusion, our data do not support the claim that short-term D-limonene supplementation beneficially affects the postprandial metabolism of postmenopausal women.

Graphical Abstract
Navigation performance analysis of Earth–Moon spacecraft using GNSS, INS, and star tracker
Authors: Wang Dixing , Xu Tianhe , Li Min , Shi Yali
Published: July 2024

Global Navigation Satellite System (GNSS) can provide an approach for spacecraft autonomous navigation in earth–moon space to make up for the insufficiency of earth-based tracking, telemetry, and control systems. However, its weak power and poor observation geometry near the moon causes new problems. After the GNSS signal characteristics and satellite visibility were evaluated in Phasing Orbit and Lunar Transfer Orbit, we proposed an adaptive Kalman filter based on the Carrier-to-Noise ratio (C/N0) and innovation vector to weaken the influence of GNSS accuracy attenuation as much as possible. The experimental results show that the spacecraft position and velocity accuracy are better than 10 m and 0.1 m/s near the Earth, and better than 50 m and approximately 0.2 m/s near the moon use GNSS with the proposed adaptive algorithms. Additionally, because of the deterioration of navigation performance based on the orbit filter during orbital maneuvering, we used accelerometer data to compensate for the dynamic model to maintain navigation performance. The results of the experiment provide a reference for subsequent studies.
Determinants associated with internet gaming disorder in female medical students: a logistic regression analysis using a random sampling survey
Authors: Kharb Aakanksha , Garg Sunny , Sharma Vineet , Yadav Mohini , Bagri Rinki
Published: July 2024

Background

Internet gaming disorder (IGD) is a momentously growing issue of all ages, and medical students are not immune from the ever-increasing online gaming vogue. The Indian context is little comprehended, necessitating further research on the magnitude and variables. This study aims to determine the prevalence and risk variables of IGD among female medical students. This cross-sectional survey was conducted from March to May 2023 on 512 female (a calculated sample size) medical undergraduate students enrolled in a tertiary center located in a rural area of North India. A stratified random sampling technique was used to choose the participants. The study included a semi-structured questionnaire containing socio-demographic and personal details and gaming characteristics. It also includes a standardized tool, i.e., the Gaming Disorder and Hazardous Gaming Scale (GDHGS) to assess the outcome. The Binary logistic regression analysis was used to investigate the determinants of the dependent variable.

Results

Among the participants, only 236 (46.1%) were identified as gamers. The mean age of the gamers was 21.09 (SD = 1.65) years. Among the gamers, around 31 (13.1%) medical undergraduate students had IGD. The Binary logistic regression analysis identified a few significant determinants of IGD such as dissatisfaction with academic performance (COR = 24.8), playing internet games for more than 2 h per day (COR = 5.9), playing paid games (COR = 2.8), and playing games daily (COR = 4.99).

Conclusion

IGD is highly prevalent among professional medical college students, and its propensity is linked with poor academic performance, using paid games, and spending long hours and days on gaming. Thus, administrators should identify at-risk students and help them in seeking therapy.
Gestational exposure to environmental chemicals and epigenetic alterations in the placenta and cord blood mononuclear cells
Authors: Puvvula Jagadeesh , Braun Joseph M. , DeFranco Emily A. , Ho Shuk-Mei , Leung Yuet-Kin , Huang Shouxiong , Zhang Xiang , Vuong Ann M. , Kim Stephani S. , Percy Zana , Calafat Antonia M. , Botelho Julianne C. , Chen Aimin
Published: July 2024

Background

Exposure to environmental chemicals such as phthalates, phenols, and polycyclic aromatic hydrocarbons (PAHs) during pregnancy can increase the risk of adverse newborn outcomes. We explored the associations between maternal exposure to select environmental chemicals and DNA methylation in cord blood mononuclear cells (CBMC) and placental tissue (maternal and fetal sides) to identify potential mechanisms underlying these associations.

Method

This study included 75 pregnant individuals who planned to give birth at the University of Cincinnati Hospital between 2014 and 2017. Maternal urine samples during the delivery visit were collected and analyzed for 37 biomarkers of phenols (12), phthalates (13), phthalate replacements (4), and PAHs (8). Cord blood and placenta tissue (maternal and fetal sides) were also collected to measure the DNA methylation intensities using the Infinium HumanMethylation450K BeadChip. We used linear regression, adjusting for potential confounders, to assess CpG-specific methylation changes in CBMC (n = 54) and placenta [fetal (n = 67) and maternal (n = 68) sides] associated with gestational chemical exposures (29 of 37 biomarkers measured in this study). To account for multiple testing, we used a false discovery rate q-values < 0.05 and presented results by limiting results with a genomic inflation factor of 1±0.5. Additionally, gene set enrichment analysis was conducted using the Kyoto Encyclopedia of Genes and Genomics pathways.

Results

Among the 29 chemical biomarkers assessed for differential methylation, maternal concentrations of PAH metabolites (1-hydroxynaphthalene, 2-hydroxyfluorene, 4-hydroxyphenanthrene, 1-hydroxypyrene), monocarboxyisononyl phthalate, mono-3-carboxypropyl phthalate, and bisphenol A were associated with altered methylation in placenta (maternal or fetal side). Among exposure biomarkers associated with epigenetic changes, 1-hydroxynaphthalene, and mono-3-carboxypropyl phthalate were consistently associated with differential CpG methylation in the placenta. Gene enrichment analysis indicated that maternal 1-hydroxynaphthalene was associated with lipid metabolism and cellular processes of the placenta. Additionally, mono-3-carboxypropyl phthalate was associated with organismal systems and genetic information processing of the placenta.

Conclusion

Among the 29 chemical biomarkers assessed during delivery, 1-hydroxynaphthalene and mono-3-carboxypropyl phthalate were associated with DNA methylation in the placenta.
Leukocyte immunoglobulin-like receptor (LILRB2)-targeted JTX-8064 plus the anti-PD1 inhibitor JTX-4014 (pimivalimab) in immune-checkpoint inhibitor (ICl) pretreated patients (pts) with advanced or metastatic renal cell cancer (mRCC): Results from the multi-stage phase 1-2 INNATE trial.
Authors: Lara Primo N. , Kroll Stew , Chatzkel Jonathan Alexander , Teoh Deanna Gek Koon , Ma Vincent T , Kilari Deepak , Hwang Clara , Sweis Randy F. , Yalamanchili Kiran , Peguero Julio Antonio , Li Tianhong , Parikh Mamta
Published: July 2024

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Background: Disease progression following treatment of mRCC pts with ICl-based therapy (tx) is nearly universal, warranting evaluation of novel immunotherapeutic approaches. LILRB2 is an immune checkpoint molecule expressed primarily in cells of myeloid origin (e.g., monocytes/macrophages). Inhibition of LILRB2 reprograms macrophages from an immunosuppressive (M2) to an immunostimulatory (M1) phenotype. JTX-8064 is a humanized monoclonal antibody that binds to LILRB2, blocking its interaction with MHC1 molecules. Preclinical studies suggest that JTX-8064 can overcome anti-PD(L)1 resistance mechanisms. Here we report the results of an expansion cohort of previously-treated mRCC pts in INNATE, a multi-stage phase 1-2 trial of JTX-8064 in combination with anti-PD1 agents in solid tumors. Methods: Pts with pathologically-confirmed clear cell mRCC progressing on or after anti-PD(L)1 tx in the most recent prior line, acceptable end-organ function, and ECOG PS 0-1 were treated with JTX-8064 700 mg and JTX-4014 500 mg IV q3 weeks. Primary endpoint was overall response rate (ORR); secondary endpoints were safety, disease control rate (DCR), progression-free survival (PFS), & overall survival (OS). A Simon 2-stage design (n=10+19) was employed where ORR >= 20% was deemed to be of further interest versus null hypothesis of ORR <= 5%, with alpha=0.05. Results: 31 pts were enrolled, with median age of 64 years (range 38-85); 84% males; 16% Hispanic; 93% White; 45% PS=0; 71% one prior tx line. Of 28 pts evaluable for response, 1 CR, 1 PR, 14 SD (6 SD>= 6 months), and 11 PD were seen for an ORR of 7% & DCR of 54%.Median PFS was 4 months (95%CI: 2, 6.8); 12-month OS was 75% (95%CI: 55,88). Tx-related adverse events (AE) of all grades were reported in 11 pts (45%), most commonly fatigue (16%) & diarrhea (10%). Only 4 protocol-related G3-4 AEs were reported: thrombocytopenia (G4); diplopia, diarrhea, & bradycardia (all G3). Three on-study deaths (hypotension; cardiorespiratory arrest; & unknown) were deemed unrelated to protocol tx. Conclusions: While ORR did not meet the protocol-defined efficacy target, evidence of anti tumor activity was seen in ICI pre-treated mRCC pts with combination JTC-8064 + JTX-4014. Treatment was reasonably well-tolerated. Identification & evaluation of clinical and molecular phenotypes most likely to benefit from LILRB2-targeted therapies are warranted. Clinical trial information: NCT04669899 .
Analyzing disparities in socioeconomic factors, clinical characteristics, and outcomes in bladder cancer: Insights from the National Cancer Database (NCDB).
Authors: Polani Faran , Hwang Min Woo , Yu Eun-mi , Wang Hongkun , Aragon-Ching Jeanny B.
Published: July 2024

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Background: Social determinants of health can influence mortality in bladder cancer. We sought to understand the trends and survival differences for urothelial cancer (UC) and non-urothelial cancer (nUC) based on demographic, socioeconomic, clinical, and treatment from the NCDB. Methods: Using the NCDB database with patient-level data extraction from 2004 to 2020, we sought to identify the socioeconomic differences, clinical characteristics and examine survival trends for both UC and nUC bladder cancer. Results: Majority of UC patients (pts) were M (555107, 75.6%) and 178733 were F; nUC pts had 14296 M and 8835 F, median age was 72 years. 669,669 (or 91.3%) of UC pts were White (W), 5.4% (39444) were Black (B) and nUC pts had 19771 (85.5%) W and 2492 (10.8%) B. 41.2% of UC pts were treated at a Comprehensive Community Cancer Program (CCCP) followed by 28.3% at an academic/research program (ARP) with 20.7% at an integrated network cancer program (INCP) compared to nUC pts at 37.5%, 34.3% and 19.2%, respectively. Most UC pts (65.6%) had Medicare followed by 26.9% with private insurance and 3.2% with Medicaid. Distribution of stage at diagnosis for UC pts were: Stage 0 at 36.9%, Stage I at 16.3%, Stage II & III at 11.8% and Stage IV at 3.6%. While most (51.74%) of F UC pts had stage I, only 12.81% of F nUC had stage I. Majority had Charlson-Deyo Score (CDS) of 0 at 512237 (69.8%). Median Overall survival (mOS) in UC for M was 89.26 months (mos) (CI 88.8-89.76) and for F it was 94.88 mos (CI 93.83-95.93), Log-rank p=0.0011; worse for B = 73.03 mos (CI 71.03 – 74.84) vs W = 90.38 mos (CI 89.95-90.81), Log-rank p<0.0001; mOS was highest for ARP at 96.46 mos (CI 95.54-97.45); CDS of 0 at 108.29 mos (CI 107.66-108.85); private insurance at 185.79 mos (CI 183.98-188.16); mOS for nUC was better for M at 15.64 (CI, 15.05 -16.28) vs F at 12.68 (CI, 12.02, 13.31), Log-rank p<0.001. mOS for metastatic involvement for bone: UC: 5.03 (CI, 4.8, 5.39) vs nUC: 5.42 (4.4, 6.34), Log-rank p=0.2007; brain: U: 3.61 (CI 2.99, 4.3) vs nUC: 5.06 (2.5, 7.13); Log-rank p=0.5765; lung: U: 5.09 (CI, 4.76, 5.39) vs nUC: 4.8 (3.68, 5.78); Log-rank p=0.2163; liver: U: 3.32 (CI,3.06, 3.61) vs nUC: 5.42 (CI, 4.11, 6.44); Log-rank p=0.0009; LN: U: 7.1 (CI, 6.6, 7.56) vs nUC: 6.34 (5.36, 6.9); Logrank p=0.0007; Treatment using surgery, radiation, chemotherapy and immunotherapy all showed improvement in U vs nUC (all Log-rank p<0.0001). Conclusions: Women had better survival than men in UC but not in nUC. Factors including lower stages, Whites, private insurance, better CDS scores, treatment at academic/research facility, and lymph node metastases all showed improved survival. These data highlight the importance of bridging the gap between socioeconomic differences to improve outcomes for UC and nUC pts.
Characterization of m6A Modifiers and RNA Modifications in Uterine Fibroids
Authors: George Jitu W , Cancino Rosa A , Griffin Miller Jennifer L , Qiu Fang , Lin Qishan , Rowley M Jordan , Chennathukuzhi Varghese M , Davis John S
Published: July 2024

Uterine leiomyoma or fibroids are prevalent noncancerous tumors of the uterine muscle layer, yet their origin and development remain poorly understood. We analyzed RNA expression profiles of 15 epigenetic mediators in uterine fibroids compared to myometrium using publicly available RNA sequencing (RNA-seq) data. To validate our findings, we performed RT-qPCR on a separate cohort of uterine fibroids targeting these modifiers confirming our RNA-seq data. We then examined protein profiles of key N6-methyladenosine (m6A) modifiers in fibroids and their matched myometrium, showing no significant differences in concordance with our RNA expression profiles. To determine RNA modification abundance, mRNA and small RNA from fibroids and matched myometrium were analyzed by ultra-high performance liquid chromatography-mass spectrometry identifying prevalent m6A and 11 other known modifiers. However, no aberrant expression in fibroids was detected. We then mined a previously published dataset and identified differential expression of m6A modifiers that were specific to fibroid genetic subtype. Our analysis also identified m6A consensus motifs on genes previously identified to be dysregulated in uterine fibroids. Overall, using state-of-the-art mass spectrometry, RNA expression, and protein profiles, we characterized and identified differentially expressed m6A modifiers in relation to driver mutations. Despite the use of several different approaches, we identified limited differential expression of RNA modifiers and associated modifications in uterine fibroids. However, considering the highly heterogenous genomic and cellular nature of fibroids, and the possible contribution of single molecule m6A modifications to fibroid pathology, there is a need for greater in-depth characterization of m6A marks and modifiers in a larger and diverse patient cohort.
Dilema do Empreendedor vs. Investidor: NLION - O empreendedor cria a arte, o investidor julga com o bolso
Authors: Rocha Gimenez Rodrigo
Published: July 2024

O caso descreve a reorganização e reposicionamento da NLION, uma produtora audiovisual Brasileira das mais premiadas, com mais de 40(quarenta) Leões no Festival de Cannes e 10(dez) prêmios Caboré. Fundada em 2003, criando conteúdos de todos os gêneros e para todas as plataformas, a NLION se consolidou como uma das principais produtoras audiovisuais independentes do País. Em meados de 2008, um Fundo Private Equity adquiriu participação na NLION para colaborar de forma ativa para o crescimento e sustentabilidade da empresa. Em paralelo, uma mudança crucial na indústria ocorreu por conta da Lei 12.485/2011, regulamentada pelas Instruções Normativas 100 e 101 da ANCINE, que teve como objetivo principal o de aumentar a produção e a circulação de conteúdo audiovisual brasileiro. Entretanto, em função de questões de gestão incorridas em períodos anteriores, a NLION não conseguiu extrair todo o potencial esperado e traduzi-lo em um melhor resultado financeiro que a possibilitasse tratar a dívida criada pelo fundador e sócios. O Fundo de Private Equity (HJ Fund), como principal credor e parceiro estratégico da família Balabanov, precisou decidir entre seguir com os investimentos necessários para aprimorar o serviço audiovisual da NLION ou desconsiderar os esforços nesta investida e se retirar.