bluuebunny/crossref_metadata_2025 huggingface dataset:
Main problems experienced by the neighbors of open drug scenes, Tehran, Iran: a mixed-method study
Authors: Eshrati Sahar , Saberizafarghandi MohammadBagher , Vameghi Meroe , Arezoomandan Reza , Ranjbar Hadi , Clausen Thomas , Waal Helge
Published: October 2023

Background

Despite law enforcement and health interventions, open drug scenes have led to problems in many countries. The problems are, however, insufficiently explored. There are different types of drug scenes in Iran. This study aimed to explore the issues related to neighbors of one of the drug scenes in Tehran known as Farahzad.

Methods

Data were generated via semi-structured interviews in the first step of the current mixed-method study (2020–2021). Interviewees were people who use drugs (PWUDs), residents and business owners (N = 25). In the next step, a quantitative observation was conducted for eight days. The results were analyzed using conventional content analysis and descriptive statistics.

Results

The perceived problems were ambivalent attitudes about drug scene-related activities, violate of the territory of the self of the effected residents, and everyday concerns. The observation results indicated that men who use drugs are involved in drug scene-related activities more than women are. PWUDs try to hide their activities from the public view. Their efforts were considered “self-regulatory strategies” in the drug scene.

Conclusions

Despite efforts of PWUDs to keep their activities invisible, drug scene-related issues are intolerable for neighbors. Neighbors and PWUDs have ambivalent attitudes. While they are concerned about the human rights of each other, drug scene-related activities have disturbed the neighbor’s daily life and economic activities. Although law enforcement and harm reduction interventions reduce some of the problems, one of the approaches should be improving the coexistence between the neighbors and the residents of the drug scene to achieve broader and more sustainable compromises.
Willingness to use a drug consumption room among people who use drugs in Lyon, France, a city with no open scene of drug use (the TRABOUL survey)
Authors: Chappuy Mathieu , Lack Philippe , David Baptiste , Penavayre Gilles , Thabourey Damien , Landulpho Maira , Plasse Anthony , Icard Christophe , Bailly François , Boutahra Faroudja , Pradat Pierre , Maynard Marianne , Jauffret-Roustide Marie , de Ternay Julia , Rolland Benjamin
Published: October 2023

Background

Drug consumption rooms (DCRs) have been developed in cities with open drug scenes, with the aim to reduce drug-related harm. In Lyon, France's second-largest city, there is no distinct drug use area, which raised doubts regarding the need for a DCR.

Methods

We conducted a face-to-face survey of 264 people who use drugs (PWUDs), recruited in harm reduction or addiction treatment centers, in the streets or in squats. We assess their willingness to use a DCR, and we collected sociodemographic and medical features. Bivariable comparisons and analyses adjusted for sociodemographic parameters explored the association between willing to use a DCR and other variables, thus providing crude (ORs) and adjusted odds ratios (aORs) and 95% confidence intervals (95% CI).

Results

In total, 193 (73.1%) PWUDs accepted to participate (mean age 38.5 ± 9.3 years; 80.3% men). Among them, 64.2% declared willing to use a DCR. Being treatment-seeker (aOR 0.20, 95% CI [0.08–0.51]; p < 0.001) and not living alone (aOR 0.29; 95% CI [0.10–0.86], p = 0.025) were negatively associated with willing to use a DCR. By contrast, receiving precarity social insurance (aOR 4.12; 95% CI [1.86–9.14], p < 0.001), being seropositive for hepatitis C (aOR 3.60; 95% CI [1.20–10.84], p = 0.022), being cannabis user (aOR 2.45; 95% CI [1.01–5.99], p = 0.049), and reporting previous problems with residents (aOR 5.99; 95% CI [2.16–16.58], p < 0.001) or with the police (aOR = 4.85; 95% CI [1.43–16.39], p = 0.011) were positively associated.

Conclusions

PWUDs, especially the most precarious ones, largely supported the opening of a DCR in Lyon, a city with no open drug scene.
A novel highly selective allosteric inhibitor of tyrosine kinase 2 (TYK2) can block inflammation- and autoimmune-related pathways
Authors: Chen Celia X.-J. , Zhang Wei , Qu Shulan , Xia Fucan , Zhu Yidong , Chen Bo
Published: October 2023

Background

As a member of the Janus kinase (JAK) family, which includes JAK1, JAK2 and JAK3, tyrosine kinase 2 (TYK2) plays an important role in signal transduction and immune system regulation. Moreover, it is also involved in the development of many types of inflammatory and autoimmune diseases, such as psoriasis and systemic lupus erythematosus (SLE). TYK2 is an attractive therapeutic target, and selective inhibition of TYK2 over other JAK family members is critical for the development of TYK2 small molecule inhibitors. However, targeting the catalytic region of the TYK2 ATP-binding site is a major challenge due to the high structural homology between the catalytic regions of the JAK family proteins.

Results

In this study, we developed a novel small molecule inhibitor (QL-1200186) by targeting the pseudokinase regulatory domain (Janus homology 2, JH2) of the TYK2 protein. The binding sites of QL-1200186 were predicted and screened by molecular docking. The inhibitory effects on IFNα, IL-12 and IL-23 signaling were tested in cell lines, human peripheral blood cells and human whole blood. The pharmacokinetic (PK) and pharmacodynamic properties of QL-1200186 were verified in mice. QL-1200186 showed high affinity for TYK2 JH2 and had no apparent selectivity for the TYK2 and JAK homologous kinase domains; these effects were demonstrated using biochemical binding, signaling pathway transduction (JAK1/2/3) and off-target effect assays. More importantly, we revealed that QL-1200186 was functionally comparable and selectivity superior to two clinical-stage TYK2 inhibitors (BMS-986165 and NDI-034858) in vitro. In the PK studies, QL-1200186 exhibited excellent exposure, high bioavailability and low clearance rates in mice. Oral administration of QL-1200186 dose-dependently inhibited interferon-γ (IFNγ) production after interleukin-12 (IL-12) challenge and significantly ameliorated skin lesions in psoriatic mice.

Conclusion

These findings suggest that QL-1200186 is a highly selective and potent inhibitor of TYK2. QL-1200186 could be an appealing clinical drug candidate for the treatment of psoriasis and other autoimmune diseases.
KDeep: a new memory-efficient data extraction method for accurately predicting DNA/RNA transcription factor binding sites
Authors: Akbari Rokn Abadi Saeedeh , Tabatabaei SeyedehFatemeh , Koohi Somayyeh
Published: October 2023

This paper addresses the crucial task of identifying DNA/RNA binding sites, which has implications in drug/vaccine design, protein engineering, and cancer research. Existing methods utilize complex neural network structures, diverse input types, and machine learning techniques for feature extraction. However, the growing volume of sequences poses processing challenges. This study introduces KDeep, employing a CNN-LSTM architecture with a novel encoding method called 2Lk. 2Lk enhances prediction accuracy, reduces memory consumption by up to 84%, reduces trainable parameters, and improves interpretability by approximately 79% compared to state-of-the-art approaches. KDeep offers a promising solution for accurate and efficient binding site prediction.
Unmet need for modern contraception by HIV status: findings from community—based studies implemented before and after earlier ART initiation program in rural Tanzania
Authors: Mkwashapi Denna , Renju Jenny , Mahande Michael , Wringe Alison , Changalucha John , Urassa Mark , Todd Jim
Published: October 2023

Background

Tanzania Health policy insists on the need to provide all women access to contraception despite HIV status. We used data from two HIV epidemiologic serological surveys carried out at different periods of ART provision in rural Tanzania to assess the level of unmet need for modern contraception by HIV status and associated factors.

Methods

We performed secondary data analysis of two surveys conducted at the Magu Health and Demographic Surveillance System site, in Mwanza, Tanzania. Information on unmet need for modern contraception was derived from fertility desire and contraception use. Unmet need, HIV status, and socioeconomic and demographic variables were analysed. The percentage of women with unmet needs for modern contraception by HIV status is presented for the 2012 and 2017 surveys. Bivariate and multivariate analyses using logistic regression were used to investigate associated factors showing adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs).

Results

Data from 3352 and 3196 women aged 15–49 years collected in the 2012 and 2017 surveys, respectively, were analysed. The percentages of women with unmet needs for modern contraception in the 2012 and 2017 surveys were 30.9% (95% CI 29.4–32.6) and 31.6% (95% CI 30.0–33.3), respectively. The unmet need for modern contraception was 26% lower in HIV-uninfected women in 2012 (aOR = 0.74; 95% CI 0.569–0.973); p = 0.031). Risk factors for unmet need for modern contraception in 2012 were HIV uninfected (adjusted OR = 0.74; 95% CI 0.569–0.973); p = 0.031), married marital status (adjusted OR = 0.768; 95% CI 0.743–0.794); p < 0.0001), higher education (adjusted OR = 0.768; 95% CI 0.743–0.794); p < 0.0001), and taking alcohol (adjusted OR = 0.768; 95% CI 0.743–0.794); p < 0.0001). Only two factors were associated with unmet need for modern contraception in 2017: married marital status (adjusted OR = 0.46; 95% CI 0.305–0.722); p = 0.001) and women who earned for their families (aOR = 0.66; 95% CI 0.494–0.887); p = 0.006).

Discussion

Nearly one-third of women had an unmet need for modern contraception, which was lower in HIV-uninfected women than in WLHIV-infected women. The study has identified women whose demand for contraception has not been met: WLHIV, post marital women, women with low education and women who were reported to earn money for their families. Family planning interventions should be tailored to these groups of women.
Vitamin C activates young LINE-1 elements in mouse embryonic stem cells via H3K9me3 demethylation
Authors: Cheng Kevin C. L. , Frost Jennifer M. , Sánchez-Luque Francisco J. , García-Canãdas Marta , Taylor Darren , Yang Wan R. , Irayanar Branavy , Sampath Swetha , Patani Hemalvi , Agger Karl , Helin Kristian , Ficz Gabriella , Burns Kathleen H. , Ewing Adam , García-Pérez José L. , Branco Miguel R.
Published: October 2023

Background

Vitamin C (vitC) enhances the activity of 2-oxoglutarate-dependent dioxygenases, including TET enzymes, which catalyse DNA demethylation, and Jumonji-domain histone demethylases. The epigenetic remodelling promoted by vitC improves the efficiency of induced pluripotent stem cell derivation, and is required to attain a ground-state of pluripotency in embryonic stem cells (ESCs) that closely mimics the inner cell mass of the early blastocyst. However, genome-wide DNA and histone demethylation can lead to upregulation of transposable elements (TEs), and it is not known how vitC addition in culture media affects TE expression in pluripotent stem cells.

Results

Here we show that vitC increases the expression of several TE families, including evolutionarily young LINE-1 (L1) elements, in mouse ESCs. We find that TET activity is dispensable for L1 upregulation, and that instead it occurs largely as a result of H3K9me3 loss mediated by KDM4A/C histone demethylases. Despite increased L1 levels, we did not detect increased somatic insertion rates in vitC-treated cells. Notably, treatment of human ESCs with vitC also increases L1 protein levels, albeit through a distinct, post-transcriptional mechanism.

Conclusion

VitC directly modulates the expression of mouse L1s and other TEs through epigenetic mechanisms, with potential for downstream effects related to the multiple emerging roles of L1s in cellular function.
Memantine administration prevented chorea movement in Huntington’s disease: a case report
Authors: Saigoh Kazumasa , Hirano Makito , Mitsui Yoshiyuki , Oda Itsuki , Ikegawa Atsuko , Samukawa Makoto , Yoshikawa Keisuke , Yamagishi Yuko , Kusunoki Susumu , Nagai Yoshitaka
Published: October 2023

Background

Huntington’s disease is an autosomal dominant inherited disorder characterized by personality changes (such as irritability and restlessness) and psychotic symptoms (such as hallucinations and delusions). When the personality changes become noticeable, involuntary movements (chorea) also develop. The disease is caused by the CAG repeat expansion in the coding region of the HTT gene, and the diagnosis is based on the presence of this expansion. However, there is currently no effective treatment for the progression of Huntington’s disease and its involuntary motor symptoms. Herein, we present a case in which memantine was effective in treating the chorea movements of Huntington’s disease.

Case presentation

A 75-year-old Japanese woman presented to the hospital with involuntary movements of Huntington’s disease that began when she was 73 years old. In a cerebral blood flow test (N-isopropyl-p-iodoamphetamine–single-photon emission computed tomography), decreased blood flow was observed in the precuneus (anterior wedge) and posterior cingulate gyrus. Usually, such areas of decreased blood flow are observed in patients with Alzheimer’s-type dementia. So, we administered memantine for Alzheimer’s-type dementia, and this treatment suppressed the involuntary movements of Huntington’s disease, and the symptoms progressed slowly for 7 years after the onset of senility. In contrast, her brother died of complications of pneumonia during the course of Huntington’s disease.

Conclusions

We recorded changes in parameters such as the results of the N-isopropyl-p-iodoamphetamine–single-photon emission computed tomography and gait videos over 7 years. Treatment with memantine prevented the chorea movement and the progression of Huntington’s disease. We believe this record will provide clinicians with valuable information in diagnosing and treating Huntington’s disease.
Immunomodulatory effects of inactivated Ligilactobacillus salivarius CECT 9609 on respiratory epithelial cells
Authors: Bravo María , Diaz-Chamorro Selene , Garrido-Jiménez Sergio , Blanco Javier , Simón Irene , García Waldo , Montero María José , Gonçalves Pilar , Martínez Carlos , Cumplido-Laso Guadalupe , Benítez Dixan Agustín , Mulero-Navarro Sonia , Centeno Francisco , Román Ángel Carlos , Fernández-Llario Pedro , Cerrato Rosario , Carvajal-González José María
Published: October 2023

The microbiota in humans and animals play crucial roles in defense against pathogens and offer a promising natural source for immunomodulatory products. However, the development of physiologically relevant model systems and protocols for testing such products remains challenging. In this study, we present an experimental condition where various natural products derived from the registered lactic acid bacteria Ligilactobacillus salivarius CECT 9609, known for their immunomodulatory activity, were tested. These products included live and inactivated bacteria, as well as fermentation products at different concentrations and culture times. Using our established model system, we observed no morphological changes in the airway epithelium upon exposure to Pasteurella multocida, a common respiratory pathogen. However, early molecular changes associated with the innate immune response were detected through transcript analysis. By employing diverse methodologies ranging from microscopy to next-generation sequencing (NGS), we characterized the interaction of these natural products with the airway epithelium and their potential beneficial effects in the presence of P. multocida infection. In particular, our discovery highlights that among all Ligilactobacillus salivarius CECT 9609 products tested, only inactivated cells preserve the conformation and morphology of respiratory epithelial cells, while also reversing or altering the natural immune responses triggered by Pasteurella multocida. These findings lay the groundwork for further exploration into the protective role of these bacteria and their derivatives.
Limiting temperatures of embryo growth and seed germination of Fraxinus excelsior L. (Oleaceae): a threshold model approach
Authors: Wawrzyniak Mikołaj Krzysztof , Ley-López Juan Manuel , Martins João Paulo Rodrigues , Chmielarz Paweł
Published: October 2023

Key message

We have examined thermal control for embryo growth and seed germination in European ash. Using historical data (span of 36 years) of embryo index in matured seeds, we showed that maturation is not influenced by the annual average temperature. Secondary dormancy in ash’s seeds is easily induced, and the thermal window for both embryo growth and seed germination was between 10 and 20 °C.

Context

Seed germination plays a crucial role in establishing plant communities. Ash seeds are characterized by deep morphophysiological dormancy, usually overcome by 32 weeks of stratification. Observed climate changes might disrupt ash’s thermal window for embryo growth and seed germination. Thus, proper examination of seed adaptability can be important for forest management.

Aims

We investigated the effect of temperature on the embryo index (ratio between embryo and seed length) as well as embryo growth and germination of European ash (Fraxinus excelsior L.) seeds under different thermal conditions.

Methods

We used seeds collected at the same site in Poland between 1985 and 2021 to first analyze the influence of the growing season on the initial embryo index in mature seeds. Subsequently, we examined embryo growth and germination of seeds at constant temperatures of 3°, 10°, 15°, 20°, 25°, and 30 °C from seeds collected in 2021. Using the modeled rate of embryo growth and germination, we predicted the cardinal temperatures for those processes in ash seeds.

Results

The embryo index of ash seeds varied; however, there was no relationship between the index and year of seed collection. The base temperature for embryo growth was 1.4 ± 1.1 °C, with a ceiling temperature of 29.9 ± 2.0 °C and an optimal temperature of 15.7 ± 0.3 °C. The base temperature for germination was at − 1.8 ± 0.3 °C. Due to the induction of secondary dormancy, the ceiling temperature of germination was impossible to establish.

Conclusions

The initial embryo index of mature ash seeds seems to be an individual trait and was not affected by local average annual temperatures. The most effective temperature ranges for embryo growth and germination were similar, however narrow (between 10 and 15 °C). Temperatures above 20 °C inducted secondary dormancy, hampering embryo growth as well as germination. Such a narrow thermal window for embryo growth can potentially act as a limiting factor for the natural regeneration of ash seeds.
Reich–Krasnoselskii-type fixed point results with applications in integral equations
Authors: Azam Akbar , Mehmood Nayyar , Ahmad Niaz , Ali Faryad
Published: October 2023

In this paper, motivated by Reich contraction and tool of measure of noncompactness, some generalizations of Reich, Kannan, Darbo, Sadovskii, and Krasnoselskii type fixed point results are presented by considering a pair of maps A, B on a nonempty closed subset M of a Banach space X into X. The existence of a solution to the equation $Ax+Bx=x$
A
x
+
B
x
=
x
, where A is k-set contractive and B is a generalized Reich contraction, is established. As applications, it is established that the main result of this paper can be applied to learn conditions under which a solution of a nonlinear integral equation exists. Further we explain this phenomenon with the help of a practical example to approximate such solutions by using fixed point techniques. The graphs of exact and approximate solutions are also given to attract readers for further research activities.
Molecular diagnosis of Chagas disease: a systematic review and meta-analysis
Authors: Pascual-Vázquez Guillermo , Alonso-Sardón Montserrat , Rodríguez-Alonso Beatriz , Pardo-Lledías Javier , Romero Alegría Angela , Fernández-Soto Pedro , Muñoz Bellido Juan Luis , Muro Antonio , Belhassen-García Moncef
Published: October 2023

Background

The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently, serology is the reference standard technique; occasionally, results are inconclusive, and a different diagnostic technique is needed. Some guidelines recommend molecular testing. A systematic review and meta-analysis of available molecular tools/techniques for the diagnosis of Chagas disease was performed to measure their heterogeneity and efficacy in detecting Trypanosoma cruzi infection in blood samples.

Methods

A systematic review was conducted up to July 27, 2022, including studies published in international databases. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA 2020 guidelines. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A random-effects model was used to calculate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Forest plots and a summary of the receiving operating characteristics (SROC) curves displayed the outcomes. Heterogeneity was determined by I2 and Tau2 statistics and P values. Funnel plots and Deek's test were used to assess publication bias. A quantitative meta-analysis of the different outcomes in the two different clinical phases was performed.

Results

We identified 858 records and selected 32 papers. Studies pertained to endemic countries and nonendemic areas with adult and paediatric populations. The sample sizes ranged from 17 to 708 patients. There were no concerns regarding the risk of bias and applicability of all included studies. A positive and nonsignificant correlation coefficient (S = 0.020; P = 0.992) was obtained in the set of studies that evaluated diagnostic tests in the acute phase population (ACD). A positive and significant correlation coefficient (S = 0.597; P < 0.000) was obtained in the case of studies performed in the chronic phase population (CCD). This resulted in high heterogeneity between studies, with the master mix origin and guanidine addition representing significant sources.

Interpretation/Conclusions and relevance

The results described in this meta-analysis (qualitative and quantitative analyses) do not allow the selection of the optimal protocol of molecular method for the study of Trypanosoma cruzi infection in any of its phases, among other reasons due to the complexity of this infection. Continuous analysis and optimization of the different molecular techniques is crucial to implement this efficient diagnosis in endemic areas.
Human rabies encephalomyelitis in the background of rabies outbreak in animals in Gelephu, Bhutan, 2023: a case report
Authors: Dorji Thinley , Lamichaney Jeewanath , Gyaltshen Choeda , Lungten Lungten , Dhakal Guru Prasad , Dorjee Sithar , Mynak Mimi Lhamu
Published: October 2023

Background

Rabies continues to pose significant public health challenges in many developing countries including Bhutan. A probable case of rabies was admitted to our hospital and its reporting led to the uncovering of an outbreak in domestic and wild animals. We discuss the challenges in the diagnosis and management of rabies in a resource-limited setting.

Case presentation

A 35-year-old male presented with intermittent fever, bilateral lower limb weakness that was rapidly progressive, urinary incontinence with episodes of palpitations and sweating. He had sustained a Category III bite on the right lower thigh with four bite marks, inflicted by a stray dog. He had received post-exposure prophylaxis with intra-dermal anti-rabies vaccine. On initial examination, the patient was in distress but cooperative for the interview. He had pulse rate ranging from 60 to 100/min with episodes of diaphoresis and palpitations, but with normal capillary blood glucose. In the lower limb, the muscle power was zero with absent tendon reflexes in the lower limb and impaired abdominal reflex below T10 level. He had hyperaesthesia below T8, hydrophobia, aerophobia and photophobia. He had multiple spontaneous fasciculations in both the thighs and right deltoid and these later involved the intercostal muscles, neck and face muscles. He had altered sensorium and desaturation for which he required mechanical ventilation. Polymerase chain reaction for rabies virus was negative in cerebrospinal fluid and saliva. Rabies virus neutralizing antibody was negative in cerebrospinal fluid but had high titres in the serum. He received Human Rabies Immunoglobulin after admission. He was managed in the intensive care unit and died 23 days later. After this case was notified, a rapid response team was deployed in the field, and uncovered rabies outbreak in animals in the locality.

Conclusions

This case called for a serious evaluation of the country’s efforts in achieving zero rabies deaths by 2030. The management of this case identified several critical areas of context-specific interventions in Bhutan. There is also an urgent need to improve diagnostic capabilities at the national reference laboratory and enhance the technical competencies of healthcare workers in the management of dog bite cases.

Graphical Abstract
Is there any influence of biodynamic preparation 501 on the physiological activity of grape leaves cv. Cesanese d’Affile?
Authors: Pettinelli Stefano , Buzzi Laura , Ceccantoni Brunella , Muleo Rosario , Bianchi Alessandro , Brunori Elena , Mencarelli Fabio
Published: October 2023

Background

Biodynamic agriculture is a management approach that aims to reduce the reliance on agrochemicals for production by emphasizing the use of specific natural preparations. A 2-year field trial spanning 2019–2020 was conducted in an established vineyard (Vitis vinifera L., cv. Cesanese d’Affile) to elucidate the impact of the cow horn silica biodynamic preparation (BD-501) on leaf vine physiology, potential resistance via chitinase activity, and analysis of secondary metabolites. The vineyard under biodynamic management was divided into two plots: one treated with BD-501 (BD-501) and the other untreated (BD). Throughout the vine growth season, measurements of carotenoid and chlorophyll levels, polyphenols, and chitinase activity were taken around key phenological phases (BBCH scale). During the ripening phase, a fluorometer was employed to assess chlorophyll fluorescence in the leaves.

Results

Leaves treated with BD-501 exhibited elevated concentrations of polyphenols and increased chitinase activity during the later phenological phases. In contrast, the untreated BD samples demonstrated high values primarily in the central phase of the observation period but not consistently throughout. At the time of harvest, chlorophyll concentration and quantum yield exhibited no statistically significant differences. BD-501 triggered a distinct response in terms of potential defense mechanisms (elevated polyphenols and chitinase activity) during the veraison phase. However, conversely, lower levels of chlorophylls and carotenoids were observed.

Conclusions

Nevertheless, a further round of experimental work is required to thoroughly comprehend the regulatory mechanisms behind this adaptive response and to ascertain the efficacy of BD-501.

Graphical Abstract
Encouraging diversity in family engagement in research: Reflections on the development of knowledge translation tools
Authors: Mah Janet W. T. , Nickerson Katie
Published: October 2023

Background

Family engagement in research is crucial to generating relevant, impactful, and meaningful priorities and outcomes. Although there has been increased awareness and value for patient-oriented research, most patient partners in North America are from Western, educated, industrialized, rich and democratic societies. Encouraging underserviced and marginalized populations to join the partnerships is important. This project demonstrates the development of two knowledge translation tools created to encourage diversity in patient-family and researcher partnerships.

Case study

Our diverse cross-Canadian team embodies the family-researcher partnership as it consists of two research personnel from non-Western origins with immigrant experiences, a parent with lived experience, and a project director. All group members have experience in the field of mental health and neurodevelopmental conditions. Four infographics were created: 3 patient-oriented ones (in English, Chinese, and Farsi) and 1 researcher-targeted one. Content for the infographics were generated to address common barriers to patient engagement identified from literature reviews, as well as key concepts discussed during the McMaster University Continuing Education Family Engagement in Research Certificate Course sponsored by CanChild & Kids Brain Health Network. Peer consultations helped to improve the infographics to be more culturally sensitive and appealing. The patient-oriented infographic presents concise bullet points about 5 main topics: (1) what is research, (2) reasons to join, (3) your role, (4) talking to researchers, and (5) how to join. The researcher-targeted infographic presents concise bullet points about 4 topics: 1) why team up with diverse patient partners, (2) ways to partner, (3) how to connect, and (4) talking to diverse partners.

Conclusion

Infographics were co-designed to encourage diversity in family engagement in research. Lessons learned throughout the project include barriers encountered (e.g., team collaboration considerations, design limitations) and strategies that facilitated the project (e.g., online collaboration platforms). Future directions include translations into other languages, increased dissemination across agencies, and evaluating the effectiveness of the infographic tools.
Self-microemulsifying system of an ethanolic extract of Heliopsis longipes root for enhanced solubility and release of affinin
Authors: Marrero-Morfa Dailenys , Ibarra-Alvarado César , Luna-Vázquez Francisco J. , Estévez Miriam , Ledesma Eremy Miranda , Rojas-Molina Alejandra , Quirino-Barreda Carlos T.
Published: October 2023

Self-microemulsifying or self-nanoemulsifying drug delivery systems (SMEDDS/SNEDDS) are well known to improve the dissolution and increase the oral bioavailability of hydrophobic drugs, including herbal extracts. Organic extracts of Heliopsis longipes root and affinin, its main component, induce a vasodilator effect; however, they are poorly water soluble and therefore are difficult to administer and dose by the oral route. This research aimed to develop, through pseudo-ternary phase diagrams, a self-microemulsifying system prepared from an ethanolic extract of H. longipes root (HL-SMDS). In addition, the optimized lipid-based formulation was characterized and its in vitro gastrointestinal simulated dissolution was determined. The formulation composed of Transcutol, 55% (solubilizer); Tween80/PG, 10% (surfactant/co-solvent); Labrasol, 35% (surfactant); and the herbal extract was selected as optimal and identified as a SMEDDS, since when coming into contact with water, it forms a micro-emulsion with droplet sizes less than 100 nm. The stability tests showed that HL-SMDS remained stable over time under extreme conditions. Furthermore, the amount of affinin released from HL-SMDS at pH 1 and 6.8 was higher than that of the ethanolic extract from H. longipes root. These results indicate that HL-SMDS is a novel alternative to improve the aqueous solubility and therefore the oral bioavailability of the ethanolic extract of H. longipes root.
Validation of brain parenchyma sonography as a marker of neurodegeneration in multiple sclerosis
Authors: Kishk Nirmeen A. , Hamdy Sherif , Amer Hanan , Shalaby Nevin M. , Othman Alshimaa S. , Mohammad Mohammad Edrees
Published: October 2023

Background

Multiple sclerosis (MS) is widely known to cause brain atrophy due to neurodegeneration. Neuroimaging investigations revealed a direct link between brain atrophy detected by MRI and impairment. Transcranial sonography is a safe, feasible and cost-effective imaging technique. In this study, we aimed to validate B-mode transcranial sonography (TCS) as a marker of neurodegeneration in MS. This study is the first study directed to set cut-off point for brain parenchyma measurement in Egyptian population. An observational, case–control study, conducted on 125 subjects; divided into 2 groups: first group, 71 healthy volunteers and patients’ group (54 patients) with relapsing–remitting multiple sclerosis (RRMS). All studied subjects were assessed using B-mode TCS. Transcranial sonography findings were categorized into: first, assessment of brain atrophy parameters by measuring diameter (cm) of third ventricle and both frontal horns of lateral ventricles. Then, the echogenicity of thalamus and brainstem structures (substantia nigra (SN), red nucleus) planimetric surface area (cm2) were assessed along with their abnormal echogenicity (cm2), while brainstem raphe was assessed semi-quantitatively for its echogenicity (intact or interrupted).

Results

Quantitative measures of brain atrophy: in normal control group the third ventricle diameter mean was 0.2 cm (± 0.08), right and left frontal horn diameter were 0.3 cm (± 0.13) and 0.28 cm (± 0.1), respectively, brain atrophy parameters could differentiate between MS patients and normal control group as a statistically significant (p< 0.001) larger ventricular diameter was found in MS patients. On the other hand, assessment of brain stem structures and thalamus showed no statistical significance between MS patients and normal control except in surface area of both red nuclei.

Conclusions

Brain parenchymal sonography may be used as a tool in assessment of neurodegeneration in MS patients.
Diagnostic value of magnetic resonance diffusion tensor imaging in evaluation of cervical spondylotic myelopathy
Authors: Mostafa Naglaa Said AbdEL-Azim , Hasanin Omar Ahmed Mohamed , Al Yamani Moqbel Esam Abdel Hai , Nagy Hanan Ahmad
Published: October 2023

Background

Radiological diagnosis of cervical spondylotic myelopathy should be made as early as possible to obtain favourable clinical outcomes when compared with later stages. Diffusion tensor imaging can reveal early structural changes of the cord in patients with cervical compressive myelopathy.

Aim

This study aimed to assess the role of magnetic resonance diffusion tensor imaging in the accurate evaluation of cervical spondylotic myelopathy.

Patients and methods

This prospective study included a group of 60 patients with neurological symptoms suggestive for cervical spondylotic myelopathy and a control group of 30 healthy subjects. The clinical severity of compressive myelopathy was assessed based on the European myelopathy score. Magnetic resonance diffusion tensor imaging and tractography were done for all patients and controls.

Results

Fractional anisotropy values at the most compressed segments of spinal cord are lower while apparent diffusion coefficient values of the same segments are higher than healthy segments in controls. Fractional anisotropy and apparent diffusion coefficient parameters had higher sensitivity (97.0% and 88.1%, respectively) than conventional T2 WIs (13.4%) and fibre tractography (10%) for the detection of early compressive myelopathy with cutoff values ≤ 0.56 and > 1.23, respectively, in differentiating between patients and control groups.

Conclusion

Diffusion tensor imaging indices are valuable tools for quantitative assessment of degenerative cervical spondylotic myelopathy in addition to routine cervical spine magnetic resonance.
Full-thickness versus sliced cartilage in type I tympanoplasty, comparative study
Authors: Sabaa Mohamed Abd Elmottaleb , Abdelhameed Abdallah Enayet , Elbatawi Ahmed Mahmoud , ElFouly Mahmoud Sayed , Mohamed Abdelhaleem Ahmed , El-essawy Mahmoud Sherif
Published: October 2023

Introduction

The use of cartilage in type I tympanoplasty is associated with concern about a poor audiological outcome. Slicing the cartilage could be a tool to overcome such a feared problem.

Objective

To compare the healing and hearing outcomes of using sliced cartilage to full-thickness cartilage in type I tympanoplasty.

Methods

Seventy patients with small to medium-sized central dry tympanic membrane perforation were included in this prospective study. The patients were randomly assigned to one of these two groups: group A: full-thickness cartilage tympanoplasty was done, and group B: partial thickness cartilage tympanoplasty was done. The assessment of healing and hearing was done at 3 and 12 months postoperatively.

Results

The healing was achieved in 88.2% and 90.9% in group A and group B, respectively. In group A, the mean ABG was 23.44 dB preoperatively and 14.2 dB, and 12.6 dB in the first and second follow-ups, respectively. In group B, preoperative ABG was 23.58 dB compared to 7.9 dB and 6.93 dB in the two follow-ups, respectively. The results were significantly better in group B rather than group A at both follow-ups.

Conclusion

Hearing results are better when sliced cartilage is used in tympanoplasty type I than full-thickness cartilage.
The effect of combined balance and strength exercise program in patients with different grades of primary knee osteoarthritis
Authors: Abdel-Fattah Yousra Hisham , Abdel Hamid Mowaffak Moustafa , Metawaa Sara Ibraheem Mohamed Seleem , Eltawab Sarah Sayed
Published: October 2023

Background

Knee osteoarthritis (KOA) is a degenerative disease that affects all parts of the joint including the surrounding ligaments, tendons, and muscles. Biomechanical changes that occur in KOA cause aggravation of symptoms with further joint damage. Thus, modifying the biomechanics of the knee joint may help in the prevention and treatment of KOA. For that reason, our aim was to assess the effect of combined balance and strengthening exercise programs in patients with different grades of primary KOA.

Results

All studied groups showed comparable significant improvement in quadricep muscle strength, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (< 0.001), time-up and go score (< 0.001), 6-m walk time (< 0.001), and dynamic balance (< 0.001) at the end of exercise program. Furthermore, patients with mild-moderate KOA showed a significant improvement in pain, physical function, total WOMAC scores, and dynamic balance compared to those with more severe KOA.

Conclusion

Combined balance and strengthening exercise programs may help improve pain, physical function, and dynamic balance in patients with KOA regardless of its severity. However, following exercise patients with milder forms of KOA may show greater improvement compared to patients with severe KOA.
Role of long-term oxygen therapy in interstitial lung diseases
Authors: Yossif Sahar Farghly , El-Qarn Atef F. , El-Tayeb Asmaa M. M. , Abd El-Ghany Mohamed F.
Published: October 2023

Background

Long-term oxygen therapy in patients with interstitial lung diseases is frequently given in order to enhance gas exchange, lessen dyspnea, and increase physical activity.

Objective

To evaluate how individuals with hypoxemia and interstitial lung disease respond to long-term oxygen therapy.

Results

Between October 2019 and July 2021, this prospective analytical (cross-sectional) study was carried out at the Assiut University Hospital’s Chest Department. Seventy ILD patients were evaluated utilizing a 6-min walk test (SMWT), the St. George respiratory questionnaire (SGRQ), MMRC, and echocardiography and follow-up was done at 1, 3, 6, and 12 months for ABG, SMWT, and MMRC. As regards echocardiography and SGRQ, a follow-up was done on admission and 1 year after starting LTOT. Significant improvement in St. George’s respiratory questionnaire score, MMRC, and EF by echocardiography was observed meanwhile PASP showed insignificant reduction.

Conclusion

Long-term oxygen therapy is beneficial for patients with ILD and hypoxemia.

Trial registration

Long-term oxygen therapy in patients with interstitial lung disease: ClinicalTrials.gov ID: NCT04089826 Registered on September 12, 2019.
Personalized Breast Cancer Screening
Authors: Bertsimas Dimitris , Ma Yu , Nohadani Omid
Published: October 2023

The summary is as follows: Novel machine learning model reduces breast cancer screening delays by 2-3 months via personalization.
Racial Differences in Patient-Reported Access to Telehealth: An Important and Unmeasured Social Determinant of Health
Authors: Iasiello John A. , Rajan Arvind , Zervos Emmanuel , Parikh Alexander A. , Snyder Rebecca A.
Published: October 2023

Racial disparities exist in access to video telehealth services.
Reassuring Data on the Cardiovascular Risk in Adults With X-linked Hypophosphatemia Receiving Conventional Therapy
Authors: Bouzemane Alexandre , Vignot Emmanuelle , Derain Dubourg Laurence , De Mul Aurélie , Molin Arnaud , Chapurlat Roland , Fontanges Elisabeth , Delsart Daphne , Akbari Alireza , Huang Shih Han Susan , McIntyre Christopher W , Bacchetta Justine , Lemoine Sandrine
Published: October 2023

Context

X-linked hypophosphatemia (XLH) is a rare genetic disorder that results in increased plasma levels of fibroblast growth factor 23 (FGF23). Several studies have demonstrated a direct association between FGF23 and cardiovascular mortality in cohorts of patients with chronic renal failure. However, in patients with XLH, studies on the cardiovascular impact of the disease are rare, with contradictory results.

Objective

The aim was to assess whether the disease led to an increased cardiovascular risk.

Methods

We conducted a single-center retrospective observational study on a local cohort of adult patients with XLH. The primary endpoint was a composite endpoint of the frequency of left ventricular hypertrophy (LVH) or presence of high blood pressure. Our secondary objectives were to assess echocardiographic, pulse wave velocity, and central blood pressure data as other markers of CV health. Independently of this cohort, tissue sodium content with magnetic resonance imaging was studied in 2 patients with XLH before and after burosumab.

Results

Twenty-two patients were included. Median serum phosphate was 0.57 (0.47-0.72) mmol/L and FGF23 94 pg/L (58-2226). Median blood pressure was 124 (115-130)/68 (65-80) mm Hg, with only 9% of patients being hypertensive. A majority of patients (69%) had no LVH, only 1 had a left ventricular mass >100 g/m² and 25% of patients had left ventricular remodeling. Pulse wave velocity was normal in all patients. No differences in skin and muscle sodium content were observed before and after burosumab in the 2 patients who underwent sodium magnetic resonance imaging.

Conclusion

We found no elevated risk of developing hypertension or LVH in patients with XLH.
Low Back Pain–Induced Dynamic Trunk Muscle Control Impairments Are Associated with Altered Spatial EMG–Torque Relationships
Authors: ARVANITIDIS MICHAIL , JIMÉNEZ-GRANDE DAVID , HAOUIDJI-JAVAUX NADÈGE , FALLA DEBORAH , MARTINEZ-VALDES EDUARDO
Published: October 2023

Purpose

We quantified the relationship between high-density surface electromyographic (HDsEMG) oscillations (in both time and frequency domains) and torque steadiness during submaximal concentric/eccentric trunk extension/flexion contractions, in individuals with and without chronic low back pain (CLBP).

Methods

Comparisons were made between regional differences in HDsEMG amplitude and HDsEMG–torque cross-correlation and coherence of the thoracolumbar erector spinae (ES), rectus abdominis (RA), and external oblique (EO) muscles between the two groups. HDsEMG signals were recorded from the thoracolumbar ES with two 64-electrode grids and from the RA and EO muscles with a single 64-electrode grid placed over each muscle. Torque signals were recorded with an isokinetic dynamometer. Coherence (δ band (0–5 Hz)) and cross-correlation analyses were used to examine the relationship between HDsEMG and torque signals. For this purpose, we used principal component analysis to reduce data dimensionality and improve HDsEMG-based torque estimation.

Results

We found that people with CLBP had poorer control during both concentric and eccentric trunk flexion and extension. Specifically, during trunk extension, they exhibited a higher HDsEMG–torque coherence in more cranial regions of the thoracolumbar ES and a higher HDsEMG cross-correlation compared with asymptomatic controls. During trunk flexion movements, they demonstrated higher HDsEMG amplitude of the abdominal muscles, with the center of activation being more cranial and a higher contribution of this musculature to the resultant torque (particularly the EO muscle).

Conclusions

Our findings underscore the importance of evaluating torque steadiness in individuals with CLBP. Future research should consider the value of torque steadiness training and HDsEMG-based biofeedback for modifying trunk muscle recruitment strategies and improving torque steadiness performance in individuals with CLBP.
Prevalence and determinants of obesity among individuals with diabetes in Indonesia
Authors: Azam Mahalul , Sakinah Luluk Fadhoh , Kartasurya Martha Irene , Fibriana Arulita Ika , Minuljo Tania Tedjo , Aljunid Syed Mohamed
Published: October 2023

Background: Obesity and diabetes mellitus (DM), both individually or simultaneously, increase the risk of morbidity and mortality. The present study aimed to determine the prevalence and determinants of obesity among diabetic individuals in Indonesia. Methods: Data were extracted based on 2018 Indonesian Basic Health Survey (Riset Kesehatan Dasar=RISKESDAS). This study involved all individuals with DM and categorized obesity based on body mass index. After data clearing, this study analyzed 3911 DM subjects of the 33.905 subjects acquired from the 2018 RISKESDAS. The study also observed demographic data, diabetes control parameters, history of hypertension, lipid profiles, and food consumption patterns. These variables were involved in a Chi-square test, and related variables were then involved in the Binary logistic regression to define the independent determinants of obesity among DM subjects. Results: Of the 3911 DM subjects included, the study found an obesity prevalence of 32.9%. This study found that female (prevalence odds ratio [POR]=2.15; 95% CI: 1.76-2.62), age 15-44 years (POR=2.46; 95% CI: 1.83-3.33), urban residence (POR=1.49; 95% CI: 1.25-1.77), history of hypertension (POR=1.25; 95% CI: 1.04-1.51), high diastolic blood pressure (POR=1.90; 95% CI: 1.58-2.29), high LDL (POR=1.44; 95% CI: 1.13-1.84), high HDL (POR=0.60; 95% CI: 0.46-0.78, and high triglycerides (POR=1.27; 95% CI: 1.07-1.50) were the risk factor of obesity  among DM subjects; while higher education (POR=0.64; 95% CI: 0.53-0.78) and married (POR=0.73; 95% CI: 0.59-0.90) were protective factors of obesity among DM subjects. Conclusions: The study concluded that almost one-third of DM subjects in Indonesia were obese. Female, age, urban residence, education level, history of hypertension, diastolic blood pressure, and lipid profiles were all associated with obesity among DM subjects in Indonesia. These findings suggest that monitoring and controlling of related determinants is needed to prevent complications caused by the doubled burden of diabetes and obesity.