bluuebunny/crossref_metadata_2025 huggingface dataset:
Horizon, homogeneity and flatness problems: do their resolutions really depend upon inflation?
Authors: Singal Ashok K.
Published: April 2024

The horizon problem, encountered in cosmology, is derived as such for world models based on Robertson–Walker metric where homogeneity and isotropy of the universe is assumed to begin with and is guaranteed for all epochs. Actually, the only thing that happens in this scenario is that in such a universe, described by a single, time-dependent scale factor, which may otherwise be independent of spatial coordinates, the light signals in a finite time might not cover all the available space. Further, the flatness problem, as it is posed, is not even falsifiable. The usual argument offered in the literature is that the present density of the universe is very close to the critical density value and that the universe must be flat since otherwise in past at $$\sim 10^{-35}$$

∼

10

-
35

second (near the epoch of inflation) there will be extremely low departures of density from the critical density value (of the order $$\sim 10^{-53}$$

∼

10

-
53

), requiring a sort of fine tuning. We show that even if the present value of the density parameter were very different, still at $$10^{-35}$$

10

-
35

second it would differ from unity by the same fraction. Thus a use of fine tuning argument to promote $$k = 0$$

k
=
0

model amounts to a priori rejection of all models with $$k \ne 0$$

k
≠
0

. Without casting any aspersions on the inflationary theory, which after all is the most promising paradigm to explain the pattern of anisotropies observed in the cosmic microwave background, we argue that one cannot use homogeneity and flatness in support of inflation.
Particle motion and tidal force in a non-vacuum-charged naked singularity
Authors: Viththani Divyesh P. , Joshi Ashok B. , Bhanja Tapobroto , Joshi Pankaj S.
Published: April 2024

We investigate the gravitational field of a charged, non-vacuum, non-rotating, spherically symmetric body of mass M assuming a static solution to the Einstein–Maxwell field equations. We show the characteristics of perihelion precession of orbits in the case of charged naked singularity (CNS) spacetime. Here we discuss some novel features of light-like geodesics in this spacetime. We also discuss the comparative study of tidal force in the null singularity spacetime and charged naked singularity spacetime.
Image Generative AI to Design Public Spaces: a Reflection of How AI Could Improve Co-Design of Public Parks
Authors: Guridi Jose A. , Cheyre Cristobal , Goula Maria , Santo Duarte , Humphreys Lee , Souras Achilleas , Shankar Aishwarya
Published: April 2024

Image generative AI (IGAI) could change how policymakers engage with the public to design public spaces, facilitating how designers translate the public’s desires into features. However, using IGAI has challenges, such as encoded biases, which might reinforce stereotypes and harm underrepresented communities. We conducted a case study to explore how using IGAI alters the co-design process of public parks through public engagement. We use data collected from interviews with immigrants discussing the Puente Hills Landfill Park design in Los Angeles, which will re-purpose a former landfill into a new public park. We use Dream Studio as a Design Probe, generating images from the interviewees’ insights and critically reflecting on the design process through internal interviews and a reflective workshop. We analyze our case in three domains: Opportunities, Risks and Challenges, and Features and Requirements. In the opportunities domain, we discuss how the enhanced translation of words to images changes the relationship between stakeholder engagement, multiplicity, and efficiency. In the risks and challenges domain, we discuss how IGAI might enhance power imbalances and biases. Finally, we reflect on what features would ease the safe and responsible use of IGAI to engage citizens in co-designing public parks.
Deep Learning for Table Detection and Structure Recognition: A Survey
Authors: Salaheldin Kasem Mahmoud , Abdallah Abdelrahman , Berendeyev Alexander , Elkady Ebrahem , Mahmoud Mohamed , Abdalla Mahmoud , Hamada Mohamed , Vascon Sebastiano , Nurseitov Daniyar , Taj-Eddin Islam
Published: April 2024

Tables are everywhere, from scientific journals, articles, websites, and newspapers all the way to items we buy at the supermarket. Detecting them is thus of utmost importance to automatically understanding the content of a document. The performance of table detection has substantially increased thanks to the rapid development of deep learning networks. The goals of this survey are to provide a profound comprehension of the major developments in the field of Table Detection, offer insight into the different methodologies, and provide a systematic taxonomy of the different approaches. Furthermore, we provide an analysis of both classic and new applications in the field. Lastly, the datasets and source code of the existing models are organized to provide the reader with a compass on this vast literature. Finally, we go over the architecture of utilizing various object detection and table structure recognition methods to create an effective and efficient system, as well as a set of development trends to keep up with state-of-the-art algorithms and future research. We have also set up a public GitHub repository where we will be updating the most recent publications, open data, and source code. The GitHub repository is available at https://github.com/abdoelsayed2016/table-detection-structure-recognition.
High-Specificity Imaging Mass Spectrometry
Authors: Colley Madeline E. , Esselman Allison B. , Scott Claire F. , Spraggins Jeffrey M.
Published: April 2024

Imaging mass spectrometry (IMS) enables highly multiplexed, untargeted tissue mapping for a broad range of molecular classes, facilitating in situ biological discovery. Yet, challenges persist in molecular specificity, which is the ability to discern one molecule from another, and spatial specificity, which is the ability to link untargeted imaging data to specific tissue features. Instrumental developments have dramatically improved IMS spatial resolution, allowing molecular observations to be more readily associated with distinct tissue features across spatial scales, ranging from larger anatomical regions to single cells. High-performance mass analyzers and systems integrating ion mobility technologies are also becoming more prevalent, further improving molecular coverage and the ability to discern chemical identity. This review provides an overview of recent advancements in high-specificity IMS that are providing critical biological context to untargeted molecular imaging, enabling integrated analyses, and addressing advanced biomedical research applications.
Medical Microrobots
Authors: Iacovacci Veronica , Diller Eric , Ahmed Daniel , Menciassi Arianna
Published: April 2024

Scientists around the world have long aimed to produce miniature robots that can be controlled inside the human body to aid doctors in identifying and treating diseases. Such microrobots hold the potential to access hard-to-reach areas of the body through the natural lumina. Wireless access has the potential to overcome drawbacks of systemic therapy, as well as to enable completely new minimally invasive procedures. The aim of this review is fourfold: first, to provide a collection of valuable anatomical and physiological information on the target working environments together with engineering tools for the design of medical microrobots; second, to provide a comprehensive updated survey of the technological state of the art in relevant classes of medical microrobots; third, to analyze currently available tracking and closed-loop control strategies compatible with the in-body environment; and fourth, to explore the challenges still in place, to steer and inspire future research.
Plasmonic-Driven Regulation of Biomolecular Activity In Situ
Authors: Xie Chen , Zhang Tingting , Qin Zhenpeng
Published: April 2024

Selective and remote manipulation of activity for biomolecules, including protein, DNA, and lipids, is crucial to elucidate their molecular function and to develop biomedical applications. While advances in tool development, such as optogenetics, have significantly impacted these directions, the requirement for genetic modification significantly limits their therapeutic applications. Plasmonic nanoparticle heating has brought new opportunities to the field, as hot nanoparticles are unique point heat sources at the nanoscale. In this review, we summarize fundamental engineering problems such as plasmonic heating and the resulting biomolecular responses. We highlight the biological responses and applications of manipulating biomolecules and provide perspectives for future directions in the field.
Industrial Policy and the Great Divergence
Authors: Juhász Réka , Steinwender Claudia
Published: April 2024

We discuss recent work evaluating the role of the government in shaping the economy during the long nineteenth century, a practice we refer to as industrial policy. States deployed a vast variety of different policies aimed primarily, but not exclusively, at fostering industrialization. A thin but growing literature has started to evaluate the economic effects of these policies, but many questions remain open for study.
Mapping Human Immunity and the Education of Waldeyer's Ring
Authors: Talks Benjamin J. , Mather Michael W. , Chahal Manisha , Coates Matthew , Clatworthy Menna R. , Haniffa Muzlifah
Published: April 2024

The development and deployment of single-cell genomic technologies have driven a resolution revolution in our understanding of the immune system, providing unprecedented insight into the diversity of immune cells present throughout the body and their function in health and disease. Waldeyer's ring is the collective name for the lymphoid tissue aggregations of the upper aerodigestive tract, comprising the palatine, pharyngeal (adenoids), lingual, and tubal tonsils. These tonsils are the first immune sentinels encountered by ingested and inhaled antigens and are responsible for mounting the first wave of adaptive immune response. An effective mucosal immune response is critical to neutralizing infection in the upper airway and preventing systemic spread, and dysfunctional immune responses can result in ear, nose, and throat pathologies. This review uses Waldeyer's ring to demonstrate how single-cell technologies are being applied to advance our understanding of the immune system and highlight directions for future research.
Polygenic Risk Scores Driving Clinical Change in Glaucoma
Authors: Kolovos Antonia , Hassall Mark M. , Siggs Owen M. , Souzeau Emmanuelle , Craig Jamie E.
Published: April 2024

Glaucoma is a clinically heterogeneous disease and the world's leading cause of irreversible blindness. Therapeutic intervention can prevent blindness but relies on early diagnosis, and current clinical risk factors are limited in their ability to predict who will develop sight-threatening glaucoma. The high heritability of glaucoma makes it an ideal substrate for genetic risk prediction, with the bulk of risk being polygenic in nature. Here, we summarize the foundations of glaucoma genetic risk, the development of polygenic risk prediction instruments, and emerging opportunities for genetic risk stratification. Although challenges remain, genetic risk stratification will significantly improve glaucoma screening and management.
Widening Educational Disparities in Health and Longevity
Authors: Montez Jennifer Karas , Bisesti Erin M.
Published: April 2024

Educational attainment level has long been a strong predictor of adult health and longevity in the United States. Interestingly, the association between education and these outcomes has strengthened in recent decades. Since the 1980s, higher-educated adults have experienced favorable trends in health and longevity, while lower-educated adults have experienced stagnation or unfavorable trends. Studies have provided important clues about why the association between education and health and longevity has strengthened over time. However, explanations remain incomplete and contested. This article discusses key findings and debates about why the association has become stronger and offers recommendations to advance robust explanations. Two key recommendations call for a fundamental shift in how researchers conceptualize and study the increasingly strong association. These include (a) reconsidering which education groups should be viewed as normative in analyses of the trends and (b) elevating attention on contexts, institutions, and actors that have had an outsized influence on the trends.
A Redox-Electrodialysis Model with Zero Fitting Parameters: Insights into Process Limitations, Design, and Material Interventions
Authors: Hudak Timothy C. , Gorski Christopher A. , Arges Christopher G.
Published: April 2024

Redox-Electrodialysis (r-ED) is an electrochemical desalination cell architecture that has recently received considerable interest, due to its low energy demand relative to electrochemical desalination technologies that rely on electrode-based ion removal. To further improve the energy efficiency of r-ED, we developed a lumped mathematical model with no adjustable parameters to investigate the various sources of overpotential within the cell. Existing models of electrodialysis and r-ED cells either do not accurately incorporate all phenomena contributing to the overpotential or utilize empirical fitting parameters. The model developed here indicates that ohmic overpotentials, especially in the diluate chamber, are the most significant contributors to energy losses. Based on this insight, we hypothesized that adding an ion exchange resin wafer in the diluate compartment would increase the ionic conductivity and decrease the energy demand. Experimental results showed an 18% reduction in specific energy use while achieving the same degree of salt removal (20 mM to 12 mM). Furthermore, the resin wafer enabled complete desalination to potable drinking levels at a current density previously unachievable within practical operating voltage limits (4.93 mA cm−2). We also expanded the model to explore differences in r-ED energy use between configurations using multiple cells and a single cell with increased area.
Communication—Oscillating Oxygen Concentration Transport through PEM Fuel Cell Gas Diffusion Layer: Variation of the Phase Angle
Authors: Kulikovsky Andrei
Published: April 2024

Recently, it was shown that performance of the cathode catalyst layer in PEM fuel cell dramatically improves if the oxygen concentration (OC) at the catalyst/ gas diffusion layer (GDL) interface oscillates in–phase with the overpotential. However, OC oscillations could only be organized in the cathode channel. Does transport through the GDL affect the phase angle of OC oscillations? Below, it is shown that at low frequencies below 1 Hz, the GDL does not change this phase angle. At high frequencies, the phase angle after transport through the GDL is −3π/4 regardless of the GDL parameters.
Comparison of unitary synaptic currents generated by indirect and direct pathway neurons of the mouse striatum
Authors: Jones James A. , Peña Jacob , Likhotvorik Rostislav I. , Garcia-Castañeda Brandon I. , Wilson Charles J.
Published: April 2024

This is the first study to record the synaptic currents generated by single identified direct or indirect pathway striatal neurons on single pallidal neurons. Each GPe neuron receives synaptic inputs from both pathways. Most striatal neurons generate small synaptic currents that become influential when occurring together, but a few are powerful enough to be individually influential.
A Scoping Review on Attitudes towards Sexuality in Residential Aged Care
Authors: Le Klara , Bennich Maria , Strandberg Thomas
Published: April 2024

Objectives. Sexuality in residential aged care is a complex and often overlooked aspect of aged care. The attitudes of both staff and residents significantly influence how sexuality is perceived and addressed in these settings. This scoping review aims to compile, analyse, and identify gaps in the existing research concerning the attitudes of residents and staff towards sexuality within the context of residential aged care. Methods. The scoping review involved a systematic search across eight databases, yielding 469 unique articles, with 29 included studies. Results. Thematic synthesis within the selected studies disclosed three themes: hollow attitudes, postsexual residents, and organizational setbacks. Discussion. The results emphasize the significance of treating sexuality as a fundamental right, emphasizing that it should be not only acknowledged in theory but also implemented in practice.
Exploring the Dynamics of Attracting and Retaining Acute Care Psychiatric Registered Nurses: An In-Depth Analysis Using Focus Groups
Authors: Ratnapradipa Kendra L. , Houfek Julia F. , Gearhart Phoebe , Schneider Erin O. , Chasek Christine , Dinkel Danae , Cordts Katrina M. , Doyle Marley , Chaudhary Priyanka , Bhale Deepanjali , Watanabe-Galloway Shinobu
Published: April 2024

The recruitment and retention of in-patient psychiatric mental health registered nurses (PMH-RNs) remains a challenge. This qualitative study sought to identify factors impacting the recruitment and retention of PMH-RNs in acute-care settings. Participants (N = 15) were recruited for focus groups including one with in-patient unit administrators (n = 4), two with current PMH-RNs (n = 7), and two with nursing students (n = 4). Data were analyzed using a directed content analysis approach. Participants were informed about the study’s purpose, procedures, potential risks, and benefits, and they provided verbal consent before participating. Administrators emphasized a focus on retention and described a variety of supports they provided PMH-RNs, including formal and informal support and education. PMH-RNs’ most prevalent concerns were their safety, co-worker and/or management challenges, and emotional and/or physical exhaustion. Students also expressed concerns about safety in psychiatric settings and desired more interaction with PMH-RNs. They were also interested in learning more about the specialty as they valued the opportunity to see change in patients. All three groups mentioned a need for more interaction between students and PMH-RNs, while safety concerns were expressed by both PMH-RNs and students. Because PMH-RNs play a critical role for in-patient psychiatric care, recruiting and retaining specialist nurses can focus on increasing student engagement with the PMH-RNs, attending to PMH-RNs’ management and staffing concerns, and providing additional resources for responding to events that threaten safety in the workplace to prevent burnout.
Performance of Diaphragm Walls during Ultra‐Deep Excavations in Karst Areas: Field Monitoring Analysis
Authors: Nong Xingzhong , Wang Yanhong , Lin Benhai , Xu Wentian , Luo Wuzhang , Tang Ren
Published: April 2024

Deep foundation pit excavations have become more extensive for the construction of underground spaces with rapid urbanization. Diaphragm walls are commonly used to support deep excavations. However, due to the complex geological conditions in karst areas, construction accidents frequently occur during the excavation of foundation pits. This study aims to investigate the performance of diaphragm walls in karst areas through field monitoring analysis. A kick‐in deformation mode of the diaphragm wall is revealed during the foundation pit excavation. Furthermore, the results show that the diaphragm walls present multiple deformation modes rather than a single mode. Additionally, this study proposes a method to calculate the lateral displacement of the diaphragm walls at different depths. It is found that the karst caves have a considerable impact on the stability of diaphragm walls, as demonstrated by their lateral displacement. The hidden karst caves reduce the bearing capacity of the bedrock, rendering it insufficient to resist the active earth pressure. As a result, the bottom of the diaphragm wall is kicked into the foundation pit, causing significant lateral displacement and posing risks during excavation. The findings of this study contribute to the design and construction of similar excavations in karst areas.
Healthcare Practitioners’ Perceptions of the Barriers to Prescribing or Promoting Exercise in the Treatment of People with Mental Illness: A Scoping Review
Authors: Kelly Kate , Moloney Andrew , de Jong Gideon , Lakeman Richard
Published: April 2024

Contemporary healthcare for those experiencing mental illness requires healthcare practitioners (HCPs) to effectively incorporate the prescription of exercise in their treatment, in accordance with clinical guidelines. However, there has been a lack of effective implementation of such recommendations. The purpose of this review was to identify barriers to exercise prescription in the treatment of people diagnosed with mental illness as perceived by HCPs. APA PsycINFO, CINAHL, MEDLINE, and PubMed electronic databases were searched for relevant articles published in the period from January 2005 to September 2023. A total of 18 papers were included for thematic synthesis. Four key themes were identified across the qualitative (8), quantitative (6), and mixed method (4) papers, including a lack of knowledge and confidence of HCPs in prescribing exercise; role and responsibility; HCPs’ misconceptions of client barriers; and systemic issues impacting exercise prescription practices. A lack of knowledge or confidence was the most common barrier. Some HCPs indicated a desire to develop their skills in exercise prescription, while others indicated a preference for an exercise professional to take responsibility for this aspect of treatment. Systemic barriers were spread across a range of issues, with lack of time, excessive workload, and difficulties accessing qualified staff most commonly cited. This review provides further insight into the barriers to exercise prescription faced by HCPs and makes recommendations regarding how to address these barriers in order to better implement clinical guidelines and thus improve the quality of treatment provided to people diagnosed with a mental illness.
Pharmacokinetics and Bioequivalence of Two Combination Metformin/Glipizide Tablets under Fasting and Fed Conditions in Chinese Healthy Subjects: A Randomized, Open‐Label, Crossover Study
Authors: Lei Yuyan , Yan Yu , Huang Lifeng , Li Canxia , Liu Wanying , Shen Qiuxia , Wang Caihong , Yang Hongying , Li Xiaohui , Zhang Wanyu , Chen Jing , Su Jiankun , Xie Yuhong , Chen Weiming , Li Chao , Lu Junli , Chen Lulu
Published: April 2024

Metformin/glipizide tablets are a compound formulation composed of metformin hydrochloride and glipizide. This study aimed to assess the pharmacokinetics and bioequivalence of two fixed‐dose combination (FDC) tablets of metformin/glipizide (500 mg/2.5 mg) in healthy Chinese subjects. We conducted a single‐center, open‐label, randomized, two‐way crossover study with a total of 48 subjects enrolled (24 in each dietary group). The test or reference formulations were given to the subjects at random at a ratio of 1 : 1, with a seven‐day washout period. Blood samples, collected at prearranged intervals before and up to 24 hours after dosage, were analyzed using validated LC‐MS/MS technology to ascertain plasma concentrations of metformin and glipizide. Finally, 23 subjects completed the fasting and fed studies, respectively. In both studies, the 90% confidence intervals for the geometric mean ratios (test/reference) of the Cmax, AUC0-t, and AUC0-∞ were all found to fall within the acceptable range for bioequivalence (80%–125%). The exposure of metformin/glipizide FDC tablets in vivo was not significantly affected by food. No serious adverse events were observed. In conclusion, this study demonstrated that both the test and reference metformin/glipizide tablets exhibited bioequivalence and were well tolerated under both fasting and fed conditions. This trial is registered with CTR202686.
Knowledge and Training Needs in Nosocomial Infection among Hospital Staff in the City of Kielce, Poland: A Cross-Sectional Study
Authors: Fortunka Kamila , Strzelecka Agnieszka , Król Grzegorz , Paprocka Paulina , Mańkowska Angelika , Lesiak Agata , Karpeta Urszula , Okła Slawomir , Spałek Jakub , Kaliniak Szczepan , Piktel Ewelina , Karasiński Maciej , Durnaś Bonita , Bucki Robert
Published: April 2024

Introduction. Nosocomial infections are an integral part of health care services, posing a threat to both patients and medical staff. The duty and role of nursing staff is to prevent nosocomial infections in every hospitalized person. Material and Methodology. The study involved 635 nurses working in various surgical and conservative wards. The technique used was the author’s questionnaire, which contained 30 questions and was divided into three components. Results. The level of knowledge among the surveyed nurses was at a sufficient level for more than half of the total tested population, and its level was influenced by two variables: the specialization held and the level of education. Nurses working in medical wards have a higher level of knowledge in the area of basic concepts related to nosocomial infections, and people who use specialist medical literature and participate in specialist courses have a sufficient level of knowledge. The shortest time since the last training results in a higher level of knowledge and a higher level of knowledge in the area covering the basic concepts of nosocomial infections. The most frequently selected issues on which nurses would like to expand their knowledge were post-exposure procedures and methods of monitoring nosocomial infections. Conclusions. The knowledge of the nursing staff in the field of nosocomial infections is diverse, and its main determinants are specialization, education, and age. A sufficient level of knowledge among the respondents is conditioned primarily by the use of specialist literature and participation in specialist courses, which determine both the scope and area of knowledge on nosocomial infections.
Profile of Patients with Maxillofacial Space Infections and Associated Risk Factors
Authors: Gadicherla Srikanth , Manglani Kirti , Pentapati Kalyana C. , Kudva Adarsh , Aramanadka Chithra , Chandravel Rajaji
Published: April 2024

Objective. To evaluate the profile of patients operated for maxillofacial space infections and associated risk factors for the length of hospital stay. Materials and Methods. We conducted a retrospective study among patients operated for maxillofacial infections at our center from 2010 to 2020. Information collected from the records were age, sex, type and number of spaces involved, clinical signs and symptoms (pain, swelling, toothache, sore throat, otalgia, hoarseness, headache, cough, neck swelling, rancid breath, sialorrhea, gingival swelling, muffled voice, trismus, fever, dysphagia, odynophagia, malaise, lymphadenopathy, dyspnoea, pus discharge), treatment modality, total leukocyte count, evidence of bacterial growth, comorbidities, complications if any and length of hospital stay. Results. A total of 128 medical records were examined, out of which 59 were female. The mean age was 38.59 ± 19.7 and the length of hospital stay was 7.56 ± 3.8 days. The most commonly involved space was submandibular space (46.1%) and the common symptoms reported were swelling (99.2%), pain (86.7%), and trismus (68%). Four patients had complications like necrotizing fasciitis (1.6%), pneumonia (0.8%), and death in one patient (0.8%). Logistic regression showed that patients more than 36 years of age, male sex, evidence of bacterial growth, and diabetics had higher odds of increased hospital stay (>6 days). Multiple logistic regression analysis showed that age (P=0.015; OR: 2.98) and evidence of bacterial culture (P=0.001; OR:6.64) were potential predictors associated with increased hospital stay. Conclusion. Our study showed that the age of the patient and evidence of bacterial culture were potential predictors of prolonged hospital stay among patients operated for maxillofacial space infections.
Advancing the Adoption of Net Metering: An Economic Assessment of Grid‐Tied Solar Photovoltaic Systems in Urban Homes in Ghana
Authors: Afonaa-Mensah Stephen , Majeed Issah Babatunde , Odoi-Yorke Flavio
Published: April 2024

Net metering schemes are pivotal in advancing grid‐tied solar PV systems and promoting renewable energy adoption in developing nations. This study investigates the economic viability of implementing net metering within urban households in Ghana, considering the existing block tariff structure and a proposed time‐of‐use (ToU) structure for grid‐tied PV systems. The study employed PVSOL premium (2023 R3) software for the economic performance assessment of the net metering schemes for simulated grid‐tied residential PV systems in selected cities of Ghana’s Coastal, Forest, and Savannah climatic zones. The evaluation encompasses key economic metrics, including the levelized cost of electricity, accrued cash flow, annual cash savings, internal rate of return, and payback period. The study findings showed that, in most scenarios, the existing block tariff structure initially proved more economically favourable than the proposed two‐tier Time‐of‐Use (ToU) structure. Consequently, financial investments were recouped within the project’s lifespan under net metering schemes based on the existing block tariff structure, whereas investments were not recouped under the ToU‐based schemes. Nevertheless, factors such as improved daytime consumption, rising electricity tariffs, and aligning peak demand pricing hours with solar power generation hours emerged as potential drivers that could make ToU‐based net metering schemes more attractive than block tariff structures. The study findings have significant implications for policy development related to tariff structures, particularly concerning the implementation of net metering for grid‐tied solar PV systems within the residential sector of Ghana and other developing countries in sub‐Saharan Africa.
Modeling Myeloma Dissemination In Vitro with hMSC-interacting Subpopulations of INA-6 Cells and Their Aggregation/Detachment Dynamics
Authors: Kuric Martin , Beck Susanne , Schneider Doris , Rindt Wyonna , Evers Marietheres , Meißner-Weigl Jutta , Zeck Sabine , Krug Melanie , Herrmann Marietta , Hartmann Tanja Nicole , Leich Ellen , Rudert Maximilian , Docheva Denitsa , Seckinger Anja , Hose Dirk , Jundt Franziska , Ebert Regina
Published: April 2024

Multiple myeloma involves early dissemination of malignant plasma cells across the bone marrow; however, the initial steps of dissemination remain unclear. Human bone marrow–derived mesenchymal stromal cells (hMSC) stimulate myeloma cell expansion (e.g., IL6) and simultaneously retain myeloma cells via chemokines (e.g., CXCL12) and adhesion factors. Hence, we hypothesized that the imbalance between cell division and retention drives dissemination. We present an in vitro model using primary hMSCs cocultured with INA-6 myeloma cells. Time-lapse microscopy revealed proliferation and attachment/detachment dynamics. Separation techniques (V-well adhesion assay and well plate sandwich centrifugation) were established to isolate MSC-interacting myeloma subpopulations that were characterized by RNA sequencing, cell viability, and apoptosis. Results were correlated with gene expression data (n = 837) and survival of patients with myeloma (n = 536). On dispersed hMSCs, INA-6 saturate hMSC surface before proliferating into large homotypic aggregates, from which single cells detached completely. On confluent hMSCs, aggregates were replaced by strong heterotypic hMSC–INA-6 interactions, which modulated apoptosis time dependently. Only INA-6 daughter cells (nMA-INA6) detached from hMSCs by cell division but sustained adherence to hMSC-adhering mother cells (MA-INA6). Isolated nMA-INA6 indicated hMSC autonomy through superior viability after IL6 withdrawal and upregulation of proliferation-related genes. MA-INA6 upregulated adhesion and retention factors (CXCL12), that, intriguingly, were highly expressed in myeloma samples from patients with longer overall and progression-free survival, but their expression decreased in relapsed myeloma samples. Altogether, in vitro dissemination of INA-6 is driven by detaching daughter cells after a cycle of hMSC-(re)attachment and proliferation, involving adhesion factors that represent a bone marrow–retentive phenotype with potential clinical relevance.

Significance:

Novel methods describe in vitro dissemination of myeloma cells as detachment of daughter cells after cell division. Myeloma adhesion genes were identified that counteract in vitro detachment with potential clinical relevance.
The Role of Neutrophil-Lymphocytes Ratio in the Prognosis of CIN2+ Recurrence after Excisional Treatment
Authors: Dominoni Mattia , Barcellini Amelia , Pasquali Marianna Francesca , De Silvestri Annalisa , Ferretti Virginia Valeria , Cesari Stefania , Fiandrino Giacomo , Orlandi Ester , Gardella Barbara
Published: April 2024

Objectives: The main risk factor involved in CIN2+ recurrence after treatment is the HPV persistent infection. The dysregulation of the immune system permits only HR-HPVs to become persistent infections, to promote cancer development, and to increase the risk of recurrence after treatment. Therefore, there is a shift to a Th2-type cytokine pattern during the carcinogenesis pathway; for this reason, the neutrophil-lymphocytes ratio (NLR) could be a marker of this immunological change. The study aimed to analyse the predictive role of NLR in the recurrence of high-grade CIN (CIN2+) after excisional treatment in a real-world life setting of patients treated for CIN2+. Design: This study wascross-sectional study. Participants/Materials, Setting, Methods: We examined a retrospective database of 444 patients, who attended the colposcopy service of our department from 2011 to 2020 due to an abnormal screening Pap smear, and we compared the clinical characteristics to NLR performed at the time of diagnosis. All analysed patients were treated according to an established protocol (colposcopy every 6 months for the first 2 years and every year for over 3 years) and HPV-DNA test and cervical biopsy were performed at entry and the end of follow-up. All patients underwent a blood sample examination, including complete white blood cell counts and collecting neutrophil and lymphocyte values expressed as 103/mL. Results: The sensitivity (SE) and specificity (SP) of the NLR cut-off point of 1.34 for the diagnosis of CIN2+ recurrence were 0.76 and 0.67, respectively. We found that CIN2+ recurrences were significantly higher in patients with NLR <1.34 (3.7% vs. 0.6%, p = 0.033) and the 5-year recurrence-free survival was higher in patients with NLR ≥1.34 (97% vs. 93%, p = 0.030). Limitations: Firstly, the retrospective analysis and low incidence of recurrence may limit the conclusions. Second, for the retrospective design of the study, we did not take into consideration the patient’s comorbidities and habits (smoking) that may influence the NLR. On the other hand, the median duration of follow-up in our study was 26 months (IQR: 22–31), which fully reflects the incidence of recurrences. Conclusions: It is well known that CIN2+ lesions are sustained by deregulation of the immune system caused by persistent HPV infection, which may lead to cervical cancer. Among the actors underlying dysregulation of immunity, lymphocytes are involved in the permission of persistent infection and for this reason, NRL could be a reliable and cost-effective biomarker in predicting the risk of recurrence, especially for high-grade cervical lesions.
Thoracocervicofacial Purpura as a Presenting Symptom of Seizure Disorder: A Case Report
Authors: Alhawsawi Waseem , Hawsawi Khalid Al , Alshareef Alhusain , Halabi Rama , Baksh Ammar , Alzubaidy Basant
Published: April 2024

Introduction: Postictal thoracocervicofacial purpura (PTP) is a rare clinical sign after a seizure episode and may be the only objective sign seen in patients who are unaware of their own seizure disorder. Moreover, it can be the only reason a patient seeks medical care after a seizure activity. Case Presentation: Herein, we report a 23-year-old, living alone and not known to have any medical illnesses, who presented to our emergency department complaining of asymptomatic purpuric facial rash extending to his neck and upper chest that started suddenly when he woke up that morning. Tongue and distal lateral thigh erosions were also noticed during physical examination, as well as conjunctival hemorrhage. In addition, the patient stated that he experienced similar prior episode of purpuric rash over the face, and disappeared uneventfully within 2 weeks. Blood work was remarkable for elevated urine creatinine (21,692 mg/L) and creatine kinase (1,207 mg/L). Given his clinical features and initial laboratory results, a diagnosis of PTP was made. Conclusion: Patients who present with petechial rash over the chest, neck, malar area along with conjunctival hemorrhage as an only complaint should be suspected to have or evaluated for seizure disorder.
Identification of Differentially Expressed MicroRNAs in the Rat Hippocampus during Adolescence through an Epigenome-Wide Analysis
Authors: Vázquez-Ágredos Ana , Rovira Paula , Gutiérrez Blanca , Gámiz Fernando , Gallo Milagros
Published: April 2024

Introduction: Epigenetic mechanisms involving microRNAs (miRNAs) play a fundamental role in many biological processes, particularly during prenatal and early postnatal development. Their role in adolescent brain development, however, has been poorly described. The present study aimed to explore miRNA expression in the hippocampus during adolescence compared to adulthood in rats. Method: The brains of female and male Wistar rats were extracted, and the hippocampus was freshly dissected at postnatal day 41 (adolescence) and postnatal day 98 (adulthood). An epigenome-wide analysis was conducted to identify the miRNAs significantly expressed in adolescence compared to adulthood. Additionally, target genes of such miRNAs were considered to perform an exploratory Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Results: We identified 16 differentially expressed miRNAs in adolescent male rats compared with adult male rats and 4 differentially expressed miRNAs in adolescent females compared with adult females. Enrichment analysis reinforced that the target genes found are related to neurodevelopmental processes such as cell proliferation, cell migration, and nervous system development. Conclusion: Our findings suggest a complex pattern of miRNA expression during adolescence, which differs from that in adulthood. The differential expression of miRNA in the hippocampus during adolescence may be associated with the late developmental changes occurring in this brain region. Furthermore, the observed sex differences in miRNA expression patterns indicate potential sexual differentiation in hippocampal development. Further comprehensive investigations are needed to elucidate the roles of miRNA in normal brain development.
Discriminant Accuracy of Standing Balance Tests for the Level of Gait Dependency in Hospitalized Patients with Alzheimer’s Disease
Authors: Nakagawa Keita , Kanai Shusaku , Kitakaze Sosuke , Okamura Hitoshi
Published: April 2024

Introduction: When determining the level of gait independence in patients with Alzheimer’s disease (AD), detailed functional assessment is difficult in some patients. The previous literature has suggested simple standing balance tests for patients with AD due to their ease of implementation in clinical practice and relevance to gait. However, their usefulness for discriminating the level of gait independence remains unclear. This study aimed to investigate the discrimination accuracy of a simple standing balance test in the level of gait independence among hospitalized patients with AD. Methods: This cross-sectional study was a post hoc analysis of a study conducted on 63 inpatients with AD in a single hospital. Participants were divided into three groups according to their level of gait independence: independent, modified independent (independent, walking with walking aids), and dependent groups (supervision). Gait independence was determined using the Functional Independence Measure. Four standing balance tests were used – closed-leg, semi-tandem, tandem, and one-leg standings – and the discrimination accuracy of each test was calculated by receiver operating characteristic analysis. Results: One-leg standing was best at discriminating between the independent and modified independent groups (positive predictive value = 80.0%, negative predictive value = 94.1%). Tandem standing was best at discriminating between the modified independent and dependent groups (positive predictive value = 74.1%, negative predictive value = 93.3%). Conclusion: A simple standing balance test may assist in the determining level of gait independence in patients with AD when it is difficult to perform a mobility assessment.
The Role of Angiotensin II Receptor Blockers in the Management of Hypertrophic Cardiomyopathy: An Updated Meta-Analysis of Randomized Controlled Trials
Authors: Wan Yong , He Shuai , Xu Tingli , Wang Shuwei , Qi Minfang , Gan Pengcheng
Published: April 2024

Introduction: The use of angiotensin II receptor blockers (ARBs) in the treatment of hypertrophic cardiomyopathy (HCM) remains a subject of controversy. Methods: We conducted a comprehensive search of the Cochrane Library, PubMed, EMBASE, ClinicalTrials.gov, and Web of Science databases until October 2023 to identify articles investigating the effects of ARBs in patients diagnosed with HCM. Predefined criteria were utilized for selecting data on study characteristics and results. Results: The study included a total of 387 patients from 6 randomized controlled trials, which were reported in 7 articles. The results of the meta-analysis revealed that the utilization of ARBs did not yield a reduction in left ventricular (LV) mass (p = 0.07) and maximum LV wall thickness (p = 0.25), nor did it demonstrate any improvement in LV fibrosis (p = 0.39). Furthermore, there was no significant impact observed on early diastolic mitral annular velocity (p = 0.19) and LV ejection fraction (p = 0.44). Conclusions: The administration of ARBs does not appear to yield improvements in cardiac structure, function, and myocardial fibrosis in patients with HCM.
Future Burden of Ischemic Stroke in Australia: Impact on Health Outcomes between 2019 and 2038
Authors: Abebe Tamrat Befekadu , Morton Jedidiah I. , Ilomaki Jenni , Ademi Zanfina
Published: April 2024

Background: Projections of the future burden of ischemic stroke (IS) has not been extensively reported for the Australian population; the availability of such data would assist in health policy planning, clinical guideline updates, and public health. Methods: First, we estimated the lifetime risk of IS (from age 40 to 100 years) using a multistate life table model. Second, a dynamic multistate model was constructed to project the burden of IS for the whole Australian population aged between 40 and 100 years over a 20-year period (2019–2038). Data for the study were primarily sourced from a large, representative Victorian linked dataset based on the Victorian Admitted Episode Dataset and National Death Index. The model projected prevalent and incident cases of nonfatal IS, fatal IS, and years of life lived (YLL) with and without IS. The YLL outcome was discounted by 5% annually; we varied the discounting rate in scenario analyses. Results: The lifetime risk of IS from age 40 years was estimated as 15.5% for males and 14.0% for females in 2018. From 2019 to 2038, 644,208 Australians were projected to develop incident IS (564,922 nonfatal and 79,287 fatal). By 2038, the model projected there would be 358,534 people with prevalent IS, 35,554 people with incident nonfatal IS and 5,338 people with fatal IS, a 14.2% (44,535), 72.9% (14,988), and 106.3% (2,751) increase compared to 2019 estimations, respectively. Projected YLL (with a 5% discount rate) accrued by the Australian population were 174,782,672 (84,251,360 in males and 90,531,312 in females), with 4,053,794 YLL among people with IS (2,320,513 in males, 1,733,281 in females). Conclusion: The burden of IS was projected to increase between 2019 and 2038 in Australia. The outcomes of the model provide important information for decision-makers to design strategies to reduce stroke burden.
Propósitos de la enseñanza de las ciencias sociales y la historia. Una aproximación desde relatos docentes
Authors: Arias Gómez Diego
Published: April 2024

El presente artículo enuncia las finalidades de la enseñanza de las ciencias sociales y la historia en Colombia en las últimas décadas, a partir de los relatos de un grupo de docentes en ejercicio recopilados en el 2015. Según esta aproximación, se pudieron identificar tres grandes vertientes sobre el sentido de las ciencias sociales escolares: hacia lo disciplinar, hacia lo axiológico y hacia la transformación social. Estas matizaciones dialogan con el contexto del país y evidencian una lucha por establecer la legitimidad del saber sobre lo histórico-social susceptible de ser enseñado en la escuela.
El antimilitarismo como postura de vida que habita y transita los cuerpos de jóvenes en un colectivo colombiano
Authors: Salazar Castilla Mónica , Fabio Ospina Hector , Velásquez Buriticá Valentina
Published: April 2024

Este artículo presenta los resultados de la investigación: “Movilizaciones de acción política de jóvenes en Colombia desde la paz y la noviolencia”, en relación con el Kolectivo Antimilitarista de Medellín. Estos jóvenes han sido marcados por la violencia, la guerra, el narcotráfico, el paramilitarismo, las milicias, por el Estado como generador de guerra y por el patriarcado que domina sus territorios y cuerpos. Esto ha derivado en el antimilitarismo como postura y como posición radical de no a la guerra, de no hacer uso de las armas, de no aceptar ningún tipo de dominación, de romper con la militarización de la vida a través de la desobediencia, la objeción de y por conciencia, y la resistencia.
Terapia ocupacional na atenção aos idosos com histórico de quedas e seus cuidadores no contexto hospitalar
Authors: Santos Ariane Monteiro Barbosa dos , Batista Marina Picazzio Perez , Almeida Maria Helena Morgani de , Toldrá Rosé Colom
Published: April 2024

: Introdução: As quedas representam uma síndrome geriátrica complexa e comum, que afeta a mobilidade e funcionalidade da pessoa idosa, gera agravos a saúde e pode ocasionar óbito. Objetivo: Descrever a atenção de terapeutas ocupacionais a idosos hospitalizados com histórico de quedas e seus cuidadores. Método: Pesquisa qualitativa, descritiva, retrospectiva documental de prontuários de Terapia Ocupacional de usuários acompanhados nas enfermarias de clínica médica e cirúrgica do Hospital Universitário da USP entre 2019 à 2021. Resultados e Discussão: Identificados 153 prontuários e selecionados 32, maioria mulheres, com 70 anos ou mais, casadas ou viúvas.  Sete categorias temáticas correspondem às ações de Terapia Ocupacional durante a hospitalização: acolhimento enquanto estratégia assistencial, manejo das emoções e vínculos familiares, impacto da hospitalização na funcionalidade, impacto da hospitalização na cognição, educação em saúde, acolhimento familiar e preparação para a alta e orientações para seguimento após a alta. Conclusão: Constatou-se o potencial das intervenções de terapia ocupacional na funcionalidade, cognição e aspectos emocionais no idoso com histórico de quedas e a importância do acompanhamento conjunto dos cuidadores. Necessário seguimento dos cuidados em saúde após a alta hospitalar, para a prevenção de novas quedas e agravos ao idoso que impactam a rede de apoio e os serviços de saúde.