bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignant Transformation in a Chondroblastoma—Does it Exist?
Authors: Rekhi Bharat , Dave Vinayak
Published: May 2024

Chondroblastoma is currently described as a benign bone tumor, histopathologically characterized by its classical features including chondroblasts, pink cartilage, and a variable number of osteoclast-like giant cells with foci of dystrophic calcification. Although recurrent and metastasizing chondroblastomas are reported, a malignant chondroblastoma is exceedingly rare and somewhat a contentious entity. A 35-year-old male presented with a lump in his ankle of 15 years’ duration. Imaging disclosed a lytic destructive lesion involving the lower ends of the tibia and fibula with a soft tissue component, indicative of atypical/“worrisome” features. Microscopic examination of the biopsy revealed distinct foci of chondroblastoma, transitioning to areas of high-grade sarcoma, including pleomorphic cells, increased mitoses, and prominent stromal hyalinization. Immunohistochemically, the entire tumor was positive for H3K36M, while DOG1 highlighted the areas of chondroblastoma. SATB2 highlighted the areas of high-grade sarcoma, sparing the areas of chondroblastoma. Additionally, the areas of a high-grade sarcoma showed multifocal desmin immunostaining. A diagnosis of a malignant transformation in a chondroblastoma was offered. The patient defaulted to further treatment and unfortunately died 8 months, post-diagnosis. The conceptual evolution of a malignant chondroblastoma with H3K36M immunostaining in the few reported tumors is described herewith.
Supporting Transition-Readiness Skills for Adolescents With Emotional and Behavioral Disorders Using Check-In/Check-Out
Authors: Hester Olivia R. , Jolivette Kristine , Swoszowski Nicole C.
Published: May 2024

Check-in/check-out (CICO) is an evidence-based practice for addressing the behavioral needs of students with and without disabilities from kindergarten through the 12th grade. The CICO intervention is easily adapted to address other areas of need, beyond behavior, including academics and social integration, making CICO appealing for all school grade levels and differing student needs. Recently, transition skills have been targeted and integrated into CICO for adolescents with disabilities. Building from the transition-focused applications of CICO, adaptations and intensifications specific to high school students with emotional and behavioral disorders related to transition-readiness skills of self-monitoring, social skills, and vocational training are provided.
Diagnostic and Prognostic Value of C1q in Sepsis-Induced Coagulopathy
Authors: Zhang Ye , Wang Li , Kuang Xiandong , Tang Dongling , Zhang Pingan
Published: May 2024

Early identification of biomarkers that can predict the onset of sepsis-induced coagulopathy (SIC) in septic patients is clinically important. This study endeavors to examine the diagnostic and prognostic utility of serum C1q in the context of SIC. Clinical data from 279 patients diagnosed with sepsis at the Departments of Intensive Care, Respiratory Intensive Care, and Infectious Diseases at the Renmin Hospital of Wuhan University were gathered spanning from January 2022 to January 2024. These patients were categorized into two groups: the SIC group comprising 108 cases and the non-SIC group consisting of 171 cases, based on the presence of SIC. Within the SIC group, patients were further subdivided into a survival group (43 cases) and non-survival group (65 cases). The concentration of serum C1q in the SIC group was significantly lower than that in the non-SIC group. Furthermore, A significant correlation was observed between serum C1q levels and both SIC score and coagulation indices. C1q demonstrated superior diagnostic and prognostic performance for SIC patients, as indicated by a higher area under the curve (AUC). Notably, when combined with CRP, PCT, and SOFA score, C1q displayed the most robust diagnostic efficacy for SIC. Moreover, the combination of C1q with the SOFA score heightened predictive value concerning the 28-day mortality of SIC patients.
Acoustic analysis of marine vibrators based on LES/FW-H model
Authors: Jiang Yuanjie , Chen Yuda , Xing Xuefeng
Published: May 2024

In the process of marine acoustic data processing, the information on acoustic traces is acquired by correlating the control signals of marine vibrators with the acoustic data in the seawater. Since the signals controlled by marine vibrators are fixed, the resolution of marine profiles is highly dependent on acoustic signals. However, conventional fluid models have lower accuracy in measuring (or predicting) the waveform, resulting in significant differences between the data received at sea and the actual designed signal. To avoid this, a hybrid method based on Ffowcs Williams and Hawkings (FW-H) equations with the large eddy simulation (LES) is proposed to simulate the process of interactions between marine vibrators and seawater, and ultimately predict the acoustic waveform. Experiment results demonstrate the method discussed in this paper is in accord with the experimental data and provides a powerful tool for the development and design of marine vibrators.
Knowledgeable Confrontations: How to Challenge Interview Participants With Information and Data
Authors: McLeod Christopher M. , Brougham Jessica K. , Pifer N. David
Published: May 2024

This article theorizes the use of knowledge in interviews, focusing on confronting interview participants with knowledge generated from prior research. This article explains when confronting participants with knowledge is ethically and epistemologically preferable to alternatives such as debriefing or not disseminating. We share examples from studies where minor league baseball players read machine learning predictions of their chances of reaching the major leagues, and esports competitors viewed illustrations of the prize earning distribution in their chosen game. The article elaborates on the ethical considerations of using confrontational knowledge in interviews and identifies three guidelines for using the strategy.
In Conversation With Erin Manning: A Refusal of Neurotypicality Through Attunements to Learning Otherwise
Authors: Manning Erin , Bozalek Vivienne Grace
Published: May 2024

This paper documents a conversation with Erin Manning in the first webinar of the series Doing Academica Differently: In conversation with Neuroatypicality. Drawing on her scholarship, teaching experience, as well as the more recent 3Ecologies project, Manning shows how systems serve to pathologize by framing difference from the angle of typicality and as a divergence from the norm. She argues, therefore, that it is necessary to move beyond the ontological presuppositions enacted by systems of whiteness/neurotypicality. She proposes that academic work must continue to remain open to the differential within difference, and value slow and convivial practices that texture qualities of existence as a mode rather than as gridded individual identities. By focusing on the crucial notion of value in higher education and how it might be reworked in experimental ways, Manning suggests ways of attuning for learning otherwise beyond a neurotypical frame.
Protest now: A systems view of 21st century movements
Authors: Leach Colin Wayne , Ferguson Shaunette T. , Teixeira Cátia P.
Published: May 2024

The 21st century has seen unprecedented levels of mass protest all over the world. Protest is a dynamic interplay of actions over time, across levels of society (e.g., individual, interpersonal, group, intergroup), and across domains (e.g., social, cultural, political, economic). To illustrate this systems view, we first describe the local and global ecology of protest as it operates in the world now. We rely mainly on macro-level social science research to describe the scale and scope of specific movements (e.g., Black Lives Matter) as well as temporal trends in protest across the world. Second, we offer an expansive conceptualization of the types of protest, and the consequences of protest, based on an integrative review of micro- and meso-level research in psychology, and macro-level research in social science. Third, we present a temporal social network analysis of the emergence of the Black Lives Matter movement as an empirical example of a systems approach.
A wave model of high frequency vibrational energy transfer in a wedge-shaped combined plate structure
Authors: Xie Miaoxia , Ren Xintao , Zhang Peng , Huang Qianlang , Gao Fengwei , Li Ling , Yan Guanhai
Published: May 2024

Wedge shaped combined plate structure (WCPS) is broadly applied in large-sized transport equipment such as aerospace and shipping. However, with the increase of equipment operating running, it is easy to cause high-frequency vibration of structure components. Therefore, studying the energy transfer and vibration response of high-frequency vibration in WCPS is significant for the structural design of aerospace and shipping. The promising method is energy finite element analysis (EFEA). However, the energy transfer coefficient at joint of WCPS is needed in EFEA. The current studies about the energy transfer coefficients are focus on the joint between two uniform thickness plate. But it is some different that getting the energy transfer coefficient for WCPS, because the near-field solve representation for wedge-shaped plate is complicated due to the non-uniform thickness of wedge-shaped plate member in WCPS. In this research, geometric acoustic approximation and an equilibrium equation on both ends of joints were used to derive the equation of the energy transfer coefficient for the WCPS. Then by setting coupling nodes, construction of a coupling matrix to characterize discontinuity of energy density at the coupling position of the WCPS and energy density governing equation of wedge-shaped plates were integrated. In doing so, the EFEA modeling of the WCPS was developed and the energy density distribution on each node of the WCPS could be obtained. Same-sized uniformly coupled structures is analyzed, the vibration energy distribution characteristics of two types of coupling structures were compared. The results show that the energy density value of the wedge plate member attenuate more slowly than that of the uniform plate member due to the acoustic black hole aggregation effect in the wedge plate part, and there is an abrupt change in the energy density value at the joint of WCPS. As a result, the factors influencing high-frequency vibration energy transfer were investigated.
Knowledge about unintended pregnancy shortly after childbirth: An issue of ineffective counseling or adherence?
Authors: Essien Samuel Kwaku , Chireh Batholomew , Essien John Kwasi
Published: May 2024

Background:

Being aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period is often overlooked but remains a significant contributor to unintended pregnancies and may lead to maternal and neonatal comorbidities. Exploring the extent of awareness and associated factors could help tailor more interventions toward reducing the rates of short-interval unplanned pregnancies.

Objective:

This study explores the extent to which Ghanaian women are aware of the possibility of becoming pregnant shortly after childbirth before the resumption of the menstrual period and its associated factors.

Design:

A cross-sectional study was conducted using the 2017 Ghana Maternal Health Survey. The women participants were sampled using a two-stage cluster sampling design.

Methods:

We analyzed the 2017 Ghana Maternal Health Survey data of 8815 women who had given birth and received both antenatal care and postnatal checks after delivery in health facilities (private and public) and responded to questions on being aware of short interpregnancy intervals. A multivariable survey logistic regression was used for the analysis.

Results:

Of the 8815 women, approximately 62% of women who received both antenatal care and postnatal examinations before discharge reported being aware of short interpregnancy intervals. Postnatal examination before discharge but not antenatal care was associated with a higher awareness of short interpregnancy intervals. Women who received a postnatal examination were more aware of short interpregnancy intervals than their counterparts (adjusted odds ratio = 1.29, 95% confidence interval: 1.03–1.61). Also, awareness of short interpregnancy intervals increased with age, education, knowledge of the fertile period, contraceptive use, and delivery via cesarean section.

Conclusion:

Over a decade following the initiation of Ghana’s free maternal health policy, there remains a significant gap in the awareness of short interpregnancy intervals, even among women who received both antenatal pregnancy care and postnatal examinations before discharge. The unawareness of the short interpregnancy interval observed in approximately 38% of women raises concerns about the effectiveness of counseling or education provided during antenatal care and immediate post-partum care regarding birth spacing, contraceptive use, the timing of resumption of sexual activity, and the extent to which women adhere to such guidance.
Pedicled flap versus skin graft for great toe defect repair after wrap-around flap transfer
Authors: Hui Taotao , Tang Yinyao , Qiang Li
Published: May 2024

This study compared the clinical outcomes of tibial-sided digital artery pedicled flap from the second toe versus full-thickness skin grafting to repair great toe defects after wrap-around flap transfers. The pedicled flap resulted in better pain scores and aesthetic outcomes.
Sex-related disparities in cough-associated symptoms across different age groups
Authors: Kang Jiyeon , Seo Woo Jung , Kim Jung Gon , Moon Ji-Yong , Kim Deog Kyeom , Kim Jin Woo , Jang Seung Hun , Kwon Jae-Woo , Lee Byung-Jae , Koo Hyeon-Kyoung
Published: May 2024

Background:

Sex-related disparities in the prevalence of chronic cough have been consistently reported globally, with varying male-to-female ratios.

Objectives:

This study aimed to evaluate sex-related differences by comparing correlations between cough-related symptoms in males and females of different age groups.

Design:

Adult patients with chronic cough who completed the Leicester Cough Questionnaire (LCQ) were recruited from 16 respiratory centers.

Methods:

Correlation networks were constructed based on Spearman’s correlation coefficients in males and females of various age groups. The distinct relationships of cough-related symptoms between subgroups were validated by an independent cohort.

Results:

A total of 255 patients were enrolled in this study (male-to-female ratio, 1:1.71). The following LCQ items were highly correlated: embarrassment and interference with daily work, anxiety, and interference with overall life enjoyment/feeling of being fed up, interference with daily work and overall life enjoyment, interference with overall life enjoyment and feeling of being fed up, and feeling of being fed up and annoyance to partner/family/friends. The patterns of these correlations between LCQ items varied in males and females of different ages. The strongest interrelationship was observed in male patients aged >50 years old, which was similar to those in the validation cohort.

Conclusion:

The correlation patterns between cough-related symptoms vary significantly according to age and sex. Understanding the mechanisms underlying the development of cough-related symptoms may facilitate sex- and age-specific strategies for chronic cough.
Post-colonial educational reforms in Zimbabwe: A fake badge of decolonisation of the curriculum
Authors: Chimbunde Pfuurai , Moreeng Boitumelo Benjamin
Published: May 2024

While educational debates on the decolonisation of education have gained momentum in Sub-Saharan Africa, little is known about the success and progress made thus far, leaving a critical gap in our understanding of the accomplishment of the decolonisation agenda and whether what has been reformed is of use. Using document analysis, the qualitative study used Zimbabwe as a case to explore the progress made in the decolonisation of the education system to address the needs of the local population. The findings reveal that post-colonial educational reforms in Zimbabwe remain cosmetic and without meaningful thrust to assist in the socio-economic development and success of the once underprivileged. The study concludes that post-colonial education in Zimbabwe and other African states despite more than four decades of reforming the education system, the plight of the ordinary graduate seems little improved. It recommends that post-colonial states in Africa must interrogate the central purpose of education, the intended audience, the way people learn, and the subject matter and how it should be organised and presented. The study contributes to the topical debate on the need to transform the African education systems and their curricula in response to the decolonialisation agenda in the Global South.
The challenge of pharmacotherapy for musculoskeletal pain: an overview of unmet needs
Authors: Moretti Antimo , Snichelotto Francesco , Liguori Sara , Paoletta Marco , Toro Giuseppe , Gimigliano Francesca , Iolascon Giovanni
Published: May 2024

Musculoskeletal disorders are characterized by several impairments, including pain, affecting muscles, bones, joints and adjacent connective tissue, resulting in temporary or permanent functional limitations and disability. Musculoskeletal pain is particularly prevalent worldwide and greatly impacts the quality of life, social participation and economic burden. To date, several issues persist about the classification of musculoskeletal pain and its management strategies and resources. The treatment of musculoskeletal pain conditions is complex and often requires a multimodal approach, including pharmacological and non-pharmacological therapy that might be ineffective in many cases, resulting in poor patient satisfaction and controversial expectations about the potential benefits of available interventions. This manuscript provides an overview of unmet needs in managing musculoskeletal pain, particularly focusing on pharmacotherapeutic pitfalls in this context.
Does Professional Self-Efficacy Provide a Shield in Troubling Situations? Evidence of Performance and Thriving Through Perceived Strength Use
Authors: Ghani Usman , Usman Muhammad , Cheng Jin , Mehmood Qaiser , Shao Xingjiang
Published: May 2024

The COVID-19 pandemic has created a more stressful and uncertain work environments, disrupting personal and organizational lives, and particularly the impact of this crises on health care professionals (i.e., doctors and nurses) is unprecedented. COVID-19 has increased the workload and job risks for frontline health care professionals, causing them significant emotional stress. In such testing times, individual’s personal effectiveness ensued by the utilization of one’s personal energy may be helpful in not only ensuring wellbeing but also providing other desired results, for example, enhanced performance. Based on this notion, we conducted a study (amidst the third wave in mid-2021) using a multi-wave design to investigate the role of professional self-efficacy of health care professionals in well-being and behavioral outcomes during crises of COVID-19. The hypothesized relationships were tested by collecting data from 361 frontline healthcare professionals dealing with COVID-19 patients in hospitals in Northern part of Pakistan. The study results verified our assumed relationships and revealed that health care workers’ professional self-efficacy was positively related to their well-being, in terms of workplace thriving, and it also showed positive association with work role performance. In addition, the results of the study also revealed that perceived strengths use mediated the relationship between professional self-efficacy and outcomes. This study discusses implications, limitations, and future directions in detail, including how the findings can be used to inform interventions and support healthcare professionals dealing with the emotional and professional stresses brought on by the pandemic.
Training Needs of In-Service Bilingual Teachers: A study of Taiwan
Authors: Luo Wen-Hsing
Published: May 2024

The present study is aimed to investigate in-service bilingual teachers’ perceptions of training needs in the competences and knowledge required to implement bilingual curricula in Taiwan. To this end, this study used mixed methods consisting of questionnaires and individual interviews to collect data from the intended cohort, that is, in-service teachers involved in bilingual curricula at elementary and junior high schools in Taiwan. In this study, data collection comprised questionnaire data from 76 respondents and transcripts of 15 interviews. Descriptive statistics and Grounded Theory method were employed to analyze the research data. The study revealed the differences in training needs of Taiwanese in-service bilingual teachers with regard to the school levels, teacher types, language proficiency levels, and bilingual teaching experiences. From the findings, several suggestions are made for professional development for in-service bilingual teachers in Taiwan. It is suggested that Taiwan’s Ministry of Education consider the factors of teacher types and school levels when developing in-service training courses. Additionally, training on the English language needs to be re-evaluated in the professional development courses for bilingual teachers in Taiwan, in particular for English language teachers. Through this study, the author wishes to shed light on training needs of bilingual teachers in Taiwan, and accordingly, to propose suggestions on bilingual teacher training.
The Effect of Explicit Information in Processing Instruction on Middle School Students’ Acquisition of English Passive Voice
Authors: Zeng Tao , Xu Peng , Gao Xi
Published: May 2024

This study aims to investigate the effectiveness of explicit information (EI) in the context of Processing Instruction (PI) as an alternative to traditional teaching methods. PI encompasses explicit information and structured input activity (SI). However, the effectiveness of EI has been a subject of debate. To address this question, grade-7 students were divided into three groups: the complete Processing Instruction group, the explicit information only group, and the structured input activity only group. Following pre-tests and the implementation of different teaching instructions on English passive voice, the scores of the participants were analyzed for the immediate post-test and delayed post-test. The results suggested that although EI did not accelerate the acquisition of the form-meaning connection of English passive voice, it was beneficial for final performance similar to SI. The complete Processing Instruction, however, proved to be the most effective. This study suggests a possible association between the effectiveness of EI and the relative difficulty of the target item for language learners.
Chronic Pancreatitis Pain Associated With Energy Drink Consumption: A Case Report
Authors: McMillan Chandler , Dower Justin , Ikeda Ian , Marhoffer Elizabeth
Published: May 2024

Chronic pancreatitis is commonly associated with heavy alcohol use and cigarette smoking, though many cases of chronic pancreatitis are idiopathic. Energy drink consumption has been on the rise over the last decade, with an adverse health risk profile including gastrointestinal symptoms such as dyspepsia, reflux, and gastritis. There have been several case reports linking energy drink consumption to presentations of acute pancreatitis in adult patients. To our knowledge, the association between energy drinks and episodes of chronic pancreatitis flares has not been well studied. This article explores a case of chronic pancreatitis pain related to excessive energy drink consumption in an adult male patient. This study aims to shed light on energy drinks as a potential etiology of chronic pancreatitis flares, and emphasizes the importance of counseling patients on the potential risks of excessive energy drink consumption.
Rethinking College Transitions: Legitimate Peripheral Participation as a Pathway to Becoming
Authors: Young Dallin George , Bunting Bryce D.
Published: May 2024

This paper’s purpose is to review theoretical explanations of college transitions, offer a critique of their utility, and make an explicit argument that the field of higher education would benefit from a shift from a view of transition as induction or development to transition as becoming. Moreover, we propose that the use of legitimate peripheral participation paired with transition as becoming as an emerging theoretical viewpoint that (1) points toward ways educators can shape environments that support transitions as becoming, (2) more effectively describes the lived experiences of students in transition, and (3) facilitates improved understanding, study, and implementation of student transition programs in the United States.
IL-1 in aging and pathologies of hematopoietic stem cells
Authors: Caiado Francisco , Manz Markus G.
Published: May 2024

Defense-oriented inflammatory reactivity supports survival at younger age but might contribute to health impairments in modern, aging societies. The interleukin-1 (IL-1) cytokines are highly conserved and regulated, pleiotropic mediators of inflammation, essential to respond adequately to infection and tissue damage but also with potential host damaging effects when left unresolved. In this review, we discuss how continuous low-level IL-1 signaling contributes to aging-associated hematopoietic stem and progenitor cell (HSPC) functional impairments and how this inflammatory selective pressure acts as a driver of more profound hematological alterations, such as clonal hematopoiesis of indeterminate potential, and to overt HSPC diseases, like myeloproliferative and myelodysplastic neoplasia as well as acute myeloid leukemia. Based on this, we outline how IL-1 pathway inhibition might be used to prevent or treat inflammaging-associated HSPC pathologies.
ECHDC2 inhibits the proliferation of gastric cancer cells by binding with NEDD4 to degrade MCCC2 and reduce aerobic glycolysis
Authors: He Jiancheng , Yi Jianfeng , Ji Li , Dai Lingchen , Chen Yu , Xue Wanjiang
Published: May 2024

Background

The Enoyl-CoA hydratase/isomerase family plays a crucial role in the metabolism of tumors, being crucial for maintaining the energy balance and biosynthetic needs of cancer cells. However, the enzymes within this family that are pivotal in gastric cancer (GC) remain unclear.

Methods

We employed bioinformatics techniques to identify key Enoyl-CoA hydratase/isomerase in GC. The expression of ECHDC2 and its clinical significance were validated through tissue microarray analysis. The role of ECHDC2 in GC was further assessed using colony formation assays, CCK8 assay, EDU assay, Glucose and lactic acid assay, and subcutaneous tumor experiments in nude mice. The mechanism of action of ECHDC2 was validated through Western blotting, Co-immunoprecipitation, and immunofluorescence experiments.

Results

Our analysis of multiple datasets indicates that low expression of ECHDC2 in GC is significantly associated with poor prognosis. Overexpression of ECHDC2 notably inhibits aerobic glycolysis and proliferation of GC cells both in vivo and in vitro. Further experiments revealed that overexpression of ECHDC2 suppresses the P38 MAPK pathway by inhibiting the protein level of MCCC2, thereby restraining glycolysis and proliferation in GC cells. Ultimately, it was discovered that ECHDC2 promotes the ubiquitination and subsequent degradation of MCCC2 protein by binding with NEDD4.

Conclusions

These findings underscore the pivotal role of the ECHDC2 in regulating aerobic glycolysis and proliferation in GC cells, suggesting ECHDC2 as a potential therapeutic target in GC.
Estimation of the earlywood and latewood ratio with different particle size of dry and wet milled Japanese cedar wood flour by using hyperspectral imaging
Authors: Kobori Hikaru , Egawa Akari , Sakaguchi Kazuya , Kojima Yoichi , Aoki Kenji
Published: May 2024

Mechanical properties of wood–plastic composites are influenced by a particle size and surface morphology of wood flour. Generally various sizes of wood flour are produced from single solid wood even if the single process is used. If the different particle size of wood flour is produced from different wood tissue such as earlywood (EW) and latewood (LW), not only particle size but also density and chemical composition of wood flour might influence the mechanical property of final products. This study aims to investigate the relationship between particle size and their origin; EW and LW. EW and LW were separately milled to produce the EW and LW flour by dry and wet milling. Hyperspectral images ranging 400–1000 nm for each wood flour were used as training data. Discriminant model of EW and LW flour developed by PLS-DA showed over 0.77 of accuracy. Then the EW and LW were dry and wet milled together and screened by three different sieve openings to obtain different particle size wood flour. Discriminant model was applied for the hyperspectral images of each size of wood flour to estimate the EW and LW ratio. The result showed that increasing sieve opening resulted in the increasing ratio of LW for dry milled wood flours. The results suggest that the EW was easily pulverized than LW.
Unveiling the genetic architecture and transmission dynamics of a novel multidrug-resistant plasmid harboring blaNDM-5 in E. Coli ST167: implications for antibiotic resistance management
Authors: Han Dengke , Ma Suzhen , He Chenhong , Yang Yuxing , Li Peng , Lu Lanfen
Published: May 2024

Background

The emergence of multidrug-resistant (MDR) Escherichia coli strains poses significant challenges in clinical settings, particularly when these strains harbor New Delhi metallo-ß-lactamase (NDM) gene, which confer resistance to carbapenems, a critical class of last-resort antibiotics. This study investigates the genetic characteristics and implications of a novel blaNDM-5-carrying plasmid pNDM-5-0083 isolated from an E. coli strain GZ04-0083 from clinical specimen in Zhongshan, China.

Results

Phenotypic and genotypic evaluations confirmed that the E. coli ST167 strain GZ04-0083 is a multidrug-resistant organism, showing resistance to diverse classes of antibiotics including ß-lactams, carbapenems, fluoroquinolones, aminoglycosides, and sulfonamides, while maintaining susceptibility to monobactams. Investigations involving S1 pulsed-field gel electrophoresis, Southern blot analysis, and conjugation experiments, alongside genomic sequencing, confirmed the presence of the blaNDM-5 gene within a 146-kb IncFIB plasmid pNDM-5-0083. This evidence underscores a significant risk for the horizontal transfer of resistance genes among bacterial populations. Detailed annotations of genetic elements—such as resistance genes, transposons, and insertion sequences—and comparative BLAST analyses with other blaNDM-5-carrying plasmids, revealed a unique architectural configuration in the pNDM-5-0083. The MDR region of this plasmid shares a conserved gene arrangement (repA-IS15DIV-blaNDM-5-bleMBL-IS91-suI2-aadA2-dfrA12) with three previously reported plasmids, indicating a potential for dynamic genetic recombination and evolution within the MDR region. Additionally, the integration of virulence factors, including the iro and sit gene clusters and enolase, into its genetic architecture poses further therapeutic challenges by enhancing the strain’s pathogenicity through improved host tissue colonization, immune evasion, and increased infection severity.

Conclusions

The detailed identification and characterization of pNDM-5-0083 enhance our understanding of the mechanisms facilitating the spread of carbapenem resistance. This study illuminates the intricate interplay among various genetic elements within the novel blaNDM-5-carrying plasmid, which are crucial for the stability and mobility of resistance genes across bacterial populations. These insights highlight the urgent need for ongoing surveillance and the development of effective strategies to curb the proliferation of antibiotic resistance.
Correlation between triglyceride glucose-body mass index and hypertension risk: evidence from a cross-sectional study with 60,283 adults in eastern China
Authors: Chen Yijia , Du Jinling , Zhou Nan , Song Yingqian , Wang Weiwei , Hong Xin
Published: May 2024

Background

Insulin resistance (IR) and obesity are established risk factors for hypertension, with triglyceride-glucose (TyG) serving as a recognized surrogate marker for IR. The aim of this study was to investigate the association between TyG-BMI and hypertension in the general population.

Methods

A total of 60,283 adults aged ≥18 years who underwent face-to-face questionnaires, anthropometric measurements, and laboratory examination were included in this study. Multivariable logistic regression models and receiver operating characteristic curve (ROC) were used to determine the association between TyG-BMI and hypertension. The restricted cubic spline model was used for the dose-response analysis.

Results

After fully adjusting for confounding variables, multivariate logistic regression model showed a stable positive association between TyG-BMI and hypertension (OR: 1.61 per SD increase; 95% CI: 1.55–1.67; P-trend < 0.001). The multivariate adjusted OR and 95% CI for the highest TyG-BMI quartile compared with the lowest quartile were 2.52 (95% CI 2.28–2.78). Dose-response analysis using restricted cubic spline confirmed that the association between TyG-BMI index and hypertension was linear. Subgroup analyses showed that stronger associations between TyG-BMI index and hypertension were detected in young and middle-aged individuals (P for interaction < 0.05). ROC analysis showed that TyG-BMI index could better predict the risk of hypertension than other parameters (TyG-BMI cut-off value: 207.105, AUC: 0.719, sensitivity 65.5%, specificity 66.8%), particularly among young and middle-aged people.

Conclusion

The TyG-BMI index was independently associated with hypertension in the study population. Further studies are required to confirm this relationship.
Older people’s perception of being frail – a qualitative exploration
Authors: Hall Abigail J. , Nikolova Silviya , Prescott Matthew , Goodwin Victoria A.
Published: May 2024

Background

Frailty is a suggested consequence of ageing, but with a variety of different definitions the understanding of what it means to be frail is challenging. There is a common belief that frailty results in a reduction of physical functioning and ability and therefore is likely to significantly affect a person’s quality of life. The aim of this study was to explore the understanding of older people about the meaning of frailty and the potential consequences of being classified as frail.

Methods

This paper forms a secondary analysis of a process evaluation of a complex intervention that was embedded within the individually randomised Home-based Extended Rehabilitation of Older people (HERO) trial. A maximum variation, purposive sampling strategy sought to recruit participants with a wide range of characteristics. Data collection included observations of the delivery of the intervention, documentary analysis and semi-structured interviews with participants. Thematic analysis was used to make sense of the observational and interview data, adopting both inductive and deductive approaches.

Results

Ninety three HERO trial participants were sampled for the process evaluation with a total of 60 observational home visits and 35 interviews were undertaken. There was a wide range in perceptions about what it meant to be classified as frail with no clear understanding from our participants. However, there was a negative attitude towards frailty with it being considered something that needed to be avoided where possible. Frailty was seen as part of a negative decline that people struggled to associate with. There was discussion about frailty being temporary and that it could be reduced or avoided with sufficient physical exercise and activity.

Conclusion

Our study provides insight into how older people perceive and understand the concept of frailty. Frailty is a concept that is difficult for patients to understand, with most associating the term with an extreme degree of physical and cognitive decline. Having a label of being “frail” was deemed to be negative and something to be avoided, suggesting the term needs to be used cautiously.

Trial registration

ISRCTN 13927531. Registered on April 19, 2017.
Tuberculosis treatment delay and associated factors among pulmonary tuberculosis patients at public health facilities in Dale District and Yirgalem Town administration, Sidama Region, South Ethiopia
Authors: Rima Daniel Dawit , Legese Derese , Woldesemayat Endrias Markos
Published: May 2024

Background

Tuberculosis (TB) treatment delay is one of the major challenges of TB care in many low-income countries. Such cases may contribute to an increased TB transmission and severity of illness. The aim of this study was to determine the magnitude of patient delay in TB treatment, and associated factors in Dale District and Yirgalem Town administration of Sidama Region, Southern Ethiopia.

Methods

Between January 1-Augst 30/ 2022, we studied randomly selected 393 pulmonary TB cases on Directly Observed Treatment Short course (DOTS) in Dale District and Yirgalem Town Administration. After conducting a pretest, we interviewed participants on sociodemographic, health seeking behavior and clinical factors and reviewed the TB registry. Trained enumerators interviewed to collect data. We entered data in to EPI-info 7 version 3.5.4 and then exported to the Statistical Package for Social Science (SPSS) version 23 for analysis. Multivariable logistic regression was used to identify associated factors of TB and statistical significance was defined using the 95% confidence interval.

Result

A total of 393 (98%) participants involved in the study. The magnitude of delay in TB treatment among the study participants was 223 (56.7%) (95% CI (51.8 – 61.6%)). Distance of the health facility from home, (adjusted odds ratio (AOR) = 2.04, 95% CI (1.3, 3.2)), seeking antibiotic treatment before being diagnosed for TB (AOR = 2.1, 95% CI (1.3, 3.5)) and the knowledge of TB prevention and treatments (AOR = 5.9, 95% CI (3.6, 9.8)), were factors associated with delay in TB treatment.

Conclusion

The prevalence of TB treatment delay among pulmonary TB patients in the study setting was high. Delay in TB treatment was associated with knowledge, behavioral and accessibility related factors. Providing health education and active case finding of TB would help in minimizing the delay.
Myoclonus improvement after seizures in progressive myoclonic epilepsy type 7: a case report
Authors: G S B Lima Pedro Lucas , Nobrega Paulo R , Freua Fernando , Braga-Neto Pedro , Paiva Anderson R B , Guimarães Thiago Gonçalves , Kok Fernando
Published: May 2024

Background

Progressive Myoclonic Epilepsy (PME) is a group of rare diseases that are difficult to differentiate from one another based on phenotypical characteristics.

Case report

We report a case of PME type 7 due to a pathogenic variant in KCNC1 with myoclonus improvement after epileptic seizures.

Discussion

Myoclonus improvement after seizures may be a clue to the diagnosis of Progressive Myoclonic Epilepsy type 7.
Safe Stop IPI-NIVO trial: early discontinuation of nivolumab upon achieving a complete or partial response in patients with irresectable stage III or metastatic melanoma treated with first-line ipilimumab-nivolumab – study protocol
Authors: Janssen J. C. , van Dijk B. , de Joode K. , Aarts M. J. B. , van den Berkmortel F. W. P. J. , Blank C. U. , Boers-Sonderen M. J. , van den Eertwegh A. J. M. , de Groot J. W. B. , Jalving M. , de Jonge M. J. A. , Joosse A. , Kapiteijn E. , Kamphuis-Huismans A. M. , Naipal K. A. T. , Piersma D. , Rikhof B. , Westgeest H. M. , Vreugdenhil G. , Oomen-de Hoop E. , Mulder E. E. A. P. , van der Veldt Astrid A. M.
Published: May 2024

Background

Patients with irresectable stage III or metastatic melanoma presenting with poor prognostic factors are usually treated with a combination of immune checkpoint inhibitors (ICIs), consisting of ipilimumab and nivolumab. This combination therapy is associated with severe immune related adverse events (irAEs) in about 60% of patients. In current clinical practice, patients are usually treated with ICIs for up to two years or until disease progression or the occurrence of unacceptable AEs. The incidence of irAEs gradually increases with duration of treatment. While durable tumour responses have been observed after early discontinuation of treatment, no consensus has been reached on optimal treatment duration. The objective of the Safe Stop IPI-NIVO trial is to evaluate whether early discontinuation of ICIs is safe in patients with irresectable stage III or metastatic melanoma who are treated with combination therapy.

Methods

The Safe Stop IPI-NIVO trial is a nationwide, multicentre, prospective, single-arm, interventional study in the Netherlands. A total of 80 patients with irresectable stage III or metastatic melanoma who are treated with combination therapy of ipilimumab-nivolumab and have a complete or partial response (CR/PR) according to RECIST v1.1 will be included to early discontinue maintenance therapy with anti-PD-1. The primary endpoint is the rate of ongoing response at 12 months after start of ICI. Secondary endpoints include ongoing response at 24 months, disease control at different time points, melanoma specific and overall survival, the incidence of irAEs and health-related quality of life.

Discussion

From a medical, healthcare and economic perspective, overtreatment should be prevented and shorter treatment duration of ICIs is preferred. If early discontinuation of ICIs is safe for patients who are treated with the combination of ipilimumab-nivolumab, the treatment duration of nivolumab could be shortened in patients with a favourable tumour response.

Trial registration

ClinicalTrials.gov ID NCT05652673, registration date: 08–12-2022.
In situ analysis of CCR8+ regulatory T cells in lung cancer: suppression of GzmB+ CD8+ T cells and prognostic marker implications
Authors: Hayashi Yoshinori , Ueyama Azumi , Funaki Soichiro , Jinushi Koichi , Higuchi Naoko , Morihara Hitomi , Hirata Michinari , Nagira Yoji , Saito Takuro , Kawashima Atsunari , Iwahori Kota , Shintani Yasushi , Wada Hisashi
Published: May 2024

Background

CCR8-expressing regulatory T cells (Tregs) are selectively localized within tumors and have gained attention as potent suppressors of anti-tumor immunity. This study focused on CCR8+ Tregs and their interaction with CD8+ T cells in the tumor microenvironment of human lung cancer. We evaluated their spatial distribution impact on CD8+ T cell effector function, specifically granzyme B (GzmB) expression, and clinical outcomes.

Methods

A total of 81 patients with lung squamous cell carcinoma (LSCC) who underwent radical surgical resection without preoperative treatment were enrolled. Histological analyses were performed, utilizing an automated image analysis system for double-stained immunohistochemistry assays of CCR8/Foxp3 and GzmB/CD8. We investigated the association of CCR8+ Tregs and GzmB+ CD8+ T cells in tumor tissues and further evaluated the prognostic impact of their distribution profiles.

Results

Histological evaluation using the region of interest (ROI) protocol showed that GzmB expression levels in CD8+ T cells were decreased in areas with high infiltration of CCR8+ Tregs, suggesting a suppressive effect of CCR8+ Tregs on T cell cytotoxicity in the local tumor microenvironment. Analysis of the association with clinical outcomes showed that patients with more CCR8+ Tregs and lower GzmB expression, represented by a low GzmB/CCR8 ratio, had worse progression-free survival.

Conclusions

Our data suggest that local CCR8+ Treg accumulation is associated with reduced CD8+ T cell cytotoxic activity and poor prognosis in LSCC patients, highlighting the biological role and clinical significance of CCR8+ Tregs in the tumor microenvironment. The GzmB/CCR8 ratio may be a useful prognostic factor for future clinical applications in LSCC.
Causal relationship between thyroid dysfunction and ovarian cancer: a two-sample Mendelian randomization study
Authors: Wang Tingting , Wang Xiaoqin , Wu Jun , Li Xin
Published: May 2024

Purpose

Observational studies and clinical validation have suggested a link between thyroid dysfunction and an elevated ovarian cancer (OC) risk. However, whether this association indicates a cause-and-effect relationship remains uncertain. We aimed to investigate the plausible causal impact of thyroid dysfunction on OC through a Mendelian randomization (MR) study.

Methods

Genome-wide association study (GWAS) data for thyrotropin (TSH), free thyroxine (FT4), hypothyroidism, and hyperthyroidism were obtained as exposures and those for OC (N = 199,741) were selected as outcomes. Inverse variance-weighted method was used as the main estimation method. A series of sensitivity analyses, including Cochran’s Q test, MR-Egger intercept analysis, forest plot scatter plot, and leave-one-out test, was conducted to assess the robustness of the estimates.

Results

Genetic prediction of hyperthyroidism was associated with a potential increase in OC risk (odds ratio = 1.094, 95% confidence interval: 1.029–1.164, p = 0.004). However, no evidence of causal effects of hypothyroidism, TSH, and FT4 on OC or reverse causality was detected. Sensitivity analyses demonstrated consistent and reliable results, with no significant estimates of heterogeneity or pleiotropy.

Conclusions

This study employed MR to establish a correlation between hyperthyroidism and OC risk. By genetically predicting OC risk in patients with hyperthyroidism, our research suggests new insights for early prevention and intervention of OC.
Gender differences in plasma S100B levels of patients with major depressive disorder
Authors: Wu Yifan , Lu Yihui , Kong Lingtao , Xie Yu , Liu Wen , Yang Anqi , Xin Kaiqi , Yan Xintong , Wu Longhai , Liu Yilin , Zhu Qianying , Cao Yang , Zhou Yifang , Jiang Xiaowei , Tang Yanqing , Wu Feng
Published: May 2024

Background

Low concentrations of S100B have neurotrophic effects and can promote nerve growth and repair, which plays an essential role in the pathophysiological and histopathological alterations of major depressive disorder (MDD) during disease development. Studies have shown that plasma S100B levels are altered in patients with MDD. In this study, we investigated whether the plasma S100B levels in MDD differ between genders.

Methods

We studied 235 healthy controls (HCs) (90 males and 145 females) and 185 MDD patients (65 males and 120 females). Plasma S100B levels were detected via multifactor assay. The Mahalanobis distance method was used to detect the outliers of plasma S100B levels in the HC and MDD groups. The Kolmogorov–Smirnov test was used to test the normality of six groups of S100B samples. The Mann–Whitney test and Scheirer-Ray-Hare test were used for the comparison of S100B between diagnoses and genders, and the presence of a relationship between plasma S100B levels and demographic details or clinical traits was assessed using Spearman correlation analysis.

Results

All individuals in the HC group had plasma S100B levels that were significantly greater than those in the MDD group. In the MDD group, males presented significantly higher plasma S100B levels than females. In the male group, the plasma S100B levels in the HC group were significantly higher than those in the MDD group, while in the female group, no significant difference was found between the HC and MDD groups. In the male MDD subgroup, there was a positive correlation between plasma S100B levels and years of education. In the female MDD subgroup, there were negative correlations between plasma S100B levels and age and suicidal ideation.

Conclusions

In summary, plasma S100B levels vary with gender and are decreased in MDD patients, which may be related to pathological alterations in glial cells.