bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperbranched Vitrimer for Ultrahigh Energy Dissipation
Authors: Cheng Lin , Zhao Jun , Xiong Zhongqiang , Liu Sijun , Yan Xuzhou , Yu Wei
Published: April 2024

Polymers are ideally utilized as damping materials due to the high internal friction of molecular chains, enabling effective suppression of vibrations and noises in various fields. Current strategies rely on broadening the glass transition region or introducing additional relaxation components to enhance the energy dissipation capacity of polymeric damping materials. However, it remains a significant challenge to achieve high damping efficiency through structural control while maintaining dynamic characteristics. In this work, we propose a new strategy to develop hyperbranched vitrimers (HBVs) containing dense pendant chains and loose dynamic crosslinked networks. A novel yet weak dynamic transesterification between the carboxyl and boronic acid ester was confirmed and used to prepare HBVs based on poly (hexyl methacrylate‐2‐(4‐ethenylphenyl)‐5,5‐dimethyl‐1,3,2‐dioxaborinane) P(HMA‐co‐ViCL) copolymers. The
‐type of macromonomers, the crosslinking points formed by the dynamic covalent connection via the associative exchange, and the weak yet dynamic exchange reaction are the three keys to developing high‐performance HBV damping materials. We found that P(HMA‐co‐ViCL) 20k‐40‐60 HBV exhibited ultrahigh energy‐dissipation performance over a broad frequency and temperature range, attributed to the synergistic effect of dense pendant chains and weak dynamic covalent crosslinks. This unique design concept will provide a general approach to developing advanced damping materials.
Synergistic effects of in situ fibrillated polytetrafluoroethylene and polystyrene–butadiene block on the microcellular foaming behaviors of polyphenylene oxide modified by high‐impact polystyrene
Authors: Yan Meiqi , Li Zhuolun , Liu Haiming , Sun Yibo , Wang Xiangdong , Chen Shihong
Published: April 2024

Microcellular foams of polyphenylene oxide/high‐impact polystyrene (PPO/HIPS) with high strength are prepared using supercritical CO2 foaming technology. The study focuses on examining the influence of polytetrafluoroethylene (PTFE) and polystyrene–butadiene block (SEBS) polymers in PPO/HIPS blends. Compared with the pure PPO/HIPS blend, the PPO/HIPS blend with 1 phr PTFE exhibits higher impact strength (7.62 kJ/m2), and the foam compressive strength is 5% larger. The PPO/HIPS foams with 1 phr PTFE (as a nucleating agent) and 5 phr SEBS (as a toughening agent) display a small cell diameter (13.73 μm) and the highest cell density (2.02 × 109 cells/cm3) compared to the pure PPO/HIPS blend. Moreover, the compressive strength of the PPO/HIPS/PTFE‐1/SEBS‐5 foam (1.63 MPa at a 5% strain) demonstrates a remarkable increase of 92% compared to that of the PPO/HIPS/PTFE‐1 foam.
A functional phosphorus/nitrogen‐containing compound for endowing epoxy resin simultaneously with better fire safety, comparable transparency and improved toughness
Authors: Wang Luze , Cai Boyu , Xu Wendi , Luo Zhonglin , Wang Biaobing
Published: April 2024

Currently, the flame retardancy of epoxy resin (EP) was achieved at the expenses of the transparency and/or toughness. In the present work, a phosphorus/nitrogen‐containing compound (FDNP) was synthesized by one‐pot method using 9,10‐dihydro‐9‐oxa‐10‐phospha‐phenanthrene‐10‐oxide, furfural and N‐phenyl‐p‐phenylenediamine as raw materials, and further adopted as a functional agent for epoxy resin. The results demonstrated that the FDNP remarkably improved the fire safety of EP. The incorporation of 4 wt% FDNP enabled EP to pass UL‐94 V‐0 rating test and achieve a limiting oxygen index value of 35.5%; meanwhile, the peak heat release rate, total heat release rate and total smoke release were significantly reduced by 41.3%, 41.6% and 72.5% as compared with the pure EP, respectively. What is more, the EP/4 wt% FDNP composite kept almost the same transparency of the pure EP, simultaneously its impact strength was more than doubled as that of the pure EP. Herein, the improved flame retardancy is contributed to a synergistic biphasic flame retardant effect including the formation of a compact protective carbon layer and the release of both non‐combustible gases and phosphorus‐containing radicals.
One‐pot preparation of nanoparticles via self‐assembly of sodium lignosulfonate and quaternary ammonium for controlled release of emamectin benzoate
Authors: Zhang Mengdong , Yang Limei , Xie Landie , Wen Xiaoqiu , Zhang Min , Ma Lin
Published: April 2024

Nanoformulation was an important strategy to reduce the use of pesticides and the impacts on the environment. However, complex process and high cost hurdled the application in agriculture. In this work, sodium lignosulfonate (SL) and cetyltrimethyl ammonium chloride (CTAC) were combined into nanoparticles and utilized as carriers for emamectin benzoate (EB), using a one‐pot method at mild conditions. The structure of nanoparticle was investigated by dynamic light scattering, ζ‐potential measurement, Fourier transform infrared spectroscopy, and transmission electron microscopy, and related to the loading and release properties. The mass ratio of SL and CTAC had great impacts on the structure of nanoparticle. The release of EB from SL‐CTAC nanoparticles was pH‐triggered. The retarding efficacy was enhanced in the medium of higher pH, due to the increased interaction between the EB and carrier. The incorporation into the nanoparticles greatly increased the insecticidal toxicity of EB. The median lethal concentration, against Spodoptera litura Fabricius larvae, of typical nanoformulation was 55% and 63% of that of conventional formulation emulsifiable concentrates after feeding for 24 and 48 h, respectively. The results indicated SL‐CTAC nanoparticles were good candidates of nanovehicles with high efficiency and low‐cost, which was of great significance to prompt the nanopesticides from laboratory investigation to agricultural application.
Harvesting sustainability: Navigating green practices and barriers in Lebanon's hospitality sector
Authors: Ashaal Ahmad , Bakri Ahmed , AlKhatib Nadine , Chreif Maya , Zakhem Najib Bou
Published: April 2024

In today's dynamic business milieu, the imperative of eco‐consciousness in hospitality cannot be overstated. This study focuses on Lebanon's burgeoning hotel industry, investigating its journey towards sustainability. Through qualitative content analysis and interviews with eight hotel managers, we unveil a crucial revelation: the integration of green practices not only enhances customer satisfaction but also engenders loyalty and positive referrals. This strategic pivot not only bestows hotels with a competitive edge but also positions them as champions of eco‐friendly experiences, resulting in tangible financial benefits and an expanded market share. Consequently, this fosters environmental sustainability within the sector, echoing its broader implications in environmental management discourse. Moreover, our research significantly contributes to institutional theory and stakeholder theory, offering valuable insights into the antecedents and consequences of green initiatives within organizational contexts. By delving into the intricate dynamics between institutional pressures and stakeholder expectations, the study provides a nuanced perspective on the drivers behind the adoption of sustainable practices in Lebanese hotels.
Baccharoides anthelmintica (L.) Moench: A Review on Ethnomedicinal, Phytochemical, Pharmacological and Toxicological Profile
Authors: Singh Rajpoot Vivek , Srinivasa Rao Kareti
Published: April 2024

Baccharoides anthelmintica (L.) Moench is a popular medicinal plant with a long history of use in several traditional remedies to cure a variety of diseases including; its effect on the central nervous system, gastrointestinal tract, metabolism, kidneys, gynecology, skin diseases, and general health. The present review aims to provide the latest, organized information on toxicological, pharmacological, phytochemical, and ethnomedicinal applications of Baccharoides anthelmintica. For this; several well‐known searchable websites (search engines) like; Web of Science, Google Scholar, Scopus‐Elsevier, Taylor & Francis, Springer, and DOAJ, were used to empirically investigate the knowledge of this useful medicinal plant. Based on previous studies, the pharmacological action of B. anthelmintica is due to various secondary metabolites including alkaloids, terpenoids, lignans, steroids, and other phytoconstituents. Hence, the present study recorded 225 phytochemicals obtained from different parts of the plant, where the steroids and derivatives (48), terpenes and sesquiterpenes (46), flavonoids and derivatives (41), fatty acids and derivatives (40), phenolic acids (12), triterpenes (11), chalcones (06), diterpenes (01) and miscellaneous (20) were reported. The present review also covered the pharmacological importance, including antioxidant, antimicrobial, antiparasitic, antidiabetic, hypolipidemic action, liver disease, anticancer potential, anti‐HIV, antiosteoporotic action, antitoxic action, skin disorder, wound healing and immunomodulatory activity, systemic infection, and treatment of neurodegenerative diseases etc. The review concluded that B. anthelmintica has several pharmacological activities, which were due to the presence of secondary metabolites present in it, and thus indicates the importance of medicinal value of this plant. Hence, B. anthelmintica may be a good source for developing a lead molecule in the process of new drug discovery and development. More study is required to determine the pharmacokinetics, mechanism of action, long‐term toxicology testing, safe dosage, and possible interactions with other herbs/drugs.
Bacteriophages as a potential substitute for antibiotics: A comprehensive review
Authors: Kushwaha Shruti O. , Sahu Santosh Kumar , Yadav Virendra Kumar , Rathod Mayuri C. , Patel Dhaval , Sahoo Dipak Kumar , Patel Ashish
Published: April 2024

Over the years, the administration of antibiotics for the purpose of addressing bacterial infections has become increasingly challenging due to the increased prevalence of antimicrobial resistance exhibited by various strains of bacteria. Multidrug‐resistant (MDR) bacterial species are rising due to the unavailability of novel antibiotics, leading to higher mortality rates. With these conditions, there is a need for alternatives in which phage therapy has made promising results. Phage‐derived endolysins, phage cocktails, and bioengineered phages are effective and have antimicrobial properties against MDR and extensively drug‐resistant strains. Despite these, it has been observed that phages can give antimicrobial activity to more than one bacterial species. Thus, phage cocktail against resistant strains provides broad spectrum treatment and magnitude of effectivity, which is many folds higher than antibiotics. Many commercially available endolysins such as Staphefekt SA.100, Exebacase (CF‐301), and N‐Rephasin®SAL200 are used in biofilm penetration and treating plant diseases. The role of CMP1 phage endolysin in transgenic tomato plants in preventing Clavibacter michiganensis infection and the effectiveness of phage in protecting Atlantic salmon from vibriosis have been reported. Furthermore, phage‐derived endolysin therapy, such as TSPphg phage exogenous treatment, can aid in disrupting cell walls, leading to bacterial cell lysis. As animals in aquaculture and slaughterhouses are highly susceptible to bacterial infections, effective phage therapy instead of antibiotics can help treat poultry animals, preserve them, and facilitate disease‐free trade. Using bioengineered phages and phage cocktails enhances the effectiveness by providing a broad spectrum of phages and target specificity. Research is currently being conducted on clinical trials to confirm the efficacy of engineered phages and phage cocktails in humans. Although obtaining commercial approval may be time‐consuming, it will be beneficial in the postantibiotic era. This review provides an overview of the significance of phage therapy as a potential alternative to antibiotics in combating resistant bacterial strains and its application to various fields and emphasizes the importance of safeguarding and ensuring treatment efficacy.
Vitronectin promotes insulin resistance in trophoblast cells by activating JNK in gestational diabetes mellitus
Authors: Ju Yuejun , Shen Ting , Guo Zhanhong , Kong Yinghong , Huang Yun , Hu Ji
Published: April 2024

Gestational diabetes mellitus (GDM) is a common disorder in the clinic, which may lead to severe detrimental outcomes both for mothers and infants. However, the underlying mechanisms for GDM are still not clear. In the present study, we performed label‐free proteomics using placentas from GDM patients and normal controls. Vitronectin caused our attention among differentially expressed proteins due to its potential role in the pathological progression of GDM. Vitronectin was increased in the placentas of GDM patients, which was confirmed by Western blot analysis. Vitronectin represses insulin signal transduction in trophoblast cells, whereas the knockdown of vitronectin further potentiates insulin‐evoked events. Neutralization of CD51/61 abolishes the repressed insulin signal transduction in vitronectin‐treated trophoblast cells. Moreover, vitronectin activates JNK in a CD51/61‐depedent manner. Inhibition of JNK rescues impaired insulin signal transduction induced by vitronectin. Overall, our data indicate that vitronectin binds CD51/61 in trophoblast cells to activate JNK, and thus induces insulin resistance. In this regard, increased expression of vitronectin is likely a risk factor for the pathological progression of GDM. Moreover, blockade of vitronectin production or its receptors (CD51/61) may have therapeutic potential for dealing with GDM.
Coronavirus Anxiety, COVID Anxiety Syndrome and Mental Health: A Test Among Six Countries During March 2021
Authors: Zvolensky Michael J. , Bakhshaie Jafar , Redmond Brooke Y. , Smit Tanya , Nikčević Ana V. , Spada Marcantonio M. , Distaso Walter
Published: April 2024

The negative impact of the COVID‐19 pandemic on mental health outcomes is widely documented. Specifically, individuals experiencing greater degrees of severity in coronavirus anxiety have demonstrated higher levels of generalized anxiety, depression and psychological distress. Yet the pathways in which coronavirus anxiety confers vulnerability are not well known. The present investigation sought to address this gap in the scientific literature by testing the indirect effect of the COVID‐19 anxiety syndrome, which centres on the function of detecting and managing the environmental threat of virus exposure and its sequalae. Data were collected during the height of the pandemic (March 2021) and included 5297 adults across six countries. Structural equation modelling techniques revealed that the COVID‐19 anxiety syndrome evidenced a statistically significant indirect effect between coronavirus anxiety and generalized anxiety, depression and work/social adjustment. Overall, results suggest there could be public health merit to targeting anxiety related to virus exposure to improve behavioural health for those who are struggling with excessive fear and worry.
Lithium Salt Combining Fluoroethylene Carbonate Initiates Methyl Methacrylate Polymerization Enabling Dendrite‐Free Solid‐State Lithium Metal Battery
Authors: Ye Xue , Liang Jianneng , Du Baorong , Li Yongliang , Ren Xiangzhong , Wu Dazhuan , Ouyang Xiaoping , Zhang Qianling , Liu Jianhong
Published: April 2024

This work demonstrates a novel polymerization‐derived polymer electrolyte consisting of methyl methacrylate, lithium bis(trifluoromethanesulfonyl)imide and fluoroethylene carbonate. The polymerization of MMA was initiated by the amino compounds following an anionic catalytic mechanism. LiTFSI plays both roles including the initiator and Li ion source in the polymer electrolyte. Normally, lithium bis(trifluoromethanesulfonyl)imide has difficulty in initiating the polymerization reaction of methyl methacrylate monomer, a very high concentration of lithium bis(trifluoromethanesulfonyl)imide is needed for initiating the polymerization. However, the fluoroethylene carbonate additive can work as a supporter to facilitate the degree of dissociation of lithium bis(trifluoromethanesulfonyl)imide and increase its initiator capacity due to the high dielectric constant. The as‐prepared poly‐methyl methacrylate‐based polymer electrolyte has a high ionic conductivity (1.19 × 10−3 S cm−1), a wide electrochemical stability window (5 V vs Li+/Li), and a high Li ion transference number () of 0.74 at room temperature (RT). Moreover, this polymerization‐derived polymer electrolyte can effectively work as an artificial protective layer on Li metal anode, which enabled the Li symmetric cell to achieve a long‐term cycling performance at 0.2 mAh cm−2 for 2800 h. The LiFePO4 battery with polymerization‐derived polymer electrolyte‐modified Li metal anode shows a capacity retention of 91.17% after 800 cycles at 0.5 C. This work provides a facile and accessible approach to manufacturing poly‐methyl methacrylate‐based polymerization‐derived polymer electrolyte and shows great potential as an interphase in Li metal batteries.
Randomized investigation of the MitraClip device in heart failure: Design and rationale of the RESHAPE‐HF2 trial design
Authors: Anker Stefan D. , Friede Tim , von Bardeleben Ralph Stephan , Butler Javed , Fatima Kaneez , Diek Monika , Heinrich Jutta , Hasenfuß Gerd , Schillinger Wolfgang , Ponikowski Piotr
Published: April 2024

Aims

The safety and effectiveness of the MitraClip device to treat functional mitral regurgitation (FMR) has been tested in previous clinical trials yielding somewhat heterogeneous results in heart failure (HF) patients. Over time, the MitraClip device system has been modified and clinical practice evolved to consider also less severely diseased HF patients with FMR for this therapeutic option. The RESHAPE‐HF2 trial aims to assess the safety and effectiveness of the MitraClip device system on top of medical therapy considered optimal in the treatment of clinically significant FMR in symptomatic patients with chronic HF.

Methods

The RESHAPE‐HF2 is an investigator‐initiated, prospective, randomized, parallel‐controlled, multicentre trial designed to evaluate the use of the MitraClip device (used in the most up‐to‐date version as available at sites) plus optimal standard of care therapy (device group) compared to optimal standard of care therapy alone (control group). Eligible subjects have signs and symptoms of HF (New York Heart Association [NYHA] class II–IV despite optimal therapy), and have moderate‐to‐severe or severe FMR, as confirmed by a central echocardiography core laboratory; have an ejection fraction between ≥20% and ≤50% (initially 15–35% for NYHA class II patients, and 15–45% for NYHA class III/IV patients); have been adequately treated per applicable standards, and have received appropriate revascularization and cardiac resynchronization therapy, if eligible; had a HF hospitalization or elevated natriuretic peptides (B‐type natriuretic peptide [BNP] ≥300 pg/ml or N‐terminal proBNP ≥1000 pg/ml) in the last 90 days; and in whom isolated mitral valve surgery is not a recommended treatment option. The trial has three primary endpoints, which are these: (i) the composite rate of total (first and recurrent) HF hospitalizations and cardiovascular death during 24 months of follow‐up, (ii) the rate of total (i.e. first and recurrent) HF hospitalizations within 24 months, and (iii) the change from baseline to 12 months in the Kansas City Cardiomyopathy Questionnaire overall score. The three primary endpoints will be analysed using the Hochberg procedure to control the familywise type I error rate across the three hypotheses.

Conclusions

The RESHAPE‐HF2 trial will provide sound evidence on the MitraClip device and its effects in HF patients with FMR. The recruitment was recently completed with 506 randomized patients.
Impact of Screw Geometry and Solids Content on the Properties of Continuously Produced Si Anodes
Authors: Grenda Tim , Weber Marcel , Jagau René , Wiegmann Eike , Müller Jannes , Strzelczyk Nanny , Gottschalk Laura , Dempwolf Wibke , Kwade Arno
Published: April 2024

Within the realm of lithium‐ion batteries, there is a growing emphasis on achieving high energy density and environmentally friendly production at a low cost. To address these demands, the battery slurries in this study incorporate the high‐energy anode material silicon. They are systematically produced through continuous extrusion, aiming to realize cost reductions by significantly reducing the overall process time. In this study, it is demonstrated that the choice of screw configuration and solids content during kneading influences the specific energy input and the stress intensity during processing significantly. The stress intensity, represented here by the specific torque, has a great influence on the slurry properties as well as the electrochemical performance of the battery. An increased stress intensity leads to an increase in adhesive strength and ionic resistance. In the results, it is indicated that carbon black decomposition increases significantly, but when a critical specific stress intensity in form of the specific torque is reached, delamination and fracture of the graphite particles occur, leading to a loss of lithium‐ion storage capacity, favoring lithium plating and severely degrading both capacity by up to 40% at 1C and long‐term performance by up to 10% after 50 cycles.
Shaking table test for subway station considering the influence of diaphragm walls
Authors: Yu Haitao , Wang Zhikun , Zhang Zhongjie , Song Yi , Liu Shu
Published: April 2024

Underground diaphragm walls are commonly used as a support system for the construction of subway stations, working together with inner side walls of subway stations to withstand the pressure from surrounding soils. However, the effect of diaphragm walls on the seismic response of subway stations is still not well understood yet, or at least not well considered during design. In this paper, a series of 1 g shaking table tests is designed to investigate the seismic response of a typical two‐story and three‐span subway station considering the influence of underground diaphragm walls. The stratum is simulated by synthetic model soil (a mixture of sand and sawdust), and the model structure and diaphragm walls are made by granular concrete with galvanized steel wires. A test case of the structure without diaphragm walls is also involved and taken as a benchmark comparison to understand the impact of diaphragm walls on the seismic response of subway station. The seismic excitations for the test include actual seismic records with the amplitude of 0.2, 0.4, and 0.8 g, respectively. Based on the test data analysis, a comprehensive discussion is conducted on the influence of diaphragm walls on the seismic design of underground structures. Current misconceptions that ignoring the role of diaphragm walls is a conservative way in seismic design of underground structures are also reviewed. Results show that the presence of underground diaphragm walls would enhance the lateral stiffness of the structure, and thus significantly reduce the lateral deformation of subway stations during earthquakes. Notably, the structure with diaphragm walls also exhibits a significant amplification in acceleration response and experiences greater dynamic earth pressures on the sidewalls, and furthermore the strains at the connection between the sidewalls and diaphragm walls are dramatically amplified during the earthquake. It is worth noting that these adverse effects of the diaphragm walls on the amplification of dynamic earth pressures on the structure as well as the increase of internal forces at the sidewalls end‐diaphragm walls connection should be carefully considered in the seismic design of underground structures.
Genomic characterization of Cronobacter sakazakii strains in the neonatal meningitis clonal complex 4
Authors: Hu Jinrui , Li Zhenpeng , Sun Yan , Shi Wenyu , Du Xiaoli , Meng Shuang , Yu Zhengfei , Liu Jinyue , Forsythe Stephen , Cui Zhigang , Zhou Haijian
Published: April 2024

Cronobacter sakazakii clonal complex 4 (CC4) is strongly associated with neonatal meningitis. However, C. sakazakii CC4‐specific pathogenicity traits have not been determined. In this study, the comparative genomic analysis of 144 genomes of C. sakazakii CC4 strains and 376 non‐CC4 C. sakazakii strains was undertaken. Twenty‐four CC4 strains were previously undescribed clinical and nonclinical strains that had been collected from various regions in China (2006–2017). The remaining genomes were of multiple sequence types of C. sakazakii strains, which had been isolated worldwide (1973–2021). The pan‐genome of C. sakazakii comprised 32,332 genes, of which 2.58% (832 genes) constituted the core genome. More C. sakazakii CC4 strains have a complete cusABCFR efflux system with a significant difference compared with non‐CC4 strains, and the ibeB‐homologous cusC gene in the cusABCFR efflux system is probably associated with the invasion of human brain microvascular endothelial cells (BMEC). In addition, the isolates with K2:CA2 capsule or type IV pili‐associated genes associated with neonatal meningitis were statistically more present in CC4 strains than non‐CC4 strains (p < .0001). The thorough description of VirB/VirD4 gene cluster for the type IV secretion system and the impB/impF and vasL/vasJ gene clusters for the type VI secretion system in C. sakazakii were provided. Overall, the specific and diverse virulence factors and genes may have led to C. sakazakii CC4 clone increasing its ability to invade human BMEC and leading to neonatal meningitis. Our findings should facilitate the development of novel strategies to prevent, diagnose, and treat C. sakazakii CC4 infections.
Heavy menstrual bleeding and dysmenorrhea in adolescents: A systematic review of self‐management strategies, quality of life, and unmet needs
Authors: Pouraliroudbaneh Shiva , Marino Jennifer , Riggs Elisha , Saber Ashraf , Jayasinghe Yasmin , Peate Michelle
Published: April 2024

Background

Heavy menstrual bleeding (HMB) and dysmenorrhea (DM) are common gynecological problems.

Objective

To systematically review the needs, quality of life (QOL), and effectiveness of self‐management strategies among young women (12–25 years) with DM or HMB.

Search Strategy

Relevant terms were searched through PubMed, EBSCO, Google Scholar, ProQuest, and Ovid between 2010 and 2022.

Selection Criteria

Qualitative and quantitative studies published in peer‐reviewed journals, females aged 12–25, exploring DM or HMB, reporting supportive care needs, quality of life, self‐treatment strategies, and/or treatment‐seeking behavior.

Data Collection and Analysis

Abstracts were reviewed for eligibility by two researchers. Included studies were extracted and assessed for quality independently by two authors, with discrepancies resolved through consensus or the involvement of a third researcher. Data extracted included study details, menstrual history, symptoms, self‐care strategies, and quality of life. The Joanna Briggs Institute checklists were used for quality assessment.

Main Results

The search returned 285 190 studies, of which 55 were eligible for inclusion. Prevalence rates of HMB and DM were in the ranges 4%–63% and 42%–94%, respectively. Over 80% of young women with DM and HMB experienced physical and psychological problems, including pelvic pain, sleep issues, mood disturbance, diarrhea, and nausea. Academic performance and daily activities were severely affected. Most (>62%) named their mothers as their primary source of information, and friends as the secondary source (10%–65%). Few studies explored needs, but they could be inferred and fell under school‐related and social needs. QOL was poorer in those who had DM than those who did not. Pain was the most common issue that drove young women to find treatment. More than 70% used medication to reduce pain. More than half chose home remedies (e.g., heat therapy, massages, herbal tea, hot drinks). No studies provided information about the efficacy and dosage of medication and herbal remedies.

Conclusions

HMB and DM have a large impact on daily living, with large areas of unmet need. Limited access to information impairs the management of symptoms and consequent QOL.
Risk of intrapartum cesarean delivery in twin pregnancies: A retrospective cohort study
Authors: Barg Moshe , Melamed Ben , Aviram Amir , Mei‐Dan Elad , Barrett Jon , Melamed Nir
Published: April 2024

Objective

To compare the risk of intrapartum cesarean delivery (CD) between patients with twin and singleton pregnancies undergoing a trial of labor and identify risk factors for intrapartum CD in twin pregnancies.

Methods

The present study was a retrospective cohort study of patients with a twin or singleton pregnancy who underwent a trial of labor at ≥340/7 weeks in a single center (2015–2022). The primary outcome was the rate of intrapartum CD. In twin pregnancies, this outcome was limited to CD of both twins. The association of plurality with intrapartum CD was estimated using multivariable Poisson regression.

Results

A total of 20 754 patients met the study criteria, 669 of whom had a twin pregnancy. Patients with twins had a greater risk of intrapartum CD (of both twins) than those with singleton pregnancies (22.1% vs 15.9%, respectively; aRR 1.38 [95% CI: 1.15–1.66]), primarily due to a greater risk of failure to progress. In addition, 4.1% of the twin pregnancies had a CD for the second twin, resulting in an overall CD rate in twin pregnancies of 26.2%. Variables associated with intrapartum CD in twin pregnancies included nulliparity (aOR 3.50, 95% CI: 2.34–5.25), birthweight discordance >20% (aOR 2.47, 95% CI: 1.27–4.78), and labor induction (aOR 1.64, 95% CI: 1.07–2.53). The rate of intrapartum CD was highest when all three risk factors were present (67% [95% CI: 41%–87%]).

Conclusion

Twin pregnancies are associated with a greater risk of intrapartum CD than singleton pregnancies. Information on the individualized risk of intrapartum CD may be valuable when counseling patients with twins regarding mode of delivery.
Impact of CYP2C19, CYP2C9, CYP3A4, and FMO3 Genetic Polymorphisms and Sex on the Pharmacokinetics of Voriconazole after Single and Multiple Doses in Healthy Chinese Subjects
Authors: Liu Shuaibing , Yao Xia , Tao Jun , Zhao Shiyu , Sun Suke , Wang Suyun , Tian Xin
Published: April 2024

Voriconazole is the first‐line treatment for invasive aspergillosis. Its pharmacokinetics exhibit considerable inter‐ and intra‐individual variability. The purpose of this study was to investigate the effects of CYP2C19, CYP2C9, CYP3A4, and FMO3 genetic polymorphisms and sex on the pharmacokinetics of voriconazole in healthy Chinese adults receiving single‐dose and multiple‐dose voriconazole, to provide a reference for its clinical individualized treatment. A total of 123 healthy adults were enrolled in the study, with 108 individuals and 15 individuals in the single‐dose and multiple‐dose doses, respectively. Plasma voriconazole concentrations were measured using a validated LC‐MS/MS method, and pharmacokinetics parameters were calculated using the non‐compartmental method with WinNonlin 8.2. CYP2C19, CYP2C9, CYP3A4, and FMO3 single‐nucleotide polymorphisms were sequenced using the Illumina Hiseq X‐Ten platform. The results suggested that CYP2C19 genetic polymorphisms significantly affected the pharmacokinetics of voriconazole at single doses of 4, 6, and 8 mg/kg and multiple doses of voriconazole. CYP3A4 rs2242480 had a significant effect on AUC0‐∞ (area under the plasma concentration‐time curve from time 0 to infinity) and MRT (mean residence time) of voriconazole at a single dose of 4 mg/kg in CYP2C19 extensive metabolizer. Regardless of the CYP2C19 genotype, CYP2C9 rs1057910 and FMO3 rs2266780 were not associated with the pharmacokinetics of voriconazole at three single‐dose levels or multiple doses. No significant differences in most voriconazole pharmacokinetics parameters were noted between male and female participants after single and multiple dosing. For patients receiving voriconazole treatment, CYP2C19 genetic polymorphisms should be genotyped for its precision administration. In contrast, based on our study of healthy Chinese adults, it seems unnecessary to consider the effects of CYP2C9, CYP3A4, and FMO3 genetic polymorphisms on voriconazole pharmacokinetics.
Three‐dimensional morphometry of kidney in New Zealand rabbit using unbiased design‐based stereology
Authors: Sadeghinezhad Javad , Lazzarini Giulia , Bojarzadeh Hadis , Gatta Alessandra , Rezai Sobhan , Pirone Andrea , Miragliotta Vincenzo
Published: April 2024

The rabbit is widely used as a laboratory animal in experimental models of kidney diseases. This species is also important from a veterinary perspective as a companion animal. Stereology has been accepted as an accurate approach to kidney morphometry. The objective of the present project was to provide normal quantitative stereological parameters for adult rabbit kidneys. The left kidneys of five adult male New Zealand rabbits were used. Isotropic sections were obtained using the orientation method. Total kidney volume was calculated by the Cavalieri principle. The volume fraction of the renal structures was estimated using the point counting system. The lengths of the proximal convoluted tubule (PCT) and distal convoluted tubule (DCT) were calculated using counting frames. The total glomerular number was accounted for using the physical/fractionator technique. The mean glomerular volume was obtained by dividing the total volume of glomeruli by their total number. The total volume of rabbit kidneys calculated was 10.39 ± 1.98 cm3. The fractional volume of the kidney cortex and medulla accounted for 57.79 ± 0.65% and 42.2 ± 0.65%, respectively. The total glomerular volume was 2.18 ± 0.32% of the whole kidney. The total number of glomeruli in the rabbit kidney was estimated as 204.68 ± 12 × 103. The mean glomerular volume measured 1.07 ± 0.12 × 106 μm3. The total length of PCT and DCT was 2.96 ± 0.29 km and 1.38 ± 0.24 km, respectively. These findings can be used as a reference in experimental nephrology research and may help to expand the knowledge of nephrology in mammals by comparing with available data on humans and other species.

Research Highlights

Three‐dimensional morphometry of adult rabbit kidney structures was analyzed using quantitative stereology.

Total volume of kidney, fractional volume of cortex and medulla, length of renal tubules and number of nephrons were estimated.

These three‐dimensional morphometrical data can be used as a reference in experimental nephrology research and may help to expand the knowledge of nephrology in mammals.
Mpox outbreak in Rio de Janeiro, Brazil: A translational approach
Authors: Lira Guilherme S. , Ota Victor A. , Melo Mariana Q. S. , Castiñeiras Anna C. P. , Leitão Isabela C. , Silva Bianca O. , Mariani Diana , Gonçalves Cássia C. A. , Ribeiro Liane J. , Halpern Marcia , Abreu Thalita F. , Carneiro Fabiana A. , Scheid Helena T. , Souza Leonardo A. V. , Rodrigues Débora G. M. , Cruz Nádia V. G. , Cony Andrea , Carvalho Silvia , de Lima Loyze P. O. , Viala Vincent L. , Caldas Lucio A. , de Souza Wanderley , Higa Luiza M. , Voloch Carolina M. , Ferreira Orlando C. , Damaso Clarissa R. , Galliez Rafael M. , Faffe Débora S. , Tanuri Amilcar , Castiñeiras Terezinha M. P. P.
Published: April 2024

Mpox is a zoonotic disease historically reported in Africa. Since 2003, limited outbreaks have occurred outside Africa. In 2022, the global spread of cases with sustained interhuman transmission and unusual disease features raised public health concerns. We explore the mpox outbreak in Rio de Janeiro (RJ) state, Brazil, in an observational study of mpox‐suspected cases from June to December 2022. Data collection relied on a public healthcare notification form. Diagnosis was determined by MPXV‐PCR. In 46 confirmed cases, anti‐OPXV IgG was determined by ELISA, and seven MPXV genomes were sequenced. A total of 3095 cases were included, 816 (26.3%) with positive MPXV‐PCR results. Most positive cases were men in their 30 s and MSM. A total of 285 (34.9%) MPXV‐PCR+ patients live with HIV. Eight were coinfected with varicella‐zoster virus. Anogenital lesions and adenomegaly were associated with the diagnosis of mpox. Females and individuals under 18 represented 9.4% and 5.4% of all confirmed cases, respectively, showing higher PCR cycle threshold (Ct) values and fewer anogenital lesions compared to adult men. Anti‐OPXV IgG was detected in 29/46 (63.0%) patients. All analyzed sequences belonged to clade IIb. In RJ state, mpox presented a diverse clinical picture, represented mainly by mild cases with low complication rates and prominent genital involvement. The incidence in females and children was higher than usually reported. The observation of a bimodal distribution of Ct values, with few positive results, may suggest the need to review the diagnostic criteria in these groups.
Risk factors and prevalence of ramp lesions in ACL ruptures: An analysis from the registry of the Francophone Arthroscopic Society
Authors: Lambrey Pierre‐Jean , Fayard Jean‐Marie , Graveleau Nicolas , Toanen Cécile , Noailles Thibaut , Letartre Romain , Barth Johannes , Cavaignac Etienne ,   The Francophone Society of Arthroscopy ACL Registry Study Group, Bouguennec Nicolas , Thaunat Mathieu
Published: April 2024

Purpose

The study aimed to estimate the prevalence of ramp lesions among patients undergoing anterior cruciate ligament (ACL) reconstruction and identify risk factors associated with these lesions.

Methods

A retrospective, multicentre cohort study was conducted using data from the Francophone Arthroscopic Society's registry, including 5359 patients who underwent ACL reconstruction (ACLR) from June 2020 to June 2023. Potential risk factors for ramp lesion such as patient demographics, revision surgery, pivot shift, side‐to‐side anteroposterior laxity, medial collateral ligament (MCL) injury, lateral meniscal tear and the volume of ligament remnant were evaluated using multivariate regression analyses. BMI and delay to surgery were also assessed.

Results

Ramp lesions were identified in 822 patients (15.3%). Univariate analysis identified male sex, younger age, revision surgery, lateral meniscal injury, percentage of ACL remnant (all p < 0.0001) and pivot shift (p = 0.0103) as significant risk factors. MCL injury was associated with a lower risk (p < 0.0001). In multivariate analysis, male sex, younger age, revision surgery, lateral meniscal injury and percentage of ACL remnants remained significant risk factors, while MCL injury remained a protective factor. The anteroposterior laxity wasn't a significant predictor in either analysis. In subgroup analysis, there were no differences concerning body mass index (n.s) and the delay to surgery (n.s).

Conclusion

The study identified male sex, younger age, revision surgery, lateral meniscal injury and pourcentage of ACL remnant as significant risk factors for ramp lesions, with MCL injury acting as a protective factor. This will help regarding the suspicion and identification of ramp lesions.

Level of Evidence

Level III.
Mechanically Actuated Kerr Soliton Microcombs
Authors: Fujii Shun , Wada Koshiro , Kogure Soma , Kumazaki Hajime , Tanabe Takasumi
Published: April 2024

Mode‐locked ultrashort pulse sources with a repetition rate of up to several tens of gigahertz greatly facilitate versatile photonic applications such as frequency synthesis, metrology, radar, and optical communications. Dissipative Kerr soliton microcombs provide an attractive solution as a broadband, high‐repetition‐rate compact laser system in this context. However, its operation usually requires sophisticated pump laser control to initiate and stabilize the soliton microcombs, particularly in millimeter‐sized ultrahigh‐Q whispering‐gallery resonators. Here, a mechanically actuated soliton microcomb oscillator is realized with a microwave repetition rate of 15 GHz. This enables direct initiation, subsequent long‐term stabilization, and fine tuning of soliton combs without pump laser tunability that is generally required for soliton microcomb operation. The prospects for using this method with a wide range of applications are revealed that will benefit from mechanical soliton actuation such as optical clocks, spectral extension, and dual‐comb spectroscopy.
MicroRNA‐431‐5p inhibits angiogenesis, lymphangiogenesis, and lymph node metastasis by affecting TGF‐β1/SMAD2/3 signaling via ZEB1 in gastric cancer
Authors: Liu Pengpeng , Ding Ping'an , Yang Jiaxuan , Wu Haotian , Wu Jiaxiang , Guo Honghai , Yang Peigang , Tian Yuan , Meng Lingjiao , Zhao Qun
Published: April 2024

Accumulating evidence suggests that lymphangiogenesis plays a crucial role in lymphatic metastasis, leading to tumor immune tolerance. However, the specific mechanism remains unclear. In this study, miR‐431‐5p was markedly downregulated in both gastric cancer (GC) tissues and plasma exosomes, and its expression were correlated negatively with LN metastasis and poor prognosis. Mechanistically, miR‐431‐5p weakens the TGF‐β1/SMAD2/3 signaling pathway by targeting ZEB1, thereby suppressing the secretion of VEGF‐A and ANG2, which in turn hinders angiogenesis, lymphangiogenesis, and lymph node (LN) metastasis in GC. Experiments using a popliteal LN metastasis model in BALB/c nude mice demonstrated that miR‐431‐5p significantly reduced popliteal LN metastasis. Additionally, miR‐431‐5p enhances the efficacy of anti‐PD1 treatment, particularly when combined with galunisertib, anti‐PD1 treatment showing a synergistic effect in inhibiting GC progression in C57BL/6 mice. Collectively, these findings suggest that miR‐431‐5p may modulate the TGF‐β1/SMAD2/3 pathways by targeting ZEB1 to impede GC progression, angiogenesis, and lymphangiogenesis, making it a promising therapeutic target for GC management.
The efficacy and safety of stereotactic body radiotherapy combined with systematic therapy for metastatic renal cell carcinoma: a systematic review and meta‐analysis
Authors: Zhang Shiyu , Xiong Xingyu , Xie Nan , Zheng Weitao , Li Yongjun , Lin Tianhai , Wei Qiang , Tan Ping
Published: April 2024

There is considerable interest in the potential of stereotactic body radiation therapy (SBRT) combined with systemic therapy such as tyrosine kinase inhibitors (TKIs) or immune checkpoint inhibitors (ICIs). However, its efficacy and safety remain unclear. The purpose of this study was to evaluate the efficacy and safety of conducting SBRT during ICI or TKI treatment in different disease settings for patients with metastatic renal cell carcinoma (mRCC). A total of 16 studies were ultimately included. Under the random effects model, the pooled 1‐year local control rate (1‐yr LCR) and objective response rate (ORR) were 90% (95% confidence interval [CI]: 80%–95%, I2 = 67%) and 52% (95% CI: 37%–67%, I2 = 90%), respectively. SBRT concomitant with different systemic therapy yield significant different 1‐yr LCR (p < 0.01) and ORR (p = 0.02). Regarding survival benefits, the pooled 1‐year progression‐free survival (1‐yr PFS) and 1‐year overall survival (1‐yr OS) rates were 45% (95% CI: 29%–62%, I2 = 91%) and 85% (95% CI: 76%–91%, I2 = 66%), respectively. 1‐yr PFS and 1‐yr OS in different disease settings demonstrated significant difference (p < 0.01). As for toxicity, the pooled incidence of grade 3–4 adverse events was 14% (95% CI: 5%–26%, I2 = 90%). This study highlights the feasibility of utilizing these strategies in mRCC patients, especially those with a low metastatic tumor burden.
Application of extended ulnar parametacarpal perforator free flap for the reconstruction of total pulp defect of the thumb: A case report
Authors: Usami Satoshi , Sonoki Kentaro , Inami Kohei , Murakami Kyoichi
Published: April 2024

Many procedures are available for the coverage of thumb pulp defects; however, to gain thumb function and esthetics, a similar tissue is desirable. If the length of the longitudinal defect is <2 cm, a volar advancement flap is appropriate; however, if the flap is >2 cm long or wider, retrograde or free flaps are required. Here, we present a case of thumb pulp reconstruction using an extended ulnar parametacarpal perforator (UPM) flap, which achieved excellent functional and esthetic outcomes. A 46‐year‐old man underwent reconstruction surgery of his thumb, which was a degloved total pulp. A sensate 5.2 × 3.2 cm UPM flap was designed on the ulnar side of the right palm and transferred to his thumb. The flap donor site was covered with a V‐Y advancement flap on the dorsal side of the right hand. At 12 months postoperatively, the patient achieved a functional and natural thumb appearance with high satisfaction. The UPM flap can offer soft tissue similar to the pulp region in the digit without a palm scar at the donor site. This extended application is suitable for the reconstruction of a total pulp defect of the digit and is an alternative option for a hemi‐pulp flap from the toe area.
Simultaneous reduction of number of spots and energy layers in intensity modulated proton therapy for rapid spot scanning delivery
Authors: Fu Anqi , Taasti Vicki T. , Zarepisheh Masoud
Published: April 2024

Background

Reducing proton treatment time improves patient comfort and decreases the risk of error from intrafractional motion, but must be balanced against clinical goals and treatment plan quality.

Purpose

To improve the delivery efficiency of spot scanning proton therapy by simultaneously reducing the number of spots and energy layers using the reweighted regularization method.

Methods

We formulated the proton treatment planning problem as a convex optimization problem with a cost function consisting of a dosimetric plan quality term plus a weighted regularization term. We iteratively solved this problem and adaptively updated the regularization weights to promote the sparsity of both the spots and energy layers. The proposed algorithm was tested on four head‐and‐neck cancer patients, and its performance, in terms of reducing the number of spots and energy layers, was compared with existing standard and group regularization methods. We also compared the effectiveness of the three methods (, group , and reweighted ) at improving plan delivery efficiency without compromising dosimetric plan quality by constructing each of their Pareto surfaces charting the trade‐off between plan delivery and plan quality.

Results

The reweighted regularization method reduced the number of spots and energy layers by an average over all patients of and , respectively, with an insignificant cost to dosimetric plan quality. From the Pareto surfaces, it is clear that reweighted provided a better trade‐off between plan delivery efficiency and dosimetric plan quality than standard or group regularization, requiring the lowest cost to quality to achieve any given level of delivery efficiency.

Conclusions

Reweighted regularization is a powerful method for simultaneously promoting the sparsity of spots and energy layers at a small cost to dosimetric plan quality. This sparsity reduces the time required for spot scanning and energy layer switching, thereby improving the delivery efficiency of proton plans.