bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental Evaluation on Blast Resistance of Reinforced Concrete Structures under Partially Confined Explosion
Authors: Park Youngjun , Kim Kukjoo , Park Sang-woo , Yum Sang-Guk , Baek Jang-Woon
Published: June 2024

As the risk of accidental explosions at ammunition storage or hydrogen charging station increases in populated area, it is needed to design the facilities against blast loading, particularly subjected to partially confined explosion. However, the partially confined explosion lacks experimental test data to efficiently design the facilities subjected to the potential threat, when compared to unconfined or confined explosion cases. As a fundamental study on partially confined explosion, two partially buried tunnel-type structures with normal- and high-strength concretes were tested under a weight charge of 5.9 kg TNT explosion. The major parameters were concrete compressive strength and reinforcement ratio. The test result showed that the damage of the concrete structure with normal-strength concrete was extremely severe, whereas that of the specimen with high-strength was relatively mild. Further, finite element (FE) analyses were performed to investigate the confinement effect of blast load. The FE analysis result showed that under partially confined explosion, the reduction of the maximum displacement by using higher concrete strength was significant, while preventing the failure of the structure. This study provides fundamental data for designing the facilities with explosives subjected to the partially confined explosion.
Characterizing the gut phageome and phage-borne antimicrobial resistance genes in pigs
Authors: Hu Jun , Chen Jianwei , Nie Yangfan , Zhou Changhao , Hou Qiliang , Yan Xianghua
Published: June 2024

Background

Mammalian intestine harbors a mass of phages that play important roles in maintaining gut microbial ecosystem and host health. Pig has become a common model for biomedical research and provides a large amount of meat for human consumption. However, the knowledge of gut phages in pigs is still limited.

Results

Here, we investigated the gut phageome in 112 pigs from seven pig breeds using PhaBOX strategy based on the metagenomic data. A total of 174,897 non-redundant gut phage genomes were assembled from 112 metagenomes. A total of 33,487 gut phage genomes were classified and these phages mainly belonged to phage families such as Ackermannviridae, Straboviridae, Peduoviridae, Zierdtviridae, Drexlerviridae, and Herelleviridae. The gut phages in seven pig breeds exhibited distinct communities and the gut phage communities changed with the age of pig. These gut phages were predicted to infect a broad range of 212 genera of prokaryotes, such as Candidatus Hamiltonella, Mycoplasma, Colwellia, and Lactobacillus. The data indicated that broad KEGG and CAZy functions were also enriched in gut phages of pigs. The gut phages also carried the antimicrobial resistance genes (ARGs) and the most abundant antimicrobial resistance genotype was diaminopyrimidine resistance.

Conclusions

Our research delineates a landscape for gut phages in seven pig breeds and reveals that gut phages serve as a key reservoir of ARGs in pigs.
Determinants and risk factors for renal damage: where do patients hospitalized for severe anorexia nervosa stand? A multi-center study
Authors: Stheneur Chantal , Blanchet Corinne , Mattar Lama , Dicembre Marika , Wilson Kayigan ,   EVHAN Group, Duclos Jeanne , Roux Hélène , Thiébaud Marie-Raphaële , Vibert Sarah , Hubert Tamara , Courty Annaig , Ringuenet Damien , Benoit Jean-Pierre , Moro Marie-Rose , Bignami Laura , Nordon Clémentine , Rouillon Frédéric , Cook Solange , Doyen Catherine , Mouren Marie-Christine , Gerardin Priscille , Lebecq Sylvie , Podlipski Marc-Antoine , Gayet Claire , Lasfar Malaika , Delorme Marc , Pommereau Xavier , Bioulac Stéphanie , Bouvard Manuel , Carrere Jennifer , Doncieux Karine , Faucher Sophie , Fayollet Catherine , Prexl Amélie , Billard Stéphane , Lang François , Mourier-Soleillant Virginie , Greiner Régine , Gay Aurélia , Carrot Guy , Lambert Sylvain , Rousselet Morgane , Placé Ludovic , Venisse Jean-Luc , Bronnec Marie , Falissard Bruno , Genolini Christophe , Hassler Christine , Tréluyer Jean-Marc , Chacornac Olivier , Delattre Maryline , Moulopo Nellie , Turuban Christelle , Auger Christelle , Berthoz Sylvie , Hanachi Mouna , Godart Nathalie
Published: June 2024

Background

Although renal damage is increasingly reported among the most undernourished patients with Anorexia Nervosa (AN), it remains underestimated in current practice, and often associated with acute dehydration. The purpose of our study was to evaluate the frequency, the extent, and the risk factors of renal involvement among adolescents and adults hospitalized in specialized units for AN.

Methods

In this multi-center study, 197 consecutive participants were included, aged 13–65, from 11 inpatient eating disorder psychiatric units. Information on the course of AN, clinical characteristics, biological data, and medication were collected.

Results

At admission, mean BMI was 13.1 (± 1.6) kg/m2 for a mean age of 20.74 (± 6.5) years and the z-score was − 3.6 (± 1.33). Six participants (3.0%) had hyponatremia, four (2.0%) had hypokalemia, and nine (4.5%) had hypochloremia. The Blood Urea Nitrogen/Creatinine ratio was over 20 for 21 (10.6%) participants. The mean plasma creatinine was 65.22 (± 12.8) µmol/L, and the mean eGFR was 74.74 (± 18.9) ml/min. Thirty- five participants (17.8%) had an eGFR > 90 ml/min, 123 (62.4%) from 60 to 90 ml/min, 35 (17.8%) from 45 to 60 ml/min, and 4 (2%) under 45 ml/min. In multivariate analysis, only BMI on admission was a determinant of renal impairment. The lower the BMI the more severe was the renal impairment.

Conclusion

When eGFR is calculated, it highlights renal dysfunction found in severe AN requiring hospitalisation in specialized units. The severity of undernutrition is an independent associated factor. Kidney functionality tests using eGFR, in addition to creatinine alone, should be part of routine care for patients with AN to detect underlying renal dysfunction.
Concussion history associated with adolescent psychological distress but not hazardous gambling: a cross-sectional study
Authors: Andersson Mitchell J. , Kapetanovic Sabina , Håkansson Anders , Claesdotter-Knutsson Emma
Published: June 2024

Background

Sustaining multiple concussions over one’s lifetime may be associated with behavioral and mood changes beyond the acute phase of injury. The present cross-sectional study examined the relationship between concussion history, the incidence of current moderate-severe psychological distress, and lifetime adolescent hazardous gambling in high school students.

Methods

Four-hundred fifty-nine high school students from southern Sweden (age: 16.81 ± 0.83, 58.2% male) completed a survey assessing concussion history (0,1,2…>8), psychological distress using the Kessler-6 scale, and lifetime hazardous gambling using the NODS-CLiP scale.

Results

Participants who self-reported three or more concussions were more likely to endorse moderate-severe symptoms of psychological distress than those with no concussion history while controlling for covariates, OR = 2.71, 95% CI [1.19, 6.18]. In contrast, concussion history was not associated with hazardous gambling after controlling for confounding variables.

Conclusions

Self-reporting three or more concussions was associated with increased current psychological distress beyond the acute phase of injury among high school students. Adolescents who have sustained multiple concussions should undergo mental health evaluations beyond the acute phase of injury to identify and treat psychological distress, but probing for hazardous gambling may not be clinically relevant in this previously concussed adolescent population.
Integrating the ESM usage and work engagement for employee agility performance: based on regulatory focus theory
Authors: Bao Yilinna , Zhu Ye , Kanwal Shamsa , Ullah Ubaid
Published: June 2024

This present research aims to clarify the intricate conjunction of enterprise social media (ESM) utilization and employee agility with a main focus on uncovering the underlying mechanisms that work through the mediating influence of work engagement and the moderating influence of regulatory focus. Drawing upon regularity focus theory, 353 Chinese samples of ESM users in organizational contexts are analyzed using SPSS 23.0. The empirical findings substantiate a robust and significant positive linkage between ESM usage and worker agility. Further reinforcing the model, the mediating role of work engagement is established as it channels the impact of ESM usage on worker agility. Turning to the moderating effects, the study unveils the differential impact of prevention focus and promotion focus, wherein individuals with a lower prevention focus exhibit a more pronounced positive linkage between ESM usage and worker agility. Similarly, individuals with a higher promotion focus demonstrate a heightened positive association between ESM usage and worker agility. By comprehensively inspecting the intricate dynamics of ESM usage, work engagement, and regulatory focus, this study enhances our theoretical understanding of how these factors synergistically shape employee agility, ultimately furnishing organizations with invaluable insights to foster and cultivate an agile workforce.
Large language models and medical education: a paradigm shift in educator roles
Authors: Li Zhui , Li Fenghe , Fu Qining , Wang Xuehu , Liu Hong , Zhao Yu , Ren Wei
Published: June 2024

This article meticulously examines the transformation of educator roles in medical education against the backdrop of emerging large language models (LLMs). Traditionally, educators have played a crucial role in transmitting knowledge, training skills, and evaluating educational outcomes. However, the advent of LLMs such as Chat Generative Pre-trained Transformer-4 has expanded and enriched these traditional roles by leveraging opportunities to enhance teaching efficiency, foster personalised learning, and optimise resource allocation. This has imbued traditional medical educator roles with new connotations. Concurrently, LLMs present challenges to medical education, such as ensuring the accuracy of information, reducing bias, minimizing student over-reliance, preventing patient privacy exposure and safeguarding data security, enhancing the cultivation of empathy, and maintaining academic integrity. In response, educators are called to adopt new roles including experts of information management, navigators of learning, guardians of academic integrity, and defenders of clinical practice. The article emphasises the enriched connotations and attributes of the medical teacher's role, underscoring their irreplaceable value in the AI-driven evolution of medical education. Educators are portrayed not just as users of advanced technology, but also as custodians of the essence of medical education.
Potential for tsunami detection via CCTV cameras in northeastern Toyama Prefecture, Japan, following the 2024 Noto Peninsula earthquake
Authors: Shirai Tomoki , Enomoto Yota , Haga Keisuke , Tokuta Tatsuhiko , Arikawa Taro , Mori Nobuhito , Imamura Fumihiko
Published: June 2024

This study explored closed-circuit television (CCTV) networks in northeastern Toyama Prefecture, Japan, as a new data source for tsunami detection following the 2024 Noto Peninsula earthquake. We analyzed CCTV footage and extracted time-series water level fluctuations at Yokoyama, Shimoiino, and Ekko. Spectral analysis of these waveforms revealed several long-period peaks (more than 100 s) in power spectral density (PSD), suggesting the presence of tsunami components. Notably, relatively large PSD peaks at approximately 5–10 min were observed at all CCTV locations in this study and at offshore wave observation points (Tanaka and Toyama). At Yokoyama, a maximum run-up of approximately 3 m was confirmed around 16:28. Although water level fluctuations at Shimoiino and Ekko were detected, identifying tsunami components proved challenging due to their small magnitude compared to other wave components. Despite these challenges, this study demonstrates the potential of CCTV networks for tsunami detection, and further research is needed to achieve real-time detection.
Incorporation of canola meal as a sustainable natural filler in PLA foams
Authors: Weal Stephanie , Shah Samir , Parker Kate , Vaidya Alankar
Published: June 2024

The canola oil industry generates significant waste as canola meal (CM) which has limited scope and applications. This study demonstrates the possibility of valorization of CM as a sustainable natural filler in a biodegradable polymer composite of Poly(lactic acid) (PLA). Generally, interfacial bonding between natural fibers and the polymer matrix in the composite is weak and non-uniform. One possible solution is to derivatize natural fibre to introduce interfacial bond strength and compatibility with the PLA polymer matrix. Here, CM was succinylated in a reactive extrusion process using succinic anhydride at 30 wt% to get 14% derivatization with 0.02 g of -COOH density per g of CM. The CM or succinylated CM at 5 and 15 wt% was co-extruded with amorphous PLA to get composite fibers. CM-PLA and succinylated CM-PLA biocomposites were foamed using a mild and green microcellular foaming process, with CO2 as an impregnating agent without any addition of organic solvents. The properties of the foams were analyzed using differential scanning calorimetry (DSC), Dynamic mechanical thermal analysis (DMTA), shrinkage, and imaging. The addition of CM or succinylated CM as a natural filler did not significantly change the glass transition temperature, melting point, percent crystallization, stiffness, and thermal stability of PLA foams. This suggests succinylation (modification) of CM is not a mandatory step for improving interphase compatibility with the amorphous PLA. The new PLA-CM foams can be a good alternative in the packaging industry replacing the existing petroleum-based polymer foams.

Graphical Abstract
Effects of Stretching or Strengthening Exercise on Spinal and Lumbopelvic Posture: A Systematic Review with Meta-Analysis
Authors: Warneke Konstantin , Lohmann Lars Hubertus , Wilke Jan
Published: June 2024

Background

Abnormal posture (e.g. loss of lordosis) has been associated with the occurrence of musculoskeletal pain. Stretching tight muscles while strengthening the antagonists represents the most common method to treat the assumed muscle imbalance. However, despite its high popularity, there is no quantitative synthesis of the available evidence examining the effectiveness of the stretch-and-strengthen approach.

Methods

A systematic review with meta-analysis was conducted, searching PubMed, Web of Science and Google Scholar. We included controlled clinical trials investigating the effects of stretching or strengthening on spinal and lumbopelvic posture (e.g., pelvic tilt, lumbar lordosis, thoracic kyphosis, head tilt) in healthy individuals. Effect sizes were pooled using robust variance estimation. To rate the certainty about the evidence, the GRADE approach was applied.

Results

A total of 23 studies with 969 participants were identified. Neither acute (d = 0.01, p = 0.97) nor chronic stretching (d=-0.19, p = 0.16) had an impact on posture. Chronic strengthening was associated with large improvements (d=-0.83, p = 0.01), but no study examined acute effects. Strengthening was superior (d = 0.81, p = 0.004) to stretching. Sub-analyses found strengthening to be effective in the thoracic and cervical spine (d=-1.04, p = 0.005) but not in the lumbar and lumbopelvic region (d=-0.23, p = 0.25). Stretching was ineffective in all locations (p > 0.05).

Conclusion

Moderate-certainty evidence does not support the use of stretching as a treatment of muscle imbalance. In contrast, therapists should focus on strengthening programs targeting weakened muscles.
A one-man bilingual cocktail party: linguistic and non-linguistic effects on bilinguals’ speech recognition in Mandarin and English
Authors: Smith Erin D. , Holt Lori L. , Dick Frederic
Published: June 2024

Multilingual speakers can find speech recognition in everyday environments like restaurants and open-plan offices particularly challenging. In a world where speaking multiple languages is increasingly common, effective clinical and educational interventions will require a better understanding of how factors like multilingual contexts and listeners’ language proficiency interact with adverse listening environments. For example, word and phrase recognition is facilitated when competing voices speak different languages. Is this due to a “release from masking” from lower-level acoustic differences between languages and talkers, or higher-level cognitive and linguistic factors? To address this question, we created a “one-man bilingual cocktail party” selective attention task using English and Mandarin speech from one bilingual talker to reduce low-level acoustic cues. In Experiment 1, 58 listeners more accurately recognized English targets when distracting speech was Mandarin compared to English. Bilingual Mandarin–English listeners experienced significantly more interference and intrusions from the Mandarin distractor than did English listeners, exacerbated by challenging target-to-masker ratios. In Experiment 2, 29 Mandarin–English bilingual listeners exhibited linguistic release from masking in both languages. Bilinguals experienced greater release from masking when attending to English, confirming an influence of linguistic knowledge on the “cocktail party” paradigm that is separate from primarily energetic masking effects. Effects of higher-order language processing and expertise emerge only in the most demanding target-to-masker contexts. The “one-man bilingual cocktail party” establishes a useful tool for future investigations and characterization of communication challenges in the large and growing worldwide community of Mandarin–English bilinguals.
Back to the future: the novel art of digital auscultation applied in a prospective observational study of critically ill Covid-19 patients
Authors: Kaimakamis Evangelos , Kotoulas Serafeim , Tzimou Myrto , Karachristos Christos , Giannaki Chrysavgi , Kilintzis Vassileios , Stefanopoulos Leandros , Chatzis Evangelos , Beredimas Nikolaos , Rocha Bruno , Pessoa Diogo , Paiva Rui Pedro , Maglaveras Nicos , Bitzani Militsa
Published: June 2024

Background

The Covid-19 pandemic has caused immense pressure on Intensive Care Units (ICU). In patients with severe ARDS due to Covid-19, respiratory mechanics are important for determining the severity of lung damage. Lung auscultation could not be used during the pandemic despite its merit. The main objective of this study was to investigate associations between lung auscultatory sound features and lung mechanical properties, length of stay (LOS) and survival, in adults with severe Covid-19 ARDS.

Methods

Consecutive patients admitted to a large ICU between 2020 and 2021 (n = 173) were included. Digital stethoscopes obtained auscultatory sounds and stored them in an on-line database for replay and further processing using advanced AI techniques. Correlation and regression analysis explored relationships between digital auscultation findings and lung mechanics or the ICU outcome. The resulting annotated lung sounds database is also publicly available as supplementary material.

Results

The presence of squawks was associated with the ICU LOS, outcome and 90-day mortality. Other features (age, SOFA score & oxygenation index upon admission, minimum crackle entropy) had significant impact on outcome. Additional features affecting the 90-d survival were age and mean crackle entropy. Multivariate logistic regression showed that survival was affected by age, baseline SOFA, baseline oxygenation index and minimum crackle entropy.

Conclusions

Respiratory mechanics were associated with various adventitious sounds, whereas the lung sound analytics and the presence of certain adventitious sounds correlated with the ICU outcome and the 90-d survival. Spectral features of crackles sounds can serve as prognostic factors for survival, highlighting the importance of digital auscultation.
Comparative study on clinicopathological characteristics of functional and non-functional subtypes in pituitary adenomas
Authors: Singh Ashish Ranjan , Kumar Prabhat
Published: June 2024

Background

Pituitary adenomas comprise clinical and pathological characteristics of functional and non-functional subtypes. To enhance our understanding of diagnostic presentations, our study aimed to know the clinicopathological characteristics of pituitary adenomas of both functional and non-functional subtypes. The purpose of our study was to investigate the clinicopathological characteristics of pituitary adenomas, including demographic characteristics, clinical presentations, hormone secretion patterns, invasiveness, and cellular characteristics.

Methods

A total of 41 cases of pituitary adenomas were analyzed, with 63.4% classified as non-functional adenomas (NFPA) and 36.6% as functional adenomas (FPA). Clinical presentations vary, with vision loss and headaches commonly occurring in both NFPA and FPA. In FPAs, serum hormone levels varied and were categorized into growth hormone-secreting (53.3%), ACTH-secreting (26.7%), PRL-secreting (13.3%), and FSH-secreting (6.7%) subtypes. Moreover, clinical presentations in FPA included diplopia, giddiness, vomiting, ptosis, and limb weakness. Clinical features varied across subtypes, with acromegaly in growth hormone-secreting adenomas, moon facies and weight gain in ACTH-secreting adenomas, poor facial growth in PRL-secreting adenomas, and vision loss in FSH-secreting adenomas. Meanwhile, NFPA were predominantly macroadenomas (88.5%) and exhibited various morphological patterns.

Results

The proliferation index is higher in functional adenomas (mean 1.32) as compared to non-functional (mean 0.91). Clinical presentations varied across functional and non-functional adenomas. Growth hormone-secreting adenomas were the most common functional subtype, while LH and null cell adenomas were common non-functional subtypes. Two cases were invasive adenomas with a low Ki67 index. Sheets were the most common morphological pattern. PCA analysis revealed significant differences between the two groups, with PC 1 explaining 92.111% of the variance.

Conclusions

Our study elucidates the clinicopathological characteristics of pituitary adenomas, highlighting significant differences between functional and non-functional subtypes. These findings underscore the importance of tailored diagnostic and management strategies to optimize outcomes for patients with pituitary adenomas.
Honey: an important nutrient and adjuvant for maintenance of health and management of diseases
Authors: Kumar Deepak , Hazra Kalyan , Prasad Peyyala Venkata Vara , Bulleddu Rajesh
Published: June 2024

Honey got its significance, both as medical and non-medical purposes. Honey is a complex matrix of several carbohydrates, amino acids, minerals and many more. Honey's carbohydrate components include a variety of mono- and disaccharide forms such as fructose, glucose, sucrose and other reducing sugars. Proline, lysine, phenylalanine, β-alanine, arginine, serine, glutamic acid and aspartic acid are the main amino acids that are present in honey. Immense nutritional benefits make honey a high demanding item in food and in medical. It is a multivitamin tonic enriched with the antimicrobial, antioxidant, cough preventing, hepato-protective, wound healing and immune modulating properties. Being a high demand item, most of the honeys available in market are adulterated by several means. Eventually, human practices developed a number of ways for detection of adulteration in honey. Even modern instrumentation like NMR is becoming a powerful and reliable tool in detection of high-rising adulteration. The present article aims to highlight a thorough of review of medicinal applications of honey with special emphasis on the traditional practices along with an overview of the history, composition, physical and nutritional properties and testing of adulteration.
Reducing edge loading and alignment outliers with image-free robotic-assisted unicompartmental knee arthroplasty: a case controlled study
Authors: Lau Wai Hong , Liu Wai Kiu Thomas , Chiu Kwong Yuen , Cheung Man Hong , Cheung Amy , Chan Ping Keung , Chan Vincent Wai Kwan , Fu Henry
Published: June 2024

Background

Survivorship of medial unicompartmental knee arthroplasty (UKA) is technique-dependent. Correct femoral-tibial component positioning associates with improved survivorship. Image-free robotic-assisted unicompartmental knee arthroplasty enables preoperative and intraoperative planning of alignment and assessment of positioning prior to execution. This study aimed to compare the radiological outcomes between robotic-assisted UKA (R-UKA) and conventional UKA (C-UKA).

Methods

This retrospective case control study involved 140 UKA (82 C-UKA and 58 R-UKA) performed at an academic institution between March 2016 to November 2020, with a mean follow-up of 3 years. Postoperative radiographs were evaluated for mechanical axis and femoral-tibial component position. Component position was measured by two methods: (1) femoral-tibial component contact point with reference to four medial-to-lateral quadrants of the tibial tray and (2) femoral-tibial component contact point deviation from the center of the tibial tray as a percentage of the tibial tray width. Baseline demographics and complications were recorded.

Results

There was a higher mean component deviation in C-UKA compared with R-UKA using method 2 (17.2% vs. 12.8%; P = 0.007), but no difference in proportion of zonal outliers using method 1 (4 outliers in C-UKA, 5.1% vs. 1 outlier in R-UKA, 1.8%; P = 0.403). R-UKA showed no difference in mean mechanical alignment (C-UKA 5° vs. R-UKA 5°; P = 0.250). 2-year survivorship was 99% for C-UKA and 97% for R-UKA. Mean operative time was 18 min longer for R-UKA (P < 0.001).

Conclusion

Image-free robotic-assisted UKA had improved component medio-lateral alignment compared with conventional technique.
Transarterial embolization of uterine arteries in emerging dysfunctional uterine bleeding: a single-center case series study
Authors: El Zaeem Esmaeel Tamer , Fouad AbdelBaki Allam Mohammad , Aboulfotouh Elsayed Mourad Mohamed , Issa Ahmad S.
Published: June 2024

Background

Uterine artery embolization is proven to be an effective treatment for symptomatic uterine fibroids. Yet, its role in the management of dysfunctional uterine bleeding is still debatable. Patients with dysfunctional uterine bleeding have abnormal bleeding from the uterine vascular bed with variable underlying mechanisms. Uterine artery embolization will reduce/prevent bleeding by occlusion of the vascular bed, with subsequent cutoff of the effect of hormones on the endometrium. The aim of this work is to demonstrate the safety, efficacy and possible short-term complications of uterine artery embolization in the treatment of dysfunctional uterine bleeding (DUB) as a first-line treatment modality rather than the current treatment options (hormonal and surgical treatment).

Methods

Thirty patients included in the study were clinically and laboratory diagnosed based on FIGO classification system (PALM-COEIN) as DUB, and the diagnosis was confirmed by MRI imaging. All patients were subjected to transcatheter uterine artery embolization with subsequent clinical and radiological follow-up to assess the treatment outcome.

Results

Uterine artery embolization was able to control bleeding in patients diagnosed as DUB, with subsequent complete cessation of medical treatment; no surgical interference was needed with much less morbidity. We had 93.3% improvement in the frequency, volume of bleeding and 100% improvement of the presenting anemia. No significant change in uterine volume or in endometrial thickness has been noted.

Conclusions

Uterine artery embolization is safe, effective procedure to control dysfunctional uterine bleeding with the preservation of the uterus especially in critical age groups.
Prevalence of musculoskeletal discomfort with associated disability among adult male motorcyclist
Authors: Afridi Zahra Khan , Khan Areeba , Masood Fatima , Rasool Danish , Hashmi Muhammad Ather
Published: June 2024

Background

This study conducted to determine the prevalence and severity of musculoskeletal discomfort among two-wheeler riders; however, musculoskeletal discomfort refers to pain, discomfort, or impairment in the muscles, bones, joints, tendons, ligaments, or other structures that support the body’s movement. It is a common problem experienced by individuals involved in various physical activities, including motorcycle riding.

Methods

This investigation was longitudinal research in which the Nordic muscular questionnaire (NMQ) was used to rule out the possibility of musculoskeletal disorders in motorcyclists. In Karachi, Pakistan, data were collected beginning in September of 2021 and continuing through February of 2022 using the convenience sampling method. Sixty-four individuals made up the sample. Participants were males ranging between the ages of 19 and 50 who rode standard motorcycles for their commute for about 6 to 8 h daily. Participants who had a tumor, an infection, or other comorbid are excluded.

Results

Sixty-four participants were included in this study, out of which 40 (62.5%) reported difficulty and discomfort in their neck, followed by their lower back (48.5%), shoulders (34.4%), and hips (26.6%). Sixteen motorcyclists (25%) complained wrist pain. When asked out their level of discomfort. However, 51.6% of individuals experienced lower back pain at the 12th month, while 46.9% had neck pain. 28.1%, 17.2%, and 14.1% reported shoulder, hip, and upper back discomfort. 51.6% of individuals had not seen a specialist for lower back symptoms. Lower back, neck, shoulders, and hip have been affected the longest, according to participants.

Conclusion

In conclusion, motorcyclists had a substantially greater rate of musculoskeletal problems than other drivers. Regulating musculoskeletal disorders in motorcyclists helps reduce symptoms and clinical indications of disease.
An exploratory randomized controlled trial of virtual reality as a non-pharmacological adjunctive intervention for adults with chronic cancer-related pain
Authors: Garrett Bernie , Tao Gordon , Taverner Tarnia , Gromala Diane , Musoke Richard , Sun Crystal , Shaw Christopher D , Cordingley Elliott
Published: June 2024

Background

The growing popularity and affordability of immersive virtual reality (VR), as adjunctive non-pharmacological interventions (NPIs) for chronic pain, has resulted in increasing research, with mixed results of its effectiveness reported. This randomized controlled superiority trial explored the effects of a home-based adjunctive 3D VR NPI for chronic pain in cancer patients, compared to the same NPI experienced through a two-dimensional (2D) medium.

Methods

The NPI used four different applications experienced for 30 min for six days a week at home for four weeks using established cognitive distraction and mindfulness meditation techniques. Participants were randomly assigned (N = 110) into two arms: a VR group (n = 57) where the NPI was delivered through a VR system, and a control group (n = 53) which used a computer screen for delivery. Participants were blinded to which arm of the study they were in, and sequence of the NPI applications experienced was randomized. Primary outcomes of daily pre/post/during exposure, and weekly average pain scores were assessed via the Visual Analog Scale (VAS) and the Short Form McGill Pain Questionnaire (SF-MPQ), and secondary outcomes of weekly Quality of Life (SF-12), and sleep quality (Pittsburgh Sleep Quality Index) were measured.

Results

Findings indicate VR applications were not significantly superior to the 2D group, but both VR and control NPIs provided clinically important pain reduction for participants when experiencing significant daily pain of a VAS ≥ 4. No significant adverse effects were encountered, although many of the participants in the VR group reported some cybersickness in certain applications (VR group n = 46 vs 2D group n = 28).

Conclusions

Overall, VR did not provide superiority as an NPI for pain relief compared to 2D computer-based applications. For those experiencing significant pain, cognitive distractive applications appeared superior for VR-based pain reduction during exposure, whilst meditative applications supplied better pain relief post-exposure. Findings from this trial support some clinical efficacy of home-based VR immersive experiences as NPIs for chronic cancer-related pain but in this context the 2D computer-based applications demonstrated similar value.

Trial registration

Clinicaltrials.gov, identifier NCT02995434, registered 2017–07-31.
Influence of ice properties on wave propagation characteristics in partially frozen soils and rocks: A temperature-dependent rock-physics model
Authors: Li Bonan , Matsushima Jun
Published: June 2024

A better understanding of the temperature effects on the propagation characteristics of elastic waves in frozen soils and rocks is imperative for accurately quantifying their freezing degrees. Although the existing rock-physics models based on the three-phase Biot (TPB) theory adeptly interpret observed velocity variation with temperature (VVT) curves, they often lack a comprehensive understanding of the mechanisms underlying attenuation variation with temperature (AVT) curves. In this study, we first extend the TPB theory to incorporate the temperature-dependent properties of ice, such as changes in volumetric fraction, morphology, and viscoelasticity, by integrating the relevant thermodynamic laws. Model parameters related to ice properties and interactions, such as rigidity, shear moduli, density, and friction, are redefined. Then, using a numerical rock-physics modeling approach, we examine influential factors and modes of the wave VVT and AVT responses. Our results indicate that the P- and S-wave velocities increase with source frequency, consolidation degree, and frame-supporting ice content, whereas they decrease with temperature and pore-floating ice content. The P- and S-wave attenuation factors increase with the frame-supporting ice content and decrease with the consolidation degree. Rising temperatures tend to amplify the peak magnitude of the P-wave attenuation factors and shift the central frequency of the S-wave attenuation factors. Finally, within a temperature-controlled laboratory environment, we conduct ultrasonic wave transmission testing on brine-saturated sediment and rock specimens. The results demonstrate that as the temperature increases from −15°C to −3°C, the P- and S-wave velocities decrease, whereas the P-wave attenuation factors decrease and the S-wave attenuation factors initially rise before declining. Our viscoelastic TPB theory outperforms the existing ones in interpreting the S-wave AVT observations. This temperature-dependent rock-physics model holds promise for interpreting the sonic logging data in the time-lapse monitoring of permafrost, glaciers, and Antarctica.
Palbociclib plus exemestane with GnRH agonist vs capecitabine in premenopausal patients with HR+/HER2- metastatic breast cancer: Updated survival results of the randomized phase 2 study Young-PEARL.
Authors: Park Yeon Hee , Lee Kyung-Hun , Kim Gun Min , Kang Seok Yun , Lee Keun Seok , Kim Jee Hyun , Lee Kyoung Eun , Ahn Hee Kyung , Lee Moon Hee , Kim Hee Jun , Kim Hanjo , Koh Su-Jin , Kim Ji-Yeon , Sohn Joohyuk , Kim Sung-Bae , Ahn Jin Seok , Kim Seonwoo , Cho Hyun , Jung Kyung Hae , Im Seock-Ah
Published: June 2024

LBA1002

Background: The Young-PEARL study demonstrated improved progression free survival (PFS) (mPFS: 20.1 vs. 14.4 mo.) of exemestane plus palbociclib with ovarian function suppression (OFS) compared to capecitabine in premenopausal patients with HR+/HER2- metastatic breast cancer (mBC). Here we report updated survival outcomes with median follow-up of 54.8 months (data cutoff, November 30, 2023). Methods: Premenopausal women aged 19 years or older with HR+/HER2- BC who had relapsed or progressed during previous tamoxifen therapy were enrolled. One line of previous chemotherapy for mBC was allowed. The primary endpoint was PFS, which was defined as the time from C1D1 to disease progression or death. The key secondary endpoint was overall survival (OS). Other secondary endpoints included objective response rate (ORR) and toxicities. Results: 184 patients were randomly assigned to exemestane plus palbociclib with OFS (n=92) or capecitabine (n=92). Median age was 44.0 years (range, 28-58). Key efficacy and safety are shown in Table. Final analysis was conducted for 174 patients. The updated mPFS was 19.5 mo. (90% CI, 14.3-22.3) for exemestane + palbociclib + OFS compared with 14.0 mo. (90% CI, 11.7-18.7) for capecitabine (HR 0.75, P=0.04). mOS was 54.8 mo. (95% CI, 48.9-77.1) for palbociclib arm and 57.8 mo. (95% CI, 46.3-N/A) for capecitabine arm (HR 1.06, P=0.77). mPFS2 (from the date of 1st PD to 2nd PD) was significantly shorter in palbociclib arm than those of capecitabine arm (7.5 vs. 11.7 mo. P=0.02). Confirmed ORR based on the investigator assessments was 33.3% (95% CI, 23.6-43.1) for palbociclib and 33.7% (95% CI, 23.6-43.9) for capecitabine. Median treatment duration was 18.9 mo. (range 1.6-88.4) in palbociclib and 13.5 mo. (range 0.1-70.8) in capecitabine. In palbociclib arm, 86 (93.5%) experienced grade 3 or more TEAEs, mainly asymptomatic neutropenia (64.1%), compared to 41 (48.2%) patients with grade ≥3 TEAEs in the capecitabine arm, mainly Hand-Foot syndrome and neutropenia (18.8% for each). Conclusions: Young-PEARL study showed exemestane + palbociclib with OFS improves efficacy compared with capecitabine in terms of PFS, which did not lead to an OS benefit for patients with premenopausal HR+/HER2- mBC (median follow-up duration: 54.8 months). The overall safety profile of palbociclib and capecitabine continues to be manageable with longer follow-up. Clinical trial information: NCT02592746 . [Table: see text]
Results from a randomised, open-label trial of a multimodal intervention (exercise, nutrition and anti-inflammatory medication) plus standard care versus standard care alone to attenuate cachexia in patients with advanced cancer undergoing chemotherapy.
Authors: Solheim Tora S. , Laird Barry J A , Balstad Trude R. , Stene Guro Birgitte , Baracos Vickie , Bye Asta , Dajani Olav , Hendifar Andrew Eugene , Strasser Florian , Chasen Martin Robert , Maddocks Matthew , Simpson Melanie R. , Skovlund Eva , Griffiths Gareth Owen , Hicks Jonathan , Graham Janet Shirley , Kyle Fiona , Bowden Joanna , Fallon Marie T. , Kaasa Stein
Published: June 2024

LBA12007

Background: Cancer cachexia arises from the interaction between the host and the tumour, triggering an inflammatory response that leads to weight and appetite loss, diminished physical activity, reduced treatment efficacy and survival. Combining interventions to address inflammation, weight loss, and physical activity is proposed as an effective strategy. Building on a promising pilot study, we conducted the MENAC (Multimodal Exercise Nutrition Anti-inflammatory Cachexia) trial to comprehensively evaluate this approach in patients with lung and pancreatic cancer undergoing systemic anti-cancer treatment (SACT). Methods: MENAC was an investigator-initiated, multicentre, open label, randomised phase 3 trial conducted at 17 sites in 4 countries. Patients with stage III or IV lung or pancreatic cancer receiving SACT with non-curative intent were randomly assigned (1:1) to a multimodal intervention consisting of nutritional counselling plus fish oil containing oral nutritional supplements, physical exercise [endurance and strength] and non-steroidal anti-inflammatory drugs [NSAIDs]) versus standard care. Randomisation was stratified by country, cancer type and stage. Primary Objective: To assess differences between arms in change in body weight. Secondary Objectives: To assess differences in muscle mass (measured by CT L3 technique) and physical activity (assessed through step counts using ActivPAL activity meter) between arms. Assessments were conducted at basline (pre-randomisation) and at endpoint (after 6 weeks). Results: From May 2015 to February 2022, 212 patients were enrolled (105 to multimodal treatment, 107 standard care). Over 6 weeks, weight stabilised in patients assigned to multimodal treatment compared with those assigned to standard care (mean weight change [SD] 0.05 kg [3.8] vs – 0.99 kg [3.2], respectively) with a mean difference in weight change of -1.04, 95 % CI -2.02 to -0.06, p=0.04. There was no conclusive difference in muscle mass (mean change [SD] -6.5cm2 [ 10.1] vs -6.3cm2 [11.9], p=0.93) or in mean step counts [SD] (-377.7 [2075] vs -458 [1858], p=0.89). There were 28 and 24 reported SAEs in the intervention and control arm respectively, no SUSARs were reported. Conclusions: A multimodal cachexia intervention stabilised weight compared to standard care at six weeks. There was no difference in physical activity or muscle mass between trial arms. Clinical trial information: NCT02330926 .
Durable complete responses to PD-1 blockade alone in mismatch repair deficient locally advanced rectal cancer.
Authors: Cercek Andrea , Sinopoli Jenna Cohen , Shia Jinru , Weiss Jill A. , Temple Lindsay , Smith Jesse Joshua , Saltz Leonard B. , Widmar Maria , Fumo Gerard , Aparo Santiago , Romesser Paul Bernard , Walch Henry S. , Patel Mitesh , Jayaprakasam Vetri Sudar , Kim Tae-Hyung , Paty Philip , Gonen Mithat , Garcia-Aguilar Julio , Weiser Martin R. , Diaz Luis A
Published: June 2024

LBA3512

Background: Early results have demonstrated that locally advanced mismatch repair deficient rectal cancers can become undetectable with PD-1 blockade alone and do not require chemotherapy, radiation, or surgery. Yet, the durability of this approach is unknown. Methods: We enrolled 47 mismatch repair deficient rectal cancers to a phase II study of 6-months of dostarlimab, a PD-1blocking monoclonal antibody. Co-primary endpoints were response rate that was previously met and the sustained clinical complete response rate, which has not yet been reported. A sustained clinical complete response was defined as complete pathologic response at surgery or no evidence of tumor by MRI, endoscopy, and digital rectal exam for at least 12 months following completion of therapy. If 13 or more patients achieved a sustained clinical complete response out of the first 30 patients, the study would be deemed successful. Results: All of the 41 patients who completed treatment achieved a clinical complete response. No patients required any additional therapy, and no patients experienced local or distant disease recurrence. Twenty patients achieved a sustained clinical complete response with a median follow-up of 28.9 months (95% CI 22.9 -37.1) from first treatment, which satisfied the second co-primary endpoint. No serious adverse events greater than grade 2 were observed. Ultrasensitive tumor-informed circulating tumor DNA levels and tumor bed biopsies normalized earlier than endoscopy, MRI or PET/CT. Conclusions: PD-1 blockade for 6-months alone yields durable recurrence-free responses in locally advanced mismatch repair deficient rectal cancer without the need for chemotherapy, radiation, or surgery. Clinical trial information: NCT04165772 .
Effect of chemotherapy/targeted therapy alone vs. chemotherapy/targeted therapy followed by radical surgical resection on survival and quality of life in patients with limited-metastatic adenocarcinoma of the stomach or esophagogastric junction: The IKF-575/RENAISSANCE phase III trial.
Authors: Al-Batran Salah-Eddin , Lorenzen Sylvie , Riera Jorge , Caca Karel , Mueller Christian , Stange Daniel E , Zander Thomas , Bolling Claus , Homann Nils , Gaedcke Jochen , Thuss-Patience Peter C. , Michl Patrick , Blau Wolfgang , Wille Kai , Koch Christine , Pauligk Claudia , Mueller Daniel Wilhelm , Bankstahl Ulli Simone , Mönig Stefan Paul , Goetze Thorsten
Published: June 2024

LBA4001

Background: The IKF-575 trial investigates the long-standing question about the role of surgical intervention in limited-metastatic gastric / esophagogastric junction cancer after systemic induction therapy. Methods: Previously untreated patients (pts) with limited metastatic disease (retroperitoneal lymph node (RPLN) metastases only or a maximum of one incurable organ site that is potentially resectable or locally controllable with or without retroperitoneal lymph nodes) received 4 cycles of FLOT, + trastuzumab if Her2+ or + nivolumab if PD-L1 positive. Pts without progression after 4 cycles were randomized to receive additional FLOT (Arm B) or radical complete surgical resection of primary and metastases followed by the same treatment (Arm A). It was planned to randomize 176 pts for which 271 pts had to enrolled. The primary endpoint was overall survival in the ITT population using Kaplan-Meier estimates. Recruitment was stopped after enrollment of 183 patients (141 patients randomized) with minimal impact on statistical power, due to a slow enrollment rate. Results: The ITT comprised 139 pts (A, 67; B, 72): 20% had RPLN metastases only, 58% organ metastases only, and 22% had both. Surgery in Arm A (ITT) was performed in 91% of pts and R0-resection rate (primary) was 82%. 30-d and 90-d mortalities in the surgery population were 3% and 8%. At least 4 additional cycles of post-op or post-randomization chemotherapy were achieved in 42% of pts in Arm A vs. 71% of pts in Arm B. The primary endpoint ovrall survival was not met due to increased early mortality in the surgery Arm leading to crossing survival curves with OS 25%- and 75%-Quantiles being 10 vs. 14 months and 65 vs. 41 months for Arms A vs. B, respectively. Pts with RPLN metastases only seemed to benefit most from the surgical approach (mOS, 30 vs. 17 months; 5y OS 38% vs. 19%; still having increased early mortality), while pts showing no response to chemo (mOS, 13 vs. 22 months) or pts with peritoneal disease (mOS, 12 vs. 19 months) derived a detrimental effect. Conclusions: The IKF-575/RENAISSANCE trial is negative but informs future research. Future protocols should focus on pts with RPLN only disease and exclude non-responding pts or those with peritoneal disease. There is a need for strategies against the early mortality caused by chemotherapy interruption. Clinical trial information: NCT02578368 .