bluuebunny/crossref_metadata_2025 huggingface dataset:
Calibration of medical gamma cameras for estimation of internal contamination from 137Cs
Authors: Hjellström Martin , Isaksson Mats
Published: March 2024

Calibration of 22 gamma camera units was performed at 15 hospitals in southern and western Sweden to estimate 137Cs contamination in humans in a supine static geometry, with a new developed calibration protocol and phantom. The minimum detectable activities (MDAs) and the estimated committed effective doses (CEDs) were calculated for each calibration. Generic calibration factors were calculated for five predetermined groups based on the detector type and manufacturer. Group 1 and 2 included NaI-based gamma cameras from General Electrics (GEs) with a crystal thickness of 5/8′′ and 3/8′′ respectively. Group 3 and 4 included NaI-based gamma cameras from Siemens Healthineers with a crystal thickness of 3/8′′, with a similar energy window as the GE NaI-based cameras and a dual window respectively. Group 5 included semiconductor-based gamma cameras from GE with a CdZnTe (CZT) detector. The generic calibration factors were 60.0 cps kBq−1, 52.3 cps kBq−1, 50.3 cps kBq−1, 53.2 cps kBq−1 and 48.4 cps kBq−1 for group 1, 2, 3, 4, and 5 respectively. The MDAs ranged between 169 and 1130 Bq for all groups, with measurement times of 1–10 min, corresponding to a CED of 4.77–77.6 μSv. A dead time analysis was performed for group 1 and suggested a dead time of 3.17 μs for 137Cs measurements. The dead time analysis showed that a maximum count rate of 232 kcps could be measured in the calibration geometry, corresponding to a CED of 108–263 mSv. It has been shown that semiconductor-based gamma cameras with CZT detectors are feasible for estimating 137Cs contamination. The generic calibration factors derived in this study can be used for gamma cameras of the same models in other hospitals, for measurements in the same measurement geometry. This will increase the measurement capability for estimating internal 137Cs contamination in the recovery phase following radiological or nuclear events.
Dynamics of neuronal firing modulated by high-frequency electrical pulse stimulations at axons in rat hippocampus
Authors: Wang Zhaoxiang , Feng Zhouyan , Yuan Yue , Guo Zheshan , Cui Jian , Jiang Tianzi
Published: March 2024

Objective. The development of electrical pulse stimulations in brain, including deep brain stimulation, is promising for treating various brain diseases. However, the mechanisms of brain stimulations are not yet fully understood. Previous studies have shown that the commonly used high-frequency stimulation (HFS) can increase the firing of neurons and modulate the pattern of neuronal firing. Because the generation of neuronal firing in brain is a nonlinear process, investigating the characteristics of nonlinear dynamics induced by HFS could be helpful to reveal more mechanisms of brain stimulations. The aim of present study is to investigate the fractal properties in the neuronal firing generated by HFS. Approach. HFS pulse sequences with a constant frequency 100 Hz were applied in the afferent fiber tracts of rat hippocampal CA1 region. Unit spikes of both the pyramidal cells and the interneurons in the downstream area of stimulations were recorded. Two fractal indexes—the Fano factor and Hurst exponent were calculated to evaluate the changes of long-range temporal correlations (LRTCs), a typical characteristic of fractal process, in spike sequences of neuronal firing. Main
results. Neuronal firing at both baseline and during HFS exhibited LRTCs over multiple time scales. In addition, the LRTCs significantly increased during HFS, which was confirmed by simulation data of both randomly shuffled sequences and surrogate sequences. Conclusion. The purely periodic stimulation of HFS pulses, a non-fractal process without LRTCs, can increase rather than decrease the LRTCs in neuronal firing. Significance. The finding provides new nonlinear mechanisms of brain stimulation and suggests that LRTCs could be a new biomarker to evaluate the nonlinear effects of HFS.
Impacts of method courses on Vietnamese pre-service teachers’ perceptions and practices: From the perspectives of model and modeling in STEM education
Authors: Khuyen Nguyen Thi To , Bien Nguyen Van , Ngan Le Hai My , Khan Samia , Faikhamta Chatree , Islami R Ahmad Zaky El
Published: March 2024

Modeling in visual representations is essential in STEM education because of its concretization in science, technology, engineering, and math learning activities. Therefore, model-based teaching needs to be improved for pre-service teachers (PSTs) to implement STEM education successfully. We conduct the model-based integrated inquiry STEM (MII-STEM) method courses for 16 PSTs in Physics Education in Vietnam. A qualitative analysis was utilized to examine how and to what extent PSTs change in perceptions of models and STEM education. The findings showed that the number of PSTs with a higher understanding of the model increased. PSTs gain a deeper understanding of STEM education and could transfer alternative perceptions of STEM education into STEM lesson plans. PSTs clarified and embedded Science and Engineering Practices in STEM lesson plans. There were changes of PSTs’ STEM lesson plan after the MII-STEM course: (1) product-oriented to process-oriented; (2) make Engineering more apparent; (3) focusing on developing students’ science and engineering practices; (4) define how STEM sub-fields integrated into STEM lesson plans; and (5) using model and modeling in STEM activities. In addition, PSTs had a positive view of the effectiveness of the STEM-focus method course.
Using the Design-Based Research Approach to Develop and Evaluate a New Study Module about Knowledge Acquisition in Science
Authors: Biedenbach Jana , Spatz Verena
Published: March 2024

The research approach design-based research has become more popular in recent years, also in the field of science didactics. Representatives of this field usually explicitly distinguish themselves from evaluation. In contrast, we have formed a synthesis of both research approaches for our development and evaluation project. By conducting the development and evaluation according to a design-based research process, we are able to take advantage of the added value of the design-based research approach. This article describes the philosophy of our research with the image of the didactic engineer and gives an insight into the implementation through the concrete description of our project, the development and evaluation of a new study module on knowledge acquisition in science for pre-service teachers. Finally, we discuss the added value of the elements of design-based Research compared to a pure evaluation and where the limits lie regarding the claims of design-based research.
The Stellarium Gornergrat: Astrophysics with your own Data
Authors: Gschwind Stéphane , Hohmann Sascha , Müller Andreas , Nordine Jeffrey , Riesen Timm-Emanuel
Published: March 2024

Remote-controlled telescopes in education provide the opportunity to obtain high quality astronomy images for a broad variety of users. The Stellarium Gornergrat is such a telescope. In addition to pure observation, it offers a user-friendly interface and teaching modules so that astronomical and astrophysical projects can be integrated into everyday school life without any special prior knowledge and without requiring a lot of time. This contribution presents the Stellarium project and a provides an overview of several teaching activities.
A mathematical model of peer-instruction including stochastic uncertainty
Authors: Nariyuki Yasuhiro
Published: March 2024

A mathematical model of peer-instruction including stochastic uncertainty is presented. By using the master equation describing stochastic transition among different states, a stochastically modified version of Nitta’s peer-instruction model is obtained. It is shown that moment equations with a simple closure reproduce the expectation and the variance obtained by using direct numerical simulations of the resultant model. Such a mathematical model will provide insights to the real data beyond the standard statistical analysis.
LUCID-3: the upgrade of the ATLAS luminosity detector for High-Luminosity LHC
Authors: Giacobbe B. ,   on behalf of ATLAS LUCID Group
Published: March 2024

The ATLAS physics program at the High Luminosity LHC (HL-LHC) calls for a precision in the luminosity measurement of 1%. A larger uncertainty would represent the dominant systematic error in precision measurements, including those in the Higgs sector. To fulfill such requirement in an environment characterized by up to 140 simultaneous interactions per crossing (200 in the ultimate scenario), ATLAS will feature several luminosity detectors. At least some of them must be both calibratable in the van der Meer scans at low luminosity and able to measure up to the highest values. LUCID-3, the upgrade of the present ATLAS luminometer (LUCID-2), will fulfill such a condition. The reasons for an upgrade of LUCID-2 and the envisaged solutions are discussed and a description of the LUCID-3 project is given. Finally, the first results obtained with the prototypes installed in ATLAS during the present LHC Run-3 are discussed as means of the validation of the final design.
Simulation method of airborne γ radiation detector response based on the equivalent transformation
Authors: Qu Jinhui , Lei Jiarong , Huang Xi , Zhang Huaiqiang , Wu Hexi , Chen Xiting , Yuan Yonggang
Published: March 2024

In airborne gamma radiation measurement, radiation
detectors' responses are simulated using the direct simulation
method. However, the number of particles recorded by the detector is
significantly lower than the number of particles emitted from the
radiation source. This imbalance leads to low simulation efficiency,
making it challenging to achieve an acceptable level of statistical
uncertainty within a limited computer time. To address this
inefficiency, we have theoretically proven the equivalent
transformation and utilized that to devise a fast Monte Carlo
simulation method known as the equivalent transformation
method. Simulation results from a large body and a large surface
source demonstrate that the detector response spectrum calculated
using the equivalent transformation method closely agrees with those
obtained through the direct simulation method. Furthermore, the
efficiency ratio for the equivalent transformation method, in
comparison to the direct simulation method, stands at
2.37 × 106 and 2.67 × 106 for a large body and a
large surface source, respectively. These findings solidify the
validity and effectiveness of the equivalent transformation method
in enhancing simulation efficiency for the research on airborne
gamma radiation measurement.
Parenteral nutrition in clinical practice: International challenges and strategies
Authors: Wischmeyer Paul E , Klek Stanislaw , Berger Mette M , Berlana David , Gray Brenda , Ybarra Joe , Ayers Phil
Published: March 2024

Purpose

Parenteral nutrition (PN) is an established therapy when oral/enteral feeding is not sufficient or is contraindicated, but nevertheless PN remains a complex, high-alert medication that is susceptible to errors that may affect patient safety. Over time, considerable progress has been made to make PN practices safer. The purpose of this article is to address ongoing challenges to improve the PN use process from prescription to administration and monitoring, and to outline practical aspects fostering the safety, quality, and cost-effectiveness of PN, as discussed at the International Safety and Quality of PN Summit.

Opportunities to improve the PN use process in clinical practice include the promotion of inter-disciplinary communication, vigilant surveillance for complications, staff education to increase competency, and more consistent use of advanced technologies that allow automated safety checks throughout the PN process. Topics covered include considerations on PN formulations, including the value of intravenous lipid emulsions (ILEs), trends in compounding PN, the current and future role of market-authorized multi-chamber PN bags containing all 3 macronutrients (amino acids, glucose/dextrose, and ILE) in the United States and in Europe, and strategies to cope with the increasing global problem of PN product shortages.

Conclusion

This review outlines potential strategies to use in clinical practice to overcome ongoing challenges throughout the PN use process, and ultimately promote PN patient safety.
Publication of pharmacy resident research projects: A systematic review and meta-analysis
Authors: Behal Michael L , Fields Paige E , Cook Aaron M , Morgan Rebecca J , Flannery Alexander H
Published: March 2024

Purpose

Pharmacy residents often aspire to develop research skills through conducting a research project. Project publication rates among pharmacy residents are variable and at times low; however, previous studies have been limited to specific geographic regions and timeframes. This study sought to conduct a systematic review and meta-analysis to determine the proportion of pharmacy resident research projects published in the peer-reviewed literature.

Methods

A systematic review of PubMed MEDLINE, Embase, and the Web of Science Core Collection was performed from database inception to May 25, 2023. Articles were included if they were full-text, peer-reviewed manuscripts of original research presenting observational data regarding pharmacy resident research project publication rates. Data extraction and assessment of risk of bias were conducted by 2 independent reviewers. A proportional meta-analysis using a random effects model of the included studies was conducted to generate a pooled, overall proportion.

Results

The search yielded 5,225 records and 12 articles that met the inclusion criteria. All studies were retrospective and observational. Risk of selection and cohort identification biases was “high,” whereas that of detection and timeframe biases was “low.” The included studies represented 6,990 resident research projects, 777 of which were published in the peer-reviewed literature. Publication rates across individual studies ranged from 1.8% to 36.2%. The pooled proportion (scale of 0 to 1) of projects published was 0.13 (95% CI, 0.09-0.19).

Conclusion

Pharmacy resident research project publication rates are low at 13%. Furthermore, studies reporting project publication rates over time suggest a neutral or negative trend in publication rates despite an exponential increase in the number of pharmacy residents.
Isothianaphthene quinoids: pyrazine-annelated structures for tuning electronic properties
Authors: Yamamoto Keitaro , Jinnai Seihou , Ie Yutaka
Published: March 2024

The development of quinoidal systems with extended π-conjugation has elucidated the influence that diradical characteristics exert on structure–property relationships, which is significant because it broadens the possibilities for the use of organic semiconducting materials in organic electronics. However, the chain-length elongation of such quinoidal molecules has resulted in low chemical stability due to the large contribution of diradical characteristics and to the high level of the highest occupied molecular orbital (HOMO), both of which limit the synthesis of π-extended quinoidal molecules. Here, we describe solving this problem via aromatic stabilization. To accomplish this, we designed a system that utilizes electron-accepting pyrazine-fused thieno[3,4-b]pyrazine following the development of the isothianaphthene quinoids of thiophene 3-mer and 6-mer. Theoretical calculations indicate that the introduction of a pyrazine-annelated structure suppresses the diradical characteristics and stabilizes the HOMO energy level of quinoidal oligothiophenes. The thermal, photophysical, and physicochemical properties of newly synthesized quinoidal molecules with full annelation of the benzene and pyrazine rings were investigated. Quinoidal thiophene 3-mer functioned as an acceptor in organic solar cells with a power conversion efficiency of 1.04%. This study demonstrates that the introduction of pyrazine-fused rings is an effective molecular design to extend the chain length of quinoidal oligothiophenes.
Perioperative immune checkpoint blockades improve prognosis of resectable non-small cell lung cancer
Authors: Tian Yu , Liu Zhichao , Pan Hanbo , Zhu Hongda , Zou Ningyuan , Jiang Long , Li Ziming , Huang Jia , Hu Yingjie , Luo Qingquan
Published: March 2024

OBJECTIVES

Immune checkpoint blockades (ICB) have been proven to improve prognosis of non-small cell lung cancer in the neoadjuvant setting, while whether its perioperative use could bring extra benefit remained unidentified. We aimed to demonstrate the prognostic benefit of perioperative ICB over preoperative-only use and investigate who could benefit from this ‘sandwich ICB therapy’.

METHODS

Patients undergoing neoadjuvant therapy followed by surgery from 2018 to 2022 were retrospectively reviewed, and were divided into 4 groups based on the perioperative regimens: pre-ICB + post-computed tomography (CT), pre-ICB-only, pre-CT + post-ICB and pre-CT-only. Treatment-related adverse events, surgical outcomes, therapeutic response, recurrence-free survival and overall survival were compared.

RESULTS

Of 214 enrolled patients with preoperative therapy, 108 underwent immunochemotherapy and 106 underwent platinum-based chemotherapy. Compared with preoperative chemotherapy, preoperative immunochemotherapy was demonstrated with significantly higher major pathologic response (57/108 vs 12/106) and pathologic complete response (35/108 vs 4/106) rates with comparable adverse events. Regarding survival, perioperative ICB significantly improved the recurrence-free survival [versus pre-CT-only hazard ratio (HR) 0.15; 95% CI 0.09–0.27; versus pre-ICB-only HR 0.36; 95% CI 0.15–0.88] and overall survival (versus pre-CT-only HR 0.24; 95% CI 0.08–0.68). In patients without major pathologic response, perioperative ICB was observed to decrease the risk of recurrence (HR 0.31; 95% CI 0.11–0.83) compared with preoperative ICB, and was an independent prognostic factor (P < 0.05) for recurrence-free survival.

CONCLUSIONS

Perioperative ICB showed promising efficacy in improving pathological response and survival outcomes of resectable non-small cell lung cancer. For patients without major pathologic response after resection followed by preoperative ICB, sequential ICB treatment could be considered.
Volume prediction of young improved Sitka spruce trees in Great Britain through Bayesian model averaging
Authors: Manso Rubén , Price Andrew , Ash Adam , Macdonald Elspeth
Published: March 2024

More and earlier thinning operations are expected in Sitka spruce planted forests in Great Britain as a result of an increased demand for biomass and faster growth driven by breeding. It is however unknown whether the current models, which were designed to predict volume in adult trees, can provide unbiased volume predictions for the young individuals that are likely to be harvested in future thinning operations. The primary objective of this study was to answer this question. To do this, we used retrospective data from a destructive experiment originally aimed at assessing timber properties to reconstruct the taper and volume of 12 improved Sitka spruce trees at different ages. These volumes were then compared against the predictions from the current methods, which were found to be from moderately to strongly biased. The second objective was to provide proof of concept that a combination of existing volume models and other theoretical volume models could yield less biased predictions. We successfully addressed this objective through the Bayesian model averaging approach. The method, albeit tested with limited data, proved to be a promising alternative until new volume models are released. Further data from other available destructive experiments can be used to refine our calibration.
Neutralized Local Entropy and Dimension bounds for Invariant Measures
Authors: Ben Ovadia S , Rodriguez-Hertz F
Published: March 2024

We introduce a notion of a point-wise entropy of measures (i.e., local entropy) called neutralized local entropy, and compare it with the Brin-Katok local entropy. We show that the neutralized local entropy coincides with Brin-Katok local entropy almost everywhere. Neutralized local entropy is computed by measuring open sets with a relatively simple geometric description. Our proof uses a measure density lemma for Bowen balls, and a version of a Besicovitch covering lemma for Bowen balls. As an application, we prove a lower point-wise dimension bound for invariant measures, complementing the previously established bounds for upper point-wise dimension.
Aminoglycoside resistance genes in early members of the Acinetobacter baumannii ST78A (SMAL, Italian clone) reside in an IS26-bounded island in the chromosome
Authors: Harmer Christopher J , Cahill Sarah M , Kenyon Johanna J , Hall Ruth M
Published: March 2024

Background

The Acinetobacter baumannii isolate called SMAL, previously used to determine the structures of capsular polysaccharide and lipooligosaccharide, was recovered in Pavia, Italy in 2002 among the collection of aminoglycoside-resistant isolates designated as SMAL type. This type was later called the Italian clone, then ST78. ST78 isolates are now widely distributed.

Objectives

To establish the resistance gene complement and the location and structure of acquired resistance regions in early members of the Italian/ST78 clone.

Methods

The draft genome of SMAL2002 was assembled from Illumina MiSeq reads. Contigs containing resistance genes were joined and located in the chromosome using PCR with custom primers. The resistance profile was determined using disc diffusion.

Results

SMAL2002 is an ST78A isolate and includes three aminoglycoside resistance genes, aadB (gentamicin, kanamycin, tobramycin) aphA1 (kanamycin, neomycin) and aac(6′)-Ian (amikacin, kanamycin, tobramycin). The aadB gene cassette is incorporated at a secondary site in a relative of the aphA1-containing, IS26-bounded pseudo-compound transposon, PTn6020. The aac(6′)-Ian gene is in an adjacent IS26-bounded structure that includes sul2 (sulphonamide) and floR (florfenicol) resistance genes. The two pseudo-compound transposons overlap and are in the chromosomal hutU gene flanked by an 8 bp target site duplication. Although aac(6′)-Ian was not noticed previously, the same genes and structures were found in several available draft genomes of early ST78A isolates.

Conclusions

This study highlights the importance of correlating resistance profiles with resistance gene content. The location of acquired resistance genes in the SMAL2002 chromosome represents the original location in the ST78A lineage of ST78.
Analysis of National Institutes of Health Funding for the COVID-19 Pandemic
Authors: Narahari Adishesh K , Horgan Taylor M , Chandrabhatla Anirudha S , Gist D Chris , Patel Paranjay D , Lantieri Mark A , Sturek Jeffrey M , Davis Claire L , Jackson Patrick E H , Bell Taison D
Published: March 2024

Background

Evaluating the National Institute’s Health’s (NIH's) response to the coronavirus disease 2019 (COVID-19) pandemic via grants and clinical trials is crucial to determining the impact they had on aiding US citizens. We determined how the NIH's funding for COVID-19 research was disbursed and used by various institutions across the United States.

Methods

We queried NIH RePORTER and isolated COVID-19–related grants from January 2020 to December 2021. We analyzed grant type, geographical location, and awardee institution. Manuscripts published from these grants were quantitatively analyzed. COVID-19 clinical trials were mapped and distances from counties to clinical trial sites were calculated using ArcGis.

Results

A total of 2401 COVID-19 NIH grants resulted in 14 654 manuscripts from $4.2 billion and generated more than 150 000 citations. R01s make up 32% of grants (763/2401) and 8% of funding ($329 million). UM1 grants account for the majority of funding (30.8%; $1.3 Billion). Five states received 50.6% of funding: North Carolina, Washington, New York, California, and Massachusetts. Finally, of the 1806 clinical trials across 1266 sites in the United States, the majority were in metropolitan areas in close proximity to areas of high COVID-19 disease burden.

Conclusions and Relevance

Evaluating the outcome of the NIH's response to the COVID-19 pandemic is of interest to the general public. The present study finds that the NIH disbursed more than $4 billion in funding to large consortiums and clinical trials to develop diagnostics, therapeutics, and vaccines. Approximately 8% of funding was used for R01 grants. Clinical trial sites were generally located in areas of high COVID-19 burden.
Experience With Four-Month Rifapentine and Moxifloxacin–Based Tuberculosis Treatment in San Francisco
Authors: Louie Janice K , Agraz-Lara Rocio , Velásquez Gustavo E , Phillips Allison , Szumowski John D
Published: March 2024

Background

A multicountry randomized controlled trial has demonstrated that pan-susceptible pulmonary tuberculosis (TB) can be successfully treated with a 4-month regimen of daily isoniazid, rifapentine, moxifloxacin, and pyrazinamide (HPMZ). We piloted HPMZ in San Francisco (SF) using a modified version of the US Centers for Disease Control and Prevention HPMZ treatment guidelines.

Methods

In this retrospective cohort, patients consecutively referred to SF TB clinic were evaluated for HPMZ eligibility based on preestablished inclusion/exclusion criteria. All underwent evaluation and management according to national recommendations. We reviewed the medical records of those initiated on HPMZ.

Results

From August 2021 to December 2023, 30 (18.8%) of 160 patients diagnosed with active TB met HPMZ inclusion criteria; of these, 22 (13.8%) started HPMZ. The median age (range) was 32.5 (14–86) years, 17 (77.3%) were otherwise healthy, and 19 (86.4%) had pulmonary TB, including 7 (36.8%) with cavitary disease. Eighteen (81.8%) patients had an adverse event, with 11 (50%) prematurely discontinuing HPMZ; the most common adverse events were vomiting, elevated transaminases, and rash. To date, 9 (40.9%) have completed treatment, with most achieving criteria for cure. One patient was diagnosed with possible TB recurrence and restarted standard TB treatment.

Conclusions

Our experience, with half of patients to date prematurely discontinuing HPMZ, illustrates the challenge of extrapolating findings from TB clinical trials commonly conducted in high-incidence, non-US settings to US clinical practice. Further experience may help identify best practices for implementing HPMZ, including identifying predictors of which patients may be most likely to benefit from and tolerate this regimen.
Training German police officers to tackle racial discrimination: Professional virtues between compliance with legal norms and dialogue with affected groups
Authors: John Emanuel
Published: March 2024

Educational formats that seek to raise police officers’ awareness about racial discrimination often focus on formal violations of the principle of non-discrimination or canons of values. First, based on a critical discussion of positions on discrimination in policing and proposals for police training in Germany this paper argues based on human rights for a broader understanding of the challenge to tackle racial discrimination in policing. In reference to neo-Aristotelian virtue ethics, competencies for proactive encounters with affected groups will thereby be explored. Second, it outlines a framework for educational formats on this issue that address police officers as whole persons, who should, in the context of their professional practice, develop the virtue to understand the perspectives of and to build relationships of care with marginalized individuals. An example of a tested format that integrates perspectives from civil society will be presented.
Thermosensitive hydrogel with programmed dual-octenidine release combating biofilm for the treatment of apical periodontitis
Authors: Cheng Yu , Huangfu Yini , Zhao Tingyuan , Wang Linxian , Yang Jing , Liu Jie , Feng Zujian , Que Kehua
Published: March 2024

The utilization of intracanal medicaments is an indispensable procedure in root-canal treatment. However, the conventional intracanal medicaments still need improvement regarding antimicrobial efficacy and ease of clinical operation. To address the above issues, OCT/PECT@OCT + ALK composite hydrogel characterized by programming sequential release of dual antimicrobial agents has been proposed. Thanks to the self-assemble ability of amphiphilic copolymer poly(ε-caprolactone-co-1,4,8-trioxa [4.6]spiro-9-undecanone)-poly(ethylene glycol)-poly(ε-caprolactone-co-1,4,8-trioxa[4.6]spiro-9-undecanone) (PECT), dual hydrophilic and hydrophobic antimicrobial agents could be easily encapsulated in the hydrogel system and tailored for sequential drug release for a better antibiofilm effect. The hydrophilic octenidine (Octenidine dihydrochloride, OCT-HCl) is encapsulated in the hydrophilic part of hydrogel for instantaneous elevating the drug concentration through bursting release, and the hydrophobic octenidine (Octenidine, OCT) is further loaded into the PECT nanoparticles to achieve a slower and sustained-release profile. Additionally, calcium hydroxide (Ca(OH)2) was incorporated into the system and evenly dispersed among PECT nanoparticles to create an alkaline (ALK) environment, synergistically enhancing the antibiofilm effect with higher efficiency and prolonged duration. The antibiofilm effect has been demonstrated in root-canal models and apical periodontitis rats, exhibiting superior performance compared to clinically used Ca(OH)2 paste. This study demonstrates that OCT/PECT@OCT + ALK composite thermosensitive hydrogel is a potential intracanal medicament with excellent antibiofilm effect and clinical operability.
The First Dog Doctors: Canine Healthcare Practitioners in the Eighteenth-Century Medical Marketplace
Authors: Howard-Smith Stephanie
Published: March 2024

The question of when dogs became the recipients of veterinary care has long been debated; current scholarship does not acknowledge the long tradition of canine healthcare provided by irregular specialists prior to the late nineteenth century. This article reveals, however, that eighteenth-century Britain was home to a thriving canine medical marketplace. Among its key actors were ‘dog doctors’—individuals without formal healthcare training who regularly treated and healed dogs. This article offers the first historical account of the eighteenth-century dog doctor, contextualising and reappraising his identity, clients and services. It focusses on the dynamic career of the celebrity practitioner John Norborn, who proudly self-identified as a ‘dog doctor’ when the term was considered an insult. In doing so the article considers the conditions in which specialist care for dogs first developed and argues for a new chronology of canine veterinary medicine.
Precision Delivery of Human Bone Marrow-Derived Mesenchymal Stem Cells Into the Pancreas Via Intra-arterial Injection Prevents the Onset of Diabetes
Authors: Primavera Rosita , Regmi Shobha , Yarani Reza , Levitte Steven , Wang Jing , Ganguly Abantika , Chetty Shashank , Guindani Michele , Ricordi Camillo , Meyer Everett , Thakor Avnesh S
Published: March 2024

Mesenchymal stem cells (MSCs) are a promising therapy to potentially treat diabetes given their potent anti-inflammatory and immune-modulatory properties. While these regenerative cells have shown considerable promise in cell culture, their clinical translation has been challenging. In part, this can be attributed to these cells not reaching the pancreas to exert their regenerative effects following conventional intravenous (IV) injection, with the majority of cells being trapped in the lungs in the pulmonary first-pass effect. In the present study, we will therefore examine whether direct delivery of MSCs to the pancreas via an intra-arterial (IA) injection can improve their therapeutic efficacy. Using a mouse model, in which repetitive low doses of STZ induced a gentle, but progressive, hyperglycemia, we tested bone marrow-derived MSCs (BM-MSCs) which we have shown are enriched with pro-angiogenic and immunomodulatory factors. In cell culture studies, BM-MSCs were shown to preserve islet viability and function following exposure to proinflammatory cytokines (IFN-γ, IL-1β, and TNF-α) through an increase in pAkt. When tested in our animal model, mice receiving IV BM-MSCs were not able to mitigate the effects of STZ, however those which received the same dose and batch of cells via IA injection were able to maintain basal and dynamic glycemic control, to similar levels as seen in healthy control animals, over 10 days. This study shows the importance of considering precision delivery approaches to ensure cell-based therapies reach their intended targets to enable them to exert their therapeutic effects.
Tolerogenic CD11c+dendritic cells regulate CD4+Tregs in replacing delayed ischemic preconditioning to alleviate ischemia–reperfusion acute kidney injury
Authors: Wang Pingping , Li Chunyao , Peng Tao , Ruan Longzhu , Wu Aijie , Zhu Jiaojiao , Shi Wenlu , Chen Menghua , Zhang Ting
Published: March 2024

Ischemia–reperfusion injury (IRI) is one of the primary clinical causes of acute kidney injury (AKI). The key to IRI lies in immune‐inflammatory damage, where dendritic cells (DCs) play a central role in eliciting immune responses within the context of inflammation induced by ischemia–reperfusion. Our previous study has confirmed that delayed ischemic preconditioning (DIPC) can reduce the kidney injury by mediating DCs to regulate T‐cells. However, the clinical feasibility of DIPC is limited, as pre‐clamping of the renal artery is not applicable for the prevention and treatment of ischemia–reperfusion acute kidney injury (I/R‐AKI) in clinical patients. Therefore, the infusion of DCs as a substitute for DIPC presents a more viable strategy for preventing renal IRI. In this study, we further evaluated the impact and mechanism of infused tolerogenic CD11c+DCs on the kidneys following IRI by isolating bone marrow‐derived dendritic cells and establishing an I/R‐AKI model after pre‐infusion of DCs. Renal function was significantly improved in the I/R‐AKI mouse model after pre‐infused with CD11c+DCs. The pro‐inflammatory response and oxidative damage were reduced, and the levels of T helper 2 (Th2) cells and related anti‐inflammatory cytokines were increased, which was associated with the reduction of autologous DCs maturation mediated by CD11c+DCs and the increase of regulatory T‐cells (Tregs). Next, knocking out CD11c+DCs, we found that the reduced immune protection of tolerogenic CD11c+DCs reinfusion was related to the absence of own DCs. Together, pre‐infusion of tolerogenic CD11c+DCs can replace the regulatory of DIPC on DCs and T‐cells to alleviate I/R‐AKI. DC vaccine is expected to be a novel avenue to prevent and treat I/R‐AKI.
Reducing falls among residents of retirement homes
Authors: Coleman Alanna
Published: March 2024

Falls among older adults (OAs) living in retirement homes (RHs) in Canada are a major public health concern due to high morbidity and mortality as well as significant healthcare expenditures. This quality improvement (QI) initiative, conducted for the author's Doctor of Nursing Practice (DNP) project, aimed to decrease fall rates and ED transfers related to falls among OAs in six RHs across the Greater Toronto Area in Ontario, Canada through a multipart intervention with two primary goals. First, the project aimed to facilitate RH NPs' implementation of a comprehensive fall risk assessment and fall prevention strategy in their practice by incorporating the Stopping Elderly Accidents, Deaths & Injuries (STEADI) toolkit into their armamentarium. Second, it sought to enhance the knowledge of the RHs' registered practical nurses (RPNs), personal support workers (PSWs), and unregulated care providers (UCPs) in assessing fall risk and incorporating fall prevention strategies in their daily practice. By improving NP, RPN, PSW, and UCP knowledge and increasing (by 20%) RPN, PSW, and UCP use of fall prevention strategies, this QI initiative successfully reduced fall rates in the RHs by 40.4%, with no falls requiring transfer to the ED, in the postintervention period. The results of this project highlight the need for an interdisciplinary approach to fall risk reduction in RHs that includes implementation of multifactorial intervention strategies as well as effective organizational policies and procedures for maximum impact.
Postmenopausal endometriosis: a challenging condition beyond menopause
Authors: Vallée Alexandre , Carbonnel Marie , Ceccaldi Pierre-François , Feki Anis , Ayoubi Jean-Marc
Published: March 2024

Importance and Objective

Postmenopausal endometriosis is a complex condition that challenges the conventional belief that endometriosis resolves with menopause. Despite the cessation of menstruation, a subset of women continues to experience or develop endometriosis-related symptoms during the postmenopausal period. Thus, this review aimed to shed light on postmenopausal endometriosis, exploring its clinical features, diagnostic considerations, management approaches, and the potential impact on women's health.

Methods

PubMed/Medline, Scopus, and Web of Science databases were used for the research, with only articles in English language, using the following terms: “postmenopausal endometriosis,” “menopause,” “management,” “treatment,” and “quality of life,” from inception to 2023.

Discussion and Conclusion

The clinical features of postmenopausal endometriosis include persistent or recurrent pelvic pain, dyspareunia, bowel, or urinary symptoms and, occasionally, abnormal vaginal bleeding. The absence of menstrual cycles presents a diagnostic challenge, as the traditional diagnostic criteria for endometriosis rely on menstrual patterns. Visual cues may be less evident, and the symptoms often overlap with other gynecological conditions, necessitating a thorough evaluation to differentiate postmenopausal endometriosis from other potential causes. Management approaches for postmenopausal endometriosis encompass surgical intervention, hormonal therapies, pain management, and individualized care. Postmenopausal endometriosis significantly impacts the quality of life, sexual health, and long-term well-being of women. Understanding the clinical features, diagnostic challenges, and management approaches of postmenopausal endometriosis is crucial for healthcare professionals to provide effective care and to improve the quality of life of women affected by this condition.
“Not feeling like myself” in perimenopause — what does it mean? Observations from the Women Living Better survey
Authors: Coslov Nina , Richardson Marcie K. , Woods Nancy Fugate
Published: March 2024

Objective

This study aimed to understand the meaning of the phrase “not feeling like myself” (NFLM) when used by those on the path to menopause by exploring the relationship of symptoms reported to ratings of NFLM.

Methods

Participants responded to the item “Many women report just not feeling like themselves during this phase of life. How often was this true for you over the past 3 months?” choosing from “none of the time” to “all of the time.” They rated bother associated with 61 symptoms and provided demographic information. Individual symptoms and the symptom bother scale scores were correlated with NFLM. Symptom scale scores were then entered in a two-stage multiple regression model to identify symptoms associated significantly with NFLM.

Results

Sixty-three percent (63.3%) of participants reported NFLM 50% of the time or more over the previous 3 months. Individual symptom ratings correlated with NFLM (r > 0.300) included the following: fatigue (r = 0.491); feeling overwhelmed/less able to cope (r = 0.463); low feelings (r = 0.440); anxiety, more nervousness (r = 0.398); being irritable (r = 0.380); harder time concentrating (r = 0.378); difficulty making decisions (r = 0.357); feeling like “I can't calm down on the inside” (r = 0.333); being more forgetful (r = 0.332); tearfulness/crying (r = 0.306); and worrying more (r = 0.302). A two-stage regression analysis revealed less education completed and greater overall stress ratings as significant predictors in stage 1. In stage 2, five symptom groups met the P < 0.001 criterion: anxiety/vigilance, fatigue/pain, brain fog, sexual symptoms, and volatile mood symptoms.

Conclusions

NFLM was associated with anxiety/vigilance, fatigue/pain, brain fog, sexual symptoms, and volatile mood symptoms. Recognizing symptoms associated with NFLM may allow for more accurate expectations and improve perimenopause care.
Current challenges in xenotransplantation
Authors: Vadori Marta , Cozzi Emanuele
Published: March 2024

Purpose of review

In recent years, the xenotransplantation science has advanced tremendously, with significant strides in both preclinical and clinical research. This review intends to describe the latest cutting-edge progress in knowledge and methodologies developed to overcome potential obstacles that may preclude the translation and successful application of clinical xenotransplantation.

Recent findings

Preclinical studies have demonstrated that it is now possible to extend beyond two years survival of primate recipients of life saving xenografts. This has been accomplished thanks to the utilization of genetic engineering methodologies that have allowed the generation of specifically designed gene-edited pigs, a careful donor and recipient selection, and appropriate immunosuppressive strategies.

In this light, the compassionate use of genetically modified pig hearts has been authorized in two human recipients and xenotransplants have also been achieved in human decedents. Although encouraging the preliminary results suggest that several challenges have yet to be fully addressed for a successful clinical translation of xenotransplantation. These challenges include immunologic, physiologic and biosafety aspects.

Recent progress has paved the way for the initial compassionate use of pig organs in humans and sets the scene for a wider application of clinical xenotransplantation.
A Case Series of Choroidal and Orbital Neuroendocrine Tumors: Metastasis
Authors: Zhuang Tony Zibo , Bergstrom Chris , El-Rayes Bassel F. , Shaib Walid L.
Published: March 2024

Neuroendocrine tumors (NETs) are rare cancers with heterogeneous histologies, response to treatments, and prognoses. Majority of these cancers originate in the gastrointestinal tract and metastasize to the liver. We report the cases of 5 patients with low-grade NET disease with rare metastases to the choroids. Two of the patients were treated with peptide receptor radionuclide therapy (lutetium 177 [177Lu]). This is the first report confirming peptide radionuclide therapy safety in patients with low-grade NET with ocular metastases.
Nutrition Knowledge, Food Insecurity, and Adverse Childhood Experiences Among Underserved College Students
Authors: Klobodu Seth S. , Chrisman Matthew
Published: March 2024

An online, cross-sectional survey examined food insecurity, adverse childhood experiences, academics, health status, dieting, and associations with nutrition knowledge among 83 freshmen Educational Opportunity Program university students in California. Mean (SD) nutrition knowledge was 13.6 (5.0) out of a perfect score of 29. Most students (84%) reported being food secure. The median adverse childhood experiences score was 1.00 (interquartile range, 0.00–3.00), an indication of intermediate risk for toxic stress, and the mean (SD) high school grade point average was 3.62 (0.38) out of 4. More adverse childhood experiences were associated with higher nutrition knowledge (P = .005). High school grade point average predicted nutrition knowledge (P = .003). The results may be helpful in designing larger, more representative studies of the Educational Opportunity Program population and finding helpful interventions.
Translating knowledge on placebo and nocebo effects into clinical practice
Authors: Caliskan Elif Buse , Bingel Ulrike , Kunkel Angelika
Published: March 2024

Introduction:

Positive and negative treatment expectations are powerful modulators of health and treatment outcomes. A substantial part of treatment success is due to contextual factors modulating patient's expectations towards a treatment. Consequently, treatment expectations should be a target of therapeutic interventions themselves.

Objectives:

This article highlights the neurobiological underpinnings of treatment expectations as well as strategies to modulate contextual factors to optimize treatment outcomes in daily clinical settings.

Methods:

This clinical update aligns with the 2022 IASP Global Year Translating Pain Knowledge into Practice and selectively reviews the best available evidence and practice.

Results:

The effects of treatment expectations, also known as placebo and nocebo effects, are observed in various clinical conditions and physiological systems. However, most of our knowledge comes from the field of pain, where expectation effects substantially contribute to overall analgesic treatment outcomes. Experimental placebo analgesia paradigms provide the best illustration of how analgesic effects can be attributed not only to a pharmacological or specific treatment, but instead are the result of the expectation towards the treatment. The impact of expectations on treatment outcome is highly variable between individuals, and the identification of factors predicting an individual's response has proven to be challenging. Further research is required to provide personalized treatment strategies for the daily clinical practice.

Conclusion:

Patient's previous experiences and expectations are powerful modulators of treatment efficacy, tolerability, and adherence. By providing a comprehensive overview of recent advances in this field, this review offers valuable insights for clinicians and researchers seeking to improve patient–clinician interaction.
Impact of Preoperative Skeletal Muscle Mass on the Outcomes and Recurrence After Total Gastrectomy in Patients With Gastric Cancer
Authors: Horvat Matjaž , Bizjak Katarina , Hladnik Gaja , Kolarič Rok , Jagrič Tomaž
Published: March 2024

Low muscle mass is a predictor of poor outcome in patients with gastric cancer after surgery. Seventy patients who underwent gastric cancer resection with curative intent were included in the study. A cross-sectional area of muscle at the third lumbar vertebra was measured and patients with skeletal muscle index below 48.6 kg/m2 were described as having low muscle mass. Surgical and oncologic outcomes were recorded. Of 70 patients, 19 (27%) were diagnosed as having low muscle mass. The postoperative recurrence was significantly higher in patients with low muscle mass (31.6 %) than in those with no low muscle mass (11.8%). Preoperative low skeletal muscle is related to poor survival and recurrence in patients with gastric cancer after total radical gastrectomy.