bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole Genome Sequencing Uncovers the Genetic Determinants of Colistin Resistance in Multi-Drug Resistant Klebsiella pneumoniae Isolated from Patients Admitted in the ICU of a Tertiary Care Hospital in Kampala, Uganda
Authors: Magulye Maximilian A. K. , Maghembe Reuben S. , Sekyanzi Simon , Achan Beatrice , Mwesigwa Savannah , Katagirya Eric
Published: October 2023

Multidrug resistance (MDR) among gram-negative bacteria is a global public health threat because it has exhausted all standard therapeutic options. This has necessitated clinicians to reconsider colistin, an “old sort” antibiotic which was deemed toxic for clinical use. Unfortunately, swift resistance towards colistin by K. pneumoniae has been reported in different parts of the world. The study aimed at investigating the genetic determinants of colistin resistance in K. pneumoniae isolated from patients admitted in a tertiary care hospital in Kampala, Uganda. 31 archived multidrug resistant K. pneumoniae isolates obtained from rectal swabs of patients admitted to the Mulago Hospital ICU were retrieved. From this collection, we selected 7 colistin resistant K. pneumoniae isolates for whole genome sequencing and molecular profile analysis. In silico sequence data analyses were performed using established web-based bioinformatics tools. The sequence analysis of the genes involved in colistin resistance revealed several non-synonymous mutations in nucleotide sequences of pmrA, pmrB, phoP, phoQ and mgrB genes. Insertion transposase genes for the insertion sequences IS1 and IS5 which are highly implicated in colistin resistance via modification or inactivation of mgrB gene were identified in all isolates and were located in the chromosomal DNA at different genomic positions. No plasmid-borne mcr genes were detected. More so, the strains harbored numerous multidrug resistant genes. This study underscores the need of genomic surveillance of K. pneumoniae strains to limit further spread of colistin resistance genes to avert the potential risk of pandrug resistance. And high throughput sequencing is imperative.
A CLINICAL CASE OF «LONG-COVID» WITH DAMAGE TO THE ENDOCRINE, CARDIOVASCULAR AND PULMONARY SYSTEMS
Authors:   Kuban State Medical University, IVANOVA LIUDMILA A. , KOVALENKO YULIYA S. ,   Kuban State Medical University, KOROL INNA V. ,   Kuban State Medical University, SMEZINOVA ANNA V. ,   Kuban State Medical University, KOKOVA YEVGENIYA A. ,   Kuban State Medical University, ANANEVA ELENA I/ ,   Kuban State Medical University
Published: October 2023

Introduction. Coronavirus infection caused by the SARS-CoV-2 virus is characterized by a large range of clinical manifestations, which is associated with the presence of angiotensin-converting enzyme-2 receptors in many organs and tissues of the body. Subacute thyroiditis induced by COVID-19 is difficult to recognize due to the frequent absence of classical symptoms of thyroiditis. Aim. Demonstrate the features of the clinical course of a new coronavirus infection complicated by subacute thyroiditis and pericarditis in the distant period. Material and Methods. A clinical case of patient K., 56 years old, with damage to the pulmonary, cardiovascular and endocrine systems as a result of a new coronavirus infection was presented. Results and discussion. Subacute thyroiditis as a result of SARS-CoV-2 infection may have an atypical course. A pathognomonic feature of subacute thyroiditis is the high rate of erythrocyte sedimentation. The treatment of subacute thyroiditis in most cases requires the prescription of glucocorticoids. In some patients, prescribing nonsteroidal anti-inflammatory drugs may be sufficient to relieve symptoms. There was no clear association of cardiovascular symptoms in long-term COVID-19 with pre-existing cardiovascular pathology.. Conclusion. In the case of subacute thyroiditis developed as a result of SARS-CoV-2 infection, it is necessary to prescribe anti-inflammatory therapy in a timely manner. From a practical point of view, it is important to recognize cardiorespiratory symptoms in time as a non-specific manifestation of the long-term COVID-19 syndrome and the manifestation of cardiovascular pathology.
THE PROCEDURE FOR COOPERATION OF THE CENTER FOR DISASTER MEDICINE WITH MEDICAL ORGANIZATIONS IN EMERGENCY SITUATIONS
Authors:   Northern State Medical University, KUBASOV ROMAN V. , SOKOLNIKOV VASILY A. ,   Arkhangelsk Regional Clinical Ambulance Station, MARTYNOV VLADISLAV O. ,   Northern State Medical University, SMYKOVSKAYA ADELINA I ,   Northern State Medical University, KRYMOVA EKATERINA S. ,   Northern State Medical University, MENSHUTIN IGOR Y. ,   Northern State Medical University, KALININ ALEXEY G. ,   Northern State Medical University, SANNIKOV ANATOLY L. ,   Northern State Medical University, KUBASOVA ELENA D. ,   Northern State Medical University
Published: October 2023

Introduction. Each emergency situation is characterized by significant health consequences. Solving the issue of saving lives, providing medical care and keeping the health of victims is one of the most important tasks. For the timely and successful supply of emergency medical care, there is a need to create special schemes for the cooperation of medical organizations. Aim. estimation of the system of interrelation of the Arkhangelsk Regional Disaster Medicine Center with medical organizations to provide emergency medical aid to victims in emergency situations. Material and methods. Normative legal documents regulating the work of the Arkhangelsk Disaster Medicine Center were used for the study. The source of the information was the official websites of the Ministry of Health of the Arkhangelsk region, the Arkhangelsk Regional Clinical Ambulance Station. Results and discussion. In case of an emergency in the region, the main volume of medical evacuation measures and emergency medical care is organized by the Disaster Medicine system. Since 2019, this function has been performed by the Disaster Medicine Center of the Arkhangelsk Regional Clinical Ambulance Station. Intradepartmental and interdepartmental cooperation is strictly regulated by the relevant normative documents. Information about the suffered is sent to the operational dispatch department of the Disaster Medicine Center. At the same time, all information is transferred to the Federal Disaster Medicine Center. A medical organization is required to report about suffered to the Disaster medicine center every day. Also, the functionality of the Disaster medicine center includes the need to create a "task plan" that accumulates information about the bed pool, formations and other forces and means located in the region. Conclusion. An analysis of recent work has shown that the integration of emergency medical care stations and disaster medicine centers into one juridical entity has had a positive effect as part of the improvement of emergency medical care. Thanks to this, the interaction schemes between the various units of the disaster medicine service have been improved. All transformations for the modernization of organizational processes conform to modern requirements and legislative needs.
FEATURES OF NEUROTRANSMITTER REGULATION OF URETERAL FUNCTION AND PROSPECTS FOR THE SEARCH FOR NEW STONE-REMOVING DRUGS
Authors:   Kazan State Medical University, ZYAPBAROV AINUR M. , ZIGANSHIN AYRAT U. ,   Kazan State Medical University
Published: October 2023

Introduction. The study of the neurotransmitter regulation of the ureters allows a better understanding of the function of the ureters, not only in the norm, but also the mechanism of development of renal colic, one of the most common acute conditions in urology. Moreover, the main type of treatment for renal colic is drug therapy used to relieve pain, as well as drug stone expelling therapy, which is gradually replenished with new drugs. Aim. The aim of the study is to review current information on the neurotransmitter regulation of the ureters. Material and Methods. A review current information on the neurotransmitter regulation of the ureters was carried out. Results and discussion. To date, the role of alpha- and beta-adrenergic receptors, cholinergic receptors is the most studied, the mechanism of action of cyclooxygenase inhibitors and Ca channel blockers is also well studied. Drugs belonging to the above groups continue to be widely and successfully used in clinical practice, including in emergency urology, and also continue to be replenished with new representatives of these groups of medicines. Recently, new clinical data have appeared on the effectiveness of the use of type 5 phosphodiesterase inhibitors, and the role of serotonin receptors in the ureters continues to be studied. Another interesting area is the study of the role of P2 receptors in normal and pathological conditions. The wide expression of all known P2 receptor subtypes on ureteral cells, as well as the release of adenosine triphosphoric acid by urothelial cells with an increase in intraureteral pressure, suggests their important role in the contractile activity of the ureters. Conclusion. The impact on the P2 receptors of the ureters can become one of the promising areas for the search and development of new stone-removing drugs with a new mechanism of action. The article discusses the roles of the above receptors and enzymes in the neurotransmitter regulation of the ureters.
COMPARATIVE ANALYSIS OF 9-YEAR DYNAMICS OF CARDIOVASCULAR STATUS PARAMETERS IN RESIDENTS OF THE ARCTIC AND SOUTHERN TERRITORIES OF THE TYUMEN REGION
Authors:   Tomsk National Research Medical Center of the Russian Academy of Sciences, GORBATENKO ELENA A. , YAROSLAVSKAYA ELENA I. ,   Tomsk National Research Medical Center of the Russian Academy of Sciences, SAPOZHNIKOVA ANASTASIA D. ,   Tomsk National Research Medical Center of the Russian Academy of Sciences
Published: October 2023

Introduction. Studies show that coronary atherosclerosis and coronary artery disease in the Arctic and Subarctic regions have their own characteristics and need to be further studied. Aim. To conduct a comparative prospective analysis of clinical, laboratory, echocardiographic and coronary angiography data in middle-aged residents of the Arctic regions compared with residents of the south of Tyumen region. Material and methods. From the Coronary Angiography Registry we selected 229 patients of mean age 45-59 years who underwent coronary angiography more than once between 2000 and 2021. The average interval between the 1st and 2nd survey points was 9.0±3.4 years. Patients who underwent coronary angiography to verify the diagnosis, patients with stable coronary artery disease and old myocardial infarction were included. Individuals with acute coronary syndrome were not included. Patients were divided into 2 groups: 85 residents of Tyumen and the south of Tyumen region and 144 residents of the Yamal-Nenets Autonomous Okrug. Differences between groups and dynamics of the studied parameters were assessed using the application package IBM SPSS Statistics 21. Results and discussion. The groups were comparable in demographic characteristics. Initially, cardiovascular status was more severe in Yamal-Nenets Autonomous Okrug group of patients: more severe (II and III) functional classes of exertional angina and a history of myocardial infarction, hemodynamically significant coronary lesions, including coronary artery occlusion, were more common. In Yamal-Nenets Autonomous Okrug group, the level of high-density lipoprotein cholesterol was initially lower. During the follow-up period, obesity and echo-signs of post-infarction changes were detected in patients of Yamal-Nenets Autonomous Okrug more often, higher asynergy index and triglyceride levels were recorded. Intergroup differences in the incidence of myocardial infarction and occlusive lesions and high-density lipoprotein cholesterol levels persisted. Conclusion. During 9-year follow-up, middle-aged patients who underwent elective coronary angiography and lived in the Arctic zone had more severe baseline indicators of cardiovascular status, as well as their more significant negative dynamics compared to patients lived in the south of Tyumen region.
STABILIZATION OF INDICATORS OF THE CARDIOLOGICAL STATUS OF PATIENTS WITH COVID-19 WITH THE USE OF EHF THERAPY
Authors:   Kazan State Medical University, KASHTANOVA NATALIA M. , ZHIVOTOVA ELENA N. ,   Kazan State Medical University, SUCHKOVA GALINA G. ,   Kazan State Medical University, DRUZHININ GEORGY A. ,   Kazan State Medical University, ORANSKAYA TATIANA I. ,   Kazan State Medical University, VALIULLIN VIKTOR V. ,   Kazan State Medical University, KHAIRULLIN ADEL E. ,   Kazan State Medical University
Published: October 2023

Introduction. Currently, non-drug methods of correction of impaired body functions are becoming increasingly important. Especially intensive research is being conducted on biological effects associated with the effects of electromagnetic radiation on living organisms. Aim. The aim of the study is to study the possible facilitating effect of extremely high-frequency therapy in recovery after physical exertion of COVID–19 patients. Material and methods. The research was conducted on volunteer students of the 1st and 2nd year of KSMU. Control groups of girls and boys were formed, as well as groups of COVID-19 patients. Extremely high-frequency radiation treatment of the C5 point on the anteromedial (inner-elbow) side of the forearm was performed, which is used in the treatment of a number of heart diseases by acupuncture. During the study, the blood pressure and heart rate of the subject were first measured using a standard tonometer – without load (control) and after 20 squats of the subject. After that, the extremely high- frequency emitter was brought to the indicated area of the forearm, and 3–minute therapy was performed. Then the blood pressure and heart rate of the subject were measured again. Alternative series were also carried out, with measurement without extremely high-frequency treatment. The comparison of the average values of the samples was carried out on the basis of the Student’s t-test. Results and discussion. It was found that in non-COVID-19 patients, the extremely high-frequency therapy performed did not significantly change the parameters of blood pressure and heart rate in the groups of boys and girls. In young men who have been ill with COVID-19, there is a tendency to earlier recovery after physical exertion when using extremely high-frequency therapy. Extremely high-frequency therapy had a greater impact on girls who had had COVID-19 than on those who had not had this disease. At the same time, this group of subjects clearly has a vector for a more complete recovery after physical exertion for all the studied indicators. However, only systolic pressure was significantly equalized (p<0.05). Conclusion. The stabilizing effect of extremely high-frequency therapy on systolic blood pressure values in COVID-19 girls was revealed.
APPLICATION OF AUTOLOGICAL MICROFRAGMENTED ADIPOSE TISSUE IN THE TREATMENT OF POST-RADIATION ULCERATIVE PROCTITIS
Authors:   Moscow Clinical Scientific and Practical Center named after I.I. A.S. Loginov, LEONTIEV ALEXANDER V. , GRISHINA ELENA A. ,   Moscow Clinical Scientific and Practical Center named after I.I. A.S. Loginov, DANILOV MIKHAIL A. ,   Moscow Clinical Scientific and Practical Center named after I.I. A.S. Loginov, KARNAUKHOV NIKOLAY S. ,   Moscow Clinical Scientific and Practical Center named after I.I. A.S. Loginov, SHISHIN KIRILL V. ,   Moscow Clinical Scientific and Practical Center named after I.I. A.S. Loginov
Published: October 2023

Introduction. Post-radiation ulcerative proctitis is a serious complication after radiotherapy for cancer of the prostate, cervix and uterine body, anal canal, and other pelvic tumors. Given the mechanism of occurrence, there are currently no pathogenetic methods for the treatment of post-radiation ulcerative proctitis. Aim. Is to develop a technique and evaluate its effectiveness in the treatment of patients with post-radiation rectal ulcers using autologous microfragmented adipose tissue. Material and methods. The study included 30 patients, of which 24 (80.0% were women and 6 (20.0%) were men. Manual lipoaspiration was used to obtain autologous adipose tissue. Then, microfragmentation was performed through transfers. The introduction of autologous concentrated adipose tissue was performed in edges of post-radiation ulcerative defect of the rectal wall under endoscopic control. Results and discussion. The duration of the manipulation from the moment of adipose tissue sampling to the end of the injection was a little more than an hour (Me = 75.0 min). No intraoperative complications were identified. One patient (3.3%) had a local recurrence of cervical cancer, and therefore the patient was excluded from the study. Control rectoscopy after 6 months in 28 (93.3%) patients showed complete epithelialization of post-radiation ulcerative defects of the rectum. Conclusion. The technique of using autologous microfragmented adipose tissue is affordable and effective in the treatment of patients with post-radiation ulcerative proctitis
A MODERN SOCIO-SOMATIC PORTRAIT OF A WOMAN WITH PATHOLOGICAL CLIMAX
Authors:   Kazan State Medical Academy, MARDIEVA REZEDA R. , MAZITOVA MADINA I. ,   Kazan State Medical Academy, MAZITOV DANIIAR A. ,   Kazan Federal University, FAUSTOVA KARINA V. ,   Kazan State Medical Academy, GARAFIEVA SALIMA M. ,   University of Manchester
Published: October 2023

Introduction. Nowadays, the number of menopausal women in the world population has strong tendency to increase. According to statistics the majority have a moderate and severe course of it. This is the reason preventive gerontology develops today, especially climatology. That is why using new machine learning technologies is relevant today. Such method as gradient boosting helped us to identify the characteristic features and factors that cause the pathological course of menopause in women which made it possible to draw up a medical «portrait» of such patients. Using the knowledge of these factors influence it is easily to recognize women needs to be observed even before the manifestations of menopause. Aim. The aim of the study is to conduct a socio-somatic «portrait» of a modern patient with a pathological menopause. Material and methods. A detailed survey of 1275 women aged 45–60 years was carried out with an assessment of the socio-cultural status, general somatic and gynecological health. The received data were sorted and categorized using modern statistical processing methods and machine learning method - gradient boosting. Results and discussion. Firstly, there are factors with high influence on menopausal syndrome developing: level of education, oncological anamnesis, diseases of the gastrointestinal tract, vegetative and insomnia disorders, the use of intrauterine contraceptives, the number of children 2 or more, the presence of abortions in anamnesis. The rest of the questionnaires were characterized as having only a small impact. This is a pathology of the thyroid gland, the cardiovascular system; hyperplastic processes in history; occupation, namely social and medical workers, as well as a negative attitude towards menopause. The greater number of these features one woman has, the higher the likelihood of developing a pathological menopause she gets. Conclusion. The collective image we have received of a modern patient with pathological menopausal syndrome is based on aspects of the life and health of women which it is worth paying attention on. This can serve as a kind of guideline for clinicians in order to achieve correction of hypoestrogenism with the development of a pathological menopause.
RELATIONSHIP OF TYPE D PERSONALITY AND ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors:   Bashkir State Medical University, GALYAUTDINOVA VELENA R. , MUTALOVA ELVIRA G. ,   Bashkir State Medical University, NIGMATULLINA ALBINA E. ,   Bashkir State Medical University, SAMIGULLINA LIANA I. ,   Bashkir State Medical University
Published: October 2023

Introduction. Major psychosocial risk factors for acute myocardial infarction include depression, anxiety (various anxiety syndromes and disorders), pessimistic D personality type, work and family stress, anger/hostility, lack of social support, and low socioeconomic status. There are few studies evaluating the association between psychological factors and myocardial infarction. Aim. The aim of the study was to study the relationship of personality type D with the development of endothelial dysfunction in patients with acute myocardial infarction. Material and methods. The study included 158 patients, mean age 58.2±2.5 years, who were admitted to the hospital for ST-segment elevation myocardial infarction. The diagnosis was established according to the clinical guidelines of the Russian Society of Cardiology, 2020. In addition to the traditional clinical and instrumental examination, on the 3rd–7th day after the development of myocardial infarction, patients underwent an assessment of plasma concentrations of inflammatory biomarkers and psychological testing using anxiety and depression rating scales. In the group of patients, individuals with and without personality type D were identified. Results and discussion. Personality type D was found in 29.1% of patients with acute myocardial infarction. Patients with personality type D were significantly younger, employed and married, had a higher body mass index and a significantly greater hereditary burden of arterial hypertension. In patients with personality type D, the values of pro-inflammatory markers were statistically significantly different from the comparison group, which indicates the intensity of subclinical inflammation and cytokine imbalance. Personality type D was significantly associated with total inflammation score and total endothelial dysfunction score. Significant differences were found in the ratio of patients with depressive conditions in subgroups of patients with personality type D. The values of echocardiographic parameters were also associated with the presence of personality type D. Conclusion. Personality type D was associated with impaired endothelial function in men with acute myocardial infarction, they were more likely to have depressive disorders. An adverse effect of personality type D on the cardiovascular system in patients with myocardial infarction was revealed.
Fakhruddin al-Razi and Sigmund Freud's Perspectives on the Concept of the Human: A Comparative Analysis
Authors: Khoir Nur Fajriati N , Ghozali Ghozali
Published: October 2023

The discourse of the human concept is an important theme constantly being studied because humans have a natural disposition to understand and understand themselves. Fakhruddin Ar-Razi and Sigmund Freud are a few who focus on studying the concept of humans. Both are important figures in the development of science. Between ar-Razi and Freud, they had a view on it. The author at least uses a descriptive analysis method with a comparative study of each character’s opinion. This paper at least examines the differences and similarities in their views about the human concept regarding personality structure, the basis of human action and the goals of human behaviour. According to ar-Razi and Sigmund Freud, the results can be seen to what extent the similarities and differences regarding human conception. The conclusion of this research, from the point of view of Islamic worldview represented by Fakhruddin al-Razi’s thoughts, is that humans are seen comprehensively not only to have natural potential (ḥayawāniyah) but also nabatiyyah dan insaniyyah.
A New, Effective, Safe, and Accurate Method of Cervical Selective Nerve Root Block
Authors: Jeong Seung Jun , Kim Sung Jin
Published: October 2023

Objective: Cervical selective nerve root block (SNRB) is an effective procedure that has long been performed for patients with radiating pain or paresthesia. However, there are several delicate structures around the cervical nerve root, damage to which could lead to irreversible neurovascular injury. Therefore, cervical SNRB requires a high skill level and extensive experience to execute it safely. To overcome these disadvantages, we used biplane computed tomography (CT)-guided fluoroscopy and a needle guidance program to achieve symptom improvement in a safer and shorter procedure. This study aimed to investigate the new method and report on its excellent clinical effects.Methods: A total of 57 patients who experienced radiating pain due to cervical spinal stenosis resulting from a herniated disc were enrolled. From September 2020 to September 2021 subjects underwent a biplane CT-guided fluoroscopic nerve block at an outpatient clinic. All procedures were performed by biplane CT-guided fluoroscopy. We analyzed treatment effects with a numerical rating scale (NRS) at 2 and 4 weeks after the procedure. Logistic regression was performed to reveal the significance of changes in NRS after the injection.Results: Pain improved in 56 of 57 patients (98%) after 2 and 4 weeks of follow-up compared to pre-injection pain. At the 2-week follow-up, the mean reduction based on NRS scores was 3.226 (2.782-3.674, 0; 95% confidence interval [CI], p < 0.001) indicating a 48% decrease in pain scores compared with the initial NRS. The mean reduction in NRS 4 weeks after the procedure was 3.544 (3.090-3.998, 0; 95% CI, p < 0.001) indicating a 52% reduction compared with the initial NRS. The average duration of the procedure was 4 minutes. Conclusion: We demonstrate a clinically effective, safe, and accurate method using a biplane CT-guided fluoroscopy and needle guide program. This new method can be an easy and relatively uncomplicated alternative to treatment for patients with cervical radiculopathy and provides safe and accurate targeting, making it easy for inexperienced surgeons.
La sostenibilidad de la acción LEADER y su influencia en la mejora de la calidad de vida en el mundo rural: el caso de las empresas de nueva creación en el CEDER Monegros (Aragón, España)
Authors: Serrano Andres Alberto , Hernández Navarro Mª Luz
Published: October 2023

¿Cuál es el nivel de continuidad de las empresas de nueva creación apoyadas a través del LEADER en el largo plazo? Y ¿Cuál es la influencia que tienen estas empresas en la mejora de la calidad de vida de sus promotores y del territorio? Estas son las dos principales preguntas a las que se da respuesta en este artículo a partir del caso de estudio del CEDER Monegros (Aragón, España). En primer lugar, el trabajo de campo realizado en el GAL aporta el resultado de que la mayor parte de las empresas de nueva creación LEADER continúan en funcionamiento (57,6%). En segundo lugar, y a partir de entrevistas con los promotores de esas empresas, se construye de forma experimental un índice sintético de percepción, aplicable a otros territorios, sobre la influencia que esas empresas LEADER han tenido en la mejora de la calidad de vida de los promotores y del territorio, obteniéndose un valor positivo alto (3,74 sobre 5). Se concluye que el método LEADER apoya la creación de empresas sostenibles y resilientes que mejoran la calidad de vida de sus promotores; que crean una cultura de emprendimiento en el territorio; y que o ponen en valor los recursos del territorio y/o mejoran la calidad de vida de sus habitantes.
Shatavari Supplementation in Postmenopausal Women Alters the Skeletal Muscle Proteome and Pathways Involved in Training Adaptation
Authors: O'Leary Mary , Jackman Sarah R , Bowtell Joanna L
Published: October 2023

Purpose: Shatavari is an understudied, widely available herbal supplement. It contains steroidal saponins and phytoestrogens. We previously showed that six weeks of shatavari supplementation improved handgrip strength and increased markers of myosin contractile function. Mechanistic insights into shatavari’s actions are limited. Therefore, we performed proteomics on vastus lateralis (VL) samples that remained from our original study.
Methods: In a randomised double-blind trial, women (68.5 ± 6 years) ingested either placebo or shatavari (equivalent to 26,500 mg/d fresh weight) for six weeks. Tandem mass tag global proteomic analysis of VL samples was conducted (N=7 shatavari, N=5 placebo). Data were normalised to total peptides and scaled using a reference sample. Data were filtered using a 5% FDR. For each protein, the pre to post supplementation difference was expressed as log2 fold change. Welch’s t tests with Benjamini-Hochberg corrections were performed for each protein. Pathway enrichment (PADOG, CAMERA) was interrogated in Reactome (v85).
Results: No individual protein was significantly different between supplementation conditions. Both PADOG and CAMERA indicated that pathways related to 1) Integrin/MAPK signalling, 2) metabolism/insulin secretion; 3) cell proliferation/senescence/DNA repair/cell death; 4) haemostasis/platelets/fibrin; 5) signal transduction; 6) neutrophil degranulation and 7) chemical synapse function were significantly upregulated. CAMERA indicated pathways related to translation/amino acid metabolism, viral infection, and muscle contraction were downregulated.
Conclusion: Our analyses indicate that shatavari may support muscle adaptation responses to exercise. These data provide useful signposts for future investigation of shatavari’s utility in conserving and enhancing musculoskeletal function in older age. Trial registration NCT05025917 30/08/21, retrospectively registered.
Global high-resolution total water storage anomalies from self-supervised data assimilation using deep learning algorithms
Authors: Gou Junyang , Soja Benedikt
Published: October 2023

Total water storage anomalies (TWSAs) describe the variations of the terrestrial water cycle, which is essential for better understanding our climate system. This study proposes a self-supervised data assimilation model with a novel loss function to provide a global TWSA product with a spatial resolution of 0.5 degrees. The model combines the hydrological simulations as well as the measurements from the Gravity Recovery and Climate Experiment (GRACE) and its follow-on (GRACE-FO) satellite missions. The efficiency of the high-resolution information is proved by closing the water balance equation while preserving large-scale accuracy inherited from the GRACE(-FO) measurements. They contribute to monitoring natural hazards locally and show potential for better understanding the impacts of natural and anthropogenic activities on the water cycle. We anticipate our approach to be generally applicable to other TWSA data sources and the resulting product to be valuable for the geoscience community and society.
Unravelling the Role of Iroquois Homeobox 4 and its Interplay with Androgen Receptor in Prostate Cancer
Authors: Batra Jyotsna , Panchadsaram Janaththani , Tevz Gregor , Fernando Achala , Malik Adil , Rockstroh Anja , Kryza Thomas , Walpole Carina , Moya Leire , Lehman Melanie , Nelson Colleen , BioResource The Australian Prostate Cancer , Consortium The Practical , Sriniva Srilakshmi , Clements Judith
Published: October 2023

Genome-wide association studies have linked Iroquois-Homeobox 4 (IRX4) as a robust expression quantitative-trait locus associated with prostate cancer (PCa) risk. However, the intricate mechanism and regulatory factors governing IRX4 expression in PCa remain poorly understood. Here, we unveil enrichment of androgen-responsive gene signatures in metastatic prostate tumors exhibiting heightened IRX4 expression. Furthermore, we uncover a novel interaction between IRX4 and the androgen receptor (AR) co-factor, FOXA1, suggesting that IRX4 modulates PCa cell behavior through AR cistrome alteration. Remarkably, we identified a distinctive short insertion-deletion polymorphism (INDEL), upstream of the IRX4 gene that differentially regulates IRX4 expression through the disruption of AR binding. This INDEL emerges as the most significant PCa risk-associated variant within the 5p15 locus, in a genetic analysis involving 82,591 PCa cases and 61,213 controls and was associated with PCa survival in patients undergoing androgen-deprivation therapy. These studies suggest the potential of this INDEL as a prognostic biomarker for androgen therapy in PCa and IRX4 as a potential therapeutic target in combination with current clinical management.
Thoracic Paravertebral Block for Perioperative Lung Preservation During VATS pulmonary surgery: Study Protocol of a Randomized Clinical Trial
Authors: Zhu Jiayu , Wei Biyu , Wu Lili , Li He , Zhang Yi , Lu Jinfeng , Su Shaofei , Xi Chunhua , Liu Wei , Wang Guyan
Published: October 2023

Background
Postoperative pulmonary complications (PPCs) extend the length of stay of patients and increase perioperative mortality after video-assisted thoracoscopic (VATS) pulmonary surgery. Thoracic paravertebral block (TPVB) provides effective analgesia after VATS, however little is known about the effect of TPVB on PPCs. This study aims to determine whether TPVB combined with GA results in reducing PPCs and achieve perioperative lung protection in VATS pulmonary surgery compared with simple general anesthesia.
Methods
A total of 302 patients undergoing VATS pulmonary surgery will be randomly divided into two groups: Paravertebral block group (PV group) and Control group (C group). Patients of PV group will receive TPVB: 15 ml of 0.5% ropivacaine will be administered to the T4 and T7 thoracic paravertebral spaces respectively before general anesthesia. Patients of C group will not undergo intervention. Both groups of patients adopted protective ventilation strategy during operation. Perioperative protective mechanical ventilation and standard fluid management will be applied in both groups. Patient controlled intravenous analgesia was used for postoperative analgesia. The primary endpoint is the composite outcome of PPCs within 7 days after surgery. Secondary end points include blood gas analysis, postoperative lung ultrasound score, NRS score, QoR-15 score, hospitalization related indicators and long-term prognosis indicators.
Discussion
This study can better evaluate the impact of the use of TPVB on PPCs and long-term prognosis in patients undergoing VATS lobectomy / segmentectomy. The results may provide clinical evidence for optimizing perioperative lung protection strategies.
Trial registration: ID: NCT05922449. Registered on June 25, 2023.
Perceptions and experiences of family physicians on the roles of administrative staff during COVID-19: Findings from a cross-provincial qualitative study
Authors: Marshall Emily Gard , Moritz Lauren R , Buote Richard , Mathews Maria , Lukewich Julia , Brown Judith Belle , Sibbald Shannon , Hedden Lindsay , Ryan Dana , Spencer Sarah
Published: October 2023

Background
Administrative staff in primary care undertake numerous tasks to support patient care delivery. Although their roles are often overlooked, administrative staff are essential to the coordination and operations of primary care clinics. The COVID-19 pandemic introduced additional clinical and administrative tasks, including transitioning to virtual appointments and triaging patients for urgency, changing typical workflows. In Canada, existing pandemic plans for primary care did not account for these administrative tasks, nor the support that family physicians would require to continue to provide patient access to primary care. This research seeks to understand the administrative roles in primary care, with a particular focus on the roles of administrative staff, to help inform future pandemic planning.
Methods
We present findings from a qualitative case study across four regions in Canada: Vancouver Coastal health region in British Columbia, Ontario Health West region, the province of Nova Scotia, and the Eastern Health region of Newfoundland and Labrador. We conducted semi-structured qualitative interviews with family physicians (n=68) across the four regions and thematically analysed the data.
Results
We identified five salient themes in the data, including 1) applying public health guidelines, 2) educating patients on COVID-19 and COVID-19 services, 3) re-organizing patient visits, 4) maintaining adequate staffing, and 5) recognizing administrative staff contributions. During the COVID-19 pandemic, family physicians took on numerous additional roles to reduce the risk of transmission of the virus with the support of their administrative staff. Family physicians emphasized the challenges of maintaining adequate staffing, and the importance of administrative staff in enabling the provision of primary care.
Conclusions
The COVID-19 pandemic exposed existing gaps in primary care, such as the lack of clinical training for administrative staff, and challenges that should be addressed in future pandemic planning such as timely and consistent guidance and clearly delineated professional roles. Given the vital role of administrative staff, their tasks and responsibilities should be included in future pandemic plans.
Prognostic factors for time-to-death from traumatic brain injury following road traffic accidents
Authors: Hailemichael Yohannes , Kassahun Taddesse
Published: October 2023

Road traffic accident is among the major public health problems worldwide and many studies have shown that it is the major contributor of traumatic brain injury especially in low and middle-income countries. The main objective of this study was to identify the prognostic factors for time-to-death from traumatic brain injury following road traffic accident. This study was conducted based on data obtained from charts of traumatic brain injury patients following road traffic accident and admitted to the emergency department of Addis Ababa Burn, Emergency and trauma Hospital between September 12, 2019 and February 1, 2022. The data analysis was performed by using R version 4.1.2 and Stata version 14. Survival analysis was used to analyze the data where the Weibull accelerated failure time model was found to be the most appropriate. Of all 279 patients, 40 (14.34%) died within 30 days after the occurrence of the accident. Of the total number of patients who died during the follow-up period, 26 (65%) were males. Traumatic brain injury patients as a result of road traffic accidents, who were > 59 years old and had diffuse axonal injury, aspiration pneumonia, intracranial hemorrhage, hemothorax, increased intracranial hemorrhage, low Glasgow coma scale score and red triage category were at risk of early death.
Application of CED and HED techniques for Shockwave Detection with High-speed Schlirden and Shadowgraph images.
Authors: Kumar Vinoth
Published: October 2023

Schlieren and shadowgraph images are valuable tools in aerospace engineering due to their user-friendly nature. They are commonly used to gain insights into flow patterns, particularly in the context of high-speed phenomena. Investigating dynamic shock wave structures, such as shock reflection patterns and interactions between shock waves and boundary layers, involves the use of high-speed Schlieren and shadowgraph systems. These techniques are vital for understanding complex aerodynamic phenomena. Typically, sequences of Schlieren and shadowgraph images are used for qualitative analysis. These image sequences serve as the foundation for understanding and interpreting the observed flow patterns. Dealing with extensive data from high-speed Schlieren and shadowgraph images often requires image processing methods. This includes techniques like background subtraction, edge recognition, and shock detection to enhance the quality of data and enable detailed analysis. The phenomenon of shock wave detection from a high-speed airflow over a forward-facing step is discussed in this article. This real-world example illustrates the practical application of Schlieren and shadowgraph imaging and the importance of accurate shockwave detection by comparing two different image processing methods for shockwave detection: Canny Edge Detection (CED) and Holistically-Nested Edge Detection (HED). According to the data, HED performs better than CED at correctly identifying shockwaves in Schlieren and shadowgraph images.
Bartender: portrayals of popular alcohol influencer’s videos on TikTok ©
Authors: Guégan Erell , Zenone Marco , Mialon Mélissa , Gallopel-Morvan Karine
Published: October 2023

Background
Despite widespread use of the short-video social media platform TikTok©, there is limited research investigating how alcohol is portrayed on the platform. Previous research suggests a driver of alcohol content on TikTok© in part comes from bartenders demonstrating making drinks. The purpose of this study is to explore the characterizing patterns of how bartender influencers on TikTok© feature and incorporate alcohol in their videos.
Methods
We identified the top 15 most followed bartenders on TikTok© in 2021 (cumulative 29.7 million subscribers). The 345 videos they posted in November and December 2021 received 270,325,600 views. The videos were coded based on five criteria: (1) presence of alcohol or not; (2) alcohol categories; (3); alcohol brand(s) if visible; (4) presence of candies and other sweet products; (5) presence of cues that refer to young people’s interests.
Results
Among the 345 videos, 92% (n = 317) displayed alcohol in their cocktail recipes (249,275,600 views). The most common types of alcohol present in videos were liquor, vodka, rum, and whiskey, all of which are high ABV beverages. 73% (n = 230) displayed or mentioned an alcohol brand. 17% (n = 55) associated alcohol with sweet products such as different types of candy (53,957,900 views). 13% (n = 43) contained cues appealing to young people (e.g., cartoons, characters) (15,763,300 views).
Conclusions
Our findings suggest a large presence of positively framed alcohol content posted by popular bartenders on TikTok©. As exposure to digital marketing is related to an increase in alcohol consumption, particularly in young people, regulations are needed to protect the public from alcohol-related harms.
Direct Observations of X-Rays Produced by Upward Positive Lightning
Authors: Oregel-Chaumont Toma , Sunjerga Antonio , Hettiarachchi Pasan , Cooray Vernon , Rubinstein Marcos , Rachidi Farhad
Published: October 2023

X-rays have been observed in natural downward cloud-to-ground light-ning for over twenty years and in rocket-triggered lightning for slightly less. In both cases, this energetic radiation has been detected during the stepped and dart leader phases of downward negative flashes. More recently, X-rays have also been reported during the dart leader phase of upward negative flashes. In this study, we present the observations of four upward positive lightning flashes from the S¨antis Tower (2.5 km ASL) in Switzerland. These consist of the simultaneous records of electric current passing through the tower, and electric field strength and X-ray flux 20 meters from the tower base. One of the flashes was captured by a high-speed camera operating at 24,000 frames per sec-ond, stills from which are also presented. We detected X-rays during the initial phase of upward negative leader propagation, which can be associated with the leader-stepping process from electric field and cur-rent waveforms. To the best of our knowledge, this is the first time that such measurements are reported in the literature. The obtained time-synchronised data confirm that the X-ray emissions detected are associated with the initial steps of the upward negative leader. The fre-quency and energy of X-ray pulses appear to decrease as a function of time, with pulses disappearing altogether within the first millisec-ond of the leader initiation. The X-ray pulse energy appears to increase with the maximum current-derivative and the electric field change of its associated leader step. These observations contribute to improving the currently lackluster understanding of upward lightning, which is a pri-mary source of damage to tall structures such as telecommunications towers and wind turbines, as well as airplanes during take-off and landing.
Relationship between gut microbiota and intussusception: an analysis based on Mendelian randomization
Authors: Cheng Feng , Luo Chun , Shang KeLei , Tan XiaoGuang
Published: October 2023

Objective
To explore the causal relationship between intestinal microbiome and intussusception utilizing two-sample Mendelian randomization (MR) method.
Methods
Genome-wide association studies (GWAS) significance level data of 211 intestinal microbiome selected from the MiBioGen consortium were used as instrumental variables, and the genetic associations with intussusception was obtained from FinnGen consortium based on intestinal condyloma susceptibility genes. Inverse variance weighting (IVW), MR-Egger, Weighted median, Weighted mode and MR-PRESSO methods were used to explore the causal relationship between intestinal microbiome and intussusception.
Results
The inverse variance weighted results showed that Bifidobacterium was inversely associated with the risk of intussusception (OR: 0.376, 95% CI: 0.157–0.899). In addition, Ruminococcustorques group (OR: 4.461, 95% CI: 1.058–18.807), Adlercreutzia (OR: 3.893, 95% CI: 1.318–11.502), Allisonella (OR: 1.715, 95% CI: 1.009–2.915), and Clostridiumsensustricto1 (OR: 2.974, 95% CI: 1.046–8.451) suggested an increased risk association with intussusception.
Conclusions
The present MR study indicated that Bifidobacterium reduces the risk of intussusception and postoperative recurrent intussusception. Further randomized controlled trials are needed to elucidate the protective effects of probiotics on the development of intussusception as well as their specific protective mechanisms.
Transient modeling of material extrusion by system identification
Authors: Colon Austin Ray , Kazmer David O. , Peterson Amy M.
Published: October 2023

Material extrusion is popular for its low barriers to entry and the flexibility it gives designers relative to traditional manufacturing techniques. Material extrusion is a transient process with a high frequency of starts, stops, and accelerations. This work presents transient data collected by an instrumented printhead and models the data by way of system identification. First-order and second-order control system models are proposed. The work also includes principal component analysis to determine which model coefficients correlate with the main effect, models the first-order model coefficients as a function of the experimental factors by regression, and predicts the apparent viscosity using a fitted static gain and known parameters. Flow rate, hot end temperature, nozzle diameter, and acceleration are the factors selected for the experiment. Each of these factors influences the steady state pressure, except for acceleration. The system identification models predict the melt pressure’s transient behavior well, with standard errors less than 4% of the mean melt pressure. Statistical analysis of the first-order model coefficients verifies that the static gain and time constant are statistically significant responses of the factors. The modeled apparent viscosity follows rheological expectations, showing the trends typically seen for viscosity as a function of shear rate.