bluuebunny/crossref_metadata_2025 huggingface dataset:
Research and Application of Chinese Auspicious Animal Images in Contemporary Clothing Design—Take “The Classic of Mountains and Seas” as Research Example
Authors: Du Bingbing , Feng Kailun
Published: November 2024

This thesis aims to investigate the auspicious animal images in “The Classic of Mountains and Seas”, exploring the profiling features and evolution of the auspicious animal patterns through cross verification of images, literature and cultural relics, and based on the research, the images are applied on the China-Chic clothing design. Ancient Chinese took the auspicious animals as things of blessing, which were endowed with many beautiful meanings to express our ancestors’ longing for a better life. Based on the concept of innovative design derived from the traditional culture, this thesis takes the images of auspicious animals in “The Classic of Mountains and Seas” as its research object to analyze their origins and evolution in China-chic fashion and, together with the case study of modern clothing design and a certain extent summary, to promote the inheritance, development and application of traditional culture in modern social life. The thesis will delve deep into the cultural connotations and aesthetic characteristics of the auspicious animal images, analyze and investigate the types, characteristics and implied meanings of such image to extract representative visual element symbols, which are then integrated into the modern fashion design, fulfilling the inheritance, development and application of traditional culture in modern social life.
The Adoption of Sustainable Supply Chain Management Practices on Performance of Agricultural Sectors in Ethiopia
Authors: Desalegn Shimelis , Nadeem Simon
Published: November 2024

In recent years, there has been a substantial increase in interest from both academic and corporate sectors concerning sustainable supply chain management. The increasing number of published papers focusing on this topic is a signal for this. To contribute further to the development of this field, this paper presents a comprehensive review of the existing literature on the impact of adopting sustainable supply chain management in the agricultural sector in Ethiopia, considering a total of 67 papers published between 2010 and 2023. This literature review aims to examine barriers, internal and external driving forces of the adoption of sustainable supply chain management practices, the impact of adopting sustainable supply chain management practices on the performance and identify constraints and opportunities of sustainable supply chain management practices in Ethiopian agricultural sectors. Focusing on the Ethiopian context, the study provides insights into the link between sustainable supply chain practices and performance outcomes. Additionally, NVIVO, qualitative data analysis software, was utilized to enhance the review process and ensure the systematic literature analysis.
Effect of Life Expectancy on Economy Growth for High-Income Nations
Authors: Okunola Kayode , Okunola Bolanle , Adewuyi Oladimeji
Published: November 2024

The global age distribution has undergone substantial changes in recent years due to a rise in life expectancy. Based on projections, the global population of those aged 60 and beyond is expected to reach 2 billion by 2050, representing almost 25% of the total population. By the year 2050, it is expected that the proportion of adults aged 80 years and older will rise by 1% to 4% of the global population. Because of this trend, economic growth may be hampered. The growing reliance on elderly people results in an increase in taxation, while political pressures may cause public funding to be redirected to adult social care. If this option is made, it could be detrimental to both growth and investment. The present study uses panel data from high-income countries to determine if life expectancy is a favorable predictor of economic growth using Granger causality and panel regression. The Hausman test was used to evaluate pooled, random, and fixed effect models in order to determine which model was the most appropriate. Based on the results, the fixed effect model tends to perform better, as indicated by the p-value being less than 0.05. Furthermore, the findings convey that life expectancy has a negative impact on economic growth.
Cartilage repair: surgical techniques and tissue engineering using polysaccharide‐ and collagen‐based biomaterials
Authors: Galois L. , Freyria A.M. , Grossin L. , Hubert P. , Mainard D. , Herbage D. , Stoltz J.F. , Netter P. , Dellacherie E. , Payan E.
Published: November 2024

Lesions of articular cartilage have a large variety of causes among which traumatic damage, osteoarthritis and osteochondritis dissecans are the most frequent. Replacement of articular defects in joints has assumed greater importance in recent years. This interest results in large part because cartilage defects cannot adequately heal themselves. Many techniques have been suggested over the last 30 years, but none allows the regeneration of the damaged cartilage, i.e. its replacement by a strictly identical tissue. In the first generation of techniques, relief of pain was the main concern, which could be provided by techniques in which cartilage was replaced by fibrocartilage. Disappointing results led investigators to focus on more appropriate bioregenerative approaches using transplantation of autologous cells into the lesion.

Unfortunately, none of these approaches has provided a perfect final solution to the problem. The latest generation of techniques, currently in the developmental or preclinical stages, involve biomaterials for the repair of chondral or osteochondral lesions. Many of these scaffolds are designed to be seeded with chondrocytes or progenitor cells. Among natural and synthetic polymers, collagen‐ and polysaccharide‐based biomaterials have been extensively used. For both these supports, studies have shown that chondrocytes maintain their phenotype when cultured in three dimensions. In both types of culture, a glycosaminoglycan‐rich deposit is formed on the surface and in the inner region of the cultured cartilage, and type II collagen synthesis is also observed. Dynamic conditions can also improve the composition of such three‐dimensional constructs. Many improvements are still required, however, in a number of key aspects that so far have received only scant attention. These aspects include: adhesion/integration of the graft with the adjacent native cartilage, cell‐seeding with genetically‐modified cell populations, biomaterials that can be implanted without open joint surgery and combined therapies, aimed at disease modification, pain relief and reduction of inflammation.
Repurposing of erythropoietin as a neuroprotective agent against methotrexate-induced neurotoxicity in rats
Authors: Sabry Nadine C , Michel Haidy E , Menze Esther T
Published: November 2024

Background:

Methotrexate (MTX) is a cytotoxic drug that can trigger neurotoxicity via enhancing oxidative stress, apoptosis, and inflammation. On the other hand, erythropoietin (EPO) functions as an antioxidant, anti-apoptotic, and anti-inflammatory agent, in addition to its hematopoietic effects.

Aim:

The present study was developed to examine the neuroprotective impact of EPO against MTX-provoked neurotoxicity in rats.

Methods:

Chemo fog was elicited in Wistar rats via injection of one dosage of MTX (20 mg/kg, i.p) on the sixth day of the study. EPO was injected at 500 IU/kg/day, i.p for 10 successive days.

Results:

MTX triggered memory and learning impairment as evidenced by Morris water maze, passive avoidance, and Y-maze cognitive tests. In addition, MTX induced oxidative stress as evident from the decline in hippocampal Nrf2 and HO-1 levels. MTX brought about apoptosis, as demonstrated by the elevation in p53, caspase-3, and Bax levels, as well as the decrease in Bcl2 levels. MTX also decreased Beclin-1, an autophagy-related marker, and increased P62 expression. In addition, MTX downregulated Sirt-1/AKT/FoxO3a pathway and increased miRNA-34a gene expression. Moreover, MTX increased acetylcholinesterase activity and reduced neurogenesis. EPO administration remarkably counteracted MTX-induced molecular and behavioral disorders in rat hippocampi.

Conclusion:

Our findings impart preclinical indication for repurposing of EPO as a promising neuroprotective agent through modulating miRNA-34a, autophagy, and the Sirt-1/FoxO3a signaling pathway.
Experiences and outcomes of patients participating in a perioperative shared decision-making pathway
Authors: Omundsen Heidi C , Franklin Renee L , Omundsen Mark S , Richardson Trevor R
Published: November 2024

The Complex Decision Pathway (CDP) is a novel perioperative shared decision-making pathway that was established in the Bay of Plenty, New Zealand in 2018. Unique features of the pathway include the use of a structured communication tool to facilitate a goals-of-care conversation in addition to medical assessment, and the use of a tikanga Māori framework for Māori patients. From May 2019 until May 2022, 81 patients attending the CDP clinic were recruited to a prospective study of their demographics, health status and experience at the time of presentation, along with outcomes and opinions over the subsequent 12 months. Participants were mostly elderly and frail with multiple comorbidities, and just over half of participants chose to undergo surgery. Participants who chose, or were recommended, not to undergo surgery were older, more comorbid and had worse outcomes over the subsequent 12 months. Qualitative data suggested an overall positive patient experience of the pathway, and an economic analysis demonstrated its cost-effectiveness. Overall, the data presented here suggested that the CDP assisted in risk-stratifying patients into operative and non-operative groups, provided a positive patient experience, and was a cost-effective intervention.
Telemedicine in Pediatric Neurology: A Survey of Patient and Provider Experience
Authors: Strasser Lauren , Hayawi Lamia , Webster Richard J. , Venkateswaran Sunita , Muir Katherine
Published: November 2024

Background

Over recent years there has been a shift in clinical practice to support care delivery via telemedicine. This study aims to highlight the patient and provider experience of telemedicine over 2.5 years within a Canadian Pediatric Neurology clinic.

Method

A REDCap survey was sent to all patients/parents and providers with a telemedicine appointment between March 2020 and September 2022.

Results

Seven providers and 272 patients responded. Ninety-one percent of patients and 100% of providers were satisfied with telemedicine. Ninety percent of patients and 100% of providers found telemedicine more convenient. Eighty-seven percent of patients and 100% of providers were interested in future telemedicine appointments. Main challenges were with performing a physical examination and technological issues.

Conclusion

Our survey shows that the majority of patients and providers had highly positive experiences with telemedicine and were interested in continuing care via telemedicine. This study supports incorporating telemedicine into future pediatric neurology practice.
Care as untranslatable
Authors: ffrench Patrick
Published: November 2024

Care has become an overdetermined word in the medical humanities and beyond, a focus not only of debate around the nature and purpose of the field, but also of the wider issue of the status of medicine in relation to society and the individual. As a symptom of this problematic, this article proposes care as an ‘untranslatable’, in the sense defined by Barbara Cassin. This is pursued via an engagement with the history of the ethics of care and with its translation into francophone contexts as une éthique du care, in tension with the philosophie du soin elaborated in the work of Frédéric Worms, and then with the several translations into French and English of Sorge and its derivations Besorgen and Fürsorge in Martin Heidegger's Sein und Zeit (Being and Time). A genealogy of care is thus established, and what emerges as the principal motif of its untranslatability is the relation between a primary form of relationality and the socio-technical dimension in which we may recognise healthcare.
Characterization of microstructural evolution and mechanical properties of Cu-Ni-Cr alloys deformed by ECAP
Authors: Wongvaranon Kittanaphum , Rojananan Siriporn , Thipprakmas Sutasn
Published: November 2024

In recent years, Cu-Ni-Cr alloy materials have been broadly applied in the marine industry. However, owing to its dendritic microstructure, this material is an obstacle to the manufacturing process, particularly in the metal-forming process. In this study, an equal-channel angular pressure (ECAP) process is proposed to improve the material microstructure and mechanical properties. A single pass of the ECAP was performed at room temperature, and the microstructural evolution and mechanical properties of the material were characterized. The ECAP compressed and tensioned the microstructures on the top and bottom surfaces, respectively. The microstructures on the front and back surfaces were similar because they were sheared. This also caused a tear-off of the dendritic microstructure. Based on the changes in the characterization of the microstructural evolution, the ultimate tensile strength increased by 32% to approximately 680 MPa, and the elongation decreased by 200% to approximately 8%. The microhardness distribution was irregular on the front and back surfaces, causing nonuniform deformation. However, the microhardness increased by an average of 35% to approximately 270 HV. Consequently, the nonuniform microstructural evolutions and mechanical properties of each surface must be considered when applying the ECAP process to improve the mechanical properties of Cu-Ni-Cr alloy materials.
Postfeminism in prison: A discourse analysis of women correctional officers’ accounts of gendered appearance at work
Authors: Walker Claudia , Riley Sarah , Stephens Christine , Beban Alice
Published: November 2024

This article explores sense-making among female prison workers as they negotiate their appearance at work. Appearance is a vehicle through which gender is performed; yet research into how women account for their appearance in this male-dominated profession remains limited. We address this gap through an analysis of 16 women's accounts of their appearance work produced from an in-depth cooperative inquiry with women working in Australian men's prisons. We discuss three overarching patterns of talk, “look good, feel good, be good,” “my choice, not yours,” and “look good, but not too good.” These accounts showed both alignments and tensions between (a) postfeminist imperatives to meet feminine appearance norms and (b) an organisational culture that devalues normative femininity but values attention to appearance. In this context, our participants developed individualised solutions, crafting their appearance in ways that would consolidate their own sense of identity and communicate their professional value to others. We find that exploring women's sense-making of appearance at work provides a critical avenue to understand the manifestation of sexism within organisations.
Frequently Asked Questions and Answers for Supporting Students With Section 504 Plans
Authors: Burke Meghan M. , Mercer Colleen , Ramos-Torres Saury , Lindsay RaeAnne , Burakov Isabelle
Published: November 2024

Although more than 1.38 million students receive accommodations and supports accorded by Section 504 of the Rehabilitation Act of 1973, many teachers report not knowing about their responsibilities under Section 504. The purpose of this article is to educate teachers about Section 504. Specifically, teachers will learn about ways to evaluate and support students with disabilities under the auspice of Section 504. Based on data collected from more than 100 students with disabilities and their families, this article is framed around frequently asked questions and answers in relation to Section 504 plans. Resources are provided to help teachers support students who are protected by Section 504.
Unconventional Histopathological Features With KIAA1549::BRAF Fusion in Advanced Prostatic Adenocarcinoma
Authors: Sharma Anurag , Khaitan Neha , Bhattarai Roshan , Homsi Haya , McKenney Jesse K. , Cheng Yu-Wei
Published: November 2024

This report delineates an intriguing example of advanced prostatic adenocarcinoma displaying distinctive histopathological characteristics associated with a KIAA1549::BRAF fusion, a genomic anomaly predominantly identified in central nervous system tumors. A 66-year-old man, presenting with acute renal failure, exhibited metastatic disease involving pelvic soft tissue, bladder, liver, and bone. Histological examination revealed a markedly unconventional morphology within the prostate, characterized by infiltrative tumor sheets exhibiting abundant vacuolated cytoplasm, hyperchromatic nuclei, and irregular nuclear membranes, distinct from typical prostatic adenocarcinoma. Immunophenotyping confirmed NKX3.1 positivity and GATA3 negativity. Molecular analysis revealed the rare KIAA1549::BRAF fusion alongside pertinent mutations in phosphatidylinositol 3-kinase, phosphatase and tensin homolog, and tumor protein 53 genes. Despite diverse therapeutic interventions targeting mitogen-activated protein kinase signaling and subsequent clinical trial enrollment, disease progression remained relentless, culminating in the patient's demise within 4 years of diagnosis. This report highlights the exceptional histopathological presentation associated with KIAA1549::BRAF fusion in prostatic adenocarcinoma, emphasizing the need for a deeper comprehension of its implications on disease behavior and therapeutic responsiveness in similar instances.
Multitask vibration transformer for abnormal vibration identification and structural damage assessment in subway tunnels
Authors: Chai Fu , Zhou Biao , Xie Xiongyao , Jiang Haili
Published: November 2024

As urban infrastructure becomes denser, subway operations face numerous risks, including adjacent construction and structural damage deterioration. Integrated monitoring is crucial to ensure safety. This study presents a multitask vibration transformer (M-TVT) model, which utilizes an Expert-Gate network to manage task-related information sharing. The model achieves integrated identification for the type and spatial distribution of internal and external tunnel abnormal vibration responses, along with assessing structural damage degree. Meanwhile, a tunnel-train-soil coupling experiment is conducted to validate the efficacy of the M-TVT model. The results demonstrate that the M-TVT model with the Expert-Gate network maintains high accuracy and stability, efficiently shares parameter information among tasks and achieves improvement in accuracy compared to single-task models.
The Relationship Between Exogenous Testosterone Use and Risk for Primary Anterior Cruciate Ligament Rupture
Authors: Quinn Matthew , Albright Alex , Lemme Nicholas J. , Testa Edward J. , Morrissey Patrick , Arcand Michel , Daniels Alan H. , Fadale Paul
Published: November 2024

Background:

In the United States, testosterone therapy has markedly increased in recent years. Currently, there is a paucity of evidence evaluating the risk of ligamentous injuries in patients taking testosterone replacement therapy (TRT).

Purpose/Hypothesis:

The purpose of this study was to quantify the association between TRT and the incidence of anterior cruciate ligament (ACL) injuries and the subsequent risk of ACL reconstruction (ACLR) failure. It was hypothesized that individuals receiving TRT would demonstrate an increased risk for index ACL injury and ACL rerupture.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This is a retrospective cohort study utilizing the PearlDiver database. Records were queried between 2011 and 2020 for patients aged 18 to 59 years who filled a testosterone prescription. A matched control group based on age, sex, Charlson Comorbidity Index, tobacco use, diabetes, and hypothyroidism consisted of patients aged 18 to 59 years who had never filled a prescription for exogenous testosterone. International Classification of Diseases, 9th and 10th Revisions and Current Procedural Terminology (CPT) codes were utilized to identify patients with ACL injuries and those undergoing reconstruction. Multivariable logistic regression was used to compare rates of ACL injury at 6 months, 1 year, and 2 years after initiating TRT. ACLR failure was also examined at 1-year intervals for 5 years for individuals filling a TRT prescription.

Results:

A total of 851,816 patients were enrolled, with 425,908 patients in the TRT and control groups, respectively. The TRT cohort was significantly more likely to experience an ACL tear during 6-month (OR, 2.66; 95% CI, 2.17-3.26), 1-year (OR, 2.46; 95% CI, 2.11-2.86), and 2-year (OR, 2.22; 95% CI, 1.98-2.48) periods. The rate of reconstruction failure did not differ between the 2 cohorts at up to 5 years of follow-up ( P > .05).

Conclusion:

Patients receiving TRT were significantly more likely to sustain a primary ACL rupture but were not at a statistically significant increased risk of reconstruction failure.
Bilateral TMJ Changes Secondary to Unilateral Condylar Hyperplasia
Authors: Sivakanthan Thiviya , Steinbacher Derek M.
Published: November 2024

Background:

Patients with unilateral condylar hyperplasia (UCH) may present with TMJ symptoms, rather than concerns or recognition of asymmetry. Localization of TMJ pain may be on the affected (long) side, unaffected side, or both. Flattening, severe erosion and internal derangement on the opposite side can be appreciated radiologically. This can be a red herring, shielding the true diagnosis of UCH from the contralateral side. We hypothesize that excessive growth of the ipsilateral condylar neck and head on the side of UCH results in an upward and backward force on the opposite side TMJ, with resultant symptoms and findings (condylar flattening, anterior disk displacement, eminence changes). The purpose of this paper is to highlight the bilateral TMJ findings in UCH, and address potential treatment strategies.

Methods:

This is a retrospective study involving radiologic and biographical data from subjects with TMJ UCH, as well as controls. Patient details and high quality Cone beam CT (CBCT) scans (1 mm slices or less) were analyzed. CT scans were digitized and morphometric points were placed using Planmeca software (Hoffman Estates, Illinois). Linear and volumetric measures were taken in reference to the eminence, TMJ space, condylar position, and neck lengths. Volumetric analysis of the condylar head and neck was done using Analyze 14.0 software (Overland Park, KS, USA). Results were assessed using univariate analysis (T-Wilcoxon test).

Results:

Forty patients were included (29 with UCH, 11 controls). The condylar head was flatter and erosive appearing on the contralateral UCH side compared to both ipsilateral side in the same subject, and compared to controls. Analysis between the affected and unaffected sides in patients with UCH showed a significant difference in condylar head and neck length ( P = .0019) and volume ( P = .0030); anterior glenoid space ( P = .035) and vertical height of condylar eminence ( P = .00044). The difference in ramus length was not significant ( P = .6533). Between the controls and the UCH patients, there was a significant difference in the variance in condylar head and neck length ( P = 1.98e-07) and volume between the 2 sides ( P = 1.94e-08) but not ramus length ( P = 1). The vertical height of the condylar eminence was smaller on the affected side than in the controls ( P = .0018) and the anterior glenoid space was significantly smaller on the unaffected side compared to the controls ( P = .0053).

Conclusion:

This study highlights TMJ morphological differences in patients with UCH. These differences in condylar and glenoid morphology are consistent and should be used to aid and underpin the diagnosis and direct treatment. Importantly, patients who present with TMJ pain and erosion on one side, should be assessed for opposite side UCH, as the underlying culprit.
A New Method for Measuring Cognition in Children With Sagittal Craniosynostosis
Authors: Chapman Leah , Runyan Christopher , Couture Daniel , Thibodaux Lia , Wright Avery , David Lisa
Published: November 2024

Objectives:

The neurocognitive profile of patients who have undergone spring-assisted surgery (SAS) for craniosynostosis is not well understood, and a variety of different cognitive measures have been used across various studies. Although neuropsychological evaluations can document cognitive strengths and weaknesses across a number of cognitive areas, they can be time consuming. This study aimed to: (1) describe the neurocognitive profile of patients who underwent SAS using both a common intelligence measure and iPad assisted testing measuring several cognitive areas, as well as parent ratings; (2) better understand the feasibility and utility of using iPad assisted assessments in this population.

Methods:

Thirty-six patients between the ages of 6 and 18 with sagittal synostosis who underwent SAS participated in a brief battery of assessments including a measure of abbreviated IQ, National Institutes of Health Toolbox Cognition Battery (NIH Toolbox), and caregiver ratings on the Behavior Rating Inventory of Executive Function – Second Edition (BRIEF-2). Statistical analyses assessed performance within the group and between measures.

Results:

Positive correlations were found between all 3 NIH Toolbox Composite scores and abbreviated IQ. Five of 7 subtests were positively correlated with Full Scale IQ, while 4 of 7 were positively correlated with both verbal and visual reasoning indices. Negative correlations between the Crystallized Composite score and BRIEF-2 were found for 8 of 9 BRIEF-2 subscales. Three of 9 BRIEF-2 subscales were negatively correlated with Fluid Composite and Total Composite scores.

Conclusions:

Cognitive data were generally aligned with the normal distribution curve. Although caregiver ratings yielded several executive functioning concerns, significant correlations were found with composite scores and a few specific subtests. Use of the NIH Toolbox was feasible in this population and shows promise as a tool for measuring a range of different cognitive domains.
Generative AI and Investigative Journalism—An Application of Baumol's Cost Disease Across Mass Communication Sectors
Authors: Wellbrock Christian-Mathias
Published: November 2024

Generative artificial intelligence (AI) has transformed various industries, automating tasks and enhancing productivity. Yet, its impact varies across sectors. In mass communication, AI has notably benefited entertainment, public relations, and advertising. However, it poses a lesser advantage for investigative journalism, where labor-intensive research and other highly specialized activities depend on highly educated journalists. This situation parallels Baumol's concept of a cost disease, which applies to labor-intensive “stagnant” service sectors such as healthcare, education, and the performing arts. These sectors rely heavily on human labor and struggle to achieve significant productivity gains from technological advances. This means they may require decreasing wages or increasing subsidies to compete with more productive industries. In mass communication, this phenomenon could be especially pertinent to (investigative) journalism, which directly competes for attention with other communication forms. This could exacerbate pressures on wages and working conditions, hindering the attraction of talent to the field and necessitating higher public spending on this vital journalism form. This commentary presents a cross-industry analysis of the impact of generative AI on communication sectors and derives directions for further research that would enhance our understanding of journalism's economic viability in a digital communication landscape and inform policy makers to address the affiliated societal challenges. It closes with a discussion of Guzman and Lewis’s call for more cross-industry research on AI in communication industries.
Societal Impact of Machine Learning on Human Emotions
Authors: Pandit Abhijit , Dey Trinankur
Published: November 2024

Modern networking conversations generate annotated metadata, necessitating a method for synthesizing insights from statistics. Emotion detection is crucial for practical conversations, distinguishing joy, grief, and wrath. Corpora are becoming the standard for human–machine interaction, aiming to make interactions feel natural and real. A paradigm that identifies debates and customer views can provide a human touch to these interactions. Researchers developed a machine learning framework for assessing emotions in English phrases, utilizing Long Short Term Memory perspective and real-time emotion recognition in idiomatic speech. Emotion recognition rule is created using ontologies like Word Net and Concept Net, Naive Bayes, and Random Forest. Real-time analysis of written words and facial expressions significantly outperforms current algorithms and commandment classifiers in identifying emotional states.
RUNX2 is stabilised by TAZ and drives pulmonary artery calcification and lung vascular remodelling in pulmonary hypertension due to left heart disease
Authors: Liu Shao-Fei , Kucherenko Mariya M. , Sang Pengchao , Li Qiuhua , Yao Juquan , Nambiar Veetil Netra , Gransar Tara , Alesutan Ioana , Voelkl Jakob , Salinas Gabriela , Grune Jana , Simmons Szandor , Knosalla Christoph , Kuebler Wolfgang M.
Published: November 2024

Background

Calcification is common in chronic vascular disease, yet its role in pulmonary hypertension due to left heart disease is unknown. Here, we probed for the role of runt-related transcription factor-2 (RUNX2), a master transcription factor in osteogenesis, and its regulation by the HIPPO pathway transcriptional coactivator with PDZ-binding motif (TAZ) in the osteogenic reprogramming of pulmonary artery smooth muscle cells and vascular calcification in patients with pulmonary hypertension due to left heart disease. We similarly examined its role using an established rat model of pulmonary hypertension due to left heart disease induced by supracoronary aortic banding.

Methods

Pulmonary artery samples were collected from patients and rats with pulmonary hypertension due to left heart disease. Genome-wide RNA sequencing was performed, and pulmonary artery calcification assessed. Osteogenic signallingviaTAZ and RUNX2 was delineated by protein biochemistry.In vivo, the therapeutic potential of RUNX2 or TAZ inhibition by CADD522 or verteporfin was tested in the rat model.

Results

Gene ontology term analysis identified significant enrichment in ossification and osteoblast differentiation genes, includingRUNX2, in pulmonary arteries of patients and lungs of rats with pulmonary hypertension due to left heart disease. Pulmonary artery calcification was evident in both patients and rats. Both TAZ and RUNX2 were upregulated and activated in pulmonary artery smooth muscle cells of patients and rats. Co-immunoprecipitation revealed a direct interaction of RUNX2 with TAZ in pulmonary artery smooth muscle cells. TAZ inhibition or knockdown decreased RUNX2 abundance due to accelerated RUNX2 protein degradation rather than reducedde novosynthesis. Inhibition of either TAZ or RUNX2 attenuated pulmonary artery calcification, distal lung vascular remodelling and pulmonary hypertension development in the rat model.

Conclusion

Pulmonary hypertension due to left heart disease is associated with pulmonary artery calcification that is driven by TAZ-dependent stabilisation of RUNX2, causing osteogenic reprogramming of pulmonary artery smooth muscle cells. The TAZ–RUNX2 axis may present a therapeutic target in pulmonary hypertension due to left heart disease.
Navigating Family Dynamics and Ethical Considerations in Genetic Diagnosis of Pulmonary Arterial Hypertension: Insights from In-Depth Semi-Structured Interviews
Authors: Swietlik Emilia M. , Fay Michaela , Morrell Nicholas W
Published: November 2024

Introduction

Genetic diagnosis and precision medicine are rapidly advancing, driven by innovations in next-generation sequencing and omic methods. The UK's collaboration between national research initiatives and the NHS facilitates translation of research into clinical practice. This rapid transition impacts family dynamics and family planning and raises ethical concerns, compounded by limited public and practitioner awareness of the long-term consequences of genetic diagnosis. Our objective is to explore the impact of genetic diagnosis on family dynamics and the ethical considerations of genetic testing at different life stages in patients with pulmonary arterial hypertension (PAH) and their at-risk relatives.

Methods

Stakeholders from the NBR and PAH Cohort studies were recruited using purposive sampling. 53 interviews and focus groups with 63 participants were recorded, transcribed, and thematically analysed using MAXQDA.

Results

The study revealed three main themes: the impact of diagnosis on family dynamics, considerations for family planning, and genetic testing of relatives. Two attitudes toward testing offspring emerged: proactive advocates and gatekeepers. The gatekeeper stance was driven by three key factors: shielding children from genetic risk awareness, feelings of guilt or a desire to avoid blame for disease transmission, and limited family connections. Each theme highlighted various moral and ethical dilemmas faced by individuals.

Conclusions

A PAH diagnosis reshapes family roles and responsibilities. Genetic risk awareness strengthens bonds but also introduces challenges like disclosing information and deciding on testing for at-risk relatives. Our research highlights the need for comprehensive genetic counselling and support systems to enhance patient care and familial well-being.
Accuracy of early warning scores for predicting clinical worsening in COPD patients
Authors: Castro-Portillo Enrique , Soriano Joan B. , López-Izquierdo Raúl , del Pozo Vegas Carlos , Martín-Conty José L. , Sánchez Soberón Irene , Delgado Benito Juan F. , Polonio-López Begoña , Sánchez-de-la-Torre Manuel , Castro Villamor Miguel Á. , Sanz-García Ancor , Martín-Rodríguez Francisco
Published: November 2024

Background

Chronic obstructive pulmonary disease (COPD), a condition whose acute exacerbations (AECOPD) are commonly faced by the emergency medical services (EMS), could modify the performance of the early warning scores (EWS). To assess the 2-day mortality predictive performance of five EWSs in patients with baseline COPD managed by an EMS with unselected acute diseases and to compare the EWS performance between those with AECOPD and those without.

Methods

Prospective observational study of adults (>18 years) with a previous COPD diagnosis who were admitted to and transferred to the emergency department by the EMS due to an unselected acute disease, whether AECOPD or other according to the emergency medical team. Demographics, vital signs for the five EWS (NEWS2, qSOFA, qCSI, CURB-65, and BAP-65) calculations, and outcomes (hospital and ICU admission and 2-day mortality) were collected.

Findings

A total of 1703 patients with COPD were selected, 524 with AECOPD and 1179 without. NEWS2 presented the highest predictive capacity for the global, AECOPD and non-AECOPD cohorts: AUC=0.880 (95%CI:0.84–0.91), AUC=0.775 (95%CI:0.68–0.86) and AUC=0.913 (95%CI:0.86–0.96), respectively.

Interpretation

NEWS2 was the best predictive model for COPD, presenting excellent performance for the global and non-AECOPD cohorts but a decreased performance for the AECOPD cohort. Therefore, the NEWS2 may aid in EMS decision-making through appropriate risk assessment, but its use in COPD patients with AECOPD should be handled with care due to decreased performance.
Poor clinical outcomes in respiratory viral sepsis: a retrospective observational study
Authors: Cao Wenhao , Xu Jiuyang , Liu Zhengping , Wang Ziming , Zhang Xueyang , Zhan Qingyuan , Cao Bin
Published: November 2024

Objectives

This study attempts to explore the clinical differences of sepsis caused by respiratory viruses and bacteria, and to search for risk factors for mortality in viral sepsis.

Methods

This single-center, retrospective cohort study enrolled patients hospitalized at our medical intensive care unit (ICU) from October 2020 to January 2024 who were diagnosed with pneumonia and sepsis. The primary and secondary pathogens were identified with comprehensive etiological tests. The baseline clinical information, biochemical tests, treatments, and clinical outcomes were collected.

Results

This study included 292 patients, comprising 191 with viral sepsis and 101 with bacterial sepsis. Compared with the bacterial sepsis group, patients with respiratory viral sepsis had lower oxygenation index levels upon ICU admission, higher proportions of acute respiratory distress syndrome (85%versus44%,p<0.001), secondary infection (84%versus39%,p<0.001), and higher ICU mortality (57%versus43%, p=0.018). After adjustment, viral sepsis patients had an odds ratio of 2.26 (95% CI, 1.26–4.07) for ICU mortality. Risk factors for ICU mortality in viral sepsis included age, sequential organ failure assessment score, secondary infection, immunocompromised status, and coronary heart disease. The subgroup analysis showed that secondary infection in viral sepsis contributed to a poorer clinical outcome.

Conclusion

ICU patients with respiratory viral sepsis presented a higher incidence of unfavorable outcome, which may partially be attributed to secondary infections.
Two forced expiratory volume in 1 s trajectories with distinct prognoses in pulmonary Langerhans cell histiocytosis
Authors: Benattia Amira , Porcher Raphaël , de Margerie-Mellon Constance , Caradec Emmanuella , Lorillon Gwenaël , Tazi Abdellatif
Published: November 2024

Background

Lung function outcomes in pulmonary Langerhans cell histiocytosis (PLCH) patients are variable and difficult to predict. Our goal was to identify different forced expiratory volume in 1 s (FEV1) trajectories in these patients during long-term follow-up.

Methods

All newly diagnosed adult PLCH patients seen between January 2004 and April 2018 were eligible for inclusion in our prospective cohort. The primary end-point was the identification of FEV1trajectories using a joint latent class model for longitudinal and time-to-event data. Internal validation was performedviabootstrapping.

Results

Among the 191 patients included (mean age of 39±12 years, 59% females, 96% current smokers), who were followed for a median of 5.1 years (interquartile range 3.2–6.0), two FEV1trajectories were identified. Patients with trajectory 1 (n=157, 82.2%) were characterised by a normal FEV1at diagnosis (mean predicted value (pred) of 95±3%) that remained stable over time (annual variation of 0.2% pred, 95% CI −0.8–0.4). Patients with trajectory 2 (n=34, 17.8%) had a decreased initial FEV1(63±7% pred) and an annual decrease of −1.8% pred (−3.4–−0.2). Trajectory 2 was associated with increased mortality (hazard ratio 9.46, 95% CI 1.24–72.2; p=0.03).

Conclusions

FEV1remained stable in most PLCH patients, but the subgroup of patients that experienced a significant decrease in FEV1over time had a poorer prognosis. These patients should be closely monitored for early therapeutic intervention. These results need to be confirmed in an external validation cohort.
Deleterious effect ofP. aeruginosaon F508del-CFTR rescued by Elexacaftor/Tezacaftor/Ivacaftor is clinical-strain dependent in patient-derived nasal cells
Authors: Allegretta Caterina , Montemitro Enza , Sgobba Maria Noemi , Capurro Valeria , Pesce Emanuela , Ciciriello Fabiana , La Bella Gianfranco , Rossito Martina , Tuccio Vanessa , Arena Fabio , Gunawardena Tarini N.A. , Guerra Lorenzo , Pedemonte Nicoletta , Capitanio Nazzareno , Piccoli Claudia , Laselva Onofrio
Published: November 2024

The triple cystic fibrosis transmembrane conductance regulator (CFTR) modulators combination Elexacaftor/tezacaftor/ivacaftor (ETI) has been approved for people with CF (pwCF) bearing at least oneF508delallele. Despite the development of CFTR modulators having dramatically improved respiratory outcomes in pwCF, clinical studies have showed variable responses to this drug formulation. Of note, airway inflammation and bacterial colonisation persist in the upper and lower respiratory tract even in ETI treated patients. Therefore, we first tested the clinical exoproducts (EXO) ofP. aeruginosaisolated from 15 CF patient in WT and F508del-CFTR CF bronchial epithelial (CFBE) cells and found that EXO variably decreased WT-, F508del- and ETI-dependent F508del-CFTR function and increased proinflammatory cytokines and ROS levels in a clinical strain-specific manner. We were then prompted to evaluate the effects of EXO inex-vivopatient-derived tissues. Therefore, we cultured primary nasal epithelial (HNE) cells with EXO isolated from the corresponding pwCF to mimic the native status of CF airway. Similarly, we observed a variable reduction of F508del-CFTR function in presence or absence of ETI and upregulation of proinflammatory cytokines and ROS levels. Interestingly, HNE cells treated with EXO isolated from the corresponding donor and 3 different pwCF, showed a variable reduction of ETI-dependent F508del-CFTR function mainly due to clinical strains with limited effect of patient background. Furthermore, we demonstrated that ETI pretreatment decreased the cytokines and ROS levels down to the levels of uninfected cells. These pre-clinical studies suggest thatin-vitroscreening of patient-specific response to CFTR modulators under infection/inflammation conditions, could prove to be a valuable tool to enhance the prediction of clinical response.
Hormonal interventions in skin wounds – a mini review
Authors: Li Zeming , Ma Rui , Tan Jiajun , Li Chunmeng , Xiao Yang , Qiu Xudong , Jin Shuo , Ouyang Peng , Zhao Yiping , Xiang Xiao , Wu Wang
Published: November 2024

The ability to heal from wounds is perhaps the most important biological function that ensures our survival and perpetuation. Cutaneous wound healing typically consists of four characteristic stages, namely hemostasis, inflammation, proliferation, and remodeling, which are carefully carried out by coordinated actions of various cells, cytokines, and hormones. Incoordination of these steps may impede complete and efficient reconstruction and functional recovery of wounds or even lead to worsened outcomes. Hormones, as powerful modulators of organ functions, participate in multiple steps of the wound healing process and play a pivotal role by choreographing the complex interplay of cellular and molecular events. Leveraging the regulatory effects of hormones to enhance the healing process, hormonal therapy has emerged as a promising approach in the clinical treatment of wounds. Current research has focused on determination of the optimal dosages, delivery methods, and combinations of hormonal therapies to maximize their therapeutic benefits while minimizing potential side effects. This review highlights the molecular mechanisms, clinical benefits and side effects of the most commonly used hormones in clinical treatment of wounds.
Molecular and morphoanatomical characterization of Urocystis heteropogonis sp. nov.: a novel smut fungus infecting Heteropogon contortus
Authors: Anwar Ayesha , Wahab Hira , Wahab Afshan , Afshan Najam ul Sehar , Moussa Ihab Mohamed , Elhindi Khalid M. , Ahmed Meraj , Malik Anurag , Singh Mahendra Pratap , Gaidhane Shilpa , Uddin Siraj
Published: November 2024

Background

A new species of smut fungus, Urocystis heteropogonis, was discovered infecting Heteropogon contortus in Shawar Valley, Swat district, Khyber Pakhtunkhwa, Pakistan. The study aimed to characterize this fungus based on its morpho-anatomical and molecular features and clarify its phylogenetic position within the genus Urocystis.

Results

Urocystis heteropogonis was identified as a novel species, distinct from other Urocystis species. Morphologically, it is characterized by larger spore balls (14–69 × 11–45 μm) and central spores that are 14–28 × 11–20 μm in size, with each spore containing1–8 central spores. The spore walls measure 0.9–2.5 μm in thickness and the species differs in infection patterns compared to other Urocystis species. Phylogenetic analysis based on the ITS and LSU regions of nuclear ribosomal DNA (nrDNA) further confirmed the novelty of the species, placing it within a distinct clade alongside U. agropyri, U. occulta, U. piptatheri, and U. tritici.

Conclusions

The discovery of Urocystis heteropogonis adds to the diversity of smut fungi infecting grasses and highlights the need for further research into its ecological and agricultural implications. Future studies should focus on the disease’s spread, management, and potential impact on host populations.
Streptococcus suis infective endocarditis in patients with Streptococcus suis bacteremia: a retrospective study of prevalence and outcomes
Authors: Kedsawadevong Pongsira , Jamnongprasatporn Sirichai , Ratanasit Nithima
Published: November 2024

Background

Streptococcus suis (S. suis) is a zoonotic disease that is transmitted to humans via contact or oral route. Although the major clinical presentation of this pathogen is known to be meningitis, S. suis infective endocarditis (IE) has recently emerged as a clinical manifestation of increasing interest. Echocardiography may be an underutilized modality for evaluating patients with S. suis bacteremia.

Objective

The primary objective was to estimate the prevalence of S. suis IE in patients with S. suis bacteremia. The secondary objective was to investigate the predictors, echocardiographic features, and clinical outcomes of S. suis IE in patients with S. suis bacteremia.

Materials and methods

This single-center retrospective study was conducted at Siriraj Hospital – Thailand’s largest university-based tertiary referral center. Adult patients (aged > 18 years) who were admitted to our center with confirmed diagnosis of S. suis bacteremia during January 2007 to September 2023 were included. Prevalence is reported as percentage and confidence interval. Baseline characteristics and clinical manifestation were compared between the IE and non-IE groups. Factors found to be statistically significant were further analyzed using binary logistic regression analysis to identify univariate predictors of S. suis IE.

Result

A total of 71 patients with S. suis bacteremia were included in this study. The prevalence of S. suis IE was 26.8% (95% confidence interval: 17.85–38.05). Perivalvular complications and significant valvular regurgitation were found in 52.6% and 80.0% of patients, respectively. Thirteen of 19 patients (68.4%) required valvular surgery according to standard guidelines. By univariate analysis, dyspnea, new murmur, immunologic phenomenon, and heart failure were predictors of S. suis IE in patients with S. suis bacteremia.

Conclusion

The results of this study revealed a sizable prevalence of S. suis IE in patients with S. suis bacteremia, and there were high rates of both valvular damage and perivalvular complications. Our results strongly suggest that echocardiography may be indicated to evaluate for S. suis IE in patients diagnosed with S. suis bacteremia. Reclassification of S. suis from an atypical organism to a typical organism should be considered.