bluuebunny/crossref_metadata_2025 huggingface dataset:
Underweight associated with water, sanitation, and hygiene among women of reproductive age in Arba Minch Health and Demographic Surveillance Site, Southern Ethiopia
Authors: Merkina Melesse Mengesha , Guyo Tamirat Gezahegn , Hayelom Desta Haftu , Assefa Darik Temesgen , Gutema Befikadu Tariku
Published: May 2024

Ethiopia is one of the sub‐Saharan African countries where underweight among women of reproductive age is high, and it is predisposing to low birth weight, preterm birth, and reduced resistance to infections. Poor water, sanitation, and hygiene (WASH) and drinking water polluted with disease‐causing microorganisms lead to undernutrition. Therefore, this study aimed to assess the association between WASH and underweight among women of reproductive age at Arba Minch Health and Demographic Surveillance Site (HDSS), Southern Ethiopia. A community‐based cross‐sectional study was conducted at Arba Minch HDSS, South Ethiopia, from April to May 2022. Women of reproductive age were included in the study. Data were collected using a pre‐tested questionnaire and checklist. Multivariate analysis was conducted to assess the association separately for WASH indicators with underweight status of the women by adjusting for sociodemographic characteristics. Adjusted Odds Ratio (AOR) with a 95% confidence interval was used to assess the association. The prevalence of underweight and overweight/obesity among women of reproductive age was 7.82% (95% CI: 5.60, 10.81) and 12.32% (95% CI: 9.50, 15.83), respectively. Latrine hygiene and use were significantly associated with being underweight. The odds of being underweight among those who use clean latrine were 0.43 (95% CI: 0.20, 0.92) compared to those who use unclean latrine or do not have toilet facilities. The utilization of clean latrine facilities is negatively associated with being underweight among women of reproductive age. From WASH components, latrine utilization and keeping the latrine clean to use need to get focused on reducing the risk of being underweight among women of reproductive age.
Optimizing antidiabetic properties of Galega officinalis extract: Investigating the effects of foliar application of chitosan and salicylic acid
Authors: Angouti Farinaz , Nourafcan Hassan , Saeedi Sar Sakineh , Assadi Assad , Ebrahimi Raheleh
Published: May 2024

Diabetes poses a significant global health burden, demanding safe and effective therapeutic interventions. Medicinal plants offer promising avenues for natural diabetic management. Galega officinalis (goat's rue) has long been recognized for its hypoglycemic potential, but optimizing its phytochemical content and antidiabetic activity remains a key challenge. This study aimed to address this aspect by investigating the impact of foliar application of chitosan and salicylic acid on the physiological and phytochemical properties of G. officinalis, and subsequently evaluating its antidiabetic efficacy compared to that of the established drug metformin. A randomized complete block design with three replications was employed. Laboratory mice were divided into treatment groups receiving G. officinalis extract from plants sprayed with four salicylic acid concentrations (0.5–3 mM/L) and four chitosan concentrations (0–0.8 g/L). Blood glucose levels and various physiological parameters were assessed. Chitosan at 0.4 g/L and salicylic acid at 2 mM significantly enhanced the growth, photosynthetic pigments, and antioxidant activity of G. officinalis. Notably, the extract from plants treated with 3 mM salicylic acid exhibited the highest total alkaloid content, a potential contributor to antidiabetic activity. In a separate study, diabetic mice treated with this optimized G. officinalis extract (50 mg/kg) exhibited significantly greater blood glucose reductions compared to those treated with metformin (500 mg). This study demonstrates the potential of chitosan and salicylic acid in optimizing the beneficial properties of G. officinalis. The extract derived from plants treated with 3 mM salicylic acid displayed superior blood glucose‐lowering efficacy compared to metformin, suggesting its promising role as a potential natural antidiabetic therapy. Further research is warranted to elucidate the specific bioactive compounds responsible for this enhanced activity and translate these findings into clinical applications.
Evaluating the pharmacological activities of Aloe perryi–Silver nanoparticles induced apoptosis against colon cancer cells (HCT‐116)
Authors: Hotan Omar , Alhaj Ali , Al‐quhaim Abdulghfor , Alburaihi Khaled , Ahmed Yahya , Munasser Qassem , Dhufer Saleh Bin , Nasran Tammam , Gabir Mohammed , Ebrahim Akram , Obadi Mohammed , Hadi Maryam , Al‐baity Hanefa , Ba‐Nafea Abdulmalek , Qaed Eskandar , Zaky Mohamed Y. , Okba Mohammed , Al‐Nasi Abdullah , Almoiliqy Marwan
Published: May 2024

Aloe perryi has been studied and possesses several activities, including antibacterial, antiparasitic, and anticancer properties. In this study, A. perryi was used as a reducing agent of silver ions into silver nanoparticles. Aloe perryi–silver nanoparticles (APS‐NPs) were characterized and evaluated using characterization techniques. However, the antioxidative, antibacterial, and anticancer assays were studied to evaluate the pharmacological activities of APS‐NPs. APS‐NPs were developed and changed to dark brown and the maximum absorption was 442 nm. SEM (5–583 nm), TEM (4–110 nm), XRD (21.84 nm), and zeta potential analysis (63.39 nm) revealed that the APS‐NPs were nano‐sized, and the APS‐NPs had a cubic crystalline structure, according to the XRD results. FTIR analysis suggested that functional groups of A. perryi metabolites were involved in forming APS‐NPs. The zeta potential indicated that the APS‐NPs were negatively charged (−32 mV), suggesting good stability. APS‐NPs showed significant antioxidative stress activity by reducing DPPH‐free radicles in a dose‐dependent manner. APS‐NPs‐induced antibacterial effect against Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), and Acinetobacter baumannii (A. baumannii). APS‐NPs reduced the cell viability and cell migration of the human colon tumor cell line (HCT 116) compared with controls, indicating that APS‐NPs could play a role in reducing metastasis and inducing cell apoptosis against colon cancer. In conclusion, the nanoparticle synthesis from A. perryi extract demonstrated excellent antioxidant, antibacterial, and anticancer activities, thus suggesting that our APS‐NPs have the potential to be used as antioxidative and antibacterial in food and pharmaceutical industries.
Interpreting disease genome‐wide association studies and polygenetic risk scores given eligibility and study design considerations
Authors: Schooling Catherine Mary , Terry Mary Beth
Published: May 2024

Genome‐wide association studies (GWAS) have been helpful in identifying genetic variants predicting cancer risk and providing new insights into cancer biology. Increasing use of genetically informed care, as well as genetically informed prevention and treatment strategies, have also drawn attention to some of the inherent limitations of cancer genetic data. Specifically, genetic endowment is lifelong. However, those recruited into cancer studies tend to be middle‐aged or older people, meaning the exposure most likely starts before recruitment, as opposed to exposure and recruitment aligning, as in a trial or a target trial. Studies in survivors can be biased as a result of depletion of the susceptibles, here specifically due to genetic vulnerability and the cancer of interest or a competing risk. In addition, including prevalent cases in a case‐control study will make the genetics of survival with cancer look harmful (Neyman bias). Here, we describe ways of designing GWAS to maximize explanatory power and predictive utility, by reducing selection bias due to only recruiting survivors and reducing Neyman bias due to including prevalent cases alongside using other techniques, such as selection diagrams, age‐stratification, and Mendelian randomization, to facilitate GWAS interpretability and utility.
Single landslide risk assessment considering rainfall‐induced landslide hazard and the vulnerability of disaster‐bearing body
Authors: Huang Faming , Liu Keji , Li Zhiyong , Zhou Xiaoting , Zeng Ziqiang , Li Wenbin , Huang Jinsong , Catani Filippo , Chang Zhilu
Published: May 2024

Quantitative calculation of single landslide risk has great significance for the prevention and treatment of landslides, through analysing the slope stability under different rainfall recurrence periods. In this study, the rainfall of the past 40 years in Xun'wu County of China is counted and the rainfall during the return periods of 10, 20 and 50 years are calculated to form three different rainfall conditions. Then, the stability of Cheng'nan landslide in Xun'wu County is calculated by the Geo‐Studio 2007 software, and the probability of landslide occurrence is obtained by Monte Carlo theory under these three conditions. Next, the field investigation is employed to obtain the statistical results of the buildings and personnel in the affected area of Cheng'nan landslide. Finally, the risk of economic loss and casualty under the three conditions are calculated. It was demonstrated that: (1) Under the three conditions, the safety factor decreased gradually, the rate of decrease was slower in the first 3 days and faster in the middle period and there was still a downward trend after the end of the rain. (2) The probability of landslide occurrence during the rainfall return periods of 10, 20 and 50 years were 1.77%, 2.97% and 1.61%, respectively. Besides, the risk index of landslide was the highest under the condition of 20‐years rainfall return period. (3) The economic loss risk and casualty risk in the rainfall return periods of 10, 20 and 50 years were 122,700‐yuan and 4.11 people, 205,900‐yuan and 6.89 people, as well as 11,600‐yuan and 3.74 people, respectively.
Mature astrocytes as source for astrocyte repopulation after deletion in the medial prefrontal cortex: Implications for depression
Authors: Fu Yi‐Wen , Jin Shi‐Yang , Li Jing‐Ting , Li Xiao‐Wen , Gao Tian‐Ming , Yang Jian‐Ming
Published: May 2024

The adult brain retains a high repopulation capacity of astrocytes after deletion, and both mature astrocytes in the neocortex and neural stem cells in neurogenic regions possess the potential to generate astrocytes. However, the origin and the repopulation dynamics of the repopulating astrocytes after deletion remain largely unclear. The number of astrocytes is reduced in the medial prefrontal cortex (mPFC) of patients with depression, and selective elimination of mPFC astrocytes is sufficient to induce depression‐like behaviors in rodents. However, whether astrocyte repopulation capacity is impaired in depression is unknown. In this study, we used different transgenic mouse lines to genetically label different cell types and demonstrated that in the mPFC of normal adult mice of both sexes, mature astrocytes were a major source of the repopulating astrocytes after acute deletion induced by an astrocyte‐specific toxin, L‐alpha‐aminoadipic acid (L‐AAA), and astrocyte regeneration was accomplished within two weeks accompanied by reversal of depression‐like behaviors. Furthermore, re‐ablation of mPFC astrocytes post repopulation led to reappearance of depression‐like behaviors. In adult male mice subjected to 14‐day chronic restraint stress, a well‐validated mouse model of depression, the number of mPFC astrocytes was reduced; however, the ability of mPFC astrocytes to repopulate after L‐AAA‐induced deletion was largely unaltered. Our study highlights a potentially beneficial role for repopulating astrocytes in depression and provides novel therapeutic insights into enhancing local mature astrocyte generation in depression.
Heritability of cerebellar subregion volumes in adolescent and young adult twins
Authors: Strike Lachlan T. , Kerestes Rebecca , McMahon Katie L. , de Zubicaray Greig I. , Harding Ian H. , Medland Sarah E.
Published: May 2024

Twin studies have found gross cerebellar volume to be highly heritable. However, whether fine‐grained regional volumes within the cerebellum are similarly heritable is still being determined. Anatomical MRI scans from two independent datasets (QTIM: Queensland Twin IMaging, N = 798, mean age 22.1 years; QTAB: Queensland Twin Adolescent Brain, N = 396, mean age 11.3 years) were combined with an optimised and automated cerebellum parcellation algorithm to segment and measure 28 cerebellar regions. We show that the heritability of regional volumetric measures varies widely across the cerebellum ( 47%–91%). Additionally, the good to excellent test–retest reliability for a subsample of QTIM participants suggests that non‐genetic variance in cerebellar volumes is due primarily to unique environmental influences rather than measurement error. We also show a consistent pattern of strong associations between the volumes of homologous left and right hemisphere regions. Associations were predominantly driven by genetic effects shared between lobules, with only sparse contributions from environmental effects. These findings are consistent with similar studies of the cerebrum and provide a first approximation of the upper bound of heritability detectable by genome‐wide association studies.
Remission after CAR T‐cell therapy: Do lymphoma patients recover a normal life?
Authors: Perthus Alya , Colin Fanny , Charton Emilie , Anota Amélie , Lhomme Faustine , Manson Guillaume , De Guibert Sophie , Daufresne Pierre , Bellec Adeline , Le Bars Laetitia , De Barros Sandra , Ysebaert Loïc , Merceur Marianne , Cogné Mélanie , Lamy De La Chapelle Thierry , Houot Roch , Moignet Aline
Published: May 2024

Chimeric antigen receptor T cells (CAR T cells) can induce prolonged remission in a substantial subset of patients with relapse/refractory lymphoma. However, little is known about patients' life after CAR T‐cell therapy. We prospectively assessed the multidimensional recovery of lymphoma patients in remission, before leukapheresis, before CAR T‐cell infusion, and 3, 6, and 12 months thereafter. Validated tools were used to measure lymphoma‐related and global health‐related quality of life (HRQoL; Functional Assessment of Cancer Therapy‐Lymphoma [FACT‐Lym] and EQ‐5D‐5L), cognitive complaint (FACT‐Cognition), fatigue (FACIT‐Fatigue subscale), psychological status (Hospital Anxiety and Depression Scale, Post‐Traumatic Check List Scale), and sexuality (Relationship and Sexuality Scale). Beyond 12 months of remission, we also surveyed physical, professional, sexual, and general life status. At 3, 6, and 12 months, 53, 35, and 23 patients were evaluable, respectively. Improvement in lymphoma‐related HRQoL was clinically relevant at 3, 6, and 12 months with a mean change from baseline of 10.9 (95% confidence interval [CI]: 5.8; 16.1), 12.2 (95% CI: 4.2; 20.1), and 11.72 (95% CI: 2.06; 21.38), respectively. Improvement in global HRQoL, fatigue, and anxiety was clinically relevant, but 20%–40% of patients experienced persistent fatigue, psychological distress, and cognitive complaints over time. Beyond 12 months after CAR T cells, 81.8% of 22 evaluable patients were satisfied with their daily life. Physical activity, professional, sexual, and global well‐being had returned to prediagnosis levels in nearly half of the patients. We found an improvement in HRQoL after CAR T‐cell therapy including anxiety, depression, sexual satisfaction, and general well‐being. However, not all patients recover a “normal life.” Further research is needed to determine which patients are at risk of quality‐of‐life impairment to improve recovery after CAR T‐cell infusion.
Depression is associated with the nonmotor symptoms of Parkinson's disease: A comparative analysis
Authors: Mayeli Mahsa , Shafie Mahan , Shiravi Maryam , Adl Parvar Tanin , Mirsepassi Zahra , Rahiminejad Fatemeh , Sattarpour Reza , Aghamollaii Vajiheh
Published: May 2024

Background and aims

The nonmotor symptoms (NMS) of Parkinson's disease (PD) and their potential role in early diagnosis are recent debates. Herein, we aimed to investigate the association between depression and NMS of PD including sleep disorders, hyposexuality, hyposmia, constipation, and orthostatic hypotension.

Methods

A total of 93 PD patients with depression and 67 PD patients without depression were included in the study, and NMS were compared between the two groups. Furthermore, the possible associations between depression severity measured by Beck Depression Inventory (BDI) and NMS were investigated using linear regression or binary logistic regression models controlled for possible confounders. Eventually, we performed a subgroup analysis in each mild, moderate, and severe depression group.

Results

Orthostatic hypotension, constipation, and hyposexuality showed a significant difference between PD patients with and without depression (p < 0.001, p = 0.029, and p < 0.001, respectively). The BDI score was significantly associated with hyposexuality, Montreal cognitive assessment (MoCA), and Pittsburgh Sleep Quality (p = 0.016, p = 0.010, and p = 0.011, respectively); however, after adjustments for possible confounders, the associations of the BDI score with the MoCA score and hyposexuality remained significant (p = 0.015 and p = 0.019, respectively). Considering subgroup analysis, a similar pattern of significant results was observed particularly in the severe group.

Conclusions

This study suggests a possible association between depression in PD patients and some NMS observed in the course of PD. These findings could be beneficial for early diagnosis of the disease, which eventually could make a considerable difference in the management of PD patients. Additional interventional longitudinal studies are warranted to explore how controlling depression could impact the NMS of patients with PD.
Assessment of infant and young child feeding practices and associated factors among less than two years' children in Leka Dullecha District, East Wollega, Ethiopia
Authors: Bulcha Fekadu , Bikila Haile , Debelo Sidise , Tolera Chimdesa , Tafesse Temesgen , Dessalegn Ra'el , Amenu Desalegn
Published: May 2024

Background and Aim

Leka Dullecha District, situated in East Wollega, Ethiopia, represents a region where infant and young child feeding practices play a crucial role in the health and well‐being of the population. Understanding the prevailing feeding practices among children under 2 years old is essential for devising effective interventions to improve child nutrition and reduce mortality rates. The context of this study involves examining various factors influencing infant and young child feeding (IYCF) practices, including socioeconomic, cultural, and environmental determinants. The main aim of the study was conducted to investigate the infant and young child feeding practice and associated factors among mothers of children 0–23 months in Leka Dullecha District, East Wollega, and Ethiopia.

Method

A community‐based, cross‐sectional study design was carried out using 590 sample sizes. A stratified sampling method was used with simple random sampling technique. Bi‐variable and multivariable logistic regression models were used to identify factors associated with infant and young child feeding practices.

Results

The overall prevalence of appropriate infant and young child feeding practice was estimated to 62.3%. According to this finding, age of child, place of delivery, and knowledge of mother were positively associated factors for inappropriate Infant and Young Child Feeding Practices.

Conclusion

The overall infant and young child feeding practices in this study is not meeting the WHO guidelines for appropriate feeding practices. To achieve better feeding practices among 0–23 months aged children, intervention should focus on encouraging institution delivery and capacitating all health workers providing health education focusing on infant and young child feeding practices.
Polar materials for photocatalytic applications: A critical review
Authors: Liu Xiaoqing , Zhang Yu , Wang Cong , Shen Lei
Published: May 2024

The critical challenges of the energy crisis and environmental degradation promote innovative approaches for energy conversion. Semiconductor‐based photocatalytic technology, which transforms solar energy into chemical energy, emerges as a promising solution. However, the practical application of this technology faces several challenges, such as the rapid recombination of photogenerated electrons and holes, significantly limiting photocatalytic efficiency. In this review, we provide a detailed discussion, an insightful perspective, and a critical evaluation of recent advances, challenges, and opportunities in the field of photocatalysis using polar materials. We present a comprehensive examination of the photocatalytic mechanisms, activity, and diverse applications of photocatalysts based on polar materials. We also briefly discuss the engineering design of polar photocatalysis in experiments and its scalability in the industry. This review outlines future trends and potential breakthroughs in the photocatalytic field using polar materials, projecting their transformative impact on environmental chemistry and energy engineering.
Effect of increasing doses of colchicine on the treatment of 333 COVID‐19 inpatients
Authors: Tiholov Rumen , Lilov Aleksander I. , Georgieva Gergana , Palaveev Kiril R. , Tashkov Konstantin , Mitev Vanyo
Published: May 2024

Background

Previous research done in Bulgaria demonstrated a fivefold reduction in mortality from COVID‐19 with increased doses of colchicine from two hospitals in the country. We report here a further 333 cases of COVID‐19 inpatients, treated with different doses of colchicine and its effect on mortality.

Materials and Methods

A case‐control comparison from two additional hospitals was conducted between increased doses of colchicine and added bromhexine to standard of care (SOC) versus current SOC. Risk and odds ratio, as well as subgroup analysis, was conducted with newly reported data, alongside aggregate data from all hospital centers to determine the extent of mortality reduction in COVID‐19 inpatients.

Results

There was a clear reduction in the mortality of inpatients with increasing doses of colchicine—between twofold and sevenfold. Colchicine loading doses of 4 mg are more effective than those with 2 mg. Despite these doses being higher than the so‐called “standard doses,” colchicine inpatients experienced lower mortality than SOC patients (5.7% vs. 19.53%). This mortality benefit was evident in different age subgroups, with a 4‐mg loading dose of colchicine proving slightly superior to a 2‐mg loading dose. Colchicine led to an overall relative risk reduction of 70.7%, with SOC patients having 3.91 higher odds of death. The safety of the doses was not different than the reported in the summary of product characteristics.

Conclusion

Inpatients in Bulgaria with added colchicine and bromhexine to SOC achieved better clinical and mortality outcomes than those on SOC alone. These results question the World Health Organization—recommended strategy to inhibit viral replication. We posit that our treatment strategy to inhibit the Severe acute respiratory syndrome coronavirus 2 entry into the cell with inhaled bromhexine and the hyperactivated NLRP3 inflammasome with higher doses of colchicine, prevents the development of cytokine storm. The timing of the initiation of treatment seems critical.
Cost‐effectiveness analysis of alternative screening strategies for the detection of cervical cancer among women in rural areas of Western Kenya
Authors: Lobin Christopher , Orang'o Elkanah Omenge , Were Edwin , Muthoka Kapten , Singh Kavita , De Allegri Manuela , Obermann Konrad , von Knebel Doeberitz Magnus , Bussmann Hermann
Published: May 2024

While the incidence of cervical cancer has dropped in high‐income countries due to organized cytology‐based screening programs, it remains the leading cause of cancer death among women in Eastern Africa. Therefore, the World Health Organization (WHO) now urges providers to transition from widely prevalent but low‐performance visual inspection with acetic acid (VIA) screening to primary human papillomavirus (HPV) DNA testing. Due to high HPV prevalence, effective triage tests are needed to identify those lesions likely to progress and so avoid over‐treatment. To identify the optimal cost‐effective strategy, we compared the VIA screen‐and‐treat approach to primary HPV DNA testing with p16/Ki67 dual‐stain cytology or VIA as triage. We used a Markov model to calculate the budget impact of each strategy with incremental quality‐adjusted life years and incremental cost‐effectiveness ratios (ICER) as the main outcome. Deterministic cost‐effectiveness analyses show that the screen‐and‐treat approach is highly cost‐effective (ICER 2469 Int$), while screen, triage, and treat with dual staining is the most effective with favorable ICER than triage with VIA (ICER 9943 Int$ compared with 13,177 Int$). One‐way sensitivity analyses show that the results are most sensitive to discounting, VIA performance, and test prices. In the probabilistic sensitivity analyses, the triage option using dual stain is the optimal choice above a willingness to pay threshold of 7115 Int$ being cost‐effective as per WHO standards. The result of our analysis favors the use of dual staining over VIA as triage in HPV‐positive women and portends future opportunities and necessary research to improve the coverage and acceptability of cervical cancer screening programs.
Postoperative pain control and opioid use with transversus abdominis plane block and scheduled multimodal pain management in patients undergoing cesarean section
Authors: Richards David C. , Dunn Brian A. , Chellappa Vivek R. , John Cameron R. , Davis Warren B.
Published: May 2024

Objective

The impact of a transversus abdominis plane (TAP) block in patients undergoing cesarean section requires further evaluation. The aim of this study was to compare postoperative pain scores and opioid use in cesarean surgery patients undergoing either a TAP block and scheduled multimodal pain management (SMPM) or SMPM alone.

Methods

In this retrospective, dual cohort study, cesarean surgery patients underwent neuraxial anesthesia and a TAP block (SMPM/TAP) or SMPM; the TAP block incorporated ropivacaine (20–30 mL) administered bilaterally. The group analyses involved a comparison of postoperative pain scores using the visual analog scale and opioid consumption at 24 and 24–48 h.

Results

There were 94 (52.8%) patients in the SMPM/TAP group and 84 (47.2%) subjects in the SMPM alone group. At 24 h postoperatively, the SMPM/TAP group exhibited significantly lower pain scores (4.07 vs 4.54) than the SMPM group (P < 0.001) and reduced opioid consumption (2.29 vs 3.28 mg; P < 0.001). However, at 24–48 h, the SMPM group demonstrated lower pain scores (5.46 vs 5.98) compared to the SMPM/TAP group (P < 0.001) and reduced opioid consumption (8.75 vs 10.21 mg; P < 0.001); overall opioid consumption was higher (12.50 vs 12.02 mg) in the SMPM/TAP group (P < 0.001).

Conclusion

The TAP block improved cesarean surgery patients' pain scores and reduced opioid consumption at 24 h postoperatively but the effect of the TAP block was ephemeral as the SMPM/TAP group exhibited inferior pain scores and greater opioid consumption compared to the SMPM group at 24–48 h postoperatively.
Age‐specific prevalence, clinical and urodynamic findings of detrusor underactivity and bladder outlet obstruction in female voiding dysfunction
Authors: Wu Pei‐Chi , Hsiao Sheng‐Mou , Lin Ho‐Hsiung
Published: May 2024

Objective

Female voiding dysfunction with cystocele have been widely studied, but there are no data regarding women without cystoceles. The present study aimed to evaluate the prevalence of detrusor underactivity (DU) and bladder outlet obstruction (BOO) without cystoceles in a large sample size.

Methods

This was a retrospective cohort study. Between April 1996 and September 2018, 602 neurologically intact women with voiding dysfunction without cystoceles were enrolled. Detrusor pressure (DU) at the maximum flow rate (PdetQmax) <20 cmH2O, maximum flow rate (Qmax) <15 mL/s, and a bladder voiding efficiency <90% and BOO (PdetQmax ≥40 cmH2O and Qmax <12 mL/s) were diagnosed by urodynamic study. Otherwise, a non‐DU/BOO diagnosis was made. The prevalence of DU and BOO was the primary outcome. The secondary outcomes were the analyses of the differences between these three groups in objective UDS parameters and subjective questionnaires and bladder diary parameters.

Results

This study included 100 (17%) women with DU, 60 (10%) with BOO, and 442 (73%) with a non‐DU/BOO diagnosis. DU increased with age, but BOO decreased as age increased. The women in the DU group were older, had higher parity and pad weights, and lower PdetQmax, maximum urethral closure pressure, and functional profile length than the BOO group. The urodynamic findings did not correlate well to subjective questionnaire parameters. None of the symptoms revealed a significant difference between the groups. The retrospective design was the limitation of the study.

Conclusion

The prevalence of DU increased with age in women with voiding dysfunction without advanced cystoceles. Conversely, BOO decreased with age. Prevalence intersected in the fourth decade. Diagnosis requires urodynamic evaluation, as subjective symptoms are inconclusive.
Uterine necrosis following uterine artery embolization as treatment for postpartum hemorrhage: A case report and literature review
Authors: Yin Huifen , Liu Haiyan , Hu Rong
Published: May 2024

Uterine necrosis is a rare complication of uterine artery embolization for postpartum hemorrhage and most patients end up having a hysterectomy. Here we report a case in which the patient experienced a recurrent fever 28 days after uterine artery embolization as treatment for postpartum hemorrhage and had no response to antibiotics. Magnetic resonance imaging of the pelvis revealed a mass which was approximately 12‐cm in size with air bubbles in the uterus, suggesting necrosis with infection. Transvaginal clamping of the uterine mass was performed and necrotic tissue removed under laparoscopic monitoring, which successfully spared the necessity for a hysterectomy. The patient's subsequent progress was favorable. In the present study we review the high‐risk factors of uterine necrosis following uterine artery embolization and summarize the key points of early diagnosis. In addition, we propose a strategy to successfully spare the necessity for a hysterectomy without the spread of infection or uterine perforation.
Initial experience of enfortumab vedotin in a patient with metastatic urothelial carcinoma on hemodialysis: Two case reports
Authors: Mori Shintaro , Matsuo Tomohiro , Honda Hiroyuki , Araki Kyohei , Mitsunari Kensuke , Ohba Kojiro , Mochizuki Yasushi , Imamura Ryoichi
Published: May 2024

Introduction

Few studies have reported on administering enfortumab vedotin to patients with metastatic urothelial carcinoma and end‐stage renal disease requiring hemodialysis.

Case presentation

Case 1: An 85‐year‐old man underwent hemodialysis for progressive renal failure 4 months after right laparoscopic radical nephroureterectomy. Case 2: A 73‐year‐old man underwent hemodialysis after two laparoscopic radical nephroureterectomies for recurrent urothelial carcinoma. In both cases, enfortumab vedotin was administered due to postoperative recurrence and progression despite platinum‐based chemotherapy and pembrolizumab. Partial response and disease progression were observed in cases 1 and 2, respectively. Adverse events included a mild skin rash in both patients and neutropenia in Case 1, both of which resolved with symptomatic treatment.

Conclusion

The efficacy and safety of enfortumab vedotin in patients with metastatic urothelial carcinoma, and end‐stage renal disease undergoing hemodialysis, were confirmed.
NSUN6 mediates 5‐methylcytosine modification of METTL3 and promotes colon adenocarcinoma progression
Authors: Cui Yuanbo , Lv Pengju , Zhang Chunyan
Published: May 2024

Colon adenocarcinoma (COAD) is a common and fatal malignant tumor of digestive system with complex etiology. 5‐Methylcytosine (m5C) modification of RNA by the NSUN gene family (NSUN1‐NSUN7) and DNMT2 reshape cell biology and regulate tumor development. However, the expression profile, prognostic significance and function of these m5C modifiers in COAD remain largely unclear. By mining multiple integrated tumor databases, we found that NSUN1, NSUN2, NSUN5, and NSUN6 were overexpressed in COAD tumor samples relative to normal samples. Clinically, high expression of NSUN6 was significantly associated with shorter survival (including both disease‐free survival and overall survival) in COAD patients. NSUN6 was further confirmed to be upregulated at both tissue and cellular levels of COAD, suggesting that NSUN6 plays a critical role in disease progression. Through comprehensive gene enrichment analysis and cell‐based functional validation, it was revealed that NSUN6 promoted the cell cycle progression and cell proliferation of COAD. Mechanistically, NSUN6 upregulates the expression of oncogenic METTL3 and catalyzes its m5C modification in COAD cells. Overexpression of METTL3 significantly relieved the cell cycle inhibition of COAD caused by NSUN6 deficiency. Furthermore, NSUN6 was negatively associated with the abundance of infiltrating immune cells in COAD tumors, such as activated B cells, natural killer cells, effector memory CD8 T cells, and regulatory T cells. Importantly, pan‐cancer analysis further uncovered that NSUN6 was dysregulated and heterogeneous in various tumors. Thus our findings extend the role of m5C transferase in COAD and suggest that NSUN6 is a potential biomarker and target for this malignancy.
An accountant in the C‐suite: Chief Accounting Officers and asymmetric timely loss recognition
Authors: Kim Robert , Lee Bryan Byung‐Hee , Lee Jay Junghun
Published: May 2024

We study the role and influence of Chief Accounting Officers (CAOs) by examining the relation between the presence of a CAO on the top management team and asymmetric timely loss recognition (ATLR). Using large‐sample data from 10‐Ks and proxy statements of S&P 1500 firms, we find that the presence of a CAO is positively associated with the level of ATLR and that this positive relation is more pronounced when the Chief Financial Officer (CFO) does not have an accounting background. Our difference‐in‐differences analysis further indicates that the level of ATLR increases significantly following the initial appointments of CAOs. The results are robust to propensity score matching, alternative ATLR models, and various control variables. Collectively, our findings suggest that adding an accounting chief to the C‐suite has a significant impact on financial reporting practices.
Oxygen consumption rate of flatworms under the influence of wake‐ and sleep‐promoting neurotransmitters
Authors: Omond Shauni E. T. , Barker Robert G. , Sanislav Oana , Fisher Paul R. , Annesley Sarah J. , Lesku John A.
Published: May 2024

Flatworms are among the best studied animal models for regeneration; however, they also represent an emerging opportunity to investigate other biological processes as well. For instance, flatworms are nocturnal and sleep during the day, a state that is regulated by sleep/wake history and the action of the sleep‐promoting neurotransmitter gamma‐aminobutyric acid (or GABA). Sleep is widespread across the animal kingdom, where it serves many nonexclusive functions. Notably, sleep saves energy by reducing metabolic rate and by not doing something more energetically taxing. Whether the conservation of energy is apparent in sleeping flatworms is unclear. We measured the oxygen consumption rate (OCR) of flatworms dosed with either (1) GABA (n = 29) which makes flatworms inactive or (2) dopamine (n = 20) which stimulates flatworms to move, or (3) day and night neurotransmitter‐free controls (n = 28 and 27, respectively). While OCR did not differ between the day and night, flatworms treated with GABA used less oxygen than those treated with dopamine, and less than the day‐time control. Thus, GABA affected flatworm physiology, ostensibly by enforcing energy‐conserving sleep. Evidence that dopamine increased metabolism was less strong. This work broadens our understanding of flatworm physiology and expands the phylogenetic applicability of energy conservation as a function of sleep.
A trial of structured debate as a self‐learning method for students and young healthcare providers to discuss social issues in general and family medicine: A case report in Japan
Authors: Ikejiri Tatsuki , Lee Jeonse , Yokoyama Natsuki , Hakariya Arisa , Otsuka Yuki , Hakariya Hayase
Published: May 2024

The structured debate as a means of medical education for medical students and young healthcare providers was performed, with diverse topics related to general and family medicine.
Prognostic clinical decision support for pneumonia in the emergency department: A randomized trial
Authors: Williams Derek J. , Nian Hui , Suresh Srinivasan , Slagle Jason , Gradwohl Stephen , Johnson Jakobi , Stassun Justine , Reale Carrie , Just Shari L. , Rixe Nancy S. , Beebe Russ , Arnold Donald H. , Turer Robert W. , Antoon James W. , Sartori Laura F. , Freundlich Robert E. , Grijalva Carlos G. , Smith Joshua C. , Weitkamp Asli O. , Weinger Matthew B. , Zhu Yuwei , Martin Judith M.
Published: May 2024

Background

Hospitalization rates for childhood pneumonia vary widely. Risk‐based clinical decision support (CDS) interventions may reduce unwarranted variation.

Methods

We conducted a pragmatic randomized trial in two US pediatric emergency departments (EDs) comparing electronic health record (EHR)‐integrated prognostic CDS versus usual care for promoting appropriate ED disposition in children (<18 years) with pneumonia. Encounters were randomized 1:1 to usual care versus custom CDS featuring a validated pneumonia severity score predicting risk for severe in‐hospital outcomes. Clinicians retained full decision‐making authority. The primary outcome was inappropriate ED disposition, defined as early transition to lower‐ or higher‐level care. Safety and implementation outcomes were also evaluated.

Results

The study enrolled 536 encounters (269 usual care and 267 CDS). Baseline characteristics were similar across arms. Inappropriate disposition occurred in 3% of usual care encounters and 2% of CDS encounters (adjusted odds ratio: 0.99, 95% confidence interval: [0.32, 2.95]). Length of stay was also similar and adverse safety outcomes were uncommon in both arms. The tool's custom user interface and content were viewed as strengths by surveyed clinicians (>70% satisfied). Implementation barriers include intrinsic (e.g., reaching the right person at the right time) and extrinsic factors (i.e., global pandemic).

Conclusions

EHR‐based prognostic CDS did not improve ED disposition decisions for children with pneumonia. Although the intervention's content was favorably received, low subject accrual and workflow integration problems likely limited effectiveness. Clinical Trials Registration: NCT06033079.
Risk factors associated with escalation of care in a quaternary academic hospital at home program
Authors: Colt Cowdell Jed , Lopez Ellen , Haney Amy , Myers Luke , Coble Barbara , Heckman Michael G. , Moerer Ryan T. , Paulson Margaret R. , Maniaci Michael
Published: May 2024

Background

Hospital‐at‐home has become a more recognized way to care for patients requiring inpatient hospitalization. At times, these patients may require escalation of care (transfer from home back to the brick‐and‐mortar (BAM) hospital for ongoing hospitalization care needs), a process that has not been extensively studied.

Objective

To evaluate what patient factors contribute to escalations of care in the hospital‐at‐home delivery model.

Designs, Settings, and Participants

We conducted a retrospective review of all patients admitted to Mayo Clinic's Advanced Care at Home (ACH) program from January 1, 2022 to December 31, 2022.

Intervention

None.

Main Outcomes and Measures

Patient information was collected via electronic health record including demographic, socioeconomic, and clinical status. The primary outcome was the of occurrence of an escalation.

Results

A total of 904 patients were included, of whom 80 (8.8%) required an escalation of care. In multivariable analysis, risk of an escalation was significantly higher for patients who were married or had a life partner (HR: 1.82, 95% CI: 1.05–3.23, p = .033) for patients admitted with procedure‐related disorders (HR: 2.61, 95% CI: 1.35–5.05, p = .005) and patients with an increased mortality risk score (HR [per each 1–category increase] = 1.86, 95% CI: 1.39–2.50, p < .001).
Fourth‐order inverse filter configuration using current differencing buffered amplifier
Authors: Ghosh Mourina , Mondal Pulak , Kumar Santosh
Published: May 2024

This article presents three different higher‐order inverse filter (IF) configurations using current differencing buffered amplifier (CDBA) as an active component and a few passive elements. The topology can be used to synthesize fourth‐order inverse low pass filter (FO‐ILPF), inverse band pass filter (FO‐IBPF), and inverse all‐pass filter (FO‐IAPF) using suitable admittance combinations. PSPICE simulations verify the functionality of the proposed IFs with the CMOS‐based CDBA using 180 nm technology. The theoretical analysis and simulated results are also carried out, which shows that they are in close agreement. The passive sensitivity analysis, non‐ideality analysis, Monte Carlo simulation, temperature analysis, percentage of total harmonic distortion (%THD), and noise analysis of the proposed filters are also performed. The proposed design has also been implemented using the current feedback operational amplifier (CFOA) as IC AD844AN to verify the functionality.
Evaluation of biogas production and bacterial load from co‐digestion of chicken manure with different types of household waste
Authors: Haque Mohammad Enamul , Ryndin Roman , Mang Heinz‐Peter , Kabir Humayun , Islam Mohammad Alimul
Published: May 2024

Background

The aim of this study was to evaluate the biogas production of chicken manure (CM) co‐digestion with different types of household waste (soft organic [SO] and food waste [FW]), as well as to evaluate the bacterial load of feeding stock and digested slurry samples before and after anaerobic digestion (AD). The experiment was carried out using lab‐based prototype digesters for co‐digestion of CM with different household wastes (5%). Three experimental groups (T1, T2, and T3) were designed using mixing ratios of SO:CM:H2O:inoculum (5:22.5:22.5:50), FW:CM:H2O:inoculum (5:22.5:22.5:50), and (SO + FW):CM:H2O:inoculum (2.5 + 2.5:22.5:22.5:50). The digesters were set at 28–34°C for 30 days for hydraulic retention time (HRT). Total viable count (TVC), Escherichia coli, and Salmonella spp. counts were determined using the spread plate technique.

Results

The study revealed that the highest average cumulative biogas yield was achieved from T1 > T3 > T2, but the concentration of CH4 was found in T3 > T2 > T1. The biogas production between the three groups was statistically nonsignificant (p > 0.05) but the daily concentration of CH4 was found statistically significant (p < 0.05). The average concentration of CH4 and CO2 in biogas was found to be 30% and 68% for T1, 60% and 37% for T2, and 69% and 27% for T3. However, the H2S content was within the acceptable range. The bacterial load was decreased by 2–3 logs before and after AD, and this reduction was statistically significant (p < 0.05).

Conclusion

The research found that the co‐digestion of CM with combined household wastes increased the methane concentration in biogas.
Extended distal femur resection: Megaprosthesis with telescopic bone allograft augmentation versus total femur prosthesis
Authors: Bruschi Alessandro , Cevolani Luca , Minerba Andrea , Conversano Davide , Falzetti Luigi , Pasini Stefano , Donati Davide M.
Published: May 2024

Background and Objective

Oncological distal femur resections can leave a proximal femur too short to host a stem. Reconstructive techniques are then challenging. The purpose of the study is to compare implant survival, complication rate and MSTS of two different options.

Methods

We retrospectively divided 33 patients with primary bone tumours of distal femur in Group 1 (16 patients reconstructed with knee megaprosthesis with proximal bone augmentation, APC) and Group 2 (17 patients reconstructed with total femur prosthesis, TFP). Less than 12 cm of remaining proximal femur were planned for all resections.

Results

MSTS score at 2 years is 25 ± 5 for Group 1 and 19 ± 7 for Group 2 (confidence interval [C.I.] 95%, p = 0.02). At 5 years it is 27 ± 2 for Group 1 and 22 ± 6 for Group 2 (C.I. 95%, p = 0.047). Failure and complication rates are lower for Group 1, but no statistical significance was reached. In APC reconstruction, union at the host‐allograft junction was achieved in 16 out of 16 patients using the telescopic bone augmentation technique.

Conclusions

APC provides higher functional results compared to TFP after extended distal femur resection. In APC reconstruction, telescopic augmentation is excellent for achieving union at the host‐allograft junction.
Acne vulgaris in a 22‐year‐old cystic fibrosis patient treated with Elexacaftor‐Tezacaftor‐Ivacaftor and good clinical response to isotretinoin—A case report
Authors: Pfeiffer Isabelle , Berneburg Mark , Hopfner Zeljka , Niebel Dennis
Published: May 2024

Cystic fibrosis (CF) is a rare autosomal recessive genetic disorder that is now commonly treated with cystic fibrosis transmembrane conductance regulator (CFTR) modulators. Typical adverse events comprise new onset (drug‐induced) acneiform eruption as well as worsening of pre‐existing acne vulgaris. We present a case report of a young adult with rapid CFTR‐modulator‐induced worsening of pre‐existing acne vulgaris refractory to minocycline treatment, which resolved within 8 months of low dose isotretinoin therapy. Monthly laboratory monitoring of liver function, lipid levels and blood count were unremarkable in this case. The optimal treatment of acne vulgaris in CF‐patients and the management of drug‐induced acne remain a challenge. The latter may jeopardize drug adherence. CFTR‐modulators might be capable to induce acneiform skin lesions by altering electrolyte concentrations and sweat production with subsequential changes of the microbiome and follicular inflammatory response. The exact mechanism remains elusive at this point and warrants further investigation.
Full‐Parameter Symmetric Jones Matrix Construction and Non‐Orthogonal‐Polarization Multiplexed Wavefront Shaping Over a Lossy Metasurface
Authors: Guan Shengnan , Cheng Jierong , Tan Zhiyu , Xu Haifeng , Fan Fei , Chang Shengjiang
Published: May 2024

Accurate full‐parameter construction of the Jones matrix is of great significance for encoding multiple functions in a single metasurface. Supercells composed of several elements are used for this purpose through coherent superposition. But all the elements in the reported studies should be lossless with near‐unity transmission, which limits the material system and restricts the Jones matrix construction in a unitary manner. Here a non‐unitary matrix decomposition method is proposed to build the supercell using a pair of 0°‐oriented rods and a pair of 45°‐oriented rods for on‐demand design of arbitrary symmetric Jones matrices. This method is applicable for lossy metasurfaces and offers straightforward physical guidance for structure design without optimization. The accuracy of the on‐demand Jones matrix generation is demonstrated by several 3D‐printed alumina metalenses with 3‐, 4‐, and 6‐channel polarization‐multiplexed focusing. The study opens a new pathway for non‐silicon meta‐optics and holds great potential for dynamic or switchable applications.