bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of the Ankle Pump Exercise (APE) counter system assisted ankle pump motion in patients after femoral neck fracture
Authors: Shi Jiaping , Weng Xia , Liu Caixia , Ge Yanzhi , Chai Lan , Ru Xuanliang , Yue Yingxing , Huang Xiaoqin
Published: November 2023

Objective

To explore the effect of the Ankle Pump Exercise (APE) counter system on moderate to high-risk Venous thromboembolism (VTE) after femoral neck fracture surgery.

Methods

From June 2021 to June 2022, a total of 140 patients with moderate and high-risk VTE after femoral neck fracture surgery treated at the Department of Orthopedics of a tertiary hospital in Zhejiang were included and divided into observation (70 cases) and control (70 cases) groups according to whether APE counter system was used or not. The control group was given routine oral propaganda, and the observation group was given a comprehensive nursing intervention with APE counter system on the basis of the control group’s treatment. The compliance rates of the two groups on the postoperative 3st, 5rd, and 7th days were compared. Moreover, the General self-efficacy scale (GSES) was used to evaluate self-efficacy before and after exercise.

Results

The compliance rates of the control group and the observation group on the postoperative 3st, 5rd, and 7th days were 74.3% vs. 85.7%, 67.1% vs. 85.7%, and 61.4% vs. 82.9%. On the 5rd and 7th days, the compliance of the observation group was obviously higher than that of the control group. Moreover, the mean postoperative GSES score was also significantly higher than that in the control group (23.20 ± 3.516 vs. 25.31 ± 4.583, P < 0.05, values are expressed in mean ± standard).

Conclusion

APE counter system can significantly improve the compliance and self-efficacy of patients with moderate and high-risk VTE after lower limb fracture surgery.
Predictive factors of ergonomic behaviors based on social cognitive theory among women workers on assembly lines: application of Bayesian networks
Authors: Hosseini Zakieh Sadat , Tavafian Sedigheh Sadat , Ahmadi Omran , Maghbouli Reza
Published: November 2023

Background

This study focuses on identifying the key factors associated with ergonomic behaviors (ERBE) among women workers on assembly lines (WwAL) to prevent musculoskeletal disorders (MSDs) caused by repetitive motions and unfavorable body postures. To achieve this objective, this study employed Bayesian networks (BN) analysis based on social cognitive theory (SCT).

Methods

A cross-sectional study was conducted to examine the predictive factors of ERBE among 250 WwAL from six different industries located in Neyshabur, a city in northeastern Iran. The study used a two-stage cluster sampling method for participant selection and self-report questionnaires to collect data on demographic characteristics, variables associated with SCT, ERBE, and the standard Nordic questionnaire. The collected data were analyzed using Netica and SPSS version 21, which involved statistical analyses such as independent t-tests, Pearson correlation, and ANOVA tests at a significance level of p < 0.05. BN analysis was conducted to identify the important factors that impact ERBE.

Results

The majority of individuals reported experiencing chronic pain in their back, neck, and shoulder areas. Engaging in physical activity, consuming dairy products, and attaining a higher level of education were found to be significantly associated with the adoption of ERBE p < 0.05. Among the various SCT constructs, observational learning, intention, and social support demonstrated the highest levels of sensitivity towards ERBE, with scores of 4.08, 3.82, and 3.57, respectively. However, it is worth noting that all SCT constructs exhibited a certain degree of sensitivity towards ERBE.

Conclusions

The research findings demonstrate that all constructs within SCT are effective in identifying factors associated with ERBE among WwAL. The study also highlights the importance of considering education levels and variables related to healthy lifestyles when promoting ERBE in this specific population.
Causal effects of gut microbiome on endometriosis: a two-sample mendelian randomization study
Authors: Liu Ziyu , Chen Peigen , Luo Liling , Liu Qianru , Shi Hao , Yang Xing
Published: November 2023

Background

Previous studies have shown observational associations between the gut microbiota and endometriosis; however, the causal nature of such associations remains unclear. This study aimed to analyze the genetic causal relationship between the two.

Methods

A gut microbiome genome-wide association study conducted by the MiBioGen consortium was used as exposure data, and summary statistics of endometriosis were obtained from the FinnGen consortium R8 release data. Inverse variance weighted, MR-Egger, weighted median, weighted model, and simple model analyses were applied to examine the causal relationship, and sensitivity analyses were conducted to validate the robustness of the results.

Results

The results showed that, out of 211 gut microbiome taxa, Clostridiales_vadin_BB60_group, Oxalobacteraceae, Desulfovibrio, Haemophilus, and Holdemania had protective effects on endometriosis, while Porphyromonadaceae and Anaerotruncus might contribute to the development of endometriosis. Heterogeneity and pleiotropy analyses confirmed the robustness of the results.

Conclusion

The two-sample Mendelian randomization analysis conducted in this study identified specific intestinal flora with a causal relationship with endometriosis at the genetic level, offering new insights into the gut microbiota-mediated development mechanism of endometriosis.
An association between ATP7B expression and human cancer prognosis and immunotherapy: a pan-cancer perspective
Authors: Zhang Zhanzhan , Zhang Aobo , Shi Yunpeng , Zhao Zijun , Zhao Zongmao
Published: November 2023

Background

ATP7B is a copper-transporting protein that contributes to the chemo-resistance of human cancer cells. It remains unclear what the molecular mechanisms behind ATP7B are in cancer, as well as its role in human pan-cancer studies.

Methods

Our study evaluated the differential expression of ATP7B in cancer and paracancerous tissues based on RNA sequencing data from the GTEx and TCGA. Kaplan–Meier and Cox proportional hazards regressions were used to estimate prognostic factors associated with ATP7B.The correlations between the expression of ATP7B and immune cell infiltration, tumor mutation burden, microsatellite instability and immune checkpoint molecules were analyzed. Co-expression networks and mutations in ATP7B were analyzed using the web tools. An analysis of ATP7B expression difference on drug sensitivity on tumor cells was performed using the CTRP, GDSC and CMap database.

Results

ATP7B expression differed significantly between cancerous and paracancerous tissues. The abnormal expression of ATP7B was linked to prognosis in LGG and KIRC. Infiltration of immune cells, tumor mutation burden, microsatellite instability and immunomodulators had all been linked to certain types of cancer. Cancer cells exhibited a correlation between ATP7B expression and drug sensitivity.

Conclusion

ATP7B might be an immunotherapeutic and prognostic biomarker based on its involvement in cancer occurrence and development.
Cytoreductive surgery is feasible in patients with limited regional platinum-resistant recurrent ovarian cancer
Authors: Zou Ruoyao , Jiang Qidi , Luo Xukai , Chen Mo , Yuan Lei , Yao Liangqing
Published: November 2023

Introduction

To evaluate the efficacy of cytoreductive surgery versus chemotherapy for the treatment of limited regional, platinum-resistant ovarian cancer (PROC).

Materials and methods

The clinical records of all patients with PROC treated in our center between March 2015 and March 2022 were retrospectively reviewed. We compared the oncology outcomes of patients who received cytoreduction or chemotherapy alone at relapse and presented information about postoperative adjuvant chemotherapy.

Results

Among 52 patients with limited regional recurrence, 40.4% (21/52) underwent cytoreduction because of platinum resistance, and 59.6% (31/52) received chemotherapy alone. No residual disease (R0) was achieved in 20 patients (95.2%). The severe morbidity rate within 30 days after the surgery was 15%. The median follow-up was 70.6 months. Compared with the chemotherapy alone group, the surgery group with R0 had better progression-free survival (PFS) (10.6 vs. 5.1 months; hazard ratio (HR) = 0.421; P = 0.0035) and post-relapse survival (PRS) (32.6 vs. 16.3 months; HR = 0.478; P = 0.047), but there was no difference in overall survival (OS) between the two groups. Laparoscopy is associated with lesser intraoperative blood loss with no differences in survival and postoperative complications compared to the open approach (P = 0.0042). Subgroup survival analysis showed that compared with chemotherapy alone, surgery prolonged PFS in patients regardless of tumor size (greater than or equal to 4 cm or less). Surgery group patients who achieved R0 had an objective response rate (ORR) of 36.8% (7/19), among whom 40% (4/10) received platinum rechallenge chemotherapy and 33.3% (3/9) were administered non-platinum chemotherapy.

Conclusion

When well-selected PROC patients with limited regional recurrence achieved R0, their outcomes were superior to those of patients who received only chemotherapy with an acceptable morbidity rate. Laparoscope technology could be a reliable alternative surgical approach. The reintroduction of platinum agents may be considered following surgery. Further analyses in a larger population are warranted to elucidate the risks and benefits of this surgery and adjuvant chemotherapy strategy.
Evaluation of the performance of advantage P.f. malaria Card® and advantage malaria Pan + Pf Card®, two rapid diagnostic tests for parasitological confirmation of malaria cases in field situation in Togo
Authors: Teou Diwaba Carmel , Dorkenoo Ameyo Monique , Ataba Essoham , Alidou Smaila , Yakpa Kossi , Abdou-Kerim Agueregna , Maman Issaka , Agbonon Amegnona
Published: November 2023

Background

In Togo, malaria remains a major public health problem, and the management of suspected cases requires confirmation with appropriate biological methods. Malaria diagnosis has been improved by the introduction of rapid diagnostic tests (RDTs), recommended by the World Health Organization (WHO) for areas where microscopy is not available. To be used, these RDTs must meet performance criteria defined by the WHO. This study was conducted to evaluate the diagnostic performance of two RDTs: Advantage P.f. Malaria Card® detecting HRP2 antigen and Advantage Malaria Pan + Pf Card® detecting both HRP2 and pLDH antigens.

Methods

This was a cross-sectional analytical study conducted from December 2019 to February 2020 on malaria-suspected cases received in three sentinel sites in Togo and from whom capillary blood was collected to perform the two RDTs according to the manufacturer's instructions. Sensitivity and specificity were estimated by comparing to thick/thin blood smear, the gold standard, and to PCR, which is a more sensitive.

Results

A total of 390 participants (54.9% female) with a median age of 18 (± 0.8) years were included in the study. The sensitivity of both Advantage P.f. Malaria Card® and Advantage Malaria Pan + Pf Card® compared to thick/thin blood smear was 91.8% and 91.3%, respectively, and for both the specificity was 94.7%. Compared to PCR, the sensitivity was 84.2% and 83.8%, respectively, and the specificity 96.5%.

Conclusions

The performances of the Advantage P.f. Malaria Card® and Advantage Malaria PAN + Pf Card® compared to microscopy, considered the gold standard, were acceptable under the field conditions found in Togo. They can therefore be used for the biological diagnosis of malaria.

Graphical Abstract
Vertebral osteomyelitis caused by Campylobacter jejuni in an immunocompetent patient
Authors: Kirk Karina Frahm , Boel Jeppe , Nielsen Hans Linde
Published: November 2023

Background

Campylobacter jejuni is the leading cause of human bacterial gastroenteritis worldwide. However, systemic infection with C. jejuni is uncommon, and osteomyelitis caused by C. jejuni is extremely rare. Cultivation from spinal bone biopsies has not previously been reported in the literature.

Case presentation

A 79-year-old immunocompetent male was admitted to the emergency department at Aalborg University Hospital in Denmark with lower back pain, fever and diarrhoea. A FecalSwab obtained upon admission was PCR-positive for Campylobacter spp, while an aerobic blood culture bottle was positive for C. jejuni (Time to detection: 70.4 h). A MRI of columna totalis showed osteomyelitis at L1/L2 with an epidural abscess from L1 to L2 with compression of the dura sack. The patient underwent spinal surgery with spondylodesis and decompression of L1/L2. The surgery was uncomplicated and the discus material was also culture positive for C. jejuni. The patient was treated with meropenem for a total duration of four weeks, followed by four weeks of oral treatment with clindamycin in tapered dosage. The patient recovered quickly following surgery and targeted antibiotic treatment with decreasing lumbar pain and biochemical response and was fully recovered at follow-up three months after end of treatment.

Conclusions

While C. jejuni osteomyelitis is rare, it should still be suspected as a possible causative bacterial aetiology in patients with vertebral osteomyelitis, in particular when symptoms of diarrhoea is involved in the clinical presentation. Susceptibility testing is crucial due to emerging resistance, and targeted treatment strategies should rely upon such tests.
Survival of Trial-Like and Non–Trial-Like Patients With Immunotherapy in Advanced Hepatocellular Carcinoma in Real World: A Collaborative Multicenter Indian Study (IMHEP)
Authors: Ramaswamy Anant , Kulkarni Anand , John George , Rauthan Amit , Patil Shekhar , Duseja Ajay , Talwar Vineet , Rajappa Senthil J. , Ghadyalpatil Nikhil , Wadhawan Manav , Shukla Akash , Krishna Vamshi M. , Srinivas Sujay , Taneja Sunil , Sravani K. Mary , Rathi Sahaj , Bhargava Prabhat , Ostwal Vikas
Published: November 2023

PURPOSE

Immune checkpoint inhibitors (ICIs) is the initial line of management in advanced hepatocellular carcinoma (HCC), but survivals in the real world are not known.

MATERIALS AND METHODS

A retrospective study of patients with advanced HCC receiving ICIs (as first-line therapy or as later lines of therapy) across 11 Indian institutions was conducted. Patients were divided into either cohort 1 (trial-like receiving ICI as first-line therapy), with a Child Pugh score (CTP) of ≤6, an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0/1, and no VP4 (main portal vein thrombosis [MPVT]) or cohort 2 (trial unlike) who did not satisfy at least one of the above criteria. The primary end point was 12-month overall survival (OS).

RESULTS

Between January 2017 and January 2022, 133 patient data were analyzed. The presence of MPVT was seen in 33 patients (25%). The ICIs used were atezolizumab-bevacizumab, nivolumab, and pembrolizumab in 89 (66%), 44 (33%), and one (1%) patients, respectively. With a median follow-up of 13.8 months, the 12-month OS for the entire cohort was 33.4% (95% CI, 23.6 to 43.2). Patients in cohort 1 (n = 31) had a significantly improved OS compared with patients in cohort 2 (n = 102; 12-month OS, 57.9% [95% CI, 38.5 to 77.3] v 24% [95% CI, 13.4 to 34.6]; P = .005). Patients with CTP A as compared with CTP B (9.7 v 4.3 months; P < .001) and an ECOG PS of 0/1 as compared with a PS of ≥2 (8.7 v 7.2 months; P = .04) and without MPVT (9.4 v 4.0; P < .001) had superior survivals.

CONCLUSION

Patients with advanced HCC in the real world, trial-like have survivals in consonance with trial data, whereas patients with features excluding them from trials, such as main portal vein thrombosis, poor ECOG PS, and child Pugh B status, have markedly inferior survivals, despite good tolerance to immunotherapy.
Normative Measurements of L1–S1 Segmental Angulation, Disk Space Height, and Neuroforaminal Dimensions Using Computed Tomography
Authors: Razzouk Jacob , Case Trevor , Brandt Zachary , Marciniak Mary , Sajdak Grant , Nguyen Kai , Small Easton , Petersen Garrett , Kagabo Whitney , Ramos Omar , Shaffrey Christopher I. , Cheng Wayne , Danisa Olumide
Published: November 2023

BACKGROUND AND OBJECTIVES:

To establish normative anatomic measurements of lumbar segmental angulation (SA) and disk space height (DSH) in relation to neuroforaminal dimensions (NFDs), and to uncover the influence of patient demographic and anthropometric characteristics on SA, DSH, and NFDs.

METHODS:

NFDs, SA, and anterior, middle, and posterior DSH were measured using computed tomography of 969 patients. NFDs were defined as sagittal anterior-to-posterior width, foraminal height, and area. Statistical analyses were performed to assess associations among SA, DSH, NFDs, and patient height, weight, body mass index, sex, and ethnicity.

RESULTS:

SA and DSH measurements increased moving caudally from L1 to S1. Foraminal width decreased moving caudally from L1 to S1. Foraminal height and area demonstrated unimodal distribution patterns with the largest values clustered at L2–L3 on the right side and L3–L4 on the left. Significant differences in SA, DSH, and NFD measurements were observed based on the disk level. Inconsistent, marginal NFD differences were observed based on laterality. Across all disk levels, only weak-to-moderate correlations were observed between SA and DSH in relation to NFDs. Patient height, weight, and body mass index were only weakly associated with SA, DSH, and NFDs. Based on patient sex, significant differences were observed for SA, DSH, and NFD measurements from L1 to S1, with males demonstrating consistently larger values compared with females. Based on patient race and ethnicity, significant differences in SA and NFD measurements were observed from L1 to S1.

CONCLUSION:

This study describes 48 450 normative measurements of L1–S1 SA, DSH, and NFDs. These measurements serve as representative models of normal anatomic dimensions necessary for several applications including surgical planning and diagnosis of foraminal stenosis. Normative values of SA and DSH are not moderately or strongly associated with NFDs. SA, DSH, and NFDs are influenced by sex and ethnicity, but are not strongly or moderately influenced by patient anthropometric factors.
Spinal Cord Injury Management Policies in High School Sports as Reported by Athletic Administrators
Authors: Scarneo-Miller Samantha E. , Swartz Erik E. , Register-Mihalik Johna K. , Coleman Kelly A. , Emrich Christina M. , DiStefano Lindsay J.
Published: November 2023

Introduction/Purpose

Athletic administrators (AA) in U.S. high schools are uniquely positioned to provide guidance and endorsement for the prevention and management of common sport-related catastrophic injuries, such as the development of a spinal cord injury management (SCIM) policy. The purpose of this project was to evaluate AA’s knowledge of comprehensive SCIM policies in U.S. high schools. Secondarily, we aimed to investigate the factors, facilitators, and barriers to the development and adoption of comprehensive policies.

Methods

An online questionnaire was distributed to 6423 AA working in U.S.-based high school athletics, with 366 included in the final data analysis. The questionnaire evaluated AA’s knowledge of comprehensive SCIM policies addressing components of adoption, documentation, and communication. The questionnaire was developed based on the 2002 “National Athletic Trainers’ Association Position Statement: Acute Management of the Cervical Spine-Injured Athlete.” The questionnaire also inquired about facilitators and barriers to developing and adopting comprehensive policies. Proportions were calculated for policy adoption, and independent-samples t-tests evaluated the influence of athletic training services on comprehensive SCIM policies.

Results

About half of AA (49.2%, n = 180/366) reported having all recommended components of a written SCIM policy. AA who had access to an athletic trainer (yes = 62.9%, no = 18.1%, unknown = 19%) were more likely to have a comprehensive SCIM policy compared with those without access (80.6% vs 19.4%, χ
2
1 = 7.091, P = 0.008, prevalence ratio = 1.24, 95% confidence interval = 1.03–1.50). The most commonly reported facilitator (49.9%) was “having a medical professional at the school,” and the main barrier (30.2%) was “my school would need more information, resources, assistance, etc.”

Conclusions

The findings identify areas for improvement in supporting the health and safety of children in high school participating in interscholastic athletics. Future dissemination and implementation research should develop strategies tailored to individual school community and need to improve SCIM policy adoption and implementation.
Mobilizacja zaciężnych w kampanii letniej 1531 r.
Authors: Bołdyrew Aleksander
Published: November 2023

Prace nad krytyczną edycją rejestrów popisowych wojska koronnego z czasów kampanii obertyńskiej 1531 r. pozwoliły na poczynienie nowych ustaleń dotyczących organizacji wojska polskiego, szczególnie w aspekcie jego gromadzenia i wykorzystania w walce. Analiza zapisów datacyjnych prowadzi do zaskakujących wniosków. Armia Jana Tarnowskiego zaczęła zbierać się 19 lipca, ale ostatnie pododdziały trafiły do niej dopiero 31 sierpnia, czyli dziewięć dni po bitwie pod Obertynem. Oznacza to nie tylko mniejszą liczebność wojska polskiego w bitwie obertyńskiej, ale również obnaża niezbyt sprawną strukturę obronną południowo-wschodnich rubieży Królestwa Polskiego.
Cmentarze w miastach staropolskich jako przestrzeń kontrastów.
Authors: Kołodziejczyk Konrad
Published: November 2023

Artykuł jest próbą zwrócenia uwagi na kwestię istnienia „polityki funeralnej” na cmentarzach doby Rzeczpospolitej przedrozbiorowej. Choć w teorii w obliczu śmierci wszyscy byli sobie równi, to badania pokazują, że zmarli otrzymywali odpowiednie miejsce pochówku ze względu na swoje pochodzenie społeczne, zamożność, osobiste zasługi dla Kościoła czy rodzaj śmierci. Zmarły mógł być więc pochowany w kościele, na cmentarzu przykościelnym, na cmentarzu filialnym lub poza terenem cmentarza. Co więcej, przestrzeń kościoła czy cmentarza także była osobno wartościowana, bowiem w postrzeganiu ówcześnie żyjących istniały tam lepsze i gorsze lokalizacje grobów. Charakterystyka pochówków w kościołach i na cmentarzach w miastach staropolskich została dokonana na przykładzie dwóch ośrodków: miasta Kazimierza pod Krakowem oraz Nowego Miasta Korczyna. Analizy wykonano w oparciu o osiemnastowieczne księgi metrykalne pogrzebów.
La ciudad como teatro poético-político
Authors: Rodríguez de la Flor Adánez Fernando
Published: November 2023

En el seno de la ciudad, escenario de la convocatoria de las fuerzas humanas psíquicas e intelectuales y como resultado de la observación atenta del acontecimiento surge la condición intelectual y se escribe una teoría poético-política
Primer premio, segundo premio... descartado
Authors: Goycoolea Prado Roberto
Published: November 2023

A propósito de las exposiciones de los concursos de proyectos para la ampliación del Museo Nacional Centro de Arte Reina Sofía, la nueva Ciudad Telefónica, la V Bienal de Arquitectura y Europan 5.
Ecología del ambiente artificial
Authors: Trachana Angelique
Published: November 2023

Haciendo un marco de la perpetuación del conflicto histórico entre civilización y naturaleza, la autora señala los cambios producidos en la consideración de los recursos naturales por el sistema productivo capitalista. La evolución de un concepto de «mercancía» hacía la «terciarización» de los recursos sigue contemplandose desde la única perspectiva de la explotación, más del consumo que de la producción hoy, que convierte los ambientes artificiales en insostenibles. La conservación y la naturalización de los sistemas urbanos ha de ser, por tanto, el objetivo de las políticas urbanas.
Al norte del futuro.
Authors: Fernández Alba Antonio
Published: November 2023

El autor se refiere a la crisis del proyecto arquitectónico desde el punto de vista de la espacialidad así como de la historicidad arquitectónica. En los nuevos contextos socioeconómicos, los escenarios de la vida tienden a cambiarse por nuevos escenarios culturales.
La lógica (mecánica) de lo gigante.
Authors: Casqueiro Barreiro Fernando
Published: November 2023

En este artículo se indaga en torno a «la lógica mecánica» de lo gigante, concluyendo con la regla de que el tipo arquitectónico es función del tamaño.
Seamless Multimodal Transportation Scheduling
Authors: Raghunathan Arvind U. , Bergman David , Hooker John N. , Serra Thiago , Kobori Shingo
Published: November 2023

Ride-hailing services have expanded the role of shared mobility in passenger transportation systems, creating new markets and creative planning solutions for major urban centers. In this paper, we consider their use for the first-mile or last-mile passenger transportation in coordination with a mass transit service to provide a seamless multimodal transportation experience for the user. A system that provides passengers with predictable information on travel and waiting times in their commutes is immensely valuable. We envision that the passengers will inform the system of their desired travel and arrival windows so that the system can jointly optimize the schedules of passengers. The problem we study balances minimizing travel time and the number of trips taken by the last-mile vehicles, so that long-term planning, maintenance, and environmental impact are all taken into account. We focus on the case where the last-mile service aggregates passengers by destination. We show that this problem is NP-hard, and we propose a decision diagram–based branch-and-price decomposition model that can solve instances of real-world size (10,000 passengers spread over an hour, 50 last-mile destinations, 600 last-mile vehicles) in computational time (∼1 minute) that is orders of magnitude faster than the solution times of other methods appearing in the literature. Our experiments also indicate that aggregating passengers by destination on the last-mile service provides high-quality solutions to more general settings.

History: Accepted by Pascal Van Hentenryck, Area Editor for Computational Modeling: Methods and Analysis.

Supplemental Material: The software that supports the findings of this study is available within the paper and its Supplemental Information ( https://pubsonline.informs.org/doi/suppl/10.1287/ijoc.2019.0163 ) as well as from the IJOC GitHub software repository ( https://github.com/INFORMSJoC/2019.0163 ). The complete IJOC Software and Data Repository is available at https://informsjoc.github.io/ .
A rare convergence: adult-onset Langerhans cell histiocytosis and HIV infection
Authors: Spyrou Andronikos , Ploumidis Michalis , Nanousi Sofia , Roumbas Charis , Adamis Georgios , Astriti Myrto
Published: November 2023

While primarily described in children, adult-onset Langerhans cell histiocytosis (LCH) has been reported, albeit infrequently. In the present scenario, we unveil a unique case of adult-onset LCH in an HIV-infected individual. After the diagnosis was made, the patient was successfully treated and demonstrated total disease remission. This case illustrates the diagnostic challenge that rare clinical entities such as LCH pose, especially in the context of an untreated HIV infection. Furthermore, the complexity of treating adult-onset Langerhans cell histiocytosis in an HIV-positive patient is highlighted, with emphasis given on a multidisciplinary approach.
Catching it early
Authors: Silver Philip
Published: November 2023

Phillip Silver discusses the importance of raising awareness of symptoms to improve outcomes.

Aims & Objectives

To understand the importance of early detection of oral cancer. To appreciate the need for increased public awareness. To recognise the benefits of screening in every appointment.
A practical guide
Authors: McLaughlin Amanda
Published: November 2023

Amanda McLaughlin discusses the need for support for care home staff when it comes to oral health.
Variants of IL6, IL10, FCN2, RNASE3, IL12B and IL17B loci are associated with Schistosoma mansoni worm burden in the Albert Nile region of Uganda
Authors: Nyangiri Oscar Asanya , Mulindwa Julius , Namulondo Joyce , Kitibwa Anna , Nassuuna Jacent , Elliott Alison , Kimuda Magambo Phillip , Boobo Alex , Nerima Barbara , Adriko Moses , Dunton Nathan J. , Madhan Gaganjit Kaur , Kristiansen Mark , Casacuberta-Partal Miriam , Noyes Harry , Matovu Enock ,   on behalf of the TrypanoGEN+ Research group of the H3Africa consortium
Published: November 2023

Background

Individuals genetically susceptible to high schistosomiasis worm burden may contribute disproportionately to transmission and could be prioritized for control. Identifying genes involved may guide development of therapy.

Methodology/Principal findings

A cohort of 606 children aged 10–15 years were recruited in the Albert Nile region of Uganda and assessed for Schistosoma mansoni worm burden using the Up-Converting Particle Lateral Flow (UCP-LF) test detecting circulating anodic antigen (CAA), point-of-care Circulating Cathodic Antigen (POC-CCA) and Kato-Katz tests. Whole genome genotyping was conducted on 326 children comprising the top and bottom 25% of worm burden. Linear models were fitted to identify variants associated with worm burden in preselected candidate genes. Expression quantitative trait locus (eQTL) analysis was conducted for candidate genes with UCP-LF worm burden included as a covariate. Single Nucleotide Polymorphism loci associated with UCP-LF CAA included IL6 rs2066992 (OR = 0.43, p = 0.0006) and rs7793163 (OR = 2.0, p = 0.0007); IL21 SNP kgp513476 (OR 1.79, p = 0.0025) and IL17B SNP kgp708159 (OR = 0.35, p = 0.0028). A haplotype in the IL10 locus was associated with lower worm burden (OR = 0.53, p = 0.015) and overlapped SNPs rs1800896, rs1800871 and rs1800872. Significant haplotypes (p<0.05, overlapping significant SNP) associated with worm burden were observed in IL6 and the Th17 pathway IL12B and IL17B genes. There were significant eQTL in the IL6, IL5, IL21, IL25 and IFNG regions.

Conclusions

Variants associated with S. mansoni worm burden were in IL6, FCN2, RNASE3, IL10, IL12B and IL17B gene loci. However only eQTL associations remained significant after Bonferroni correction. In summary, immune balance, pathogen recognition and Th17 pathways may play a role in modulating Schistosoma worm burden. Individuals carrying risk variants may be targeted first in allocation of control efforts to reduce the burden of schistosomiasis in the community.
Dual-polarized 8-port sub 6 GHz 5G MIMO diamond-ring slot antenna for smart phone and portable wireless applications
Authors: Fawad Yasir , Ullah Sadiq , Irfan Muhammad , Ullah Rizwan , Rahman Saifur , Muhammad Fazal , Almawgani Abdulkarem H. M. , Mursal Salim Nasar Faraj
Published: November 2023

This manuscript presents high performance dual polarized eight-element multiple input multiple output (MIMO) fifth generation (5G) smartphone antenna. The design consists of four dual-polarized microstrip diamond-ring slot antennas, positioned at corners of printed circuit board (PCB). Cheap Fr-4 dielectric with permittivity 4.3 and thickness of 1.6mm is used as substrate with overall dimension of 150 × 75 × 1.6 mm3. In mobile system due to limited space mutual coupling between nearby antenna elements is an issue that distort MIMO antenna performance. Defected ground structure is used to control coupling. The defected ground structure has advantages like ease of fabrication, compact size and high efficiency as compare to other techniques. Less than 30dB coupling is achieved for adjacent elements. The -10 dB impedance bandwidth of 700 MHz is achieved for all radiating elements ranging from 3.3 GHz to 4.1 GHz. The value is about 900MHz for -6dB. The proposed antenna offers good results in terms of fundamental antenna parameters like reflection coefficient, transmission coefficient, maximum gain, total efficiency. The antenna achieved average gain more than 3.8dBi and average radiation efficiency more than 80% for single dual polarized element. The antenna provides sufficient radiation coverage in all sides. The MIMO antenna characteristics like diversity gain (DG), envelope correlation coefficient (ECC), total active reflection coefficient (TARC) and channel capacity are calculated and found according to standards. Furthermore, effect of user on antenna performance in data-mode and talk-mode are studied. Proposed design is fabricated and tested in real time. The measured results shows that proposed design can be used in future smartphones applications. The design is compared with some of the existing work and found to be the best one in many parameters and can be used for commercial use.
Teaching-learning in clinical education based on epistemological orientations: A multi-method study
Authors: Khani Hamed , Ahmady Soleiman , Sabet Babak , Namaki Ali , Zandi Shirdel , Niakan Somayeh
Published: November 2023

Introduction

Teaching-learning is the heart of medical education in the clinical setting. The objective of this research was to develop a conceptual model of effective clinical teaching in undergraduate medical education and conceptualize its operational framework based on the best fit approach.

Materials and methods

This research consisted of three sub-studies conducted using a multi-method approach. The first sub-study was conducted using a qualitative meta-synthesis approach. The second sub-study used Clarke’s situational analysis approach as a postmodern version of grounded theory. Finally, the third sub-study was designed in two stages. First, it was conducted using the expert panel, in the second step, framework of synthesis based on best fit, and the framework of Ottenhoff- de Jonge et al., which formed the basis of this study.

Results

In the first sub-study, qualitative evidence on the factors of effective teaching-learning in clinical education was synthesized into five dimensions. Based on the second sub-study, the clinical teaching-learning situation in undergraduate medical education in Iran was represented in three maps, including situational, social worlds/arenas, and positional. Finally, in the third sub-study, based on model modification and development in the expert panel, the effective teaching-learning dimensions were developed into behavioral, social, pedagogical, technology, contextual, educational leadership, and financial dimensions. In the second step, based on the framework of Ottenhoff- de Jonge et al., a three-dimensional matrix was developed concerning epistemological orientations about teaching and learning.

Discussion

Moving from a single teaching-centered and learning-centered orientation to a teaching-learning-centered orientation is required for effective teaching-learning in clinical medical education.
Subjective risk and associated electrodermal activity of a self-driving car passenger in an urban shared space
Authors: Petit Jeffery , Charron Camilo , Mars Franck
Published: November 2023

Shared spaces are urban areas without physical separation between motorised and non-motorised users. Previous research has suggested that it is difficult for users to appropriate these spaces and that the advent of self-driving cars could further complicate interactions. It is therefore important to study the perception of these spaces from the users’ perspectives to determine which conditions may promote their acceptance of the vehicles. This study investigates the perceived collision risk of a self-driving car’s passenger when pedestrians cross the vehicle’s path. The experiment was conducted with a driving simulator. Seven factors were manipulated to vary the dynamics of the crossing situations in order to analyse their influence on the passenger’s perception of collision risk. Two measures of perceived risk were obtained. A continuous subjective assessment, reflecting an explicit risk evaluation, was reported in real time by participants. On the other hand, their skin conductance responses, which reflects implicit information processing, were recorded. The relationship between the factors and the risk perception indicators was studied using Bayesian networks. The best Bayesian networks demonstrate that subjective collision risk assessments are primarily influenced by the factors that determine the relative positions of the vehicle and the pedestrian as well as the distance between them when they are in close proximity. The analysis further reveals that variations in skin conductance response indicators are more likely to be explained by variations in subjective assessments than by variations in the manipulated factors. These findings could benefit the development of self-driving navigation among pedestrians by improving understanding of the factors that influence passengers’ feelings.
Examining the exposure-reception-retention link in realistic communication environments via VR and eye-tracking: The VR billboard paradigm
Authors: Schmälzle Ralf , Lim Sue , Cho Hee Jung , Wu Juncheng , Bente Gary
Published: November 2023

Exposure is key to message effects. No effects can ensue if a health, political, or commercial message is not noticed. Yet, existing research in communication, advertising, and related disciplines often measures ‘opportunities for exposure’ at an aggregate level, whereas knowing whether recipients were ‘actually exposed’ to a message requires a micro-level approach. Micro-level research, on the other hand, focuses on message processing and retention, takes place under highly controlled laboratory conditions with forced message exposure, and largely ignores how recipients attend selectively to messages under more natural conditions. Eye-tracking enables us to assess actual exposure, but its previous applications were restricted to screen-based reading paradigms lacking ecological validity or field studies that suffer from limited experimental control. Our solution is to measure eye-tracking within an immersive VR environment that creates the message delivery and reception context. Specifically, we simulate a car ride down a highway alongside which billboards are placed. The VR headset (HP Omnicept Pro) provides an interactive 3D view of the environment and holds a seamlessly integrated binocular eye tracker that records the drivers’ gaze and detects all fixations on the billboards. This allows us to quantify the nexus between exposure and reception rigorously, and to link our measures to subsequent memory, i.e., whether messages were remembered, forgotten, or not even encoded. An empirical study shows that incidental memory for messages differs based on participants’ gaze behavior while passing the billboards. The study further shows how an experimental manipulation of attentional demands directly impacts drivers’ gaze behavior and memory. We discuss the large potential of this paradigm to quantify exposure and message reception in realistic communication environments and the equally promising applications in new media contexts (e.g., the Metaverse).
Learning from the experiences of pregnant women participating in a research study investigating human cytomegalovirus shedding: A qualitative study
Authors: Sapuan Shari , Heath Paul T. , Strang Blair L. , Khalil Asma , Jones Christine E.
Published: November 2023

Transmission of human cytomegalovirus (CMV), from a pregnant woman to her fetus can cause congenital CMV infection, with life-long problems in some infected children. The presence of CMV in an infected individual’s bodily fluid is known as shedding. An individual can become infected with CMV through contact with another individual who is shedding CMV in their bodily fluid, and the avoidance of contact with infected fluids may reduce the risk of infection. We explored the experiences of pregnant women taking part in a study investigating CMV shedding, to identify the potential facilitators and barriers towards engaging pregnant women with CMV risk-reduction measures. Twenty pregnant women participated in semi-structured, end-of-study, telephone interviews, analysed using thematic analysis. They participated in an observational study investigating CMV shedding in pregnant women previously infected with CMV living with young children. Participating women considered that CMV testing of themselves and their newborns was a benefit of participation, without raising additional concerns. They identified that their participation was contingent on a balance of convenience and inconvenience, and benefits and risks. Participation increased their awareness of their hygiene-based practices, leading to behavioural modifications that put them in contact with urine and saliva of their children without instructions to do so. These behavioural modifications might interfere with household routines. However, they recognised it to be a time-limited risk-reduction measure, and felt empowered by the knowledge they had gained through study participation and the support they had received from their partners. Participating women gained an increased awareness of their behaviour, resulting in behavioural modification without instructions to do this, in line with previous findings that trial participation can impact on participants’ thinking about their behaviour with a possibility to influence change. Maternal research and risk-reduction measures should be centred around being informative, convenient, empowering, and supportive.
TK1 expression influences pathogenicity by cell cycle progression, cellular migration, and cellular survival in HCC 1806 breast cancer cells
Authors: Bitter Eliza E. , Skidmore Jonathan , Allen Carolyn I. , Erickson Rachel I. , Morris Rachel M. , Mortimer Toni , Meade Audrey , Brog Rachel , Phares Tim , Townsend Michelle , Pickett Brett E. , O’Neill Kim L.
Published: November 2023

Breast cancer is the most common cancer diagnosis worldwide accounting for 1 out of every 8 cancer diagnoses. The elevated expression of Thymidine Kinase 1 (TK1) is associated with more aggressive tumor grades, including breast cancer. Recent studies indicate that TK1 may be involved in cancer pathogenesis; however, its direct involvement in breast cancer has not been identified. Here, we evaluate potential pathogenic effects of elevated TK1 expression by comparing HCC 1806 to HCC 1806 TK1-knockdown cancer cells (L133). Transcriptomic profiles of HCC 1806 and L133 cells showed cell cycle progression, apoptosis, and invasion as potential pathogenic pathways affected by TK1 expression. Subsequent in-vitro studies confirmed differences between HCC 1806 and L133 cells in cell cycle phase progression, cell survival, and cell migration. Expression comparison of several factors involved in these pathogenic pathways between HCC 1806 and L133 cells identified p21 and AKT3 transcripts were significantly affected by TK1 expression. Creation of a protein-protein interaction map of TK1 and the pathogenic factors we evaluated predict that the majority of factors evaluated either directly or indirectly interact with TK1. Our findings argue that TK1 elevation directly increases HCC 1806 cell pathogenicity and is likely occurring by p21- and AKT3-mediated mechanisms to promote cell cycle arrest, cellular migration, and cellular survival.
Predicting health insurance uptake in Kenya using Random Forest: An analysis of socio-economic and demographic factors
Authors: Yego Nelson Kimeli Kemboi , Nkurunziza Joseph , Kasozi Juma
Published: November 2023

Universal Health Coverage (UHC) is a global objective aimed at providing equitable access to essential and cost-effective healthcare services, irrespective of individuals’ financial circumstances. Despite efforts to promote UHC through health insurance programs, the uptake in Kenya remains low. This study aimed to explore the factors influencing health insurance uptake and offer insights for effective policy development and outreach programs. The study utilized machine learning techniques on data from the 2021 FinAccess Survey. Among the models examined, the Random Forest model demonstrated the highest performance with notable metrics, including a high Kappa score of 0.9273, Recall score of 0.9640, F1 score of 0.9636, and Accuracy of 0.9636. The study identified several crucial predictors of health insurance uptake, ranked in ascending order of importance by the optimal model, including poverty vulnerability, social security usage, income, education, and marital status. The results suggest that affordability is a significant barrier to health insurance uptake. The study highlights the need to address affordability challenges and implement targeted interventions to improve health insurance uptake in Kenya, thereby advancing progress towards achieving Universal Health Coverage (UHC) and ensuring universal access to quality healthcare services.
Effect of climate change on hematotoxicity/hepatoxicity oxidative stress, Oncorhynchus mykiss, under controlled conditions
Authors: Alak Gonca , Özgeriş Fatma Betül , Uçar Arzu , Parlak Veysel , Kocaman Esat Mahmut , Özcan Sinan , Atamanalp Muhammed
Published: November 2023

Described as the ’main ecological factor’, temperature, strongly affects the physiological stress responses of fish. In order to evaluate the effects of temperature variations on fish culture and food value chain, the present study was designed as a climate change model. Furthermore, the present study provides a theoretical basis for a better understanding of the mechanisms of the environmentally induced changes. In this direction, we examined the blood physiology and oxidative stress responses induced by temperature variation in the rainbow trout, a temperature-sensitive cold-water fish. The obtained results showed that climate changes promoted the inhibited activities’ expressions and the development of potential tissue and hematological defense mechanisms against temperature-induced toxic damage. This study showed that climate change could be a subset of the studies on the stress physiology in aquaculture, which can be developed for new experimental designs and research collaborations. Furthermore, it highlights knowledge gaps to guide future research in this emerging field.
DTLR-CS: Deep tensor low rank channel cross fusion neural network for reproductive cell segmentation
Authors: Zhao Xia , Wang Jiahui , Wang Jing , Wang Jing , Hong Renyun , Shen Tao , Liu Yi , Liang Yuanjiao
Published: November 2023

In recent years, with the development of deep learning technology, deep neural networks have been widely used in the field of medical image segmentation. U-shaped Network(U-Net) is a segmentation network proposed for medical images based on full-convolution and is gradually becoming the most commonly used segmentation architecture in the medical field. The encoder of U-Net is mainly used to capture the context information in the image, which plays an important role in the performance of the semantic segmentation algorithm. However, it is unstable for U-Net with simple skip connection to perform unstably in global multi-scale modelling, and it is prone to semantic gaps in feature fusion. Inspired by this, in this work, we propose a Deep Tensor Low Rank Channel Cross Fusion Neural Network (DTLR-CS) to replace the simple skip connection in U-Net. To avoid space compression and to solve the high rank problem, we designed a tensor low-ranking module to generate a large number of low-rank tensors containing context features. To reduce semantic differences, we introduced a cross-fusion connection module, which consists of a channel cross-fusion sub-module and a feature connection sub-module. Based on the proposed network, experiments have shown that our network has accurate cell segmentation performance.