bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative transcriptomic analysis of salivary glands between the zoophytophagous Cyrtorhinus lividipennis and the phytozoophagous Apolygus lucorum
Authors: He Fang , Gao Yang-Wei , Ye Zhuang-Xin , Huang Hai-Jian , Tian Cai-Hong , Zhang Chuan-Xi , Chen Jian-Ping , Li Jun-Min , Lu Jia-Bao
Published: January 2024

Background

Saliva plays a crucial role in shaping the feeding behavior of insects, involving processes such as food digestion and the regulation of interactions between insects and their hosts. Cyrtorhinus lividipennis serves as a predominant natural enemy of rice pests, while Apolygus lucorum, exhibiting phytozoophagous feeding behavior, is a destructive agricultural pest. In this study, a comparative transcriptome analysis, incorporating the published genomes of C.lividipennis and A.lucorum, was conducted to reveal the role of salivary secretion in host adaptation.

Results

In contrast to A.lucorum, C.lividipennis is a zoophytophagous insect. A de novo genome analysis of C.lividipennis yielded 19,706 unigenes, including 16,217 annotated ones. On the other hand, A.lucorum had altogether 20,111 annotated genes, as obtained from the published official gene set (20,353 unigenes). Functional analysis of the top 1,000 salivary gland (SG)-abundant genes in both insects revealed that the SG was a dynamically active tissue engaged in protein synthesis and secretion. Predictions of other tissues and signal peptides were compared. As a result, 94 and 157 salivary proteins were identified in C.lividipennis and A.lucorum, respectively, and were categorized into 68 and 81 orthogroups. Among them, 26 orthogroups were shared, potentially playing common roles in digestion and detoxification, including several venom serine proteases. Furthermore, 42 and 55 orthogroups were exclusive in C.lividipennis and A.lucorum, respectively, which were exemplified by a hyaluronidase in C.lividipennis that was associated with predation, while polygalacturonases in A.lucorum were involved in mesophyll-feeding patterns.

Conclusions

Findings in this study provide a comprehensive insight into saliva secretions in C.lividipennis and A.lucorum via a transcriptome approach, reflecting the intricate connections between saliva secretions and feeding behaviors. It is found that conserved salivary secretions are involved in shaping the overlapping feeding patterns, while a plethora of unique salivary secretions may drive the evolution of specific feeding behaviors crucial for their survival. These results enhance our understanding of the feeding mechanisms in different insects from the perspective of saliva and contribute to future environmentally friendly pest control by utilizing predatory insects.
The correlation between sperm percentage with a small acrosome and unexplained in vitro fertilization failure
Authors: Li Chuyan , Ni Ya , Yao Lingnv , Fang Jiajie , Jiang Nan , Chen Jing , Lin Wenqin , Ni Hanchen , Zheng Haiyan
Published: January 2024

Purpose

Since the unexplained in vitro fertilization failure occurs frequently, it is of great importance and clinical value to identify potential underlying predictors. This study aimed to explore whether the percentage of sperm with a small acrosome was correlated with unexplained in vitro fertilization failure.

Methods

A new acrosomal function evaluation index (the percentage of sperm with a small acrosome) was introduced into the analysis of sperm morphology. The association between the index and acrosome function by acrosin activity detection test and acrosome reaction test was investigated. In addition, the correlation with unexplained in vitro fertilization failure was further explored. Finally, the ROC curve was used to analyze the diagnostic efficacy on the failure of in vitro fertilization and the cutoff value was calculated.

Results

As the increasing of the percentage of sperm with a small acrosome, the value of acrosin activity, acrosome reaction rate, and in vitro fertilization rate were reduced, with a statistically significant difference (P < 0.05). The index in the low fertilization rate group was significantly higher than that in the normal fertilization rate group (P < 0.05). Finally, the results of ROC curve found that when the index was 43.5%, the sensitivity and specificity were 74.2% and 95.3%, respectively.

Conclusion

The percentage of sperm with a small acrosome was positively correlated with unexplained in vitro fertilization failure, which could be potentially used as a prognostic index for the failure of in vitro fertilization.

Trial registration

[Ethics review acceptance No IIT20210339B]
Amputation in patients with extremity soft tissue sarcoma: the experience of an East Asian referral center
Authors: Kim Yongsung , Kim Han-Soo , Han Ilkyu
Published: January 2024

Background

This study aimed to investigate the characteristics and clinical outcomes in a series of patients with extremity soft tissue sarcoma (STS) who underwent amputation at a large East Asian referral center.

Patients and methods

Of the 652 patients who underwent surgery for extremity STS, data of 37 consecutive patients who underwent amputation were reviewed retrospectively. The median follow-up period was 96.0 months (range, 15–216). The patients were classified in to three cohorts. The primary localized (PL) group included patients who underwent amputation as a primary surgical procedure with curative intent. The recurrent localized (RL) group included patients who underwent amputation as a revision procedure after failure of previous limb sparing surgeries. The metastatic group included patients who underwent amputation as a palliative procedure.

Results

There were 22 cases of amputation in 596 STS patients and the amputation rate was 3.6% (22/596). Further, 1.8% (9/490) of patients with primary localized STS underwent amputation. Patients with localized STS who underwent amputation had a 5-year disease-specific survival (DSS) rate of 89.9% (95% Confidence Interval (CI), 87.1–92.7%), a local-recurrence-free survival (LRFS) of 84.1% (95% CI, 80.5–87.6%), and a metastasis-free survival (MFS) of 84.6%. (95% CI, 81.1–88.0%) Compared with previous studies, our results showed higher DSS and MFS rates with similar LRFS.

Conclusions

The amputation rate of extremity STS in our institute in East Asia was similar but slightly lower than that reported in Western studies. The oncologic outcome of amputation reported in this study was higher than that indicated in Western studies and oncologic outcome of amputation was not statistically different from those of limb salvage surgery. However, considering the small cohort in single institute study, there is a possibility of selection bias and future multi-center study is necessary. From our results, amputation is still a feasible option for appropriately selected patients unsuitable for limb-conserving surgery.
Detection of a novel gross deletion in the UNC13D gene ends the diagnostic odyssey for a family with familial hemophagocytic lymphohistiocytosis 3
Authors: Nagaraj Chinmayee B. , Brightman Diana S. , Rea Hannah , Wakefield Emily , Harkavy Nina V. G. , Dyer Lisa , Zhang Wenying
Published: January 2024

Background

Familial hemophagocytic lymphohistiocytosis (FHL) is an immunological disorder characterized by overactivation of macrophages and T lymphocytes. This autosomal recessive condition has been characterized into multiple types depending on the genetic etiology. FHL type 3 is associated with bi-allelic pathogenic variants in the UNC13D gene.

Case presentation

We present a 12-year diagnostic odyssey for a family with FHL that signifies the advances of FHL genetic testing in a clinical genetic diagnostic laboratory setting. We describe the first case of a large UNC13D gross deletion in trans to a nonsense variant in a family with FHL3, which may have been mediated by Alu elements within introns 12 and 25 of the UNC13D gene.

Conclusions

This case highlights the importance of re-evaluating past genetic testing for a patient and family as test technology evolves in order to end a diagnostic odyssey.
Socioeconomic differences in dietary habits in Italy before and during COVID-19 pandemic: secondary analysis of a nationwide cross-sectional study
Authors: Dolcini Jacopo , Ponzio Elisa , D’Errico Marcello Mario , Barbadoro Pamela
Published: January 2024

Background

Several socioeconomic conditions may influence subjects’ adherence to healthy eating habits. Food consumption may be influenced by external stress during crisis periods; however, the effects of these events on food habits are difficult to predict. Also, a pandemic crisis like the recent COVID-19 pandemic may have influenced dietary habits and food consumption. The objective of this study was to compare the dietary habits of Italian people before the COVID-19 pandemic with those belonging to the year 2020 in a nationwide population sample.

Materials and methods

Information on dietary habits has been obtained from the multi-purpose survey on families’ “Aspects of daily life”, carried out in Italy by the Italian National Statistics Institute (ISTAT). We analyzed data coming from 2016 and 2020 editions of the survey (43,000 subjects each year). We used population attributable fraction (PAF) adjusted for age, defined as the proportional reduction in unhealthy diet that would occur if all participants had had a higher education, assuming higher educated individuals as more socially advantaged. Prevalence association for each dietary exposition has been calculated through logistic regression.

Results

Looking at aggregated data from 2016 and 2020 both men and women showed a high prevalence of unhealthy dietary habits. Regarding men, excessive consumption of eggs, pork meat, and bovine meat was characterized by a PAF attributable to socioeconomic conditions to an extent greater than 30%. Women showed the same trend. Focusing on different years of investigation, in 2020, during the COVID-19 pandemic, men and women increased their consumption of eggs, cooked fats, snacks, and sweets, and reduced consumption of fruits and vegetables. Additionally, women increased the assumption of dietary products and meat. Both sexes registered an increase in overweight and obese subjects in 2020.

Conclusions

To our knowledge, this study was the first in our country to use a yearly, nationwide sample to analyze dietary habits by examining specific types of various foods on a nationwide scale and establishing a correlation between these habits and the COVID-19 pandemic. Our results showed unbalanced dietary habits of the Italian population with an excess of consumption of several foods like eggs, cooked fats snacks, and sweets with low consumption of fruits and vegetables. Socioeconomic differences influence food choices but in a complex way since they seemed to affect some wrong dietary habits but not others, especially regarding fruits and vegetables assumption where differences were less evident among social classes. Outside stressors like a crisis period such as the COVID-19 pandemic seem to have an important role in both men and women regarding the assumption of so-called “junk food”.
Genus Curcuma: chemical and ethnopharmacological role in aging process
Authors: Elhawary Esraa A. , Moussa Ashaimaa Y. , Singab Abdel Nasser B.
Published: January 2024

Aging or senescence is part of human life development with many effects on the physical, mental, and physiological aspects which may lead to age-related deterioration in many organs. Genus Curcuma family Zingieraceae represents one of the well-studied and medically important genera with more than eighty species. The genus is reported to contain different classes of biologically active compounds that are mainly presented in diphenylheptanoids, diphenylpentanoids, diphenylalkanoids, phenylpropene derivatives, alkaloids, flavonoids, chromones, terpenoids, phenolic acids and volatile constituents. Rhizomes and roots of such species are rich with main phytoconstituentsviz.curcumin, demethoxycurcumin and bis-demethoxycurcumin. A wide variety of biological activities were demonstrated for different extracts and essential oils of genusCurcumamembers including antioxidant, anti-inflammatory, cytotoxic and neuroprotective. Thus, making them as an excellent safe source for nutraceutical products and as a continuous promising area of research on lead compounds that may help in the slowing down of the aging process especially the neurologic and mental deterioration that are usually experienced upon aging. In this review different species of the genusCurcumawere summarized with their phytochemical and biological activities highlighting their role as antiaging agents. The data were collected from different search enginesviz.Pubmed®, Google Scholar®, Scopus® and Web of Science® limiting the search to the period between 2003 up till now.
Formative research to adapt the ‘Diabetes Prevention Program- Power to Prevent’ for implementation in Bamako, Mali
Authors: Doumbia Lancina , Findley Sally , Ba Hamidou Oumar , Maiga Bonkana , Ba Aissata , Béréthé Rokiatou Koné , Sangaré Hadja Madjè , Kachur S Patrick , Besançon Stéphane , Doumbia Seydou
Published: January 2024

Background

There are few community-level behaviors change interventions for reducing diabetes and hypertension risk in Africa, despite increasing cases of type 2 diabetes and cardiovascular diseases. Thus, this study was designed to adapt the United States Centers for Disease Control and Prevention’s “Diabetes Prevention Program Power to Prevent” (DPP-P2P) for use in low-income urban communities of Bamako, Mali.

Methods

Feedback was elicited on an initial French PowerPoint adaptation of the DPP-P2P session guidelines from stakeholders at the ministry of health, organizational partners, and medical care providers. Two community health centers in districts with high levels of diabetes or hypertension were selected to assist in developing the Malian adaptation. Focus groups were conducted with 19 community health workers (CHWs) of these centers. Based on feedback from these discussions, more graphics, demonstrations, and role plays were added to the PowerPoint presentations. The 19 CHWs piloted the proposed 12 sessions with 45 persons with diabetes or at-risk patients over a one-month period. Feedback discussions were conducted after each session, and changes in dietary and exercise habits were assessed pre and post participation in the program. This feedback contributed to finalization of a 14-session sequence.

Results

The DPP-P2P session guidelines were adapted for use by low-literacy CHWs, converting the written English guidelines into French PowerPoint presentations with extensive use of pictures, role plays and group discussions to introduce diabetes, diet, and exercise concepts appropriately for the Bamako context. CHWs recommendations for a strong family-oriented program led to expanded sessions on eliciting support from all adults in the household. The 45 participants in the pilot adaptation were enthusiastic about the program. At the end of the program, there were significant increases in the frequency of daily exercise, efforts to limit fat intake, and goals for more healthy diets and exercise levels.

Conclusion

This study documents how an iterative process of developing the DPP-P2P adaptation led to the development of a culturally appropriate set of materials welcomed by participants and having promise for reaching the low-income, low-literacy population with or at risk for diabetes in Bamako, Mali.
Combination of the glycated hemoglobin levels and prognostic nutritional index as a prognostic marker in patients with acute coronary syndrome and type 2 diabetes mellitus
Authors: Sun Shuaifeng , Wang Yue , Pang Shuo , Wu Xiaofan
Published: January 2024

Background

Increased susceptibility to malnutrition and inadequate glycemic control are frequently observed in diabetic patients with coronary artery disease. The assessment of malnutrition is performed using the prognosis nutritional index (PNI). The inadequate glycemic control is measured using glycated hemoglobin (HbA1c). However, the combined effect of PNI and HbA1c on the prognosis in diabetic patients with coronary artery disease remains unknown.

Methods

A study was conducted at Beijing Anzhen Hospital and included 2,005 patients diagnosed with type 2 diabetes mellitus (T2DM) accompanied by acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) from September 2021 to January 2022. Based on the median PNI and HbA1c, we categorized the patients into four groups including high (H)-PNI/low (L)-HbA1c, H-PNI/H-HbA1c, L-PNI/L-HbA1c, and L-PNI/H-HbA1c. Major adverse cardiac and cerebrovascular events (MACCE) were the primary outcome, including all-cause mortality, nonfatal myocardial infarction (MI), and nonfatal strokes.

Results

Throughout a median follow-up of 16.3 months, 73 patients had MACCE, which comprised 36 cases of all-cause mortality. In comparison to the H-PNI, the L-PNI showed an obvious rise in MACCE and all-cause mortality (log-rank P = 0.048 and 0.021, respectively) among the H-HbA1c group. Compared to the other groups, the L-PNI/H-HbA1c group exhibited the greatest risk of MACCE (adjusted hazard ratio [aHR]: 2.50, 95% confidence interval [CI] 1.20–5.23, P = 0.014) and all-cause mortality (HR: 3.20, 95% CI 1.04–9.82, P = 0.042). With the addition of PNI, MACCE and all-cause mortality prediction models performed significantly better in patients with ACS and T2DM after PCI, particularly in those with H-HbA1c levels.

Conclusions

The combination of L-PNI and H-HbA1c is a prognostic marker for MACCE and all-cause mortality in patients diagnosed with ACS and T2DM who underwent PCI. The PNI can serve as an assessment tool of malnutrition in patients with ACS and T2DM accompanied by H-HbA1c who underwent PCI. Therefore, monitoring the long-term change of the PNI deserves attention in clinical practice.
An ovalbumin fusion strategy to increase recombinant protein secretion in chicken eggs
Authors: Xie Long , Huang Zhenwen , Lan Meiyu , Cao Yaqi , Sun Lingling , Zhang Lang , Zuo Erwei , Lu Yangqing
Published: January 2024

Maternal secretion of recombinant proteins into chicken eggs may provide a viable approach for pharmaceutical production but remains limited by poor secretion efficiency through the membrane of oviduct cells, despite high expression levels. Here, we used site-specific integration of an EGFP fused to the OVAL gene by a rigid linker, (EAAAK)3, at the endogenous ovalbumin locus in chicken primordial germ cells to generate OVAL-E3-EGFP transgenic chickens, with transgenic chickens expressing CMV immediate enhancer/β-actin-driven EGFP (CAG-EGFP) as a non-secreted control. In OVAL-E3-EGFP chickens, EGFP protein produced in maternal oviducts accumulates to high levels in eggs, but not in eggs of CAG-EGFP chickens. These results indicated that the secretion of foreign proteins can be substantially increased through fusion to the highly secreted endogenous ovalbumin. This study describes a basis for high yield recombinant protein expression in chicken eggs, enabling rapid and scalable production of numerous pharmaceutical proteins or metabolites.
A multidimensional strategy to managing dysfunctional breathing and exercise-induced laryngeal obstruction in adolescent athletes
Authors: Kolnes Liv-Jorunn , Stensrud Trine , Andersen Oddbjørn Klomsten
Published: January 2024

Background

Exercise induced laryngeal obstruction (EILO) causes inspiratory distress in the upper airway in many adolescent athletes. The nature of EILO is not fully understood, and effective management strategies are lacking. This study aimed to assess the effectiveness of a multidimensional individually tailored intervention, including Norwegian Psychomotor Physiotherapy (NPMP), elements of cognitive behavioural therapy and a rehabilitation plan, in reducing inspiratory distress and dysfunctional breathing in adolescent athletes with EILO.

Methods

A mixed methods design, which combined qualitative and quantitative research, was used. Data, including subjective experiences of respiratory distress, findings from body examinations and objective measurements of lung function and aerobic capacity were gathered before and after a five month intervention involving 18 participants.

Results

Following the intervention, the participants showed a reduction in respiratory distress and anxiousness associated with their breathing difficulties. Furthermore, the participants reported to be more in control of their breathing. The body assessments revealed a more functional breathing motion and improved posture, which imply that the breathing was less thoracic and more diaphragmatic in rest and exercise in all participants after the intervention.

Conclusions

Our results suggest that a multidimensional individually tailored intervention, including NPMP based physiotherapy, cognitive behavioural therapy elements, and a rehabilitation plan may reduce inspiratory distress and dysfunctional breathing in athletes with EILO.

Trial registration

ClinicalTrials.gov Protocol Registration and Results system NCT06033755, date of registration: September12, 2023. Retrospectively registered.
Unsupervised domain adaptive bearing fault diagnosis based on maximum domain discrepancy
Authors: Wang Cuixiang , Wu Shengkai , Shao Xing
Published: January 2024

In the existing domain adaptation-based bearing fault diagnosis methods, the data difference between the source domain and the target domain is not obvious. Besides, parameters of target domain feature extractor gradually approach that of source domain feature extractor to cheat discriminator which results in similar feature distribution of source domain and target domain. These issues make it difficult for the domain adaptation-based bearing fault diagnosis methods to achieve satisfactory performance. An unsupervised domain adaptive bearing fault diagnosis method based on maximum domain discrepancy (UDA-BFD-MDD) is proposed in this paper. In UDA-BFD-MDD, maximum domain discrepancy is exploited to maximize the feature difference between the source domain and target domain, while the output feature of target domain feature extractor can cheat the discriminator. The performance of UDA-BFD-MDD is verified through comprehensive experiments using the bearing dataset of Case Western Reserve University. The experimental results demonstrate that UDA-BFD-MDD is more stable during training process and can achieve higher accuracy rate.
Edge-aware nonlinear diffusion-driven regularization model for despeckling synthetic aperture radar images
Authors: Bua Anthony , Kapyela Goodluck , Massawe Libe , Maiseli Baraka
Published: January 2024

Speckle noise corrupts synthetic aperture radar (SAR) images and limits their applications in sensitive scientific and engineering fields. This challenge has attracted several scholars because of the wide demand of SAR images in forestry, oceanography, geology, glaciology, and topography. Despite some significant efforts to address the challenge, an open-ended research question remains to simultaneously suppress speckle noise and to restore semantic features in SAR images. Therefore, this work establishes a diffusion-driven nonlinear method with edge-awareness capabilities to restore corrupted SAR images while protecting critical image features, such as contours and textures. The proposed method incorporates two terms that promote effective noise removal: (1) high-order diffusion kernel; and (2) fractional regularization term that is sensitive to speckle noise. These terms have been carefully designed to ensure that the restored SAR images contain stronger edges and well-preserved textures. Empirical results show that the proposed model produces content-rich images with higher subjective and objective values. Furthermore, our model generates images with unnoticeable staircase and block artifacts, which are commonly found in the classical Perona–Malik and Total variation models.
Photovoltaics in agricultural landscapes: “Industrial land use” or a “real compromise” between renewable energy and biodiversity? Perspectives of German nature conservation associations
Authors: Hilker Janna Marie , Busse Maria , Müller Klaus , Zscheischler Jana
Published: January 2024

Background

One common renewable energy source for substituting fossil sources is photovoltaic (PV) systems. However, installing PV systems in agricultural areas can lead to competition with other land uses. These projects, therefore, often encounter problems with social acceptance in affected communities. Especially from the perspective of nature conservation targets, conflicts can arise. These potential differences are still under-researched but represent important knowledge for the societally broadly accepted design of such facilities and their contribution to energy transformation. In this paper, we investigate the perspectives of nature conservationists on PV in the region of Brandenburg, Germany. We comparatively analyse attitudes towards ground-mounted photovoltaics (GM-PV) and agrophotovoltaics (APV). APV combines energy supply and agricultural production on the same land and could thus be a possible solution for mitigating land-use conflicts.

Results

We investigated the degree of local acceptability and positive and negative influencing factors through a qualitative text analysis of ten interviews with local representatives and position papers by Nature Conservation Associations. Our findings show a growing consensus around basic assumptions of the need for renewable energies, the prioritised support for PV systems on rooftops over the installation on agricultural land (GM-PV and APV), and the necessity for PV systems to be compatible with nature conservation objectives. Regarding specific site decisions on agricultural land, we find diverging attitudes when comparing the content of position papers and the responses of interviewees. The interviewees advocate taking into account local interests and specific regional conditions, the effects of PV systems on the local environment, and the need for distributional justice. Large-scale plants are locally less accepted than smaller ones and there is a more open attitude towards the expansion of APV than of GM-PV on agricultural land. However, a range of concerns regarding consequences for landscape and biodiversity persists, and further research and clarification is required to address these issues.

Conclusions

We conclude that basic ecological standards and the demands of local stakeholders and interest groups should be taken into account when planning, implementing and reviewing PV projects in the future.
Neutrophil-to-lymphocyte ratio associated with symptomatic saccular unruptured intracranial aneurysm
Authors: Zheng De-Xiang , Lv Yi-Yang , Zhang Xiao-Jing , Ye Jie-Shun , Zhang Jian-Xing , Chen Cha , Luo Bin , Yan Dan
Published: January 2024

Background and purpose

Whether symptomatic unruptured intracranial aneurysms (UIAs) lead to change in circulating inflammation remains unclear. This study aims to evaluate the role of hematological inflammatory indicators in predicting symptomatic UIA.

Methods

Adult patients diagnosed with saccular intracranial aneurysm from March 2019 to September 2023 were recruited retrospectively. Clinical and laboratory data, including the white blood cells (WBC), neutral counts (NEUT), lymphocyte counts (LYM), and monocyte counts (MONO) of each patient, were collected. The neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated as NLR = NEUT/LYM, LMR = LYM/MONO, SII = PLT*NEUT/LYM. The hematological inflammatory indicators were compared in symptomatic saccular and asymptomatic UIA patients. Multivariable logistic regression analyses were performed to explore the factors predicting symptomatic UIA.

Results

One hundred and fifty UIA patients with a mean age of 58.5 ± 12.4 were included, of which 68% were females. The NLR and LMR were significantly associated with symptomatic UIA, and the association remained in small UIAs (< 7 mm). The multiple logistic regression analysis showed that NLR was independently associated with symptomatic UIA. On ROC curve analysis, the optimal cutoff value of NLR to differentiate symptomatic from asymptomatic was 2.38. In addition, LMR was significantly associated with symptomatic UIA smaller than 7 mm.

Conclusion

There was a significant correlation between NLR and symptomatic UIA. The NLR was independently associated with symptomatic UIA.
Effect of Buteyko breathing technique on clinical and functional parameters in adult patients with asthma: a randomized, controlled study
Authors: Vagedes Katrin , Kuderer Silja , Ehmann Rainer , Kohl Matthias , Wildhaber Johannes , Jörres Rudolf A. , Vagedes Jan
Published: January 2024

Background

The established therapy of asthma might be supported by additional non-pharmaceutical measures, such as the Buteyko breathing technique (BBT); however, the available data are mixed. To clarify the effects of BBT in patients with asthma, we investigated whether it led to clinical improvements with correlation to functional parameters.

Methods

Using a randomized, controlled design, we studied two groups (n = 30 each) of patients with asthma under either BBT or usual therapy (UT) w/o BBT over a period of 3 months. The primary outcome comprised the voluntary control pause (CP) after 3 months, secondary outcomes an additional breathhold parameter, forced expiratory volume in 1 s (FEV1), capnovolumetry, exhaled nitric oxide (FeNO), Asthma Control Questionnaire (ACQ) and Nijmegen Questionnaire (NQ), and the use of medication (β2-agonists; inhaled corticosteroids, ICS).

Results

CP showed significant time-by-group interaction [F(1,58.09) = 28.70, p < 0.001] as well as main effects for study group [F(1,58.27) = 5.91, p = 0.018] and time [F(1,58.36) = 17.67, p < 0.001]. ACQ and NQ scores were significantly (p < 0.05 each) improved with BBT. This was associated with reductions in the use of β2-agonists and ICS (p < 0.05 each) by about 20% each. None of these effects occurred in the UT group. While FEV1 and the slopes of the capnovolumetric expiratory phases 2 and 3 did not significantly change, the capnovolumetric threshold volume at tidal breathing increased (p < 0.05) with BBT by about 10 mL or 10%, compared to baseline, suggesting a larger volume of the central airways. No significant changes were seen for FeNO.

Conclusions

BBT was clinically effective, as indicated by the fact that the improvement in symptom scores and the small increase in bronchial volume occurred despite the significant reduction of respiratory pharmacotherapy. As the self-controlled Buteyko breathing therapy was well-accepted by the participants, it could be considered as supporting tool in asthma therapy being worth of wider attention in clinical practice.

Trial registration Retrospectively registered on 10 March 2017 at ClinicalTrials.gov (NCT03098849).
Pandemic fatigue and depressive symptoms among college students in the COVID-19 context: indirect effects through sense of control and intolerance of uncertainty
Authors: Wu Qinglu , Zhang Tian-Ming , Wang Xue , Zhang Yan
Published: January 2024

Pandemic fatigue, the state of weariness, exhaustion, and demotivation to engage in protective behaviors during the coronavirus disease 2019 (COVID-19) pandemic, have been linked with depressive symptoms. However, the mechanism underlying this association remains unclear. Based on the stress process model, the present study examined the indirect effects of pandemic fatigue on depressive symptoms through the indirect roles of sense of control and intolerance of uncertainty. Data were collected from 1,162 Chinese undergraduate and postgraduate students (Mage = 21.61 years old, SD = 2.81, 64.29% women) through electronic questionnaires. The pandemic fatigue scale, the personal mastery scale, the short version of the Intolerance of Uncertainty Scale, and the Depression subscale of the Depression-Anxiety-Stress Scales were employed. Indirect effects were analyzed using structural equation modeling. The results revealed that pandemic fatigue related to COVID-19 was positively associated with depressive symptoms through (a) sense of control; (b) intolerance of uncertainty; and (c) a sequential pathway from sense of control to intolerance of uncertainty. The findings expand the application of the stress process model to the context of COVID-19 and deepen the understanding of pandemic fatigue—depressive symptoms link with considering the indirect roles of sense of control and intolerance of uncertainty. Psychological distress in the context of COVID-19 could be alleviated by the interventions on strengthening sense of control and tolerance of uncertainty and lessening the adverse effects of pandemic fatigue.
Does the carbon emission trading pilot policy promote green innovation cooperation? Evidence from a quasi-natural experiment in China
Authors: Xiaobao Peng , Jian Wu , Yuhui Chen , Ali Sumran , Qijun Xie
Published: January 2024

Green and low carbon transition is a broad and profound economic and social systematic change. Green innovation is a critical way to promote energy saving and emission reduction. Has China continuously promoted a carbon emission trading policy to significantly promote green innovation cooperation? Taking the implementation of the carbon emission trading pilot policy as a “quasi-natural experiment,” this study answers this question by exploring the impact of the policy on green innovation cooperation. Based on data on 274 cities from 2008 to 2020, the multi-time difference-in-differences model is used to evaluate the impact of the policy on green innovation cooperation. The results reveal that the carbon emission trading pilot policy significantly improved inter- and intra-city green innovation cooperation through the upgrading effect of industrial structure and the coverage effect of digital finance compared with the non-pilot cities at the city level. In addition, there are significant differences in the policy effects among cities with different degrees of openness to the outside world and command-and-control environmental regulation.
How simulated patients contribute to student learning in an authentic way, an interview study
Authors: Lovink Annelies , Groenier Marleen , van der Niet Anneke , Miedema Heleen , Rethans Jan-Joost
Published: January 2024

Introduction

Simulated patients (SPs) play an instrumental role in teaching communication skills and enhancing learning outcomes. Prior research mostly focused on the SP’s contribution to students’ learning outcomes by providing feedback afterwards. A detailed understanding of the contribution of the SP during SP-student encounters is currently lacking although the majority of the interaction between SPs and students occurs during the SP-student encounter. Therefore, this study focuses on how SPs see their contribution to meaningful student learning experiences during SP-student encounters.

Methods

We interviewed fifteen simulated patients from one institution. We explored their perspectives on meaningful learning experiences during SP-student encounters through in-depth, semi-structured interviews and analyzed using thematic analysis.

Results

SPs view their contribution to meaningful student learning during SP-student encounters from two perspectives. A collective perspective as a member of the community of SPs and an individual perspective. From the collective perspective, SPs believe that the fact that students deal with multiple varied SP-student encounters over time is of value for meaningful learning. From the individual perspective, we noticed that SPs think, act, and react from three different positions. First, as the patient in the role description, second, as a teaching aid and third, as an individual with personal experiences, beliefs, and values. SPs mentioned that the ratio between these different positions can vary within and between encounters.

Conclusions

According to SPs, we should value the variation between SPs, thereby creating meaningful variation in authentic interactions in SP-student encounters. SPs should be allowed to act and react from different positions during SP-student encounters, including their role description, as teaching aid, and based on their own experiences. In this way, SP-student encounters are optimized to contribute to meaningful student learning through authenticity.
Minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient-acceptable symptom state (PASS) in patients who have undergone total knee arthroplasty: a systematic review
Authors: Migliorini Filippo , Maffulli Nicola , Schäfer Luise , Simeone Francesco , Bell Andreas , Hofmann Ulf Krister
Published: January 2024

Background

The present systematic review investigated the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient-acceptable symptom state (PASS) of several frequent and established PROMs used to assess patients who have undergone TKA. This study was conducted according to the 2020 PRISMA statement.

Methods

In September 2023, PubMed, Web of Science, and Embase were accessed with no time constraint All clinical studies investigating tools to assess the clinical relevance of PROMs used to evaluate patients having received TKA were accessed. Only studies which evaluated the MCID, PASS, or SCB were eligible. The PROMs of interest were the Forgotten Joint Score-12 (FJS-12), the Oxford Knee Score (OKS), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and its related subscales activity of daily living (ADL), pain, quality of life (QoL), sports and recreational activities, and symptoms, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, the Knee Society Score (KSS) and related function score, and the Short Form-12 (SF-12) and Short Form-36 (SF-36).

Results

Data from 29,737 patients were collected. The overall risk of bias was low to moderate. The great variability of thresholds for MCID, SCB and PASS between questionnaires but also between investigated aspects was noted, whereby MCIDs for the SF-36 appear lower than for knee-specific questionnaires.

Conclusion

Despite its critical role from a patient’s perspective, the dimension of SCB is still neglected in the literature. Moreover, thresholds for the different concepts need to be condition-specific. We encourage authors to specifically report such data in future studies and to adhere to previously reported definitions to allow future comparison.

Level of evidence Level IV, systematic review and meta-analysis
Systemic sarcoidosis and primitive Gougerot-Sjörgen syndrome: a rare, complex yet intriguing association
Authors: Ikrou H. , Elkadah F. , Serhane H.
Published: January 2024

Primary Sjogren’s syndrome is a chronic autoimmune disease affecting mainly the exocrine glands, typically presenting with sicca syndrome, but systemic multi-organ manifestations are possible. The diagnosis is based on the 2016 ACR-EULAR criteria. On the other hand, sarcoidosis, which is also a chronic systemic disease, is characterized by tissue infiltration with noncaseating granulomas. The granulomas may occur in any organ, but the most frequently affected sites are the lungs, lymph nodes, skin, eyes, and liver. Traditionally, sarcoidosis is considered to be an exclusion criterion for the diagnosis of primary Sjogren’s syndrome, mainly because of overlapping clinical features.

We report the case of a 60-year-old female patient of North African descent, hospitalized initially for chronic dyspnea associated with other systemic manifestations such as sicca syndrome, and in whom we have objectified biological and histological features of both systemic sarcoidosis and systemic primitive Sjogren’s syndrome at the same time.

The coexistence of sarcoidosis and Sjogren’s syndrome is not frequent and has been rarely reported. We aim to bring more attention to the possibility of an association of these two systemic diseases despite what is typically recommended. Subsequently, it might be of interest to remove sarcoidosis from the elimination criteria in order to avoid the possibility of misdiagnosis.
Research following trauma in minority ethnic and faith communities: lessons from a study of the psychosocial sequelae of the Christchurch mosque terror attacks
Authors: Sulaiman-Hill Ruqayya , Porter Richard , Schluter Philip , Beaglehole Ben , Dean Shaystah , Tanveer Sandila , Boden Joseph , Bell Caroline
Published: January 2024

Recruiting participants for research from highly traumatised ethnic and faith communities requires a participatory and trauma-informed approach that considers logistic barriers, as well as trauma-related and culture-specific issues. Active community engagement through every stage of the project and employing community members in research roles can help build trust, identify and mitigate concerns early, prevent re-traumatization, and ensure that findings will be of value to the community. Some of these research challenges are discussed in the context of the Christchurch mosque terror attacks. These insights may be helpful for researchers and clinicians working in similarly challenging environments.
Understanding the Termination of Urologic Cancer Clinical Trials: Insights and Challenges
Authors: Alhajahjeh Abdulrahman , Hmeidan Majedah , Elatrsh Mus'ab , Al-Abbadi Faris , Kakish Diala , Sukerji Razan , Salah Mohammad , Al Awamlh Bashir Al Hussein , Lee David I. , Shahait Mohammed
Published: January 2024

PURPOSE

Clinical trials are valuable evidence for managing urologic malignancies. Early termination of clinical trials is associated with a waste of resources and may substantially affect patient care. We sought to study the termination rate of urologic cancer clinical trials and identify factors associated with trial termination.

METHODS

A cross-sectional search of ClinicalTrials.gov identified completed and terminated kidney, prostate, and bladder cancer clinical trials started. Trials were assessed for reasons for termination. Multivariable analyses were conducted to determine the significant factors associated with the termination.

RESULTS

Between 2000 and 2020, 9,145 oncology clinical trials were conducted, of which 11.30% (n = 1,033) were urologic cancer clinical trials. Of the urologic cancer clinical trials, 25.38% (n = 265) were terminated, with low patient accrual being the most common reason for termination, 52.9% (n = 127). Multivariable analysis showed that only the university funding source odds ratio (OR) of 2.20 (95% CI, 1.45 to 3.32), single-center studies OR of 2.11 (95% CI, 1.59 to 2.81), and sample size of <50 were significant predictors of clinical trial termination OR of 5.26 (95% CI, 3.85 to 7.69); all P values are <.001.

CONCLUSION

The termination rate of urologic cancer clinical trials was 25%, with low accrual being the most frequently reported reason. Trials funded by a university, single-center trials, and small trials (sample size <50) were associated with early termination. A better understanding of these factors might help researchers, funding agencies, and other stakeholders prioritize resource allocations for multicenter trials that aim to recruit a sufficient number of patients.
Use of Neoadjuvant Vandetanib in Aggressive Pediatric Medullary Thyroid Carcinoma
Authors: Kothari Ronik , Kreimer Sara , Nadel Helen , Seeley Hilary , Hartman Gary , Meister Kara D.
Published: January 2024

Novel use of vandetanib in a child with aggressive MTC with prolonged response to treatment
Validity and Efficiency of Progression-Free Survival-2 as a Surrogate End Point for Overall Survival in Advanced Cancer Randomized Trials
Authors: Woodford Rachel , Zhou Deborah , Kok Peey-Sei , Lord Sally J. , Friedlander Michael , Marschner Ian , Simes R. John , Lee Chee Khoon
Published: January 2024

PURPOSE

Progression-free survival (PFS)-2, defined as the time from randomization to progression on second-line therapy, is potentially a more reliable surrogate than PFS for overall survival (OS), but will require longer follow-up and a larger sample size. We sought to compare the validity and efficiency, defined as proportional increase in follow-up time and sample size, of PFS-2 to PFS.

METHODS

We performed an electronic search to identify randomized trials of advanced solid tumors reporting PFS, PFS-2, and OS as prespecified end points. Only studies that had protocols that defined measurement of PFS-2 and follow-up for patients after first disease progression were included. We compared correlations in the relative treatment effect for OS with PFS and PFS-2. We reconstructed individual patient data from survival curves to estimate time to statistical significance (TSS) of the relative treatment effect. We further computed the sample size (person-year [PY] follow-up) required to reach statistical significance.

RESULTS

Across the 42 analysis units and 21,255 patients, the correlation of the relative treatment effect between OS and PFS-2, r, was 0.70 (95% CI, 0.41 to 0.80) and r = 0.46 (95% CI, 0.26 to 0.74) for OS and PFS. The median differences in TSS between OS with PFS, OS with PFS-2, and PFS with PFS-2 were 16.59 (95% CI, 4.48 to not reached [NR]), 10.0 (95% CI, 2.2 to NR), and 4.31 (95% CI, 2.92 to 13.13) months, respectively. The median difference in PYs required to reach statistical significance for PFS-2 over PFS was 156 (95% CI, 82 to 500) PYs, equivalent to an estimated median 12.7% increase in PYs.

CONCLUSION

PFS-2 offers improved correlation with OS than PFS with a modest increase in follow-up time and sample size. PFS-2 should be considered as a primary end point in future trials of advanced cancers.
The Health Literacy Among Turkish University Students
Authors: Solak Müjgan
Published: January 2024

Background: Health literacy is a very important indicator in determining the health level of individuals and society.
Materials and Method: This  descriptive and cross-sectional study aimed to determine the health literacy  level of the  university students. A total of 1171 students, who agreed to participate in the study, were included in the sample of the study. Data were collected using the Personal Information Form and the Turkish Health Literacy Scale-32. Number, percentage, t-test, chi-square, one-way variance, and Post Hoc tests were used for the evaluation of the data. 
Results: It was found out that of the students, 8.7% of them had inadequate levels of health literacy, 33.8% had problematic, 37.2% had sufficient and 20.3% had excellent. Of the students participating in the study, 9.8% of the female students had inadequate levels of health literacy, while 36.4% had problematic levels of health literacy.
Conclusion: It was found that university students do not have the expected level of health literacy. It may be recommended to increase the health literacy levels of university students through training.