bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi‐Interface Electromagnetic Wave Absorbing Material Based on Liquid Marble Microstructures Anchored to SEBS
Authors: Xiao Yuting , Chen Geng , Shi Bin , Chang Qing , Zhang Limin , Wu Hongjing
Published: May 2024

The direct application of liquid marbles in electromagnetic wave (EMW) absorption is challenging due to their poor stability, susceptibility to gravitational collapse, and shaping difficulties. To address this issue, a novel strategy is proposed to incorporate liquid marble microstructures (NaCl/nano‐SiO2) encapsulated in organic phases (Octadecane) into the rubber‐matrix (SEBS) using the ultrasound‐assisted emulsion blending method. The resulting NaCl/SiO2/Octadecane microstructures anchored to SEBS offer a substantial solid–liquid interface consisting of NaCl solution and SiO2. When subjected to an alternating electromagnetic (EM) field, the water molecules and polysorbate within SiO2 exhibit heightened responsiveness to the EM field, and the movement of Na+ and Cl− within these microstructures leads to their accumulation at the solid–liquid interface, creating an asymmetric ion distribution. This phenomenon facilitates enhanced interfacial polarization, thereby contributing to the material's EMW absorption properties. Notably, the latex with 16 wt% SEBS (E‐3), exhibiting a surface morphology similar to human cell tissues, achieves complete absorption of X‐band (fE = 4.20 GHz, RLmin = −33.87 dB). Moreover, the latex demonstrates light density (0.78 g cm−3) and environmental stability. This study not only highlights the predominant loss mechanism in rubber‐based wave‐absorbing materials but also provides valuable insights into the design of multifunctional wave‐absorbing materials.
Synapse Neurotransmitter Channel‐Inspired AlOx Memristor with “V” Type Oxygen Vacancy Distribution
Authors: Yue Junlin , Zou Lanqing , Bai Na , Zhu Chuqian , Yi Yunhui , Xue Fan , Sun Huajun , Hu Shane , Cheng Weiming , He Qiang , Lu Hong , Ye Lei , Miao Xiangshui
Published: May 2024

Memristor possesses great potential and advantages in neuromorphic computing, while consistency and power consumption issues have been hindering its commercialization. Low cost and accuracy are the advantages of human brain, so memristors can be used to construct brain‐like synaptic devices to solve these problems. In this work, a five‐layer AlOx device with a V‐shaped oxygen distribution is used to simulate biological synapses. The device simulates synapse structurally. Further, under electrical stimulation, O2− moves to the Ti electrode and oxygen vacancy (Vo) moves to the Pt electrode, thus forming a conductive filament (CF), which simulates the Ca2+ flow and releases neurotransmitters to the postsynaptic membrane, thus realizing the transmission of information. By controlling applied voltage, the regulation of Ca2+ gated pathway is realized to control the Ca2+ internal flow and achieve different degrees of information transmission. Long‐term Potentiation (LTP)/Long‐term Depression (LTD), Spike Timing Dependent Plasticity (STDP), these basic synaptic performances can be simulated. The AlOx device realizes low power consumption (56.7 pJ/392 fJ), high switching speed (25 ns/60 ns), and by adjusting the window value, the nonlinearity is improved (0.133/0.084), a high recognition accuracy (98.18%) is obtained in neuromorphic simulation. It shows a great prospect in multi‐value storage and neuromorphic computing.
Certificate‐of‐Need laws in healthcare: A comprehensive review of the literature
Authors: Mitchell Matthew D.
Published: May 2024

Certificate‐of‐Need (CON) laws limit the supply of healthcare services in about two‐thirds of U.S. states. The regulations require those who wish to open or expand their facilities to first prove that their services are needed. Once encouraged by the federal government, Congress eliminated the inducement in the 1980s and since then several states have either pared their CON programs back or eliminated them altogether. To date, there have been 128 academic assessments of CON laws and together these papers contain over 450 tests. In this paper, I review this literature, organizing the results around the most common rationales for CON laws. The accumulated evidence is overwhelming that CON laws do not achieve their purpose. Instead, the balance of evidence suggests that these regulations increase spending, reduce access to care, undermine quality, and fail to ensure care for underserved populations.
Ultrasound assessment of the gravid cervix to assess for risk of spontaneous preterm birth: Introducing an evidence‐based clinical guideline for sonographers
Authors: Thoirs Kerry , O'Hara Sandra , Quinton Ann , Coombs Peter , Srayko Sarah , Spurway Jaqueline , Pedretti Michelle , Parange Nayana , Kinnane Paula , O'Brien Sophie
Published: May 2024

This article introduces a new evidence‐based clinical practice guideline (CPG) for sonographers; Ultrasound assessment of the gravid cervix to assess for risk of spontaneous preterm birth (sPTB). The purpose of this new CPG is to provide evidence‐based guidance for sonographers in Australia and New Zealand when making decisions on how and when they should sonographically assess the cervix in the gravid patient. Clinical questions relevant to the sonographic assessment of the gravid cervix were developed to inform the CPG. The primary sources to answer the clinical questions were relevant, existing CPGs. Recommendations in these existing CPGs were appraised for the level of evidence on which they were based and adapted for use in the new CPG. New recommendations were adapted from 19 existing CPGs rated as being based on best evidence and were applicable to three specific patient groups, each at different risk for sPTB. ‘How to Guidance’, statements about safety, acceptability, feasibility of ultrasound techniques, sonographer training and supplementary material were also developed using information from existing CPGs, relevant literature and the clinical experience of clinical guideline group members. The CPG recommendations, ‘how to guides’ and areas of future research are presented in this article. The full guideline and its supplementary materials are available at https://www.sonographers.org/resources-tools/clinical-guidance.
Fluorinated Azobenzenes in UiO‐66: Unveiling Unprecedented Photoswitching Stability and Efficiency in Azobenzene‐Based Switch@MOF Systems
Authors: Rödl Markus , Küssner Kira , Schwartz Heidi A.
Published: May 2024

Understanding the interactions between hosts and guests in two‐component systems remains a formidable challenge due to the diverse array of adjusting factors at play. Particularly intriguing within the realm of two‐component systems are those incorporating a photoswitchable molecule within a porous metal‐organic framework (MOF) host. In such configurations, the non‐covalently attached guest molecule undergoes distinct physicochemical changes influenced by factors like guest structure, guest density, and the shape of the MOF pores. In this study, fluorinated azobenzenes (Fx‐AZB) were introduced into the rigid UiO‐66 host, and the resulting optical properties were examined with a focus on the degree of fluorination. The photoisomers of all examined compounds exhibited remarkable stability under repetitive light exposure, showing no signs of fatigue. Moreover, both photoisomers remained stable at room temperature, defying the typical T‐type photochromism associated with azobenzenes. Most notably, all fluorinated azobenzene derivatives displayed nearly complete photoswitching upon exposure to visible light within the UiO‐66 MOF host. This positions these composite materials as leaders in the realm of azobenzene‐based switch@MOF systems.
Pole-skipping and chaos in hot$$\mathcal{M}{\text{QCD}}$$
Authors: Yadav Gopal , Kushwah Shivam Singh , Misra Aalok
Published: May 2024

Abstract

We address the question of whether thermal QCD at high temperature is chaotic from the $$\mathcal{M}$$ theory dual of QCD-like theories at intermediate coupling as constructed in [1]. The equations of motion of the gauge-invariant combination Zs(r) of scalar metric perturbations is shown to possess an irregular singular point at the horizon radius rh. Very interestingly, at a specific value of the imaginary frequency and momentum used to read off the analogs of the “Lyapunov exponent” λL and “butterfly velocity” vb not only does rh become a regular singular point, but truncating the incoming mode solution of Zs(r) as a power series around rh, yields a “missing pole”, i.e., Cn,n+1 = 0, det M(n) = 0, n ∈ $${\mathbb{Z}}^{+}$$ is satisfied for a single n ≥ 3 depending on the values of the string coupling gs, number of (fractional) D3 branes (M)N and flavor D7-branes Nf in the parent type IIB set [2], e.g., for the QCD(EW-scale)-inspired N = 100, M = Nf = 3, gs = 0.1, one finds a missing pole at n = 3. For integral n > 3, truncating Zs(r) at $$\mathcal{O}\left({\left(r-{r}_{h}\right)}^{n}\right)$$, yields Cn,n+1 = 0 at order n, ∀n ≥ 3. Incredibly, (assuming preservation of isotropy in $${\mathbb{R}}^{3}$$ even with the inclusion of higher derivative corrections) the aforementioned gauge-invariant combination of scalar metric perturbations receives no $$\mathcal{O}\left({R}^{4}\right)$$ corrections. Hence, (the aforementioned analogs of) λL, vb are unrenormalized up to $$\mathcal{O}\left({R}^{4}\right)$$ in $$\mathcal{M}$$ theory.
A bootstrap study of minimal model deformations
Authors: Antunes António , Lauria Edoardo , van Rees Balt C.
Published: May 2024

Abstract

For QFTs in AdS the boundary correlation functions remain conformal even if the bulk theory has a scale. This allows one to constrain RG flows with numerical conformal bootstrap methods. We apply this idea to flows between two-dimensional CFTs, focusing on deformations of the tricritical and ordinary Ising model. We provide non-perturbative constraints for the boundary correlation functions of these flows and compare them with conformal perturbation theory in the vicinity of the fixed points. We also reproduce a completely general constraint on the sign of the $$T\overline{T }$$ deformation in two dimensions.
PRDM14 extinction enables the initiation of trophoblast stem cell formation
Authors: Xu Chunfang , Zhao Weijie , Peng Lijin , Yin Tingxuan , Guo Jiani , Li Yue , Liu Lu , Yang Jinying , Xu Congjian , Du Meirong
Published: May 2024

Trophoblast stem cells (TSCs) can be chemically converted from embryonic stem cells (ESCs) in vitro. Although several transcription factors (TFs) have been recognized as essential for TSC formation, it remains unclear how differentiation cues link elimination of stemness with the establishment of TSC identity. Here, we show that PRDM14, a critical pluripotent circuitry component, is reduced during the formation of TSCs. The reduction is further shown to be due to the activation of Wnt/β-catenin signaling. The extinction of PRDM14 results in the erasure of H3K27me3 marks and chromatin opening in the gene loci of TSC TFs, including GATA3 and TFAP2C, which enables their expression and thus the initiation of the TSC formation process. Accordingly, PRDM14 reduction is proposed here as a critical event that couples elimination of stemness with the initiation of TSC formation. The present study provides novel insights into how induction signals initiate TSC formation.
Physiological and pathological functions of TMEM106B in neurodegenerative diseases
Authors: Zhu Min , Zhang Guoxin , Meng Lanxia , Xiao Tingting , Fang Xin , Zhang Zhentao
Published: May 2024

As an integral lysosomal transmembrane protein, transmembrane protein 106B (TMEM106B) regulates several aspects of lysosomal function and is associated with neurodegenerative diseases. The TMEM106B gene mutations lead to lysosomal dysfunction and accelerate the pathological progression of Neurodegenerative diseases. Yet, the precise mechanism of TMEM106B in Neurodegenerative diseases remains unclear. Recently, different research teams discovered that TMEM106B is an amyloid protein and the C-terminal domain of TMEM106B forms amyloid fibrils in various Neurodegenerative diseases and normally elderly individuals. In this review, we discussed the physiological functions of TMEM106B. We also included TMEM106B gene mutations that cause neurodegenerative diseases. Finally, we summarized the identification and cryo-electronic microscopic structure of TMEM106B fibrils, and discussed the promising therapeutic strategies aimed at TMEM106B fibrils and the future directions for TMEM106B research in neurodegenerative diseases.
Determinants of plasma levels of proglucagon and the metabolic impact of glucagon receptor signalling: a UK Biobank study
Authors: Winther-Sørensen Marie , Garcia Sara L. , Bartholdy Andreas , Ottenheijm Maud E. , Banasik Karina , Brunak Søren , Sørensen Charlotte M. , Gluud Lise Lotte , Knop Filip K. , Holst Jens J. , Rosenkilde Mette M. , Jensen Majken K. , Wewer Albrechtsen Nicolai J.
Published: May 2024

Aims/hypotheses

Glucagon and glucagon-like peptide-1 (GLP-1) are derived from the same precursor; proglucagon, and dual agonists of their receptors are currently being explored for the treatment of obesity and metabolic dysfunction-associated steatotic liver disease (MASLD). Elevated levels of endogenous glucagon (hyperglucagonaemia) have been linked with hyperglycaemia in individuals with type 2 diabetes but are also observed in individuals with obesity and MASLD. GLP-1 levels have been reported to be largely unaffected or even reduced in similar conditions. We investigated potential determinants of plasma proglucagon and associations of glucagon receptor signalling with metabolic diseases based on data from the UK Biobank.

Methods

We used exome sequencing data from the UK Biobank for ~410,000 white participants to identify glucagon receptor variants and grouped them based on their known or predicted signalling. Data on plasma levels of proglucagon estimated using Olink technology were available for a subset of the cohort (~40,000). We determined associations of glucagon receptor variants and proglucagon with BMI, type 2 diabetes and liver fat (quantified by liver MRI) and performed survival analyses to investigate if elevated proglucagon predicts type 2 diabetes development.

Results

Obesity, MASLD and type 2 diabetes were associated with elevated plasma levels of proglucagon independently of each other. Baseline proglucagon levels were associated with the risk of type 2 diabetes development over a 14 year follow-up period (HR 1.13; 95% CI 1.09, 1.17; n=1562; p=1.3×10−12). This association was of the same magnitude across strata of BMI. Carriers of glucagon receptor variants with reduced cAMP signalling had elevated levels of proglucagon (β 0.847; 95% CI 0.04, 1.66; n=17; p=0.04), and carriers of variants with a predicted frameshift mutation had higher levels of liver fat compared with the wild-type reference group (β 0.504; 95% CI 0.03, 0.98; n=11; p=0.04).

Conclusions/interpretation

Our findings support the suggestion that glucagon receptor signalling is involved in MASLD, that plasma levels of proglucagon are linked to the risk of type 2 diabetes development, and that proglucagon levels are influenced by genetic variation in the glucagon receptor, obesity, type 2 diabetes and MASLD. Determining the molecular signalling pathways downstream of glucagon receptor activation may guide the development of biased GLP-1/glucagon co-agonist with improved metabolic benefits.

Data availability

All coding is available through https://github.com/nicwin98/UK-Biobank-GCG

Graphical Abstract
Heat treatment effects on tribocorrosion resistance of Inconel 718® alloy produced by conventional and laser powder bed fusion methods
Authors: Wieczorek Daniel , Ulbrich Dariusz , Stachowiak Arkadiusz , Gruber Konrad , Bartkowski Dariusz , Bartkowska Aneta , Miklaszewski Andrzej
Published: May 2024

The article presents a study of the tribocorrosion phenomenon and its effects on Inconel 718 alloy produced conventionally by extrusion and additively manufactured using the laser powder bed fusion method. In addition, the samples were subjected to a heat treatment process to change their properties. The research was carried out using the pin-on-disk method in 3.5% NaCl. Based on the study, it was found that the material made with additive technology is more resistant to tribocorrosion phenomenon, and the difference from conventionally made material is about 50%. The synergistic effect between friction and corrosion (ΔZ) occurred. However, heat treatment in the AA-2 variant ensures higher hardness and reduces purely mechanical wear (ZM) and the synergy effect (ΔZ).
Pharmacologic profile of ITI-333: a novel molecule for treatment of substance use disorders
Authors: Snyder Gretchen L. , Li Peng , Martin Terry , Zhang Lei , Yao Wei , Zheng Hailin , Maguire David R. , Gerak Lisa R. , Vanover Kimberly E. , France Charles P. , Davis Robert
Published: May 2024

Rationale

Medications are urgently needed to treat symptoms of drug withdrawal and mitigate dysphoria and psychiatric comorbidities that drive opioid abuse and relapse. ITI-333 is a novel molecule in development for treatment of substance use disorders, psychiatric comorbidities, and pain.

Objective

Characterize the preclinical profile of ITI-333 using pharmacological, behavioral, and physiological assays.

Methods

Cell-based assays were used to measure receptor binding and intrinsic efficacy of ITI-333; animal models were employed to assess effects on opioid reinstatement, precipitated oxycodone withdrawal, and drug abuse liability.

Results

In vitro, ITI-333 is a potent 5-HT2A receptor antagonist (Ki = 8 nM) and a biased, partial agonist at μ-opioid (MOP) receptors (Ki = 11 nM; lacking β-arrestin agonism) with lesser antagonist activity at adrenergic α1A (Ki = 28 nM) and dopamine D1 (Ki = 50 nM) receptors. In vivo, ITI-333 blocks 5-HT2A receptor-mediated head twitch and MOP receptor-mediated effects on motor hyperactivity in mice. ITI-333 alone is a naloxone-sensitive analgesic (mice) which suppresses somatic signs of naloxone-precipitated oxycodone withdrawal (mice) and heroin cue-induced reinstatement responding without apparent tolerance or physical dependence after chronic dosing (rats). ITI-333 did not acutely impair gastrointestinal or pulmonary function (rats) and was not intravenously self-administered by heroin-maintained rats or rhesus monkeys.

Conclusions

ITI-333 acts as a potent 5-HT2A receptor antagonist, as well a biased MOP receptor partial agonist with low intrinsic efficacy. ITI-333 mitigates opioid withdrawal/reinstatement, supporting its potential utility as a treatment for OUD.
Wastewater treatment bacteria show differential preference for colonizing natural biopolymers
Authors: Liu Zongzong , Kimyon Onder , Manefield Mike
Published: May 2024

Most reduced organic matter entering activated sludge systems is particulate (1–100-µm diameter) or colloidal (0.001–1-µm diameter), yet little is known about colonization of particulate organic matter by activated sludge bacteria. In this study, colonization of biopolymers (chitin, keratin, lignocellulose, lignin, and cellulose) by activated sludge bacteria was compared with colonization of glass beads in the presence and absence of regular nutrient amendment (acetate and ammonia). Scanning electron microscopy and quantitative PCR revealed chitin and cellulose were most readily colonized followed by lignin and lignocellulose, while keratin and glass beads were relatively resistant to colonization. Bacterial community profiles on particles compared to sludge confirmed that specific bacterial phylotypes preferentially colonize different biopolymers. Nitrifying bacteria proved adept at colonizing particles, achieving higher relative abundance on particles compared to bulk sludge. Denitrifying bacteria showed similar or lower relative abundance on particles compared to sludge.

Key points

• Some activated sludge bacteria colonize natural biopolymers more readily than others.

• Nitrifying bacteria are overrepresented in natural biopolymer biofilm communities.

• Biopolymers in wastewater likely influence activated sludge community composition.
The GH3 Protein from the Clubroot Pathogen Plasmodiophora brassicae Causes Hormone-Related Phenotypes in Arabidopsis thaliana
Authors: Smolko Ana , Jülke Sabine , Benade Freia , Široká Jitka , Pěnčík Aleš , Vuk Tamara , Bauer Nataša , Salopek-Sondi Branka , Ludwig-Müller Jutta
Published: May 2024

In the genome of the obligate biotrophic protist Plasmodiophora brassicae, which causes clubroot disease in the Brassicaceae family, a single gene was identified with homology to the group of GH3 proteins synthesizing amino acid conjugates with carboxylic acids. In comparison to plant members the P. brassicae GH3 protein seems to be very promiscuous with respect to the substrates converted. In vitro assays showed conversion of three different auxins (indole-3-acetic, IAA; indole-propionic, IPA; and indole-3-butyric acids, IBA), jasmonic acid (JA) and also 12-oxo-phytodienoic acid (OPDA). Auxin and Methyl-JA responsive elements were found in the promoter sequence of PbGH3. For further analysis Arabidopsis thaliana was transformed with PbGH3. Seedlings with confirmed constitutive PbGH3 protein production were grown to adult plants that were shown to produce fewer inflorescences per plant. Growth on 10 µM IAA or JA levels also altered the phenotype of the seedlings, but not so much between wild types and transgenic lines. The hormone profiles in seedlings and adult plants were examined for IAA, JA, OPDA, and respective conjugates. Transgenic seedlings displayed changes that could be partially attributed to the overexpression of a GH3 gene like lower levels of free IAA and the JA precursor cis-OPDA under control conditions, and higher levels of some auxin conjugates accumulated after IAA treatment compared to the corresponding wild types. However, the hormone patterns in adult plants were more complex and varied based on different tissue types analyzed. After inoculation with P. brassicae the transgenic plants did not show any changes in infection rate and disease index, but had higher shoot and lower root weight in infected plants compared to controls. Based on the above findings we discuss a role for PbGH3 during pathogenesis.
Understanding the alleviation of “Double-ITCZ” bias in CMIP6 models from the perspective of atmospheric energy balance
Authors: Ren Zikun , Zhou Tianjun
Published: May 2024

The simulation of tropical precipitation has been a challenge to climate models. The multi-model ensemble mean of CMIP6 models only show limited improvement relative to the CMIP3 and CMIP5 models. However, a simple ensemble mean may mask the improvement of individual models. Here we evaluated 20 CMIP6 models and their corresponding earlier version in CMIP5. The results show that the CMIP6 models is significantly improved in the tropical precipitation compared to their counterparts in CMIP5, and the alleviation of bias mainly happened in the top ten model pairs with largest RMSE reduction (TOP10). For the mean of TOP10, the antisymmetric (symmetric) bias mode in CMIP5 is significantly reduced by 55% (78%). Further energetics evaluation shows that, the CMIP5-to-CMIP6 decrease of antisymmetric bias in the bulk of TOP10 models is accompanied by more realistic southward cross-equatorial atmospheric energy transport ($${AET}_{EQ}$$

AET

EQ

), which is mainly contributed by the better representation of the extra-tropical surface turbulent flux ($$STF$$

STF

). On the other hand, the decrease in the symmetric bias of TOP10 models is associated with the enlargement of the negative bias in the seasonal contrast of $${AET}_{EQ}$$

AET

EQ

, which is caused by the alleviation of the biases in the seasonal contrast of extra-tropical $$STF$$

STF

. Our analysis revealed the improvement in the simulation of tropical precipitation in CMIP6, and we pointed out that the improvement is associated with the model-generational changes in the simulated atmospheric energy balances.
Effect of severity and etiology of chronic kidney disease in patients with heart failure with mildly reduced ejection fraction
Authors: Schupp Tobias , Weidner Kathrin , Lau Felix , Forner Jan , Schmitt Alexander , Reinhardt Marielen , Abel Noah , Ayasse Niklas , Bertsch Thomas , Akin Muharrem , Weiß Christel , Akin Ibrahim , Behnes Michael
Published: May 2024

Objective

The study investigates the prognostic impact of the severity and etiology of chronic kidney disease (CKD) in patients with heart failure with mildly reduced ejection fraction (HFmrEF).

Background

Data regarding the outcomes in patients with CKD in HFmrEF is scarce.

Methods

Consecutive patients with HFmrEF were retrospectively included at one institution from 2016 to 2022. Prognosis of patients with different stages and etiologies of CKD was investigated with regard to the primary endpoint of all-cause mortality at 30 months.

Results

A total of 2155 consecutive patients with HFmrEF were included with an overall prevalence of CKD of 31%. Even milder stages of CKD (i.e., KDIGO stage 3a) were associated with an increased risk of 30-months all-cause mortality (HR = 1.242; 95% CI 1.147–1.346; p = 0.001). However, long-term prognosis did not differ in patients with KDIGO stage 5 compared to patients with stage 4 (HR = 0.886; 95% CI 0.616–1.275; p = 0.515). Furthermore, the highest risk of HF-related rehospitalization was observed in patients with KDIGO stages 3b and 4 (log rank p ≤ 0.015), whereas patients with KDIGO stage 5 had a lower risk of HF-related rehospitalization compared to patients with KDIGO stage 4 (HR = 0.440; 95% CI 0.228–0.849; p = 0.014). In contrast, the etiology of CKD was not associated with the risk of 30-month all-cause mortality (log rank p ≥ 0.347) and HF-related rehospitalization (log rank p ≥ 0.149).

Conclusion

In patients with HFmrEF, even milder stages of CKD were independently associated with increased risk of 30-months all-cause mortality.
The value of biomarkers in the therapy of CRSwNP with biologicals—a long-term follow-up of dupilumab therapy
Authors: Sarnoch Sven Ole , Pepić Amra , Schmitz Lisa , Becker Benjamin , Betz Christian , Hoffmann Anna-Sophie
Published: May 2024

Purpose

Since its release, Dupilumab has shown great results in treating severe uncontrolled CRSwNP. However, there is a lack of real-world data beyond 12 months of follow-up, and it is not clear to what extent biomarkers are appropriate for monitoring and predicting the Dupilumab therapy success. Hence, this study aims to analyze biomarkers for monitoring therapy, predicting therapy success and assess the effect of Dupilumab in real-world settings.

Methods

The follow-up was performed with 104 patients retrospectively up to 22 months, assessing SNOT-22, NPS, olfactometry, ACS, FEV-1, and blood biomarkers (total serum IgE, Eosinophils, ECP). Patients were divided into subgroups depending on their pretherapeutic biomarker levels and subsequent development was analyzed.

Results

There was substantially improvement in all clinical parameters up to 1 year and then continuously up to month 22. Patients with initially elevated baseline blood eosinophil counts (> 0.5 billion/L) had a trend of better SNOT-22 development after 1 year (− 12.19 points, p = 0.03). The course of total serum IgE showed moderate correlation with almost all clinical variables obtained. Therapy was well tolerated with only mild and transient adverse events.

Conclusion

Dupilumab has considerably reduced symptoms and disease severity even beyond 1 year of treatment, supporting its role as targeted and effective treatment option for CRSwNP. Our data shows that total serum IgE is a promising biomarker for the monitoring during the treatment with Dupilumab. Elevated pre-therapeutic serum eosinophil counts may be a predictor of good subjective response to therapy. Larger cohorts and a long-term-follow-up over years are needed to further consolidate these findings.
Mapping quality of life after balloon dilatation in subglottic stenosis using Dyspnea index and Short Form Health Survey-36
Authors: Erlandsson Anders , Lundquist Anders , Olofsson Katarina
Published: May 2024

Purpose

An accurate diagnosis and proper treatment plan are required to restore an adequate patent airway in fibrotic subglottic stenosis (SGS). Currently, the definitive treatment entails single-stage balloon dilatation with steroid injections. The primary aim was to evaluate successful airway restoration and general quality of life in cases with SGS in northern Sweden using robust patient reported outcomes.

Methods

All participants with need of surgical treatment due to SGS that had been referred to the department of otorhinolaryngology, University Hospital of Umeå from September 2020 to August 2023 was included. Exclusion criteria included malignant, extrathoracic or cartilaginous cause, age < 18 years, or incompetent to sign consent documents. We assessed the patient-reported outcome measures pre- as well as 3 months postoperatively.

Results

Of the 40 cases fulfilling the eligibility criteria’s, 33 cases completed the Dyspnea index (DI) and the short form health survey (SF-36) pre- as well as 3 months post-operatively. Receiver operating characteristics showed significant improvement in DI as well as in SF 36 scores post-operatively.

Conclusions

Evaluation of balloon dilatation in SGS in this cohort follow-up analysis shows clear improvement in patient quality of life using robust PROM 3 months postoperatively, ensuring the use of a safe and well-tolerated procedure.
Does forced whisper have an impact on voice parameters?
Authors: Echternach Matthias , Köberlein Marie , Döllinger Michael , Kirsch Jonas , Pilsl Theresa
Published: May 2024

Objectives

There has been the assumption that whispering may impact vocal function, leading to the widespread recommendation against its practice after phonosurgery. However, the extent to which whispering affects vocal function and vocal fold oscillation patterns remains unclear.

Methods

10 vocally healthy subjects (5 male, 5 female) were instructed to forcefully whisper a standardized text for 10 min at a sound level of 70 dB(A), measured at a microphone distance of 30 cm to the mouth. Prior to and following the whisper loading, the dysphonia severity index was assessed. Simultaneously, recordings of high speed videolaryngoscopy (HSV), electroglottography, and audio signals during sustained phonation on the vowel /i/ (250 Hz for females and 125 Hz for males) were analyzed after segmentation of the HSV material.

Results

The pre-post analysis revealed only minor changes after the intervention. These changes included a rise in minimum intensity, an increase in the glottal area waveform-derived open quotient, and the glottal gap index. However, no statistically significant changes were observed in the harmonic-to-noise-ratio, the glottal- to-noise-excitation-ratio, and the electroglottographic open quotient.

Conclusion

Overall, the study suggests that there are only small effects on vocal function in consequence of a forced whisper loading.
Effects of work-directed interventions on return-to-work in people on sick-leave for to common mental disorders—a systematic review
Authors: Brämberg Elisabeth , Åhsberg Elizabeth , Fahlström Gunilla , Furberg Elisabet , Gornitzki Carl , Ringborg Anna , Thoursie Peter Skogman
Published: May 2024

Purpose

To evaluate the body of evidence of the effects of work-directed interventions on return-to-work for people on sick leave due to common mental disorders (i.e., mild to moderate depression, anxiety, adjustment disorders and reactions to severe stress).

Methods

The systematic review was conducted in accordance with an a priori developed and registered protocol (Prospero CRD42021235586). The certainty of evidence was assessed by two independent reviewers using the Grading of Recommendations, Assessment, Development and Evaluations.

Results

We reviewed 14,794 records published between 2015 and 2021. Of these, eight RCTs published in eleven articles were included in the analysis. Population: Working age adults (18 to 64 years), on sick leave due to mild to moderate depression, anxiety, adjustment disorders or reactions to severe stress. Intervention: Work-directed interventions. Comparator: No comparator, Standard care, or other measures. Outcome: return to work, number of days on sick leave, income. Overall, the effects of work-focused CBT and work-focused team-based support on RTW resulted in increased or faster return-to-work compared with standard care or no intervention (low certainty of evidence). The effects of Individual Placement and Support showed no difference in RTW compared with standard care (very low certainty of evidence).

Conclusion

Interventions involving the workplace could increase the probability of RTW. Areas in need of improvement in the included studies, for example methodological issues, are discussed. Further, suggestions are made for improving methodological rigor when conducting large scale trials.
Eight weeks of high-intensity interval training versus stretching do not change the psychoneuroendocrine response to a social stress test in emotionally impulsive humans
Authors: Javelle F. , Bloch W. , Borges U. , Burberg T. , Collins B. , Gunasekara N. , Hosang T. J. , Jacobsen T. , Laborde S. , Löw A. , Schenk A. , Schlagheck M. L. , Schoser D. , Vogel A. , Walzik D. , Zimmer P.
Published: May 2024

Purpose

Research supports physical activity as a method to heighten stress resistance and resilience through positive metabolic alterations mostly affecting the neuroendocrine system. High-intensity interval training (HIIT) has been proposed as a highly effective time-saving method to induce those changes. However, existing literature relies heavily on cross-sectional analyses, with few randomised controlled trials highlighting the necessity for more exercise interventions. Thus, this study aims to investigate the effects of HIIT versus an active control group on the stress response to an acute psychosocial stressor in emotionally impulsive humans (suggested as being strong stress responders).

Methods

The study protocol was registered online (DRKS00016589) before data collection. Sedentary, emotionally impulsive adults (30.69 ± 8.20 y) were recruited for a supervised intervention of 8 weeks and randomly allocated to either a HIIT (n = 25) or a stretching group (n = 19, acting as active controls). Participants were submitted to a test battery, including saliva samples, questionnaires (self-efficacy- and perceived stress-related), visual analogue scales (physical exercise- and stress-related), and resting electroencephalography and electrocardiography assessing their reaction to an acute psychological stressor (Trier Social Stress Test) before and after the exercise intervention.

Results

HIIT increased aerobic fitness in all participants, whereas stretching did not. Participants from the HIIT group reported perceiving exercising more intensively than those from the active control group (ƞp2 = 0.108, p = 0.038). No further group differences were detected. Both interventions largely increased levels of joy post-TSST (ƞp2 = 0.209, p = 0.003) whilst decreasing tension (ƞp2 = 0.262, p < 0.001) and worries (ƞp2 = 0.113, p = 0.037). Finally, both interventions largely increased perceived levels of general self-efficacy (ƞp2 = 0.120, p = 0.029).

Conclusion

This study suggests that 8 weeks of HIIT does not change the psychoneuroendocrine response to an acute psychological stress test compared to an active control group in emotionally impulsive humans. Further replications of supervised exercise studies highly powered with active and passive controls are warranted.
Safety, efficacy, and survival of different transarterial chemoembolization techniques in the management of unresectable hepatocellular carcinoma: a comparative single-center analysis
Authors: Schindler Philipp , Kaldewey Daniel , Rennebaum Florian , Trebicka Jonel , Pascher Andreas , Wildgruber Moritz , Köhler Michael , Masthoff Max
Published: May 2024

Purpose

Transarterial chemoembolization (TACE) has become the standard of care for the treatment of intermediate-stage hepatocellular carcinoma (HCC). However, current clinical practice guidelines lack consensus on the best selection of a specific TACE technique. This study aims to compare safety, tumor response, and progression-free survival (PFS) of conventional TACE (cTACE), drug-eluting bead TACE (DEB-TACE), and degradable starch microsphere TACE (DSM-TACE).

Methods

This retrospective study included n = 192 patients with HCC who underwent first TACE with unbiased follow-up at 4–6 weeks at our center between 2008 and 2021. Eligibility for TACE was BCLC intermediate stage B, bridging/down-staging (B/D) to liver transplantation (LT), or any other stage when patients were not suitable for resection, LT, local ablation, or systemic therapy. Patients were grouped into three cohorts (n = 45 cTACE, n = 84 DEB-TACE, n = 63 DSM-TACE), and further categorized by TACE indication (B/D or palliative). Liver function and adverse events, response assessed by the modified response evaluation criteria in solid tumors (mRECIST) 4–6 weeks post-TACE and PFS were analyzed.

Results

There were no significant differences in age, gender distribution, BCLC stage, or etiology of liver disease among the three TACE groups, even in the B/D or palliative subgroups. DEB-TACE induced slight increases in bilirubin in the palliative subgroup and in lactate dehydrogenase in the entire cohort 4–6 weeks post-TACE, and more adverse events in the palliative subgroup. DEB-TACE and DSM-TACE showed significantly higher disease control rates (complete and partial response, stable disease) compared to cTACE, especially in the B/D setting (p < 0.05). There was no significant difference in PFS between the groups [median PFS (months): cTACE, 10.0 vs. DEB, 7.0 vs. DSM, 10.0; p = 0.436].

Conclusion

Our study provides valuable perspectives in the decision-making for a specific TACE technique: DEB-TACE and DSM-TACE showed improved tumor response. DEB-TACE showed a prolonged impact on liver function and more side effects, so patients with impaired liver function should be more strictly selected, especially in the palliative subgroup.
Modified Lichong decoction intervenes in colorectal cancer by modulating the intestinal flora and the Wnt/β-catenin signaling pathway
Authors: Liu Longhui , Zhao Mengmeng , Lang Xiaomeng , Jia Sujie , Kang Xin , Liu Yue , Liu Jianping
Published: May 2024

Background

The pathogenesis and treatment of colorectal cancer (CRC) continue to be areas of ongoing research, especially the benefits of traditional Chinese medicine (TCM) in slowing the progression of CRC. This study was conducted to investigate the effectiveness and mechanism of action of modified Lichong decoction (MLCD) in inhibiting CRC progression.

Methods

We established CRC animal models using azoxymethane/dextran sodium sulfate (AOM/DSS) and administered high, medium, or low doses of MLCD or mesalazine (MS) for 9 weeks to observe MLCD alleviation of CRC. The optimal MLCD dose group was then subjected to metagenomic and RNA sequencing (RNA-seq) to explore the differentially abundant flora and genes in the control, model and MLCD groups. Finally, the mechanism of action was verified using WB, qRT‒PCR, immunohistochemistry and TUNEL staining.

Results

MLCD inhibited the progression of CRC, and the optimal effect was observed at high doses. MLCD regulated the structure and function of the intestinal flora by decreasing the abundance of harmful bacteria and increasing that of beneficial bacteria. The differentially expressed genes were mainly associated with the Wnt/β-catenin pathway and the cell cycle. Molecular biology analysis indicated that MLCD suppressed the Wnt/β-catenin pathway and the epithelial–mesenchymal transition (EMT), inhibited abnormal cell proliferation and promoted intestinal epithelial cell apoptosis.

Conclusion

MLCD mitigated the abnormal growth of intestinal epithelial cells and promoted apoptosis, thereby inhibiting the progression of CRC. This inhibition was accomplished by modifying the intestinal microbiota and disrupting the Wnt/β-catenin pathway and the EMT. Therefore, MLCD could serve as a potential component of TCM prescriptions for CRC treatment.
The association of permanent versus absorbable fixation on developing chronic post-herniorrhaphy groin pain in patients undergoing laparoscopic inguinal hernia repair
Authors: Woo Kimberly P. , Ellis Ryan C. , Maskal Sara M. , Remulla Daphne , Shukla Priya , Rosen Alexandra J. , Wetzka Isabella , Osei-Koomson Wilhemina , Phillips Sharon , Miller Benjamin T. , Beffa Lucas R. , Petro Clayton C. , Krpata David M. , Prabhu Ajita S. , Menzo Emanuele Lo , Rosen Michael J.
Published: May 2024

Introduction

Fixation of mesh during minimally invasive inguinal hernia repair is thought to contribute to chronic post-herniorrhaphy groin pain (CGP). In contrast to permanent tacks, absorbable tacks are hypothesized to minimize the likelihood of CGP. This study aimed to compare the rates of CGP after laparoscopic inguinal hernia repair between absorbable versus permanent fixation at maximum follow-up.

Methods

This is a post hoc analysis of a randomized controlled trial in patients undergoing laparoscopic inguinal hernia repair (NCT03835351). All patients were contacted at maximum follow-up after surgery to administer EuraHS quality of life (QoL) surveys. The pain and restriction of activity subdomains of the survey were utilized. The primary outcome was rate of CGP, as defined by a EuraHS QoL pain domain score ≥ 4 measured at ≥ 1 year postoperatively. The secondary outcomes were pain and restriction of activity domain scores and hernia recurrence at maximum follow-up.

Results

A total of 338 patients were contacted at a mean follow-up of 28 ± 11 months. 181 patients received permanent tacks and 157 patients received absorbable tacks during their repair. At maximum follow-up, the rates of CGP (27 [15%] vs 28 [18%], P = 0.47), average pain scores (1.78 ± 4.38 vs 2.32 ± 5.40, P = 0.22), restriction of activity scores (1.39 ± 4.32 vs 2.48 ± 7.45, P = 0.18), and the number of patients who reported an inguinal bulge (18 [9.9%] vs 15 [9.5%], P = 0.9) were similar between patients with permanent versus absorbable tacks. On multivariable analysis, there was no significant difference in the odds of CGP between the two groups (OR 1.23, 95% CI [0.60, 2.50]).

Conclusion

Mesh fixation with permanent tacks does not appear to increase the risk of CGP after laparoscopic inguinal hernia repair when compared to fixation with absorbable tacks. Prospective trials are needed to further evaluate this relationship.
Temporal changes in temperature-related mortality in relation to the establishment of the heat-health alert system in Victoria, Australia
Authors: Osborne Nicholas J. , Amoatey Patrick , Selvey Linda , Phung Dung
Published: May 2024

Extreme heat alerts are the most common form of weather forecasting services used in Australia, yet very limited studies have documented their effectiveness in improving health outcomes. This study aimed to examine the temporal changes in temperature-related mortality in relation to the activation of the heat-health alert and response system (HARS) in the State of Victoria, Australia. We examined the relationship between temperatures and mortality using quasi-Poisson regression and the distributed lag non-linear model (dlnm) and compared the temperature-mortality association between the two periods: period 1– prior-HARS (1992–2009) and period 2– post-HARS (2010–2019). Since the HARS heavily weights heatwave effects, we also compared the main effects of heatwave events between the two periods. The heatwaves were defined for three levels, including 3 consecutive days at 97th, 98th, and 99th percentiles. We also controlled the potential confounding effect of seasonality by including a natural cubic B-spline of the day of the year with equally spaced knots and 8 degrees of freedom per year. The exposure-response curve reveals the temperature mortality was reduced in period 2 in comparison with period 1. The relative risk ratios (RRR) of Period 2 over Period 1 were all less than one and gradually decreased from 0.86 (95% CI, 0.72–1.03) to 0.64 (95% CI, 0.33–1.22), and the differences in attributable risk percent increased from 13.2 to 25.3%. The reduction in the risk of heatwave-related deaths decreased by 3.4% (RRp1 1.068, 95% CI, 1.024–1.112 versus RRp2 1.034, 95% CI, 0.986–1.082) and 10% (RRp1 1.16, 95% CI, 1.10–1.22 versus RRp2 1.06, 95% CI, 1.002–1.119) for all groups of people. The study indicated a decrease in heat-related mortality following the operation of HARS in Victoria under extreme heat and high-intensity heatwaves conditions. Further studies could investigate the extent of changes in mortality among populations of differing socio-economic groups during the operation of the heat-health alert system.
Surgical resection of advanced intrathoracic tumors through a combination of the hemiclamshell and transmanubrial approaches
Authors: Miyashita Yudai , Fukui Eriko , Ishida Hiroto , Kimura Toru , Kanou Takashi , Ose Naoko , Funaki Soichiro , Shintani Yasushi
Published: May 2024

Purpose

The hemiclamshell (HCS) approach provides a comprehensive view of the anterior mediastinum, whereas the transmanubrial osteomuscular sparing approach (TMA) allows sufficient exposure of the cervico-thoracic transition. We assessed the effectiveness and the outcomes of the combined HCS plus TMA approach to resect thoracic malignant tumors.

Methods

We reviewed five patients with thoracic malignant tumors invading the thoracic outlet who underwent surgery using an HCS and TMA approach between 2018 and 2021.

Results

The preoperative diagnosis was myxofibrosarcoma, lung cancer, thymic cancer, thymoma, and neurofibromatosis type1 in one patient each, respectively. Cardiovascular reconstruction was done on the aortic arch in two patients, on the descending aorta in one, and on the superior vena cava in one, combined with resection of the vagus nerve in three patients, of the phrenic nerve in two, and of vertebra in one, with overlap in some cases. The TMA was added because all patients required dissection of the periphery of the subclavian artery, and two had tumor extension to the neck. Macroscopic complete resection was achieved in four patients. There was no postoperative mortality.

Conclusion

The combination of the HCS and TMA approaches at the same operation provides a comprehensive view of the mediastinum, lung, and cervico-thoracic transition and allows safe access to the thoracic great vessels and subclavian vessels.