bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of physical exercises on initiation, progression, and treatment of breast cancer
Authors: Xu Junwei , Jiao Xiance , Bayat Reyhaneh
Published: May 2024

The emergence of drug resistance is a substantial obstacle to the effective management of breast cancer, which is the primary cause of cancer-related deaths in women worldwide. To facilitate the development of targeted therapies that can effectively overcome drug resistance, it is crucial to possess a comprehensive comprehension of the molecular mechanisms that underpin resistance to breast cancer treatment. So far, considerable progress has been made in the field of exercise-oncology research and overcome drug resistance, specifically about breast cancer. Evidence has suggested that participation in physical activity is correlated with a decrease in reappearance and fatality rates of breast cancer patients. It has been reported that participation in physical activity can yield favorable outcomes in the prevention, treatment, and post-treatment of breast cancer. An increasing body of empirical evidence suggests that participation in physical activity can alter diverse biological mechanisms, potentially augmenting breast cancer treatments’ efficacy. Comparing increased physical activity versus reduced physical activity in breast cancer patients who received chemotherapy, radiotherapy, and surgery supported the significance of exercise in comprehensive care strategies to enhance overall health and treatment efficacy. Furthermore, previous studies have reported that physical activity can enhance the efficacy of breast cancer treatments. This review provides the current literature regarding the influence of physical activity on the occurrence and progression of breast cancer.
Total knee arthroplasty following lateral closing-wedge high tibial osteotomy versus primary total knee arthroplasty: a propensity score matching study
Authors: Xie Tianshun , de Vries Astrid J. , van der Veen Hugo C. , Brouwer Reinoud W.
Published: May 2024

Background

The disparity in patient-reported outcomes between total knee arthroplasty (TKA) following high tibial osteotomy (HTO) and primary TKA has yet to be fully comprehended. This study aims to compare the patient-reported outcomes, radiological parameters and complication rates between TKA following HTO and primary TKA.

Methods

Sixty-five patients who underwent TKA following lateral closing-wedge HTO were compared to a matched group of primary TKA at postoperative 6-months and 1-year. Between-group confounders of age, gender, smoking status, Body Mass index, preoperative Numeric Rating Scale (NRS) pain in rest, Knee injury and Osteoarthritis Outcome Score-Physical function Shortform (KOOS-PS), EuroQol five-dimensional (EQ-5D) overall health score, and Oxford Knee Score (OKS) were balanced by propensity score matching. Patient-reported outcome measures were NRS pain in rest, KOOS-PS, EQ-5D overall health score, and OKS. Radiological parameters were femorotibial angle, medial proximal tibial angle, anatomical lateral distal femoral angle, posterior tibial slope, and patellar height assessed by Insall-Salvati ratio. The complication rates of TKA were compared between the two groups. The HTO survival time, the choice of staple removal before or during TKA in patients who underwent TKA following HTO patients, and the rate of patellar resurfacing were assessed. The p value < 0.0125 indicates statistical significance after Bonferroni correction.

Results

After propensity score matching, no significant between-group differences in the patient-reported outcome measures, radiographical parameters and complication rates were found (p > 0.0125). In the TKA following HTO group, with an average HTO survival time of 8.7 years, staples were removed before TKA in 46 patients (71%) and during TKA in 19 patients, and 11 cases (17%) had patella resurfacing. In the primary TKA group, 15 cases (23%) had patella resurfacing.

Conclusion

The short-term assessment of TKA following HTO indicates outcomes similar to primary TKA. A previous HTO does not impact the early results of subsequent TKA, suggesting that the previous HTO has minimal influence on TKA outcomes.

Level of evidence

III, cohort study.
Twenty-year experience following aortic valve replacement in patients younger than 60 years of age
Authors: Imamura Yuki , Kowatari Ryosuke , Koizumi Junichi , Tabayashi Azuma , Saitoh Daiki , Kin Hajime
Published: May 2024

Objective

Reports on long-term outcomes of surgical aortic valve replacement (AVR) for patients aged < 60 years are scarce in Japan. Hence, we aimed to evaluate these outcomes in patients aged < 60 years.

Methods

Between March 2000 and December 2020, 1477 patients underwent aortic valve replacement. In total, 170 patients aged < 60 years who underwent aortic valve replacement were recruited. Patients aged < 18 years were excluded. Patient data collected from the operative records and follow-up assessments were reviewed.

Results

The mean age was 49 ± 9 years, and 64.1% of patients were male. One-hundred-and-fifty-two patients (89.4%) underwent aortic valve replacement with a mechanical valve and 18 (10.6%) with a bioprosthetic valve. The mean follow-up period was 8.1 ± 5.5 years. No operative mortality occurred, and in-hospital mortality occurred in one patient (0.6%). Ten late deaths occurred, with seven cardiac-related deaths. The overall survival rate was 95.4 ± 1.7%, 93.9 ± 2.3%, 90.6 ± 3.9%, and 73.2 ± 11.8% at 5, 10, 15, and 20 years, respectively. Freedom from major bleeding was 96.4 ± 1.6% at 5, 10, and 15 years, and 89.0 ± 7.3% at 20 years. Freedom from thromboembolic events was 98.7 ± 1.3%, 97.3 ± 1.9%, 90.5 ± 4.5%, and 79.0 ± 11.3% at 5, 10, 15, and 20 years, respectively. Freedom from valve-related reoperation was 99.4 ± 0.6% at 5 years, 97.8 ± 1.7% at 10 and 15 years, and 63.9 ± 14.5% at 20 years.

Conclusions

Patients aged < 60 years undergoing aortic valve replacement with a high mechanical valve implantation rate had favorable long-term outcomes.
Causal association between low vitamin D and polycystic ovary syndrome: a bidirectional mendelian randomization study
Authors: Gao Bingrui , Zhang Chenxi , Wang Deping , Li Bojuan , Shan Zhongyan , Teng Weiping , Li Jing
Published: May 2024

Background

Recent studies have revealed the correlation between serum vitamin D (VD) level and polycystic ovary syndrome (PCOS), but the causality and specific mechanisms remain uncertain.

Objective

We aimed to investigate the cause-effect relationship between serum VD and PCOS, and the role of testosterone in the related pathological mechanisms.

Methods

We assessed the causality between serum VD and PCOS by using genome-wide association studies (GWAS) data in a bidirectional two-sample Mendelian randomization (TS-MR) analysis. Subsequently, a MR mediation analysis was conducted to examine the mediating action of testosterone in the causality between serum VD and PCOS. Ultimately, we integrated GWAS data with cis-expression quantitative loci (cis-eQTLs) data for gene annotation, and used the potentially related genes for functional enrichment analysis to assess the involvement of testosterone and the potential mechanisms.

Results

TS-MR analysis showed that individuals with lower level of serum VD were more likely to develop PCOS (OR = 0.750, 95% CI: 0.587–0.959, P = 0.022). MR mediation analysis uncovered indirect causal effect of serum VD level on the risk of PCOS via testosterone (OR = 0.983, 95% CI: 0.968–0.998, P = 0.025). Functional enrichment analysis showed that several pathways may be involved in the VD-testosterone-PCOS axis, such as steroid hormone biosynthesis and autophagy process.

Conclusion

Our findings suggest that genetically predicted lower serum VD level may cause a higher risk of developing PCOS, which may be mediated by increased testosterone production.
Multidisciplinary follow-up in a patient with Morgagni hernia leads to diagnosis of Marfan syndrome
Authors: Capecchi Ester , Villa Roberta , Pini Alessandro , Iascone Maria , Messina Laura , Ajmone Paola Francesca , Mosca Fabio , Gangi Silvana , Bedeschi Maria Francesca
Published: May 2024

Background

congenital diaphragmatic hernia (CDH) is a birth defect occurring in isolated or syndromic (chromosomal or monogenic) conditions. The diaphragmatic defect can be the most common one: left-sided posterolateral, named Bochdalek hernia; or it can be an anterior-retrosternal defect, named Morgagni hernia. Marfan syndrome (MFS) is a rare autosomal dominant inherited condition that affects connective tissue, caused by mutations in fibrillin-1 gene on chromosome 15. To date various types of diaphragmatic defects (about 30 types) have been reported in association with MFS, but they are heterogeneous, including CDH and paraesophageal hernia.

Case presentation

We describe the case of a child incidentally diagnosed with Morgagni hernia through a chest X-ray performed due to recurrent respiratory tract infections. Since the diagnosis of CDH, the patient underwent a clinical multidisciplinary follow-up leading to the diagnosis of MFS in accordance with revised Ghent Criteria: the child had typical clinical features and a novel heterozygous de novo single-base deletion in exon 26 of the FBN1 gene, identified by Whole-Exome Sequencing. MFS diagnosis permitted to look for cardiovascular complications and treat them, though asymptomatic, in order to prevent major cardiovascular life-threatening events.

Conclusion

Our case shows the importance of a long-term and multidisciplinary follow-up in all children with diagnosis of CDH.
Novel 14q32.2 paternal deletion encompassing the whole DLK1 gene associated with Temple syndrome
Authors: Baena Neus , Monk David , Aguilera Cinthia , Fraga Mario F. , Fernández Agustín F. , Gabau Elisabeth , Corripio Raquel , Capdevila Nuria , Trujillo Juan Pablo , Ruiz Anna , Guitart Miriam
Published: May 2024

Background

Temple syndrome (TS14) is a rare imprinting disorder caused by maternal UPD14, imprinting defects or paternal microdeletions which lead to an increase in the maternal expressed genes and a silencing the paternally expressed genes in the 14q32 imprinted domain. Classical TS14 phenotypic features include pre- and postnatal short stature, small hands and feet, muscular hypotonia, motor delay, feeding difficulties, weight gain, premature puberty along and precocious puberty.

Methods

An exon array comparative genomic hybridization was performed on a patient affected by psychomotor and language delay, muscular hypotonia, relative macrocephaly, and small hand and feet at two years old. At 6 years of age, the proband presented with precocious thelarche. Genes dosage and methylation within the 14q32 region were analyzed by MS-MLPA. Bisulfite PCR and pyrosequencing were employed to quantification methylation at the four known imprinted differentially methylated regions (DMR) within the 14q32 domain: DLK1 DMR, IG-DMR, MEG3 DMR and MEG8 DMR.

Results

The patient had inherited a 69 Kb deletion, encompassing the entire DLK1 gene, on the paternal allele. Relative hypermethylation of the two maternally methylated intervals, DLK1 and MEG8 DMRs, was observed along with normal methylation level at IG-DMR and MEG3 DMR, resulting in a phenotype consistent with TS14. Additional family members with the deletion showed modest methylation changes at both the DLK1 and MEG8 DMRs consistent with parental transmission.

Conclusion

We describe a girl with clinical presentation suggestive of Temple syndrome resulting from a small paternal 14q32 deletion that led to DLK1 whole-gene deletion, as well as hypermethylation of the maternally methylated DLK1-DMR.
Correlation between CEUS LI-RADS categorization of HCC < 20 mm and clinic-pathological features
Authors: Yang Daohui , Chen Xuejun , Huang Linjin , Wang Xi , Mao Lijuan , Lin Lewu , Han Hong , Lu Qing
Published: May 2024

Objective

To retrospectively evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) LI-RADS in liver nodules < 20 mm at high risk of hepatocellular carcinoma (HCC) and their correlation with clinic-pathological features.

Methods

A total of 432 pathologically proved liver nodules < 20 mm were included from January 2019 to June 2022. Each nodule was categorized as LI-RADS grade (LR)-1 to LR-5 through LR-M according to CEUS LI-RADS. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) of CEUS LI-RADS were evaluated using pathological reference standard. Correlations between clinic-pathological features and CEUS LI-RADS categorization, together with major CEUS features, were further explored.

Results

With LR-5 to diagnose HCC, the sensitivity, specificity, PPV, NPV, and AUC were 50.3%, 70.0%, 91.2%, 18.5%, and 0.601, respectively. The proportion of LR-5 in primary HCCs was significantly higher than that in recurrent ones (p = 0.014). HCC 10–19 mm showed significantly more frequent arterial phase hyper-enhancement (APHE) and late washout (p < 0.05) and less no-washout (p = 0.003) compared with those in HCC < 10 mm. Well-differentiated HCCs showed more frequent non-APHE and no-washout than moderate- and poor-differentiated HCCs (p < 0.05). Upgrading “APHE without washout” LR-4 nodules 10–19 mm with HCC history and “APHE with late mild washout” LR-4 nodules < 10 mm to LR-5 could improve the diagnostic performance of LR-5. The corresponding sensitivity, specificity, PPV, NPV, and AUC are 60.2%, 70.0%, 92.6%, 22.1%, and 0.651, respectively.

Conclusions

CEUS LI-RADS is valuable in the diagnosis of HCC < 20 mm and performance can be improved with the combination of clinic-pathological features.

Critical relevance statement

CEUS LI-RADS was valuable in the diagnosis of HCC < 20 mm and its diagnostic performance can be improved by combining clinic-pathological features. Further research is needed to define its value in this set of lesions.

Key Points

Contrast-enhanced ultrasound can detect small liver lesions where LI-RADS accuracy is uncertain.

Many LI-RADS Grade-4 nodules were upgraded to Grade-5 by combining imaging with clinic-pathological factors.

The reclassification of LI-RADS Grade-5 can improve sensitivity without decreasing positive predictive value.

Graphical Abstract
Enhancing human behavior recognition with spatiotemporal graph convolutional neural networks and skeleton sequences
Authors: Xu Jianmin , Liu Fenglin , Wang Qinghui , Zou Ruirui , Wang Ying , Zheng Junling , Du Shaoyi , Zeng Wei
Published: May 2024

Objectives

This study aims to enhance supervised human activity recognition based on spatiotemporal graph convolutional neural networks by addressing two key challenges: (1) extracting local spatial feature information from implicit joint connections that is unobtainable through standard graph convolutions on natural joint connections alone. (2) Capturing long-range temporal dependencies that extend beyond the limited temporal receptive fields of conventional temporal convolutions.

Methods

To achieve these objectives, we propose three novel modules integrated into the spatiotemporal graph convolutional framework: (1) a connectivity feature extraction module that employs attention to model implicit joint connections and extract their local spatial features. (2) A long-range frame difference feature extraction module that captures extensive temporal context by considering larger frame intervals. (3) A coordinate transformation module that enhances spatial representation by fusing Cartesian and spherical coordinate systems.

Findings

Evaluation across multiple datasets demonstrates that the proposed method achieves significant improvements over baseline networks, with the highest accuracy gains of 2.76$$\%$$%on the NTU-RGB+D 60 dataset (Cross-subject), 4.1$$\%$$%on NTU-RGB+D 120 (Cross-subject), and 4.3$$\%$$%on Kinetics (Top-1), outperforming current state-of-the-art algorithms. This paper delves into the realm of behavior recognition technology, a cornerstone of autonomous systems, and presents a novel approach that enhances the accuracy and precision of human activity recognition.
Effects of improved amino acid balance diet on lysine mammary utilization, whole body protein turnover and muscle protein breakdown on lactating sows
Authors: Zhang Sai , Marini Juan C. , Mavangira Vengai , Claude Andrew , Moore Julie , Mohammad Mahmoud A. , Trottier Nathalie L.
Published: May 2024

Background

The study objective was to test the hypothesis that low crude protein (CP) diet with crystalline amino acids (CAA) supplementation improves Lys utilization efficiency for milk production and reduces protein turnover and muscle protein breakdown. Eighteen lactating multiparous Yorkshire sows were allotted to 1 of 2 isocaloric diets (10.80 MJ/kg net energy): control (CON; 19.24% CP) and reduced CP with “optimal” AA profile (OPT; 14.00% CP). Sow body weight and backfat were recorded on d 1 and 21 of lactation and piglets were weighed on d 1, 14, 18, and 21 of lactation. Between d 14 and 18, a subset of 9 sows (CON = 4, OPT = 5) was infused with a mixed solution of 3-[methyl-2H3]histidine (bolus injection) and [13C]bicarbonate (priming dose) first, then a constant 2-h [13C]bicarbonate infusion followed by a 6-h primed constant [1-13C]lysine infusion. Serial blood and milk sampling were performed to determine plasma and milk Lys enrichment, Lys oxidation rate, whole body protein turnover, and muscle protein breakdown.

Results

Over the 21-d lactation period, compared to CON, sows fed OPT had greater litter growth rate (P < 0.05). Compared to CON, sows fed OPT had greater efficiency of Lys (P < 0.05), Lys mammary flux (P < 0.01) and whole-body protein turnover efficiency (P < 0.05). Compared to CON, sows fed OPT tended to have lower whole body protein breakdown rate (P = 0.069). Muscle protein breakdown rate did not differ between OPT and CON (P = 0.197).

Conclusion

Feeding an improved AA balance diet increased efficiency of Lys and reduced whole-body protein turnover and protein breakdown. These results imply that the lower maternal N retention observed in lactating sows fed improved AA balance diets in previous studies may be a result of greater partitioning of AA towards milk rather than greater body protein breakdown.
Cognitive, social, and mental health functions of refugee children – screening and supportive actions at school: a study protocol
Authors: Lahtinen Oskari , Kangaslampi Samuli , Aalto Sanni , Soosalu Joosu , Peltonen Kirsi
Published: May 2024

Background

Despite a world-leading educational system, an achievement gap in educational outcomes exists between children of refugee background and native-born peers in Finland. To offer targeted support for children at schools, we need to be able to reliably assess and understand the interplay of the aspects of children’s cognitive, social, and mental health functions that may explain the underachievement of refugee children.

This study tests a novel research-based, universally applicable screening battery for evaluating cognitive, social, and mental health functioning of children at schools and planning supportive actions. It aims to answer research questions about a) the cognitive, social, and mental health functioning of refugee children compared with non-refugee immigrant and native-born children, b) the interplay of these different functions among refugee and other children, c) whether implementing a screening battery can inform schools in planning supportive actions for (refugee) children, and d) whether such supportive actions result in improvements in cognitive, social, and mental health functioning.

Methods

Four hundred fifty children aged 10–12 will be recruited from primary schools, including 150 children of refugee background, 150 of non-refugee immigrant background, and 150 native-born Finnish children. A screening battery including tasks and questionnaires on different aspects of cognitive, social, and mental health functioning will be used to assess the children in their classrooms at the start and end of a school year. Supporting information will also be collected from parents and teachers. The information gathered will be collated into class-level feedback reports for teachers and, with parental permission, individualized reports for multiprofessional student welfare bodies, for informing supportive actions. Correlational and latent profile analyses, ANOVAs, and linear regression will be used to answer the research questions.

Discussion

This study will help clarify how the interplay of cognitive, social, and mental health factors may explain underachievement at school among refugee children. It will provide evidence about the extent to which a standardized screening battery could be helpful in informing and planning supportive actions for children at schools, and whether such supportive actions can lead to positive cognitive, social, or mental health outcomes.

Trial registration

The study will be preregistered on the Open Science Framework.
Bloomery iron production in the Holy Cross Mountains (Poland) area during the Roman period: conditions during the metallurgical process and their uniformity between locations
Authors: Kupczak Krzysztof , Warchulski Rafał , Gawęda Aleksandra , Janiec Jan
Published: May 2024

The study assessed the uniformity of the metallurgical process carried out during the period of Roman influence in Poland. The age of the investigated material was confirmed based on an analysis of the 12C/14C isotope ratio in the charcoal found in slag. The comparison was based on four Holy Cross Mountains (Poland) locations. The evaluation included smelting temperature, viscosity of the metallurgical melt, oxidation–reduction conditions, and slag cooling rate determined based on geochemical (XRF) and mineralogical (XRD, SEM, EPMA) analyses. Despite the distance between individual sampling sites, the conditions in which smelting was carried out were similar for all samples. The liquidus temperature of the analyzed slags was in the range of 1150–1200 °C. Oxidation–reduction conditions were determined through thermodynamic calculations using SLAG software. In the temperature range of 1150–1200 °C, the oxygen fugacity had to be below logP O2 = − 13.20 to − 12.53 atm to reduce iron oxides to metallic iron. The viscosity of the metallurgical melt was calculated and ranged from 0.15 to 1.02 Pa s, indicating a low viscosity. The slag cooling rate determined based on olivine morphology was in the range of > 5 to 300 °C/h. Smelting parameters were compared with other locations in Poland, and similar results were obtained for slags from Masovia and Tarchlice. In the case of one site (Opole), despite the higher maximum value of liquidus temperature, it was indicated that the process could have taken place in similar conditions, and the differences resulted from contamination of the slag with material from the furnace/pit walls.
Systemic defense induced by fatty acid compounds from marine macroalgae, Chaetomorpha antennina in tomato (Solanum lycopersicum) plants alters the susceptibility of the polyphagous agricultural pest, Spodoptera litura Fab
Authors: Chanthini Kanagaraj Muthu-Pandian , Deva-Andrews Arulsoosairaj , Kirupaanntha-Rajan Pandian , Almutairi Bader O. , Senthil-Nathan Sengottayan
Published: May 2024

Background

Seaweeds contain a widespread range of fatty acids (FA), and several of them have potential bioactivity. FAs are dynamic members of all biota, as well as being acknowledged for their critical function in initiating phytohormone interactions and acting as important participants in many defense signalling pathways of the plant system. The current study looks at the defense-eliciting potentials of fatty acids from the green seaweed Chaetomorpha antennina (Bory) Kützing and their impact on the polyphagous insect pest Spodoptera litura (Fab).

Results

The seaweed was detected with 19 fatty acids, with larger proportion of hexa and octadecanoic and linoleic acids. The algal fatty acid compounds (CFA) were successful in eliciting salicylic acid and phenolic compounds biosynthesis along with defense enzymes peroxidase (PO) and polyphenol oxidase (PPO). CFA enhanced the synthesis of defense enzymes, PO and PPO and phenols, post infestation with S. litura (> 50%) compared to control plants exposed to the pest. CFA was also effective in causing direct mortalities (96–98%) to the larvae (II-V instars). S. litura larvae exposed to elicited tomato plants displayed physiological incursions that extended larval-pupal duration to 26–28 days, preventing both morphogenetic transitions as well as affecting their morphology, that lead to the emergence of adults with malformed wings, legs. As a consequence, the fecundity was reduced by 60% affecting the reproductive performances of second-generation adults. The consumption rate (RCR) of larvae exposed to CFA was decreased by 84%, depicting feeding deterrence. These larvae were also observed with > 50% reduction in the levels of phosphatase enzyme secretion, bringing down larval growth rate from 0.58 to 0.34 mg/day. Histological analysis of exposed larvae displayed midgut cell disruption.

Conclusion

Hence, the study finally confirms the elicitor potentials of fatty acid compounds from C. antennina, by inducing natural systemic defenses. This investigation unlocks novel forecasts besides delivering an unconventional method for crop protection to moderate or interchange the solicitation of chemical pesticides.

Graphical Abstract
NIHR Race Equality Framework: development of a tool for addressing racial equality in public involvement
Authors: Faluyi David , Ovseiko Pavel V. , Dziedzic Krysia , Scott Fay ,   on behalf of the NIHR Race Equality Public Action Group, Tulloch André , Barker Caroline , Wallace-Watson Claire , Cole Jon , Castledine John , Holmes Kate , Cook Katie , Oliva Laurie , Slocombe Mark , Rogers Mike , Bent Nikki , Ovseiko Pavel , John Royston , Richards Sandra , Knowles Sarah , Kosar Zahra
Published: May 2024

Background

While there has been a long recognition of the importance of race equality in health and care research, there is a lack of sustained action among research funding and research performing organisations to address racial equality in public involvement. This paper describes how the UK’s National Institute for Health and Care Research (NIHR) convened a Race Equality Public Action Group (REPAG), which co-developed with public contributors and stakeholders a Race Equality Framework – a tool for addressing racial equality in public involvement.

Methods

The REPAG, through meetings and discussions, defined the focus of the Framework, and developed an initial draft of the Framework. Public contributors identified the need for broader consultation with other public members. Three community consultation events with a total of 59 members of Black African-, Asian- and Caribbean-heritage communities were held to seek their views on health and care research generally and on the draft Framework specifically. The draft Framework was modified and piloted among 16 organisations delivering health and care research. Following feedback from the pilot, the Framework was modified and prepared for publication.

Results

The Framework is designed as a self-assessment tool comprised of 50 questions pertaining to five domains of organisational activity: 1) individual responsibility, 2) leadership, 3) public partnerships, 4) recruitment, and 5) systems and processes. The questions were co-designed with REPAG public members and provide key concepts and elements of good practice that organisations should consider and address on their path to achieving racial competence. The accompanying materials provide implementation guidance with 20 detailed steps, case studies of actions taken in seven pilot organisations, and links to additional resources. The pilot demonstrated the feasibility of conducting a meaningful self-assessment over a period of three months and the usefulness of the results for developing longer-term action plans.

Conclusion

The Framework represents the first self-assessment tool for addressing racial equality in public involvement. Co-design with REPAG public members enhanced its authenticity and practicality. Organisations in the field of health and care research and any other organisations that use partnerships with the public are encouraged to adopt the Framework.
A retrospective study of the prevalence of isolated prolongation of activated partial thromboplastin time in the preoperative setting
Authors: Watanabe Yasuhiro , Kato Yuki , Matsuno Takayuki
Published: May 2024

Background

Isolated prolongation of activated partial thromboplastin time (APTT) has various causes including inheritable bleeding disorders, and has medical significance as it can lead to the cancelation of surgery. However, even an emergency surgery can be conducted in a patient presenting with severe APTT prolongation, provided careful evaluation and appropriate measures are taken. Hence, the identification of the underlying etiology of the prolonged APTT is crucial. To date, little evidence exists regarding the prevalence of isolated APTT prolongation in Japanese patients undergoing surgery. Herein, we aimed to clarify the prevalence of isolated prolongation of APTT in the preoperative setting and to identify the reasons underlying isolated, severely prolonged APTT.

Methods

Preoperative coagulation data of all elective and emergent patients who presented to the anesthetic department between January 1, 2020, and June 30, 2023, were retrospectively collected. Isolated prolongation of APTT was defined as an APTT ≥ 37 s with an international normalized ratio of prothrombin time < 1.2. The underlying etiology of the patient with isolated, severely prolonged APTT (≥ 46 s) was investigated, and canceled surgical procedures in relation to the isolated APTT prolongation were searched.

Results

Overall, 10,684 measurements from 9413 patients were included, of which 725 (6.8%) were identified as having isolated APTT prolongation. The reasons for the severely prolonged APTT (n = 60) were miscellaneous, with the most frequently detected etiology being antiphospholipid antibody positivity. Preoperative isolated APTT prolongation contributed to the cancellation of surgery in elective five cases.

Conclusions

We clarified the prevalence of preoperative isolated prolongation of APTT. The presence of antiphospholipid antibody was the most frequently detected etiology of the patient with isolated, severely prolonged APTT. The present study provides an important dataset regarding the isolated prolongation of APTT in East Asian patients undergoing surgery.
Five social and ethical considerations for using wildfire visualizations as a communication tool
Authors: Edgeley Catrin M. , Cannon William H. , Pearse Scott , Kosović Branko , Pfister Gabriele , Kumar Rajesh
Published: May 2024

Background

Increased use of visualizations as wildfire communication tools with public and professional audiences—particularly 3D videos and virtual or augmented reality—invites discussion of their ethical use in varied social and temporal contexts. Existing studies focus on the use of such visualizations prior to fire events and commonly use hypothetical scenarios intended to motivate proactive mitigation or explore decision-making, overlooking the insights that those who have already experienced fire events can provide to improve user engagement and understanding of wildfire visualizations more broadly. We conducted semi-structured interviews with 101 residents and professionals affected by Colorado’s 2020 East Troublesome and 2021 Marshall Fires, using 3D model visualizations of fire events on tablets as a discussion tool to understand how fire behavior influenced evacuation experiences and decision-making. We provide empirically gathered insights that can inform the ethical use of wildfire visualizations by scientists, managers, and communicators working at the intersection of fire management and public safety.

Results

Study design, interview discussions, and field observations from both case studies reveal the importance of nuanced and responsive approaches for the use of 3D visualizations, with an emphasis on the implementation of protocols that ensure the risk of harm to the intended audience is minimal. We share five considerations for use of visualizations as communication tools with public and professional audiences, expanding existing research into post-fire spaces: (1) determine whether the use of visualizations will truly benefit users; (2) connect users to visualizations by incorporating local values; (3) provide context around model uncertainty; (4) design and share visualizations in ways that meet the needs of the user; (5) be cognizant of the emotional impacts that sharing wildfire visualizations can have.

Conclusions

This research demonstrates the importance of study design and planning that considers the emotional and psychological well-being of users. For users that do wish to engage with visualizations, this technical note provides guidance for ensuring meaningful understandings that can generate new discussion and knowledge. We advocate for communication with visualizations that consider local context and provide opportunities for users to engage to a level that suits them, suggesting that visualizations should serve as catalysts for meaningful dialogue rather than conclusive information sources.
Mapping the diversity & transformative potential of approaches to sustainable just cities
Authors: Avelino Flor , van Steenbergen Frank , Schipper Karlijn , Steger Tamara , Henfrey Tom , Cook Ian M. , Bach Matthew , Crowley Duncan , Kotsila Panagiota , Kramer Jakob , Crudi Franco
Published: May 2024

How can cities be more sustainable and just? This question has guided a process of synthesizing insights from previously funded research and innovation projects that deal with approaches tackling urban sustainability and justice. As part of this process, a database in the form of a knowledge commons was developed to gather 40+ approaches: sets of interventions, actions, strategies, solutions or policies that address urban sustainability and justice. This paper reflects on what we can learn from this database of approaches from an urban transitions perspective, both by sharing the method we used to develop the database and by analysing the content of those approaches and what research has revealed in relation to them. Not only do we introduce our methodology of co-creating the database (Section 2) we also present its outcomes in terms of the interlinkages between sustainable and just cities in the identified approaches (Section 3), their transformative potential (Section 4) and which institutional logics are involved (Section 5). We conclude that in addressing sustainability challenges in cities, tensions and contradictions emerge between ecological sustainability on the one hand and inclusivity, recognition and equity on the other (Section 6). Based on the identified approaches, we find that issues linked to justice are frequently glossed over, implicitly addressed, and instrumentalized in favour of ecological improvements or profitability which causes serious implications for future urban research and innovation. In order to address this gap, we present four recommendations for city-makers and city-thinkers across the globe to integrate sustainability and justice at the urban level.
Assessment of olfactory and gustatory functions in COVID-19 patients
Authors: Behairy Essam A. , Khalil Yaser A. , Hamza Ahmed A. , Hamdan Ahmad M.
Published: May 2024

Background

Olfactory and gustatory disorders are common problems encountered during the COVID-19 pandemic with a significant impact on the patient’s quality of life: The aim of this study was to assess the olfactory and gustatory functions in COVID-19 patients with correlation between them and clinical and laboratory markers. This was a cross-sectional study conducted on 63 subjects recruited from the COVID-19 clinics at Police Authority and Menoufia University hospitals. The patients were assessed using history taking, anterior rhinoscopy, endoscopic examination, computed tomography, and polymerase chain reaction (PCR) test. Olfactory functions were assessed using the alcohol threshold test. Gustatory functions were assessed using the three-drop method. The olfactory and gustatory functions were correlated with age, gender, and laboratory parameters. Also, the recovery of smell and taste disorders was correlated with our assessed laboratory markers.

Results

The prevalence of olfactory dysfunction among study participants was 41 patients (65%) of the participants including 12 patients (19.1%) having mild hyposmia, 10 patients (15.8%) having moderate hyposmia, 9 patients (14.3%) having severe hyposmia, and 10 patients (15.8%) having complete anosmia. The prevalence of gustatory dysfunction among study participants was 24 patients (38.1%). Age, gender, and laboratory parameters did not show any statistically significant difference between those who experienced olfactory dysfunction or gustatory dysfunction and those who did not. However, there was a significant positive correlation between the total leucocytic count, serum level of CRP, and serum level of D-dimer and the degree of olfactory dysfunction (0.049, 0.03, and 0.02, respectively). There was a nonsignificant correlation between recovery of olfactory and gustatory dysfunction and laboratory markers.

Conclusion

Olfactory and gustatory dysfunction are established clinical presentations among COVID-19-positive patients. The laboratory markers had no correlation with the incidence of these dysfunctions or their recovery. However, TLC, serum CRP, and serum D-dimer had a significant positive correlation with the severity of olfactory dysfunction.
Latent groups from multidimensional factors and effects on suicidal ideation in older adults
Authors: Lee Hyun , Lee Eunjin
Published: May 2024

Background

Suicide is a serious social problem among older adults. However, little is known about how multidimensional factors affect suicide of older adults.

Aims

We classify the multidimensional suicidal risk types of older adults based on their characteristics and identify differences in suicidal ideation.

Method

Data were obtained via a nationwide online survey targeting 612 older adults over the age of 55 years. A latent profile analysis identified three profiles, one of which represented the optimal situation for these adults.

Results

We identified three distinct multidimensional suicidal risk types in older adults: high-risk predicament (24.5%), moderate-risk predicament (57.7%) and abundant internal/external resources (17.8%). In particular, depression, a major risk factor for suicide, was found together with self-neglect in each group. Multiple regression analysis showed that older adults in the moderate-risk predicament and high-risk predicament groups were more likely to have suicidal ideation than those in the abundant internal/external resources group.

Conclusions

Our findings suggest that co-occurrence of depression and self-neglect represents a suicide risk pattern in high-risk older individuals. Therefore, local communities need to urgently screen and provide interventions for such older adults and strengthen their capacity for multidimensional aspects of life to prevent suicide in the long term.
Differential Effect of 2 Hormonal Contraceptives on the Relative Telomere Length of Youth With Type 1 Diabetes
Authors: Castro Andrea , Lardone M Cecilia , Giraudo Franco , López Patricia , Ortiz Eliana , Iñiguez Germán , Cassorla Fernando , Codner Ethel
Published: May 2024

Context

Adolescents and young women (AYA) with type 1 diabetes (T1D) may require hormonal contraception for an extended period. However, it is unclear what effect hormonal contraception has on telomere length, a marker of the risk for complications.

Objective

To investigate the relative telomere length (RTL) in AYA with T1D (AYA-T1D) and healthy young women (AYA-C) after 18 months of combined oral contraception use (COC) with ethinyl estradiol/desogestrel, or a subdermal etonogestrel implant (IM).

Methods

A nonrandomized prospective study was performed in which 39 AYA-T1D and 40 AYA-C chose the COC or the IM. RTL was measured by monochrome multiplex–quantitative PCR in DNA from peripheral blood mononuclear cells (PBMC). The impact of contraceptives and clinical variables on RTL was assessed using lineal regression analysis.

Results

Longer RTL compared to baseline was observed in AYA-T1D (P < .05) and AYA-C (P  < .01) after using the IM. However, the total of AYA and the AYA-C group treated with COC decreased RTL after 18 months of treatment compared to baseline (P < .05). The type of contraceptive used was determinant for the changes in RTL compared to baseline in all subjects and controls (P ≤ .006). For AYA-T1D, HbA1c levels were not associated with RTL, but the high-sensitivity C-reactive protein was negatively related with the changes in RTL at 18 months compared to baseline (standardized R2: 0.230, P  = .003).

Conclusion

IM was associated with longer RTL in AYA-T1D and AYA-C. In contrast, a shortening of telomere length in PBMC was observed after using COC.
Identification of Predictors of Metastatic Potential in Paragangliomas to Develop a Prognostic Score (PSPGL)
Authors: Iguchi Daniela Yone Veiga , Martins Filho Sebastião Nunes , Soares Iberê Cauduro , Siqueira Sheila Aparecida Coelho , Alves Venâncio Avancini Ferreira , Assato Aline Kawassaki , Yang Ji Hoon , Almeida Madson Q , Villares Fragoso Maria Candida Barisson , Fagundes Gustavo Freitas Cardoso , Mendonca Berenice B , Lourenço Junior Delmar Muniz , Hoff Ana O , Castroneves Luciana Audi , Ferraz-de-Souza Bruno , Giannella Maria Lucia Cardillo Correa , Pereira Maria Adelaide Albergaria
Published: May 2024

Context

Paragangliomas (PGLs) are rare tumors in adrenal and extra-adrenal locations. Metastasis are found in approximately 5% to 35% of PGLs, and there are no reliable predictors of metastatic disease.

Objective

This work aimed to develop a prognostic score of metastatic potential in PGLs.

Methods

A retrospective analysis was conducted of clinical data from a cohort with PGLs and tumor histological assessment. Patients were divided into metastatic PGL (presence of metastasis) and nonmetastatic PGL (absence of metastasis ≥96 months of follow-up) groups. Univariate and multivariable analysis were performed to identify predictors of metastatic potential. A prognostic score was developed based on coefficients of multivariable analysis. Kaplan-Meier curves were generated to estimate disease-specific survival (DSS).

Results

Out of 263 patients, 35 patients had metastatic PGL and 110 patients had nonmetastatic PGL. In multivariable analysis, 4 features were independently related to metastatic disease and composed the Prognostic Score of Paragangliomas (PSPGL): presence of central or confluent necrosis (33 points), more than 3 mitosis/10 high-power field (HPF) (28 points), extension into adipose tissue (20 points), and extra-adrenal location (19 points). A PSPGL of 24 or greater showed similar sensitivity with higher specificity than the Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and Grading System for Adrenal Pheochromocytoma and Paraganglioma (GAPP). PSPGL less than or equal to 20 was associated with a risk of metastasis of approximately 10%, whereas a PSPGL of 40 or greater was associated with approximately 80%. The presence of metastasis and Ki-67 of 3% or greater were related to lower DSS.

Conclusion

The PSPGL, composed of 4 easy-to-assess parameters, demonstrated good performance in predicting metastatic potential and good ability in estimating metastasis risk.
Delirium management and current practice among Intensive Care Units Doctors, Khartoum
Authors: Seidna Hamid Sheema Hamid , Abd El-Raheem Ghada Omer Hamad , Salih Elamin Hana  Eltayeb , Ahmed  Abdallah Mudawi Mohammed
Published: May 2024

Delirium is a brain dysfunction characterized by attention and cognitive disturbances in a fluctuating manner. The international guidelines recommend daily screening for delirium. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) are the most commonly used methods for assessing delirium. This study aimed to identify barriers and gaps in knowledge and practice. This was a hospital-based Cross-Sectional study. Stratified random sampling was used in this study. 72 ICU doctors were randomly selected. Statistical analyses were performed using IBM SPSS version 23. Descriptive data were presented, and the chi-squared test was used to determine the associations among variables. Statistical significance was set at p < 0.05. More than 70% of the doctors were ≤ 30 years of age and female. A total of 69.4% of the participants had < 1year of experience. In total, 94.4% of the participants worked in medical ICUs. Less than 20% of the doctors used delirium assessment tools, with a statistically significant difference based on experience (p=0.012). Delirium was not regularly assessed in 13.9% of the patients. Non-pharmacological management was applied by 76.4% of doctors, and communication with patients was the most frequent (75%). Haloperidol was the most commonly used drug (83.3%). A total of 40.3% of doctors did not stop delirium medication on ICU discharge. A regular delirium assessment was performed. However, the use of validated assessment tools is uncommon. Nonpharmacological management of delirium is important and is mostly performed. Our doctors prescribed antipsychotics for the treatment of both forms of delirium, and almost half of them did not stop the medications on ICU discharge. Medication reconciliation and contact with the next in-charge of the patients are important.
Evaluation of intravenous magnesium sulphate on haemodynamic responses to laryngoscopy and tracheal intubation in surgeries of ear, nose and throat
Authors: Sawant Urvi , Sen Jayashree , Paul Amreesh
Published: May 2024

Heart rate, arterial blood pressure, and arrhythmias significantly surge during laryngoscopy and intubation. Anesthesiologists constantly look for ways to minimize these unwanted reactions. Several medicinal interventions have been suggested to mitigate these side effects; intravenous magnesium sulphate injection is one such intervention. Magnesium sulphate is a divalent salt widely recognized for its capacity to lower sympathetic nervous system muscle cell excitability, which lowers blood pressure and causes vasodilation. It is approved as a medicine to treat preeclampsia and control blood pressure. Moreover, there is growing recognition of its benefits on hemodynamic parameters in patients suffering from ischemic infective endocarditis and heart disease. Magnesium is an asset for reducing negative cardiovascular reactions occurring at the time of laryngoscopy and intubation because of its capacity to reduce catecholamine synthesis from adrenergic nerve ends and the adrenal medulla. Intravenous magnesium sulphate will be used in this trial to assess its effect on reducing adverse hemodynamic responses in candidates for elective laryngoscopy and intubation for ENT surgeries.