bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with adolescent pregnancy and public health interventions to address in Nigeria: a scoping review
Authors: Alukagberie Majesty Enaworoke , Elmusharaf Khalifa , Ibrahim Nuha , Poix Sébastien
Published: June 2023

Background

Adolescent pregnancy is a global public health and social problem that affects both developed and developing countries. Reducing adolescent pregnancy is central to achieving sustainable development goals. In 2021 Nigeria’s Adolescent pregnancy was 106 per 1000 and showed an increasing rate. This study, therefore, aims to explore the literature to map the risk factors and interventions against adolescent pregnancy in Nigeria.

Method

A scoping review of studies published between January 2007 and December 2022 using PubMed, Web of Science and Africa Journals Online were searched using the keywords' adolescent pregnancy' AND 'Nigeria'. Studies were screened using the eligibility criteria.

Results

A total of 241 articles, of which 229 were identified through the databases and 12 were identified through hand search. After the full-text review, 28 studies met the inclusion criteria and were included in the final review. In Nigeria, the prevalence of adolescent pregnancy is between 7.5 and 49.5%. Associated factors for adolescent pregnancy in Nigeria are multifactorial, including individual, community, societal, school, family, and peer factors. Policies on adolescent sexual and reproductive health exist in Nigeria. Still, the policies need more sponsorship, implementation, and monitoring, while only some interventions on adolescent pregnancy majorly based on contraceptives and education of health providers are available in Nigeria.

Conclusion

Associated factors for adolescent Pregnancy in Nigeria are multidimensional, with educational attainment and wealth index being the highest associated factor. Intervention strategies aimed at the educational level have been identified as a critical factor in curbing adolescent pregnancy. Thus, policies on sexual, reproductive, and mental health development specifically targeting adolescents to reduce the cycle of societal dependence by empowering this group economically and educationally are justifiably warranted.
Development and validation of a two glycolysis-related LncRNAs prognostic signature for glioma and in vitro analyses
Authors: Xu Xiaoping , Zhou Shijun , Tao Yuchuan , Zhong Zhenglan , Shao Yongxiang , Yi Yong
Published: June 2023

Background

Mounting evidence suggests that there is a complex regulatory relationship between long non-coding RNAs (lncRNAs) and the glycolytic process during glioma development. This study aimed to investigate the prognostic role of glycolysis-related lncRNAs in glioma and their impact on the tumor microenvironment.

Methods

This study utilized glioma transcriptome data from public databases to construct, evaluate, and validate a prognostic signature based on differentially expressed (DE)-glycolysis-associated lncRNAs through consensus clustering, DE-lncRNA analysis, Cox regression analysis, and receiver operating characteristic (ROC) curves. The clusterProfiler package was applied to reveal the potential functions of the risk score-related differentially expressed genes (DEGs). ESTIMATE and Gene Set Enrichment Analysis (GSEA) were utilized to evaluate the relationship between prognostic signature and the immune landscape of gliomas. Furthermore, the sensitivity of patients to immune checkpoint inhibitor (ICI) treatment based on the prognostic feature was predicted with the assistance of the Tumor Immune Dysfunction and Exclusion (TIDE) algorithm. Finally, qRT-PCR was used to verify the difference in the expression of the lncRNAs in glioma cells and normal cell.

Results

By consensus clustering based on glycolytic gene expression profiles, glioma patients were divided into two clusters with significantly different overall survival (OS), from which 2 DE-lncRNAs, AL390755.1 and FLJ16779, were obtained. Subsequently, Cox regression analysis demonstrated that all of these lncRNAs were associated with OS in glioma patients and constructed a prognostic signature with a robust prognostic predictive efficacy. Functional enrichment analysis revealed that DEGs associated with risk scores were involved in immune responses, neurons, neurotransmitters, synapses and other terms. Immune landscape analysis suggested an extreme enrichment of immune cells in the high-risk group. Moreover, patients in the low-risk group were likely to benefit more from ICI treatment. qRT-PCR results showed that the expression of AL390755.1 and FLJ16779 was significantly different in glioma and normal cells.

Conclusion

We constructed a novel prognostic signature for glioma patients based on glycolysis-related lncRNAs. Besides, this project had provided a theoretical basis for the exploration of new ICI therapeutic targets for glioma patients.
Combined electric and magnetic field therapy for bone repair and regeneration: an investigation in a 3-mm and an augmented 17-mm tibia osteotomy model in sheep
Authors: Darwiche Salim E. , Kaczmarek Anna , Schwarzenberg Peter , Inglis Brendan J. , Lechmann Beat , Kronen Peter , Ferguson Stephen J. , Dailey Hannah , von Rechenberg Brigitte , Klein Karina
Published: June 2023

Background

Therapies using electromagnetic field technology show evidence of enhanced bone regeneration at the fracture site, potentially preventing delayed or nonunions.

Methods

Combined electric and magnetic field (CEMF) treatment was evaluated in two standardized sheep tibia osteotomy models: a 3-mm non-critical size gap model and a 17-mm critical size defect model augmented with autologous bone grafts, both stabilized with locking compression plates. CEMF treatment was delivered across the fracture gap twice daily for 90 min, starting 4 days postoperatively (post-OP) until sacrifice (9 or 12 weeks post-OP, respectively). Control groups received no CEMF treatment. Bone healing was evaluated radiographically, morphometrically (micro-CT), biomechanically and histologically.

Results

In the 3-mm gap model, the CEMF group (n = 6) exhibited higher callus mineral density compared to the Control group (n = 6), two-fold higher biomechanical torsional rigidity and a histologically more advanced callus maturity (no statistically significant differences). In the 17-mm graft model, differences between the Control (n = 6) and CEMF group (n = 6) were more pronounced. The CEMF group showed a radiologically more advanced callus, a higher callus volume (p = 0.003) and a 2.6 × higher biomechanical torsional rigidity (p = 0.024), combined with a histologically more advanced callus maturity and healing.

Conclusions

This study showed that CEMF therapy notably enhanced bone healing resulting in better new bone structure, callus morphology and superior biomechanical properties. This technology could transform a standard inert orthopedic implant into an active device stimulating bone tissue for accelerated healing and regeneration.
Translation and validation of the simplified Chinese version of the Chronic Pain Coping Inventory-42
Authors: Kou Jun , Xu Wei , Sun Qiqi , Xie Qingyun , Wang Wei
Published: June 2023

Background

The Chronic Pain Coping Inventory-42(CPCI-42) is mainly used for chronic pain management project, its original version is written in English and has been widely used in western countries. Therefore, the purpose of our study is to apply the CPCI-42 to Chinese patients and evaluate its responsiveness, reliability, and validity for Chinese patients with lumbar disc herniation (LDH).

Methods

Translation and adaptation were carried out in accordance with the guidelines of the American Academy of Orthopedic Surgeons Outcome Committee. A total of 133 patients who were diagnosed with LDH were included in this study. Psychometric evaluations were then performed and included score distribution, internal consistency, test–retest reliability, construct validity, and responsiveness.

Results

CPCI-42 is well adapted to the assessment of the cognitive and behavioral strategies of patients with LDH, and the scores of score distribution, internal consistency, test–retest reliability, construct validity, and responsiveness are excellent. Forward and reverse translation of the CPCI-42 to English from Chinese worked smoothly.

Conclusion

It is applicable to the assessment of quality of life of the cognitive and behavioral strategies of patients with LDH, and the scores of all indicators are excellent.
Efficacy and safety of extracorporeal shockwave therapy in chronic low back pain: a systematic review and meta-analysis of 632 patients
Authors: Liu Kun , Zhang Qingyu , Chen Lili , Zhang Haoran , Xu Xiqiang , Yuan Zenong , Dong Jun
Published: June 2023

Background

Extracorporeal shock wave therapy (ESWT) has been widely used for pain control in musculoskeletal disorders. Whether ESWT can relieve chronic low back pain (CLBP) and improve lumbar function is still unclear. Therefore, we conducted a meta-analysis of relevant studies to comprehensively analyse and determine the efficacy and safety of ESWT for chronic low back pain.

Methods

Four databases were systematically searched for randomized controlled trials (RCTs) on ESWT for CLBP. The quality of the included studies was evaluated according to Cochrane systematic review criteria, relevant data were extracted, and meta-analysis was performed using RevMan 5.4 software. The primary outcomes were pain intensity, disability status, and mental health. The data were expressed as standardized mean differences (SMD) or weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was assessed using the I2 statistic. If I2 ≥ 50%, a random effects model was applied; otherwise, a fixed effects model was used.

Results

Twelve RCTs involving 632 patients were included in this meta-analysis. The ESWT group reported significantly more pain relief than the control group at 4 weeks (WMD =  − 1.04; 95% CI =  − 1.44 to − 0.65; P < 0.001) and 12 weeks (WMD =  − 0.85; 95% CI =  − 1.30 to − 0.41; P < 0.001). Regarding the dysfunction index, ESWT led to significant improvement in lumbar dysfunction compared with the control group at 4 weeks (WMD =  − 4.22; 95% CI =  − 7.55 to − 0.89; P < 0.001) and 12 weeks (WMD =  − 4.51; 95% CI =  − 8.58 to − 0.44; P = 0.03). For mental health, there was no significant difference between the ESWT group and the control group after 4 weeks of intervention (SMD = 1.17; 95% CI =  − 0.10 to 2.45; P = 0.07).

Conclusion

This systematic review and meta-analysis found that ESWT provided better pain relief and improved lumbar dysfunction compared with the other interventions included, and no serious adverse effects were found. There was no significant effect of ESWT on the mental health of patients, but we hope to obtain more RCTs for further analysis in the future. Based on the pooled results, we suggest that ESWT is effective and safe for treating chronic low back pain.
A comprehensive study of the rare diseases and conditions targeted by orphan drug designations and approvals over the forty years of the Orphan Drug Act
Authors: Fermaglich Lewis J. , Miller Kathleen L.
Published: June 2023

Background

Rare diseases affect more than 30 million Americans. The passage of the Orphan Drug Act (ODA) in the United States in 1983 represented a launching point for a rare disease drug development revolution for these patients. Financial incentives provided by the ODA through its Orphan Drug Designation Program, in addition to remarkable scientific advances over the past 40 years, have led to hundreds of drug approvals for rare diseases. Our research examines the rare diseases that have been targeted by orphan drug designations and subsequent approvals since the law was enacted.

Methods

Using an internal FDA database, we classified and analyzed all orphan drug designations and approvals from 1983 to 2022 by disease and therapeutic area.

Results

Over the 40 years of the ODA, 6,340 orphan drug designations were granted, representing drug development for 1,079 rare diseases. Additionally, 882 of those designations resulted in at least one FDA approval for use in 392 rare diseases. Much of this development has been concentrated in oncology as seven of the top ten most designated and approved diseases were rare cancers.

Conclusions

Researchers have estimated that there may be 7000–10,000 rare diseases that have been identified and described. Based on our study, we can conclude that around 5% of rare diseases have an FDA-approved drug and up to 15% of rare diseases have at least one drug that has been developed and shown promise in their treatment, diagnosis or prevention. Funding of basic and translational science for rare disease drug development should continue in order to bring therapies to the millions of affected patients who remain without treatment options.
Development and application of nanomaterials, nanotechnology and nanomedicine for treating hematological malignancies
Authors: Li Jinxin , Wang Qiwei , Han Yingli , Jiang Lingli , Lu Siqi , Wang Beini , Qian Wenchang , Zhu Meng , Huang He , Qian Pengxu
Published: June 2023

Hematologic malignancies (HMs) pose a serious threat to patients’ health and life, and the five-year overall survival of HMs remains low. The lack of understanding of the pathogenesis and the complex clinical symptoms brings immense challenges to the diagnosis and treatment of HMs. Traditional therapeutic strategies for HMs include radiotherapy, chemotherapy, targeted therapy and hematopoietic stem cell transplantation. Although immunotherapy and cell therapy have made considerable progress in the last decade, nearly half of patients still relapse or suffer from drug resistance. Recently, studies have emerged that nanomaterials, nanotechnology and nanomedicine show great promise in cancer therapy by enhancing drug targeting, reducing toxicity and side effects and boosting the immune response to promote durable immunological memory. In this review, we summarized the strategies of recently developed nanomaterials, nanotechnology and nanomedicines against HMs and then proposed emerging strategies for the future designment of nanomedicines to treat HMs based on urgent clinical needs and technological progress.
Emerging therapies targeting the delta-like ligand 3 (DLL3) in small cell lung cancer
Authors: Rudin Charles M. , Reck Martin , Johnson Melissa L. , Blackhall Fiona , Hann Christine L. , Yang James Chih-Hsin , Bailis Julie M. , Bebb Gwyn , Goldrick Amanda , Umejiego John , Paz-Ares Luis
Published: June 2023

Small cell lung cancer (SCLC) is an aggressive neuroendocrine carcinoma with a poor prognosis. Initial responses to standard-of-care chemo-immunotherapy are, unfortunately, followed by rapid disease recurrence in most patients. Current treatment options are limited, with no therapies specifically approved as third-line or beyond. Delta-like ligand 3 (DLL3), a Notch inhibitory ligand, is an attractive therapeutic target because it is overexpressed on the surface of SCLC cells with minimal to no expression on normal cells. Several DLL3-targeted therapies are being developed for the treatment of SCLC and other neuroendocrine carcinomas, including antibody-drug conjugates (ADCs), T-cell engager (TCE) molecules, and chimeric antigen receptor (CAR) therapies. First, we discuss the clinical experience with rovalpituzumab tesirine (Rova-T), a DLL3-targeting ADC, the development of which was halted due to a lack of efficacy in phase 3 studies, with a view to understanding the lessons that can be garnered for the rapidly evolving therapeutic landscape in SCLC. We then review preclinical and clinical data for several DLL3-targeting agents that are currently in development, including the TCE molecules—tarlatamab (formerly known as AMG 757), BI 764532, and HPN328—and the CAR T-cell therapy AMG 119. We conclude with a discussion of the future challenges and opportunities for DLL3-targeting therapies, including the utility of DLL3 as a biomarker for patient selection and disease progression, and the potential of rational combinatorial approaches that can enhance efficacy.
The combined effect of EGR and hydrogen addition on a Syzygium cumini (jamun) liquid biofuel engine
Authors: Kannappan Chandrasekar , Sengottaiyan Sudhakar , Ramasamy Rajappan
Published: June 2023

Rapid depletion of fossil fuels required the development of alternate and sustainable fuel sources that could replace conventional fuel while having no negative environmental impact. Combining hydrogen induction with biodiesel ensures strict emission standards and lowers energy consumption compared to conventional fuels. In this study, the performance, emissions, and combustion of a CI engine for Syzygiumcumini (B20) were assessed and compared to diesel fuel while using a fixed amount of hydrogen flow rate (6L/m). Throughout the experiment, an exhaust gas recirculation (EGR) technology of 10% and 20% and a constant engine speed of 1500 rpm at varying engine load circumstances were used. When hydrogen is added to B20, it decrease the emissions of carbon monoxide (CO), unburned hydrocarbons (UHC), brake thermal efficiency (BTE), and brake specific energy consumption (BSEC). At maximum load, the use of the EGR system decreased the exhaust gas temperature (EGT) by 13.4% and nitrogen oxide (NOX) emission by 25%, but it had a negative impact on BTE, BSEC, as well as other emission parameters including CO and UHC. Therefore, using hydrogen in dual fuel mode in a CI engine enhances performance and lowers exhaust emissions, while using the EGR approach reduces NOX emissions.
Screening of skatole-degrading bacteria and control of human fecal odor by compound bacteria
Authors: Ye Jiangyu , Fu Qian
Published: June 2023

Purpose

The biodegradation of skatole was used as a starting point in this study, and existing strains of degrading NH3 and H2S in the laboratory were combined to create a composite deodorant. The deodorization effect of the composite deodorant on human feces was investigated in order to provide a foundation for fecal odor gas treatment.

Methods

Skatole-degrading bacteria were identified, degradation conditions were optimized, and skatole metabolites were identified using liquid chromatography-mass spectrometry (LC-MS). The skatole-degrading bacteria were combined with the existing strains of degrading NH3 and H2S in the laboratory to make a compound deodorizer, and the deodorizing effect of the compound deodorizer on fresh human feces and old human feces was compared. Liquid chromatography, specific sensors, and gas chromatography were used to determine the contents of skatole, NH3, H2S, and volatile organic compounds, and the microbial diversity was examined.

Results

Microbial agents H and Y capable of utilizing skatole were screened out under aerobic and facultative anaerobic conditions, respectively. Within 48 h, the degradation rate of skatole by microbial agent Y was 88.52%. Following condition optimization, the optimum temperature for skatole degradation by microbial agent Y was 33 °C, and the optimum pH was 7. The main functional bacteria were Acinetobacter xiamenensis. The metabolites of skatole were determined by liquid chromatography-mass spectrometry (LC–MS), and six possible metabolites were found, including 3-aldehyde indole, 3-carboxyl indole, 1H-indole-2,3-dione, and 3-methyl indole pyruvate. The skatole-degrading bacteria Lactobacillus rhamnosus and Saccharomyces cerevisiae were then combined in proportion to form a composite deodorant. The 5-day degradation rate of skatole in the old manure group was 88.11%, while the 5-day degradation rate in the fresh manure group was 47.56%.

Conclusions

The compound microbial agent developed in this study has a solid deodorizing effect, particularly in the control of the odor of obsolete feces. The use of composite microbial agents can efficiently degrade skatole in human feces, providing a theoretical foundation for the use of microbial remediation in the actual world.

Graphical Abstract
Urban electricity governance and the (re)production of heterogeneous electricity constellations in Dar es Salaam
Authors: Koepke Mathias , Monstadt Jochen , Pilo’ Francesca
Published: June 2023

Background

Electricity infrastructures in sub-Saharan African cities are characterized by heterogeneous socio-technical constellations, including alternative grid access channels and off-grid systems. These constellations secure access beyond conventional grids but also produce adverse social, environmental, and economic outcomes affecting sustainable energy transition efforts. In fact, interventions aiming to promote energy transitions may be restricted by institutional mechanisms that produce and maintain these heterogeneous constellations. This article explores these institutional mechanisms by focusing on the governance of heterogeneous electricity constellations in Dar es Salaam, Tanzania. It develops a novel framework on governance modalities to understand and explain the logics, mechanisms, and actors that govern different constellations across diverse neighborhoods as well as to unpack how they limit the potential of sustainable energy transitions and offer specific opportunities for them.

Results

This article is based on a qualitative case study covering three diverse neighborhood types in Dar es Salaam (i.e., low-income, peri-urban, and affluent areas) that reflect heterogeneous user demands. The research draws on interviews with residents and community leaders to understand local modes of coordination, the participatory observation of technical features and user practices, as well as document sources and semi-structured expert interviews to analyze institutional aspects. Our study demonstrates that heterogeneous electricity constellations in Dar es Salaam are governed by the place-based interplay of four governance modalities: hierarchical, market-based, network-based, and managerial governance. Based on this conceptualization, we identified critical barriers for interventions toward urban energy transitions in the context of infrastructural heterogeneity, namely, conflicting logics that shape conventional grid services, complex and fragmented actor constellations, and diverging, place-based interests among various actors, including different state actors.

Conclusions

Our study indicates that heterogeneous urban infrastructure constellations are not merely a response to the considerable socio-spatial inequalities within Southern cities. Rather, their prevailing importance and (re)production must be understood as resulting from the interplay of various governance modalities. The study contributes to debates on urban energy transitions in sub-Sahara Africa by explaining the institutional complexity associated with infrastructural heterogeneity, which can restrict interventions aiming to improve and universalize service provision through heterogeneous urban electricity constellations.
“I wouldn’t need Narcan for myself, but I can have it for somebody else:” perceptions of harm reduction among hospitalized patients with OUD
Authors: French Rachel , Holliday Davis M. , Aronowitz Shoshana V. , Crowe Molly , Abrams Matthew , Edwards Grace , Lowenstein Margaret
Published: June 2023

Background

Extant literature is limited on adoption of evidence-based harm reduction strategies in hospitals. We explored patient perceptions of incorporating harm reduction supplies and education in hospital care with patients with opioid use disorder (OUD).

Methods

Qualitative descriptive study of hospitalized patients with OUD in Philadelphia, PA using semi-structured interviews conducted between April and August of 2022.

Results

Three major themes emerged from 21 interviews with hospitalized patients with OUD: (1) Applicability and Acceptability of Harm Reduction Practices for Oneself; (2) Applicability and Acceptability of Harm Reduction Practices for Others; (3) Perceptions of Harm Reduction Conversations. Most participants were familiar with harm reduction but varied in their perceptions of its relevance for their lives. We noted differences in how participants viewed the applicability and acceptably of harm reduction practices that they perceived as intended to help others (e.g., naloxone) versus intended to help themselves (e.g., syringes). Most participants reported that meaningful conversations about drug use did not happen with their care team but that these conversations would have been acceptable if they were conducted in a way consistent with their individual substance use goals.

Conclusions

Patients' interest and perceived acceptability of harm reduction services during hospitalization varied by individual patient factors and the perceived user of specific interventions. Given their positive potential, harm reduction practices should be incorporated in hospitals, but this must be done in a way that is acceptable to patients. Our findings reveal ways to integrate concepts from a harm reduction approach within a traditional medical model. More work is needed to understand the impact of such integration.
The effect of e-commerce livestreaming services on customer loyalty: a test of the chain mediation model
Authors: Ye XinMei , Batool Hira , Huang Shi-Zheng
Published: June 2023

The outbreak of COVID-19 has made the offline real economy suffer an unprecedented test, and the online e-commerce livestreaming model, as a new marketing model, has been rapidly developed. Based on the SOR model, this paper clarifies the interaction between e-commerce livestreaming and consumer decision-making, taking the e-commerce livestream as an independent variable, customer engagement and value co-creation as intermediary variables, and customer loyalty as the dependent variable. This paper explores the evolution from e-commerce livestreaming to customer loyalty. The target sample consists of 475 Chinese e-commerce livestream viewers. Structural equation modelling (SEM) is used for empirical analysis, and MPLUS8.0 is used for data analysis. Aesthetic appeal, functional layout and verbal communication have a direct impact on customer engagement, while financial security, Nonverbal communication and service skills have no significant impact. In value co-creation, customer engagement has a direct impact on functional, hedonic and social values, which all have a direct impact on customer loyalty. Customer engagement does not singularly mediate between e-commerce livestreaming and customer loyalty, while value co-creation does have a mediating effect. Customer engagement and value co-creation have an enchained mediating effect between e-commerce livestreaming and customer loyalty. The research results reveal the effects of e-commerce livestreaming, provide a new entry point for considering stimuli in the application of SOR theory to e-commerce, and demonstrate how e-commerce livestreaming provides customers with visual beauty and personalized experiences while enhancing the communication skills of the operations and service staff. This research extends the scene theory of e-commerce livestreaming services and provides significant insights into e-commerce livestreaming platforms and enterprise management.
Incidence of intraoperative hypotension during non-cardiac surgery in community anesthesia practice: a retrospective observational analysis
Authors: Saasouh Wael , Christensen Anna L. , Xing Fei , Chappell Desirée , Lumbley Josh , Woods Brian , Mythen Monty , Dutton Richard P.
Published: June 2023

Background

Intraoperative hypotension (IOH) is well-described in the academic setting but not in community practice. IOH is associated with risk of postoperative morbidity and mortality. This is the first report of IOH in the community setting using the IOH measure definition from the Centers for Medicare and Medicaid Services Merit-based Incentive Payment System program. Objectives: To describe the incidence of IOH in the community setting; assess variation in IOH by patient-, procedure-, and facility-level characteristics; and describe variation in risk-adjusted IOH across clinicians.

Methods

Design

Cross-sectional descriptive analysis of retrospective data from anesthesia records in 2020 and 2021.

Setting

Forty-five facilities affiliated with two large anesthesia providers in the USA.

Participants

Patients aged 18 years or older having non-emergent, non-cardiac surgery under general, neuraxial, or regional anesthesia. Cases were excluded based on criteria for the IOH measure: baseline mean arterial pressure (MAP) below 65 mmHg prior to anesthesia induction; American Society of Anesthesiologists (ASA) physical status classification of I, V, or VI; monitored anesthesia care only; deliberate induced hypotension; obstetric non-operative procedures; liver or lung transplant; cataract surgery; non-invasive gastrointestinal cases.

Main outcomes

IOH, using four definitions. Primary definition: binary assessment of whether the case had MAP < 65 mmHg for 15 min or more. Secondary definitions: total number of minutes of MAP < 65 mmHg, total area under MAP of 65 mmHg, time-weighted average MAP < 65 mmHg.

Results

Among 127,095 non-emergent, non-cardiac cases in community anesthesia settings, 29% had MAP < 65 mmHg for at least 15 min cumulatively, with an overall mean of 12.4 min < 65 mmHg. IOH was slightly more common in patients who were younger, female, and ASA II (versus III or IV); in procedures that were longer and had higher anesthesia base units; and in ambulatory surgery centers. Incidence of IOH varied widely across individual clinicians in both unadjusted and risk-adjusted analyses.

Conclusion

Intraoperative hypotension is common in community anesthesia practice, including among patients and settings typically considered “low risk.” Variation in incidence across clinicians remains after risk-adjustment, suggesting that IOH is a modifiable risk worth pursuing in quality improvement initiatives.
Outcome differences between PD-1/PD-L1 inhibitors-based monotherapy and combination treatments in NSCLC with brain metastases
Authors: Wang Haowei , Liu Fangfang , Chen Xiaoxia , Zhao Chao , Li Xuefei , Zhou Caicun , Hu Jie , Chu Qian , Jiang Tao
Published: June 2023

Introduction

Without the clear immunophenotyping of brain metastases (BrMs), the optimal treatment strategy based on PD-1/PD-L1 inhibitor for patients with non-small-cell lung cancer (NSCLC) and BrMs remains unknown.

Methods

308 patients with NSCLC received PD-1/PD-L1 inhibitor-based monotherapy or combination therapy were retrospectively identified. Kaplan-Meier curves with log-rank tests were used to determine the treatment outcomes differences. Transcriptomic analysis of paired primary lung lesions and BrMs were performed to dissect the specific tumor immune microenvironment (TIME) of BrMs.

Results

The presence of BrMs was associated with significantly inferior PFS (2.5 vs. 3.7 months; P = 0.0053) and OS (8.3 vs. 15.4 months; P = 0.0122) in monotherapy group, while it was only associated with poorer PFS (4.6 vs. 7.0 months; P = 0.0009) but similar OS (22.8 vs. 21.0 months; P = 0.9808) in combination treatment group. Of patients with BrMs, PD-1/PD-L1 inhibitor plus antiangiogenic therapy was associated with longest PFS (7.7 vs. 3.2 vs. 2.5 months; P = 0.0251) and OS (29.2 vs. 15.8 vs. 8.3 months; P = 0.0001) when compared with PD-1/PD-L1 inhibitor plus chemotherapy or anti-PD-1/PD-L1 monotherapy. Multivariate analyses suggested that combination treatment was independently correlated with significantly longer PFS (P = 0.028) and OS (P < 0.001) in patients with BrMs. Transcriptomic analysis showed a suppressive TIME in BrMs with decreased CD4+ T cells and M1 macrophages but increased M2 macrophages infiltration.

Conclusion

NSCLC with BrMs obtained barely satisfactory overall benefit from anti-PD-1/PD-L1 monotherapy, partly due to its immunosuppressive TIME. PD-1/PD-L1 inhibitor-based combination treatment, especially anti-PD-1/PD-L1 plus anti-angiogenic treatment, could significantly improve the clinical outcomes of patients with NSCLC and BrMs.
Investigating the material properties of hemp fiber and puffed rice for use in heritage conservation
Authors: Dar Saleh Abeer , Agiel Ahmed , Khoukhi Maatouk , Haris Sabeera
Published: June 2023

A nation’s customs and traditions are unique, including the appearance of its buildings. Restoring older buildings retains cultural connections and enhances sensitivity to the past. Conservation process materials must be distinguishable from originals for easy removal or change while matching features, a challenging task. The goal is to adopt materials similar in texture, scale, color, and form to the original. The increasing need for a sustainable environment attracts the scientific community towards alternative natural materials instead of traditional ones, adopting ecological principles. Eco-friendly materials from agricultural waste are less polluting. Bio-based materials, like hemp and rice, offer good thermal properties and replace traditional materials. Some are commercialized, while others are in the early production stages. Application conditions and potential adoption in heritage building conservation still need to be studied. Gaps in existing knowledge are addressed by assessing biomaterials’ physical properties in various conservation scenarios. Comparative analysis between new and conventional materials identifies vital advantages. The analysis also determines characteristics like thermal resistance, fire resistance, color, texture, environmental and health impact, and the production process. Findings indicate outstanding performance and can be developed in various colors and textures, essential for preserving the original structural appearance.
Analyzing visual behavior of consumers in a virtual reality fashion store using eye tracking
Authors: Jang Ju Yeun
Published: June 2023

This study investigated the visual behavior of consumers within an immersive virtual reality (VR) fashion store on the basis of their fashion involvement. Their shopping motivation was considered as a moderator. A total of 23 consumers participated, and the participants’ actual visual behaviors were recorded in real-time during their store experience section using an eye-tracking device attached to a VR head-mounted display. Results revealed that the greater the consumer’s fashion involvement, the greater their attention to the store area, and the greater their ability to observe more diverse areas in the store. Consumers with higher fashion involvement and browsing motivation spent less time focusing on the product area. Meanwhile, consumers with higher fashion involvement and searching motivation spent more time focusing on the product area. Visual attention to the store area positively affected experience satisfaction, and the effect of visual attention to the product area on satisfaction was moderated by consumers’ shopping motivation.
Development of digitized evaluation methods for fabric shrinkage and damage using image analysis
Authors: Yun Eunbi , Kim Sungmin , Yun Changsang
Published: June 2023

The aim of this study is to develop digitalized evaluation methods for fabric shrinkage and damage using image analysis. To develop the shrinkage assessment method, 81 grid dots (nine horizontal lines and nine vertical lines) are introduced into the test fabric. This allows the shrinkage to be verified based on the change in distance between neighboring dots, which not only presents the shrinkage in the warp and weft directions, but also the area shrinkage and skewness. The developed evaluation method yields a value that differs from the actual measured value by less than 1 mm, which confirms its significance. To develop a damage evaluation method using the Original Danish MA test fabric, the change in area caused by loosening threads in five holes is evaluated. The area change in the developed method and the number of loosened threads in the conventional method has a high correlation. Comparing the number of dots in the Poka-Dot test fabric before and after washing enables one to distinguish incorrectly created dots during the manufacturing process and to accurately measure the number of missing dots such that the result is similar to the actual measurement. The accuracy and reproducibility of the developed measurement method are confirmed using various verification such as error rate, washing cycle, and washing time. Digitizing the evaluation method can contribute to the digital transformation of apparel quality evaluation by reducing labor and errors between evaluators.
The importance of the cricoid cartilage as an anatomic land mark of cervical level
Authors: Ozalp Horsanali Burcu , Tekgul Zeki Tuncel , Esen Özgür , Şenoğlu Gizem Demir
Published: June 2023

Background

We aimed to evaluate the correlation of the changes radiologically in the vertebral level of the cricoid cartilage according to age and gender to reduce the application difficulties and complication rates in cervical region nerve blockades and surgeries.

Results

The mean age of all patients included in the study was 56.06 ± 17.22 years. We observed that while the line drawn from the cricoid cartilage to the vertebral column level passed over the C6 transverse process in women, it was below the C6 transverse process in men. A significant difference was also observed between the vertebral corpus level according to gender (p < 0.001). We could not find a significant difference between the transverse process and corpus level according to age.

Conclusions

We found a significant difference according to gender in the correlation of the cervical vertebra transverse process and corpus with the cricoid cartilage line which are two important levels frequently used in clinical practice to ensure successful and non-complicated blockage.
The role of miRNAs in the diagnosis and treatment of male infertility: a review study
Authors: Sinaei Roya , Jamebozorgi Khosro , Mirshekarpour Hossein , Poormasoumi Hossein , Mahdizadeh Amirhossein , Akbari Zahra , Taghizadeh Eskandar
Published: June 2023

Infertility is a widespread issue that affects over five million couples globally. The cause of this condition can be related to women, men, or both. Male infertility, as a clinical disorder, can be caused by problems in spermatogenesis, testicular development, epididymal, and sperm maturation. Various methods have been proposed to diagnose and treat this disorder, but in some cases, it still remains idiopathic. Nowadays, the investigation of miRNAs is being discussed for the diagnosis and treatment of male infertility. miRNAs are small non-coding RNAs that regulate the expression of many genes after transcription. The aim of this review is to study miRNAs as noninvasive biomarkers for the diagnosis of infertility, as well as proposed treatment strategies and the challenges ahead in these avenues.
Risks and familial coaggregation of death by suicide, accidental death and major psychiatric disorders in first-degree relatives of individuals who died by suicide
Authors: Tsai Shih-Jen , Cheng Chih-Ming , Chang Wen-Han , Bai Ya-Mei , Hsu Ju-Wei , Huang Kai-Lin , Su Tung-Ping , Chen Tzeng-Ji , Chen Mu-Hong
Published: June 2023

Background

Evidence suggests a familial coaggregation of major psychiatric disorders, including schizophrenia, bipolar disorder, major depression (MDD), autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Those disorders are further related to suicide and accidental death. However, whether death by suicide may coaggregate with accidental death and major psychiatric disorders within families remains unclear.

Aims

To clarify the familial coaggregation of deaths by suicide with accidental death and five major psychiatric disorders.

Method

Using a database linked to the entire Taiwanese population, 68 214 first-degree relatives of individuals who died by suicide between 2003 and 2017 and 272 856 age- and gender-matched controls were assessed for the risks of death by suicide, accidental death and major psychiatric disorders.

Results

A Poisson regression model showed that the first-degree relatives of individuals who died by suicide were more likely to die by suicide (relative risk RR = 4.61, 95% CI 4.02–5.29) or accident (RR = 1.62, 95% CI 1.43–1.84) or to be diagnosed with schizophrenia (RR = 1.53, 95% CI 1.40–1.66), bipolar disorder (RR = 1.99, 95% CI 1.83–2.16), MDD (RR = 1.98, 95% CI 1.89–2.08) or ADHD (RR = 1.34, 95% CI 1.24–1.44).

Conclusions

Our findings identified a familial coaggregation of death by suicide with accidental death, schizophrenia, major affective disorders and ADHD. Further studies would be required to elucidate the pathological mechanisms underlying this coaggregation.
Five Women American Society of Anesthesiologists Presidents: Their Lives and Careers
Authors: Yang Qiuwei , Desai Manisha S.
Published: June 2023

This article examines the only 5 women to become presidents of the American Society of Anesthesiologists (ASA) so far. Through their personal histories, these physicians tell a collective history of women in this specialty from the 1950s to today. We trace their initial interest in medicine, medical educations and training, careers, and family lives. In doing so, the diversity of these individuals’ choices and experiences emerge, and also the context in which women anesthesiologists worked. They shaped the specialty by creating new programs, addressing emerging professional problems, and mentoring successive generations. Simultaneously, they dealt with issues common to professional women in the twentieth and twenty-first centuries, such as balancing a demanding career and family.
Agency and Strategy: Chastity Exemplars in an Early Qing Anthology
Authors: Moyer Jessica Dvorak
Published: June 2023

This article reads exemplary biographies of chaste widows and women who committed suicide to preserve their chastity in the 1656 Yuding Nei ze yanyi 御定内則衍義 (Imperially Commissioned Expanded Meaning of the “Inner Standards”) by Fu Yijian 傅以漸 (1609–1665, jinshi 1646). In this anthology commissioned by the Shunzhi emperor on behalf of his mother, Fu's commentary emphasizes both the agency of individual women and the mutual resonance of personal virtue and political order. He not only praises the exemplars' virtue but also their agency, intelligence, and strategy. He explicitly acknowledges the different factors that could make chastity more difficult and states that in some situations, multiple courses of action were possible. He comments both on his heroines' political ability and on the political importance of recognizing chastity. Finally, in a context where women's chastity was often linked to political loyalism to the fallen Ming, Fu uses these biographies in a very different way: he presents chastity exemplars of conquered dynasties as foils to the decadent society around them. His commentary is thus recognizably tailored to his audience's circumstances as Manchu and Mongolian imperial women and his own as a Chinese male scholar at the beginning of the Qing.
Direct Transorbital Approach for Treatment of Carotid Cavernous Fistula: An Illustrative Case Series
Authors: Steinberg Jeffrey A. , Brandel Michael G. , Wali Arvin R. , Mahata Sumana , Rennert Robert C. , Santiago Dieppa David R. , Pannell J. Scott , Khalessi Alexander A. , Olson Scott E.
Published: June 2023

BACKGROUND AND OBJECTIVES:

Endovascular techniques have become the first-line treatment for carotid-cavernous fistulas (CCFs). Direct transorbital venous access may be used if anatomic constraints limit standard transarterial or transvenous access. We describe our institutional experience with the transorbital approach for Barrow Type A-D CCFs.

METHODS:

Patients with CCFs undergoing transorbital endovascular treatment at our institution between 2017 and 2019 were retrospectively reviewed. Demographic, treatment, and outcome data were collected.

RESULTS:

Eight patients met inclusion criteria, 4 female and 4 male patients. The mean age was 43 years, with 6 right-sided CCF and 2 left-sided CCFs. Symptoms were present for an average of 1.5 months before treatment. All patients presented with eye pain and subjective visual changes. Seven (87.5%) patients presented with proptosis, 6 (75%) patients had elevated intraocular pressure (IOP), and 3 (37.5%) patients had ophthalmoplegia. Six CCFs (75%) were spontaneous, and 2 CCFs (25%) were traumatic. Barrow types were A (n = 1), B (n = 1), C (n = 1), and D (n = 5). All patients underwent direct percutaneous transorbital embolization with coils followed by Onyx. Three patients had undergone prior transarterial and/or transvenous treatment. A radiographic cure was obtained in all patients after direct transorbital embolization. After CCF cure, cranial nerve palsies resolved in 66.7% of patients, visual acuity in the affected eye was improved or stable in 75% of patients, and IOP had normalized in 85.7% of patients. Proptosis improved in all patients, with complete resolution in 75%.

CONCLUSION:

Direct transorbital embolization is a safe and potentially curative treatment for all 4 Barrow types of CCFs.
How Health and Fitness Professionals Can Further Advance the Nation's Health by Working Across the Ecological Model
Authors: Brown David R. , Zaganjor Hatidza , Graff Kaitlin A. , Rose Ken , Sallis James F.
Published: June 2023

Apply It!

From this article, readers should:

• Identify how health and fitness professionals can promote health and wellness among their fitness center, health club, or gym members, clients, patients, and communities by working collaboratively with colleagues across multiple levels of an ecological model.

• Understand how using evidence-based intervention approaches recommended by the Community Preventive Services Task Force may enhance the effect of health and fitness professionals on increasing physical activity.

• Learn why it's important to help create physical activity-friendly communities and how they can help support fitness centers, health clubs, or gyms and the efforts of members, clients, or patients to be more physically active in and out of health and fitness facilities.

• Identify ways to take action in their community in support of Active People, Healthy Nation
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, CDC's national initiative to increase physical activity, by creating and contributing to equitable policy, systems, and environmental changes to support active lifestyles and decrease physical inactivity.
Sun, sea, sex and return to work: supporting people to live with heart failure
Authors: Welch Mandie , Simpson Maggie
Published: June 2023

As the days become longer and warmer, people living with heart failure face certain challenges, for which they may require additional support. Mandie Welch and Maggie Simpson reflect on a pertinent webinar held by the British Society for Heart Failure, which provided a wealth of information to help nurses deliver this support.
Teaching for Accessibility: Introduction
Authors: Shepherd Craig E. , Short Cecil R.
Published: June 2023

Technology regularly helps people communicate ideas and information; explore the world; and capture, store, and interpret large amounts of information. However, some learning environments may prevent individuals from accessing these resources. Fortunately, guidance exists to develop more widely accessible materials and tools. This special issue of the Journal of Technology-Integrated Lessons and Teaching (JTILT) focuses on professional development workshops, lessons, activities, and materials to facilitate accessibility.