bluuebunny/crossref_metadata_2025 huggingface dataset:
Patellar Tendon Debridement and Reconstruction With Hamstring Tendon Autografts in the Setting of Severe Patellar Tendinopathy
Authors: Shoemaker Evan P. , Tollefson Luke V. , Slette Erik L. , LaPrade Robert F.
Published: September 2024

Background:

Patellar tendinopathy is a multifactorial condition characterized by micro-degenerative changes in the patellar tendon. This results from repeated stress to the knee extensor mechanism from explosive movement, axial malalignment, and/or abnormal patellar height. Currently, there is no standard surgical procedure for the treatment of severe patellar tendinopathy.

Indications:

Patellar tendon reconstructions for patellar tendinopathy may be indicated when >50% of the tendon attachment is degenerative and detached from the distal patella and non-operative treatment, like physical therapy, bracing, and injections, have not relieved symptoms. Debridement may not offer long-term viability against augmentation of the patellar tendon with autografts, with a risk of recurrent breakdown of the patellar tendon attachment with resumption of previous activities that initially lead to overload.

Technique Description:

An anterior incision was made from the superior pole of the patella to the tibial tubercle. Then, dissection was performed medially to harvest the gracilis and semitendinosus tendons. Open harvesters were used, and the hamstring tendons were released proximally, keeping the tibial insertions attached. A horizontal pin was drilled across the tibial tubercle and reamed with a 4.5 mm reamer. A passing stitch was fed through the tunnel. The proximal and distal margins of the patella were localized with spinal needles and a pin was drilled across its midportion, 5 mm deep to the dorsal cortical margin, and then rearmed. Degenerative tissue at the patellar tendon was excised. The gracilis tendon was passed medial to lateral through the tibial tubercle, and a Q-Fix anchor anchored the grafts medially and laterally. The semitendinosus graft was passed medial to lateral through the patella followed by the gracilis tendon lateral to medial. Appropriate reconstruction graft tension was confirmed and grafts were whipstitched together.

Results:

Clinical outcomes for the debridement of severe patellar tendinopathy report 77% symptomatic relief. With many unable to return to activity, patellar tendon reconstruction can be indicated. Outcomes for reconstructions for severe patellar tendinopathy are not reported.

Discussion:

Patellar tendon reconstruction with hamstring autografts for the treatment of severe patellar tendinopathy can provide a strong reconstruction graft to allow for the resumption of high-level activities.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Constraint-based methodological innovations: Tales of doctoral and early career researchers in a pandemic-ridden world
Authors: Lee Yenn
Published: September 2024

This special issue aims to share the lessons learned during the COVID-19 pandemic with the broader research community. The pandemic exposed deep societal inequalities, particularly affecting junior researchers. Through 12 articles from doctoral and early career researchers in their own words, the collection highlights the paradox of constraints driving innovation. The special issue underscores the importance of flexibility, ethical sensitivity and the critical questioning of established practices in research. Ultimately, it demonstrates that constraints can catalyse new possibilities and that mutual support is essential in navigating turbulent times.
Exploring the Potential to Identify Early Development Pre-Atherosclerotic Disease in Pediatric Carotid Arteries
Authors: Evans Kevin D. , Stephens Julie A. , Bradbury Peter , Bloom Isaiah W. , Stigall-Weikle Nicole , Khalsa Amrik Singh , Spees Colleen
Published: September 2024

Objective:

The aim of these analyses was to determine the potential development of increased carotid intima-media thickness (cIMT) and spectral Doppler velocity in a cohort of children who were eligible for federal nutrition support services.

Materials and Methods:

A secondary data analysis was conducted based on data collected during a larger randomized clinical trial. Data were pulled on 108 children, ages 8 to 11 years, who had both cIMT measures, as well as spectral Doppler data, at the level of measured intimae. Additional data such as vessel geometry, body mass index (BMI), and blood pressure (BP) were added to the analysis to provide additional descriptive data.

Results:

The posterior cIMT data provided the best visualization and measurements to assess the presence of early risk for atherosclerosis. In this cohort of 8- to 11-year-olds, the median spectral Doppler values did not exceed the published values for these ages, nor did their systolic blood pressure. In this group, 77 (71%) were classified as having a healthy BMI. However, the posterior cIMT data were compared to published measures of pediatric cIMT values and 60 children (55%) exceeded the expected mean thickness of 0.38 mm + 0.04 on the right and 58 (53%) on the left.

Conclusion:

The use of spectral Doppler to assess the risk of developing atherosclerosis may not be the best diagnostic tool, based on this cohort. The measurement of cIMT has the most promise to proper classify healthy appearing 8- to 11-year-olds, for early signs of diminished cardiovascular health.
Integrating hot topics and implementation of treatable traits in asthma
Authors: Gibson Peter G. , McDonald Vanessa M.
Published: September 2024

People with asthma experience many different problems related to their illness. The number and type of problems differ between patients. This results in asthma being a complex and heterogeneous disorder which mandates a personalised approach to management. These features pose very significant challenges for the effective implementation of evidence-based management. “Treatable traits” is a model of care that has been specifically designed to address these issues. Traits are identified in the pulmonary, extrapulmonary (comorbidity) and behavioural/risk factor domains. Traits are clinically relevant, recognisable with validated trait identification markers and treatable using evidence-based therapies. The clinician and patient agree on a personalised management plan that addresses the relevant traits, and trials show superiority of this approach with significant improvements in asthma control and quality of life. A number of tools have now been developed to assist the clinician in the implementation of this approach. The success of the treatable traits model of care is now being realised in other disease areas.
Cathepsin C (dipeptidyl peptidase 1) inhibition in adults with bronchiectasis: AIRLEAF, a phase II randomised, double-blind, placebo-controlled, dose-finding study
Authors: Chalmers James D. , Shteinberg Michal , Mall Marcus A. , O'Donnell Anne E. , Watz Henrik , Gupta Abhya , Frahm Edith , Eleftheraki Anastasia , Rauch Johanna , Chotirmall Sanjay H. , Armstrong April W. , Eickholz Peter , Hasegawa Naoki , Sauter Wiebke , McShane Pamela J.
Published: September 2024

Background

Bronchiectasis is characterised by uncontrolled neutrophil serine protease (NSP) activity. Cathepsin C (CatC; dipeptidyl peptidase 1) activates NSPs during neutrophil maturation. CatC inhibitors can potentially reduce neutrophil-mediated lung damage. This phase II, randomised, double-blind, placebo-controlled trial (AIRLEAF®; clinicaltrials.gov identifierNCT05238675) evaluated efficacy, safety and optimal dosing of BI 1291583, a novel, reversible CatC inhibitor, in adults with bronchiectasis.

Methods

In total, 322 participants were randomised (2:1:1:2) to receive one of three oral doses of BI 1291583 (1 mg/2.5 mg/5 mg) or placebo for 24–48 weeks. A multiple comparison procedure and modelling approach was used to demonstrate a nonflat dose–response curve based on the time to first pulmonary exacerbation up to week 48. In addition, efficacy of individual BI 1291583 doses was evaluated based on the frequency of exacerbations, severe exacerbations (fatal or leading to hospitalisation and/or intravenous antibiotic administration), lung function and quality of life.

Results

A significant dose-dependent benefit of BI 1291583 over placebo was established based on time to first exacerbation (shape: maximum effect curve 1; adjusted p=0.0448). Treatment with BI 1291583 5 mg and 2.5 mg numerically reduced the risk of an exacerbation compared with placebo (hazard ratio (95% CI) 0.71 (0.48 to 1.05) and 0.66 (0.40 to 1.08), respectively; both p>0.05). BI 1291583 2.5 mg showed numerically better efficacy compared with 5 mg across several end-points; 1 mg was similar to placebo. The safety profile of BI 1291583 was similar to placebo.

Conclusion

Treatment with BI 1291583 resulted in a reduction in the risk of experiencing an exacerbation in adults with bronchiectasis.
IDH2 regulates macrophage polarization and tumorigenesis by modulating mitochondrial metabolism in macrophages
Authors: Lee Sung Woo , Kim Soyoon , Kim Bokyung , Seong Jung Bae , Park Young-Ho , Lee Hong Jun , Choi Dong Kyu , Yeom Eunbyul , Lee Dong-Seok
Published: September 2024

Background

Targeting the tumor microenvironment represents an emerging therapeutic strategy for cancer. Macrophages are an essential part of the tumor microenvironment. Macrophage polarization is modulated by mitochondrial metabolism, including oxidative phosphorylation (OXPHOS), the tricarboxylic acid (TCA) cycle, and reactive oxygen species content. Isocitrate dehydrogenase 2 (IDH2), an enzyme involved in the TCA cycle, reportedly promotes cancer progression. However, the mechanisms through which IDH2 influences macrophage polarization and modulates tumor growth remain unknown.

Methods

In this study, IDH2-deficient knockout (KO) mice and primary cultured bone marrow-derived macrophages (BMDMs) were used. Both in vivo subcutaneous tumor experiments and in vitro co-culture experiments were performed, and samples were collected for analysis. Western blotting, RNA quantitative analysis, immunohistochemistry, and flow cytometry were employed to confirm changes in mitochondrial function and the resulting polarization of macrophages exposed to the tumor microenvironment. To analyze the effect on tumor cells, subcutaneous tumor size was measured, and growth and metastasis markers were identified.

Results

IDH2-deficient macrophages co-cultured with cancer cells were found to possess increased mitochondrial dysfunction and fission than wild-type BMDM. Additionally, the levels of M2-associated markers decreased, whereas M1-associated factor levels increased in IDH2-deficient macrophages. IDH2-deficient macrophages were predominantly M1. Tumor sizes in the IDH2-deficient mouse group were significantly smaller than in the wild-type mouse group. IDH2 deficiency in macrophages was associated with inhibited tumor growth and epithelial–mesenchymal transition.

Conclusions

Our findings suggest that IDH2 deficiency inhibits M2 macrophage polarization and suppresses tumorigenesis. This study underlines the potential contribution of IDH2 expression in macrophages and tumor microenvironment remodeling, which could be useful in clinical cancer research.
MicroRNAs in metabolism for precision treatment of lung cancer
Authors: Carrà Giovanna , Petiti Jessica , Tolino Federico , Vacca Rita , Orso Francesca
Published: September 2024

The dysregulation of miRNAs in lung cancer has been extensively documented, with specific miRNAs acting as both tumor suppressors and oncogenes, depending on their target genes. Recent research has unveiled the regulatory roles of miRNAs in key metabolic pathways, such as glycolysis, the tricarboxylic acid cycle, fatty acid metabolism, and autophagy, which collectively contribute to the aberrant energy metabolism characteristic of cancer cells. Furthermore, miRNAs are increasingly recognized as critical modulators of the tumor microenvironment, impacting immune response and angiogenesis. This review embarks on a comprehensive journey into the world of miRNAs, unraveling their multifaceted roles, and more notably, their emerging significance in the context of cancer, with a particular focus on lung cancer. As we navigate this extensive terrain, we will explore the fascinating realm of miRNA-mediated metabolic rewiring, a phenomenon that plays a pivotal role in the progression of lung cancer and holds promise in the development of novel therapeutic strategies.
Estimates of eskd risk and timely kidney replacement therapy education
Authors: Haggerty Lauren E. , Rifkin Dena E. , Nguyen Hoang Anh , Abdelmalek Joseph A. , Sweiss Natalie , Miller Lindsay M. , Potok O. Alison
Published: September 2024

Background

Kidney replacement therapy (KRT) needs preparation and its timing is difficult to predict. Nephrologists’ predictions of kidney failure risk tend to be more pessimistic than the Kidney Failure Risk Equation (KFRE) predictions. We aimed to explore how physicians’ risk estimate related to referral to KRT education, vs. the objective calculated KFRE.

Methods

Prospective observational study of data collected in chronic kidney disease (CKD) clinics of the Veterans Affairs Medical Center San Diego and the University of California, San Diego. The study included 257 participants who were aged 18 years or older, English speaking, prevalent CKD clinic patients, with estimated glomerular filtration rate (eGFR) < 60 mL/min per 1.73 m2 (MDRD equation). The exposure consisted of end stage kidney disease (ESKD) risk predictions. Nephrologists’ kidney failure risk estimations were assessed: “On a scale of 0–100%, without using any estimating equations, give your best estimate of the risk that this patient will need dialysis or a kidney transplant in 2 years.” KFRE was calculated using age, sex, eGFR, serum bicarbonate, albumin, calcium, phosphorus, urine albumin/creatinine ratio. The outcomes were the pattern of referral to KRT education (within 90 days of initial visit) and kidney failure evaluated by chart review. The population was divided into groups either by nephrologists’ predictions or by KFRE. Referral to KRT education was examined by group and sensitivity and specificity were calculated based on whether participants reached kidney failure at 2 years.

Results

A fifth were referred for education by 90 days of enrollment. Low risk patients by both estimates had low referral rates. In those with nephrologists’ predictions ≥ 15% (n = 137), sensitivity was 71% and specificity 76%. In those with KFRE ≥ 15% (n = 55), sensitivity was 85% and specificity 41%.

Conclusions

Although nephrologists tend to overestimate patients’ kidney failure risk, they do not appear to act on this overestimation, as the rates of KRT education referrals are lower than expected when a nephrologist identifies a patient as high risk.

Clinical Trial Number

Not applicable
Family member reported symptom burden, predictors of caregiver burden and treatment effects in a goal-oriented community-based randomized controlled trial in the chronic phase of traumatic brain injury
Authors: Løvstad Marianne , Borgen Ida Maria Henriksen , Hauger Solveig Lægreid , Kleffelgård Ingerid , Brunborg Cathrine , Røe Cecilie , Søberg Helene Lundgaard , Forslund Marit Vindal
Published: September 2024

Background

Family members are often affected by the long-term consequences of traumatic brain injury, but are rarely involved in rehabilitation programs in the chronic phase. We thus do not know what family members´ main concerns are in the chronic phase, what factors are associated with perceived caregiver burden, and whether family members´ health and functioning improves due to rehabilitation efforts received by the patients. This study explored family-members` functioning, predictors of caregiver burden and effect for family members of a goal-oriented intervention in the chronic phase of traumatic brain injury.

Methods

Family members self-reported data measuring their caregiver burden, depression, general health, loneliness, and their evaluation of patient competency in everyday life, patient awareness levels, main problem areas (target outcomes) for the patient related to the brain injury, and demographic data were collected. Regression models were used to explore predictors of caregiver burden, and mixed models analysis was used to explore treatment effects.

Results

In total, 73 family members were included, 39 in the intervention group and 34 in the control group. Moderate to high caregiver burden was reported by 40% of family members, and 16% experienced clinical levels of depression. Family member loneliness and their evaluation of the patient`s level of functional competency explained 57% of the variability in caregiver burden. There were no treatment-related changes in caregiver burden, family member depression or general health. At T2 there was however a significant reduction in how family members rated severity of target outcomes that the family members had nominated at baseline (-0.38, 95% CI, -0.75 to -0.02, p = 0.04), but not for the target outcomes the patients had nominated.

Conclusions

A significant proportion of family members to patients in the chronic phase of TBI continue to experience challenging caregiver burden and emotional symptoms. Both family member-related and patient factors contribute to caregiver burden. Interventions targeting patient complaints do not automatically alleviate family members´ burden. It is important to address social support for family members early after injury, and there is a need for more interventions specifically targeting family members´ needs.

Trial registration

The trial was registered at ClinicalTrials.gov, NCT03545594 on the 4th of June 2018.
Prediction of poststroke independent walking using machine learning: a retrospective study
Authors: Tang Zhiqing , Su Wenlong , Liu Tianhao , Lu Haitao , Liu Ying , Li Hui , Han Kaiyue , Moneruzzaman Md. , Long Junzi , Liao Xingxing , Zhang Xiaonian , Shan Lei , Zhang Hao
Published: September 2024

Background

Accurately predicting the walking independence of stroke patients is important. Our objective was to determine and compare the performance of logistic regression (LR) and three machine learning models (eXtreme Gradient Boosting (XGBoost), Support Vector Machines (SVM), and Random Forest (RF)) in predicting walking independence at discharge in stroke patients, as well as to explore the variables that predict prognosis.

Methods

778 (80% for the training set and 20% for the test set) stroke patients admitted to China Rehabilitation Research Center between February 2020 and January 2023 were retrospectively included. The training set was used for training models. The test set was used to validate and compare the performance of the four models in terms of area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and F1 score.

Results

Among the three ML models, the AUC of the XGBoost model is significantly higher than that of the SVM and RF models (P < 0.001, P = 0.024, respectively). There was no significant difference in the AUCs between the XGBoost model and the LR model (0.891 vs. 0.880, P = 0.560). The XGBoost model demonstrated superior accuracy (87.82% vs. 86.54%), sensitivity (50.00% vs. 39.39%), PPV (73.68% vs. 73.33%), NPV (89.78% vs. 87.94%), and F1 score (59.57% vs. 51.16%), with only slightly lower specificity (96.09% vs. 96.88%). Together, the XGBoost model and the stepwise LR model identified age, FMA-LE at admission, FAC at admission, and lower limb spasticity as key factors influencing independent walking.

Conclusion

Overall, the XGBoost model performed best in predicting independent walking after stroke. The XGBoost and LR models together confirm that age, admission FMA-LE, admission FAC, and lower extremity spasticity are the key factors influencing independent walking in stroke patients at hospital discharge.

Trial registration

Not applicable.
PAM50 breast cancer subtypes and survival of patients in rural Ethiopia without adjuvant treatment: a prospective observational study
Authors: Ballé Judith Katharina , Vetter Martina , Kenea Tariku Wakuma , Eber-Schulz Pia , Reibold Christian , Ziegenhorn Hannes-Viktor , Stückrath Kathrin , Wickenhauser Claudia , Addissie Adamu , Santos Pablo , Kantelhardt Eva Johanna , Getachew Sefonias , Bauer Marcus
Published: September 2024

Purpose

Survival rates of breast cancer (BC) patients are particularly low in rural regions in sub-Saharan Africa (SSA) which is due to limited access to therapy. In recent years, gene expression profiling (GEP) of BC showed a strong prognostic value in patients with local tumour surgery and (neo)adjuvant treatment. The aim of this study was to evaluate the impact of intrinsic subtypes on survival of patients in rural Ethiopia without any (neo)adjuvant therapy.

Methods

In total, 113 female patients from Aira Hospital with histologically proven BC and treated only with surgery were included in this study. All samples were analysed by immunohistochemistry (IHC) for estrogen receptor, progesterone receptor, HER2 and Ki67, as well as RNA-expression analysis for PAM50 subtyping.

Results

A positive hormone receptor status was found in 69.0% of the tumours and intrinsic subtyping demonstrated Luminal B to be the most common subtype (34.5%). Follow-up data was available for 79 of 113 patients. Two-year overall survival (OS) was 57.3% and a considerably worse OS was observed in patients with Basal-like BC compared to Luminal A BC. Moreover, advanced tumours showed an increased risk of mortality.

Conclusion

The OS was very low in the patient cohort that received no (neo)adjuvant treatment. Immunohistochemistry and GEP confirmed endocrine-sensitive tumours in more than half of the patients, with a large proportion of Luminal B, HER2-enriched and Basal-like tumours so that adjuvant chemotherapy should be recommended.
Interdisciplinary CBT treatment for patients with odontophobia and dental anxiety related to psychological trauma experiences: a case series
Authors: Westad Yngvill Ane Stokke , Flemmen Gina Løge , Solem Stian , Monsen Trine , Hollingen Henriette , Feuerherm Astrid , Havnen Audun , Hagen Kristen
Published: September 2024

Background

While cognitive-behavioural therapy (CBT) is a well-established treatment for odontophobia, research is sparse regarding its effect on patients with dental anxiety related to psychological trauma experiences. This study aimed to evaluate changes in symptoms and acceptability of interdisciplinary Torture, Abuse, and Dental Anxiety (TADA) team treatment for patients with odontophobia or dental anxiety. We also wanted to describe the sample’s oral health status. The TADA teams offer targeted anxiety treatment and adapted dental treatment using a CBT approach.

Methods

The study used a naturalistic, case series design and included 20 consecutively referred outpatients at a public TADA dental clinic. Pre- and post-treatment assessments included questionnaires related to the degree of dental anxiety, post-traumatic stress, generalized anxiety, and depression. Patients underwent a panoramic X-ray before treatment. Before dental restoration, patients underwent an oral health examination to determine the mucosal and plaque score (MPS) and the total number of decayed, missing, and filled teeth (DMFT). Patients were referred to dentist teams for further dental treatment and rehabilitation (phase 2) after completing CBT in the TADA team (Phase 1). Results from the dental treatment in phase 2 is not included in this study.

Results

All patients completed the CBT treatment. There were significant improvements in symptoms of dental anxiety, post-traumatic stress, and depression and moderate changes in symptoms of generalized anxiety. Dental statuses were heterogeneous in terms of the severity and accumulated dental treatment needs. The TADA population represented the lower socioeconomic range; 15% of patients had higher education levels, and half received social security benefits. All patients were referred to and started adapted dental treatment (phase 2).

Conclusions

TADA treatment approach appears acceptable and potentially beneficial for patients with odontophobia and dental anxiety related to psychological trauma experiences. The findings suggest that further research, including larger controlled studies, is warranted to validate these preliminary outcomes.

Trial registration

The study was approved by the regional ethical committee in Norway (REK-Midt: 488462) and by the Data Protection Board at Møre and Romsdal County Authority.
Current landscape of mRNA technologies and delivery systems for new modality therapeutics
Authors: Lu Ruei-Min , Hsu Hsiang-En , Perez Ser John Lynon P. , Kumari Monika , Chen Guan-Hong , Hong Ming-Hsiang , Lin Yin-Shiou , Liu Ching-Hang , Ko Shih-Han , Concio Christian Angelo P. , Su Yi-Jen , Chang Yi-Han , Li Wen-Shan , Wu Han-Chung
Published: September 2024

Realizing the immense clinical potential of mRNA-based drugs will require continued development of methods to safely deliver the bioactive agents with high efficiency and without triggering side effects. In this regard, lipid nanoparticles have been successfully utilized to improve mRNA delivery and protect the cargo from extracellular degradation. Encapsulation in lipid nanoparticles was an essential factor in the successful clinical application of mRNA vaccines, which conclusively demonstrated the technology's potential to yield approved medicines. In this review, we begin by describing current advances in mRNA modifications, design of novel lipids and development of lipid nanoparticle components for mRNA-based drugs. Then, we summarize key points pertaining to preclinical and clinical development of mRNA therapeutics. Finally, we cover topics related to targeted delivery systems, including endosomal escape and targeting of immune cells, tumors and organs for use with mRNA vaccines and new treatment modalities for human diseases.
Composite activity type and stride-specific energy expenditure estimation model for thigh-worn accelerometry
Authors: Lendt Claas , Hansen Niklas , Froböse Ingo , Stewart Tom
Published: September 2024

Background

Accurately measuring energy expenditure during physical activity outside of the laboratory is challenging, especially on a large scale. Thigh-worn accelerometers have gained popularity due to the possibility to accurately detect physical activity types. The use of machine learning techniques for activity classification and energy expenditure prediction may improve accuracy over current methods. Here, we developed a novel composite energy expenditure estimation model by combining an activity classification model with a stride specific energy expenditure model for walking, running, and cycling.

Methods

We first trained a supervised deep learning activity classification model using pooled data from available adult accelerometer datasets. The composite energy expenditure model was then developed and validated using additional data based on a sample of 69 healthy adult participants (49% female; age = 25.2 ± 5.8 years) who completed a standardised activity protocol with indirect calorimetry as the reference measure.

Results

The activity classification model showed an overall accuracy of 99.7% across all five activity types during validation. The composite model for estimating energy expenditure achieved a mean absolute percentage error of 10.9%. For running, walking, and cycling, the composite model achieved a mean absolute percentage error of 6.6%, 7.9% and 16.1%, respectively.

Conclusions

The integration of thigh-worn accelerometers with machine learning models provides a highly accurate method for classifying physical activity types and estimating energy expenditure. Our novel composite model approach improves the accuracy of energy expenditure measurements and supports better monitoring and assessment methods in non-laboratory settings.
A grassroots approach to peer support by the Danish Reproducibility Network
Authors: Topor Marta , Bonnet Philippe , Cheplygina Veronika , Dam Vibeke Høyrup , Wildgaard Lorna
Published: September 2024

The Danish Reproducibility Network (DKRN) is a grassroots initiative for establishing a peer-supportive reproducibility-focused academic network in Denmark. We modelled our approach on already existing national Reproducibility Networks. We consulted with researchers and research support professionals to identify the needs of the research community. Three themes emerged around policy implementation, training and the appropriate application of reproducible practices. The network aims to address these three themes in a strategic plan, which harnesses the benefits of grassroots initiatives. The mission of the DKRN is therefore to facilitate communication, peer-support, and the exchange of ideas through a network of topic and geographical nodes. The network is open to researchers and research support professionals from all career stages and disciplines. It aligns with broader international initiatives, and national institutions, positioning itself as a contributor to the Danish research ecosystem.
Shared decision-making in end-of-life care for end-stage renal disease patients: nephrologists’ views and attitudes
Authors: Hatoum Wassiem Bassam Abu , Sperling Daniel
Published: September 2024

Background

The term end-stage renal disease (ESRD) refers to the final stage of chronic kidney disease. Not all ESRD patients are suitable for dialysis treatment, which despite its advantages, is not without risks. Shared nephrologist-patient decision-making could be beneficial at this stage, yet little is known about such practices in Israel. This study aimed at examining the practice of shared decision-making (SDM) between nephrologists and ESRD patients in Israel, while exploring related conflicts, ethical dilemmas, and considerations.

Methods

The descriptive-quantitative approach applied in this study included a validated questionnaire for nephrologists, based on Emanual and Emanual (1992). The survey, which was distributed via social-media platforms and snowball sampling, was completed by 169 nephrologists. Data analysis included t-tests for independent samples, f-tests for analysis of variance, and t-tests and f-tests for independence. Descriptive analysis examined attitudes towards SDM in end-of-life care for ESRD patients.

Results

The findings show that the research sample did not include nephrologists who typically act according to the paternalistic decision-making style. Rather, 53% of the respondents were found to act in line with the informative decision-making style, while 47% act according to the interpretive decision-making style. Almost 70% of all respondents reported their discussing quality-of-life with patients; 63.4% provide prognostic assessments; 61.5% inquire about the patient’s desired place of death; 58.6% ask about advance directives or power-of-attorney; and 57.4% inquire about cultural and religious beliefs in end-of-life treatment. Additionally, informative nephrologists tend to promote the patients’ autonomy over their health (P < 0.001); they are also in favor of conservative treatment, compared to paternalistic and interpretive nephrologists, and use less invasive methods than other nephrologists (P = 0.02).

Conclusions

Nephrologists in Israel only partially pursue an SDM model, which has the potential to improve quality-of-care for ESRD patients and their families. SDM programs should be developed and implemented for increasing such practices among nephrologists, thereby expanding the possibilities for providing conservative care at end-of-life.
Fine spatial scale assessment of structure and configuration of vegetation cover for northern bobwhites in grazed pastures
Authors: Avila-Sanchez J. Silverio , Perotto-Baldivieso Humberto L. , Massey Lori D. , Ortega-S J. Alfonso , Brennan Leonard A. , Hernández Fidel
Published: September 2024

Background

Monitoring forage in livestock operations is critical to sustainable rangeland management of soil and ecological processes that provide both livestock and wildlife habitat. Traditional ground-based sampling methods have been widely used and provide valuable information; however, they are time-consuming, labor-intensive, and limited in their ability to capture larger extents of the spatial and temporal dynamics of rangeland ecosystems. Drones provide a solution to collect data to larger extents than field-based methods and with higher-resolution than traditional remote sensing platforms. Our objectives were to (1) assess the accuracy of vegetation cover height in grasses using drones, (2) quantify the spatial distribution of vegetation cover height in grazed and non-grazed pastures during the dormant (fall–winter) and growing seasons (spring–summer), and (3) evaluate the spatial distribution of vegetation cover height as a proxy for northern bobwhite (Colinus virginianus) habitat in South Texas. We achieved this by very fine scale drone-derived imagery and using class level landscape metrics to assess vegetation cover height configuration.

Results

Estimated heights from drone imagery had a significant relationship with the field height measurements in September (r2 = 0.83; growing season) and February (r2 = 0.77; dormant season). Growing season pasture maintained residual landscape habitat configuration adequate for bobwhites throughout the fall and winter of 2022–2023 following grazing. Dormant season pasture had an increase in bare ground cover, and a shift from many large patches of tall herbaceous cover (40–120 cm) to few large patches of low herbaceous cover (5–30 cm) (p < 0.05).

Conclusions

Drones provided high-resolution imagery that allowed us to assess the spatial and temporal changes of vertical herbaceous vegetation structure in a semi-arid rangeland subject to grazing. This study shows how drone imagery can be beneficial for wildlife conservation and management by providing insights into changes in fine-scale vegetation spatial and temporal heterogeneity from livestock grazing.
An analysis of the contribution of the informal milk market to nutrition in Kenya
Authors: Revoredo-Giha Cesar , Zavala-Nacul Hasibi
Published: September 2024

Background

The dairy sector in Kenya is an important part of the agricultural GDP of the country. Its legal framework was reformed in 2004 to address the economic importance that the informal sector (i.e. trading on raw milk) had for smallholders’ producers. However, this reform was accused of being a pro-poor policy instead of focusing on the development of the formal dairy sector. In recent years, there has been pressure to go back to the pre-2004 regulatory system and to illegalize the raw milk trade. An aspect that has been absent from the discussion is the contribution that the informal market has to households’ nutrition. The contribution of this paper is to address this shortcoming using the most recent Kenya Integrated Household Budget Survey for 2015–16.

Results

The results indicate that the rural annual milk consumption (70.2 L) surpasses that of urban areas (68.8 L). These values are different to those found in the literature. County consumption varies depending on the availability of milk, which appears associated to the production capacity and the climate of the region. However, regardless of the region unpacked milk is the most consumed dairy item representing 72 per cent of the total countrywide; 84 per cent of the rural total and 55 per cent of the urban area.

Conclusions

The results indicate that the sector provides significant nutrition especially to poor economic groups. Therefore, attempting to ban the informal sector would have negative consequences for Kenya's food security, impacting mostly on the nutritional security of low-income households. In addition, the nutritional aspects that the informal dairy sector provides need to be considered alongside the economic ones in future debates regarding regulatory reforms of the sector.
Adult attachment and love psychological stress among college students: the mediating role of core self-evaluation and the moderating role of meaning in life
Authors: Song Minghua , Hu Xianman , Liu Shen
Published: September 2024

Background

With college students going into dating relationships, dating partners become their new attachment figures. We aimed to investigate the relationship between adult attachment, and love psychological stress among college students, which also explored the roles of core self-evaluation and meaning in life.

Methods

We conducted a questionnaire survey on 813 college students using the adult attachment scale, core self-evaluation scale, meaning in life scale, and love psychological stress scale. We constructed a moderated mediation model to analyze the relationship between adult attachment and love psychological stress, as well as the mediating effect of core self-evaluation and the moderating effect of meaning in life.

Results

The results showed that after controlling for single parent or not, adult attachment significantly negatively predicted love psychological stress of college students. Core self-evaluation partially mediated the relationship between adult attachment and love psychological stress of college students. The second half of the mediation model was moderated by meaning in life, that is, with the increase of meaning in life, the negative predictive effect of core self-evaluation on love psychological stress of college students gradually strengthened. The findings of this study demonstrate the detrimental impact of adult attachment on love psychological stress of college students, as well as the mediating core self-evaluation and the moderating role of meaning in life.

Conclusions

The mediating and moderating effect of adult attachment between love psychological stress, as well as the mediating effect of core self-evaluation and the moderating effect of meaning in life were confirmed. Overall, promoting the healthy development of adult attachment and helping them shape a positive meaning in life can enhance individuals’ core self-evaluation, thus alleviating love psychological stress among college students. It can also provide references for mental health education in colleges and universities.
Characterization of indigenous lactobacilli from dairy fermented foods of Haryana as potential probiotics utilizing multiple attribute decision-making approach
Authors: Samtiya Mrinal , Bhushan Bharat , Sari T. P. , Badgujar Prarabdh C. , Chandratre Gauri A. , Singh Phool , Kumar Ashwani , Dhewa Tejpal
Published: September 2024

The interest in region-specific ethnic fermented foods and their functional microbiota is rising. The demands for functional foods are continuously rising, so research is going on to develop nutritious food with many beneficial attributes and low safety concerns. The present study was designed to isolate and characterize lactobacilli probiotic candidates from locally resourced fermented foods (dahi, lassi, and raabadi) to make ready-to-eat fermented functional products later. Cultures were isolated from 82 fermented food samples collected from different villages. The initial experiments of gram staining, catalase test, and carbohydrate fermentation were assessed for the morphology, purity, and primary characterization on the genus level, which was verified through molecular characterization using PCR. Seven lactobacilli strains (no. MS001-MS007) were then assessed for safety, probiotic candidacy, phytase degradation, and biofilm forming abilities. All seven bacterial cultures showed no hemolytic activity and antibiotic sensitivity against more than 14 antibiotics out of 20. All seven lactobacilli isolates were able to tolerate pH 3.0, 0.3% bile 0.5% pancreatin, lysozyme (100 mg/L to 300 mg/L) and also shown possessed phytase degradation ability. All the cultures showed antioxidative potential and biofilm formation ability. Culture MS007 showed considerably higher bile salt hydrolase activity among all the isolates, whereas MS005 possessed excellent phytate degradation ability among others. Bacterial strains were identified using 16S rRNA gene sequencing. Moreover, the order of preference of isolates was calculated using the multidimensional Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) based on probiotic and other functional properties. The most promising attributes showing cultures were recognised as Limosilactobacillus fermentum MS005 and Lactiplantibacillus plantarum MS007, which could be further used for functional food product development.

Graphical Abstract
Assessment of hepcidin in Egyptian patients with rheumatoid arthritis and its relation to anemia: a single-center study
Authors: Genedy Manal M. , Shabana Adel Abd Elsalam Hussien , Elghzaly Ashraf Antar Mohamad , Bassiouni Sherine Abdel Rahman Abdel Karim
Published: September 2024

Background

Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disorder characterized by synovial inflammation that leads to joint damage, bony erosions, and related deformities. Between 30 and 70% of RA patients will experience anemia. Early detection of anemia is of great importance. This study aimed to evaluate the serum level of hepcidin (HEP) in RA patients and to assess its relation to disease activity and anemia. The current cross-sectional study included 44 cases with RA in addition to 44 healthy controls. The disease activity in the RA patient was assessed by using the disease activity score (DAS) 28 score-CRP. The serum levels of HEP and ferritin were assessed in both groups using enzyme-linked immunosorbent assay (ELISA) technique.

Results

Hepcidin level in the RA group was statistically significantly higher as compared to the control group (p = 0.001). The prevalence of Anemia of chronic disease (ACD) was 40.9%, and iron deficiency anemia (IDA) was 27.3% which accounted for 68.2% of the total anemia cases. The HEP level was statistically significantly higher in the RA patients with ACD than those without anemia (P = 0.028), RA patients with IDA (P < 0.001), and control group (P < 0.001). There was a statistically significant positive correlation between HEP level and serum ferritin level (p = 0.005). HEP level was significantly and inversely correlated with hemoglobin (Hb) in patients with ACD. Serum HEP level is higher in RA patients with high disease activity than those with moderate activity, low activity, and patients in remission (p = 0.380). However, the difference was not statistically significant. The best cutoff point of HEP level to identify RA patients from healthy controls was > 355.5 Pg/ml. This point showed moderate sensitivity (70.5%) with moderate specificity (63.6%) with a statistically significant value.

Conclusions

We found the anemia, and particularly ACD, is more common in RA patients. In RA patients with ACD, serum HEP levels were considerably higher. Although serum HEP showed no diagnostic significance when it came to evaluating disease activity, it could be a dependable non-invasive biomarker for the diagnosis of various forms of anemia in RA patients.
Relationship Between Radiation Dose and Markers of Insulin Resistance and Inflammation in Atomic Bomb Survivors
Authors: Tatsukawa Yoshimi , Sposto Richard , Yamada Michiko , Ohishi Waka , Imaizumi Misa , Hida Ayumi , Sakata Ritsu , Fujiwara Saeko , Nakanishi Shuhei , Ohno Haruya
Published: September 2024

Context

In recent studies of childhood cancer survivors, diabetes has been considered a late effect associated with high therapeutic doses of radiation therapy. Our recent study of atomic bomb (A-bomb) survivors also suggested an association between radiation dose and diabetes incidence, with exposure city and age at exposure as radiation dose effect modifiers. Insulin resistance mediated by systemic inflammation and abnormal body composition has been suggested as a possible primary mechanism for the incidence of diabetes after total body irradiation; however, no studies have examined low to moderate radiation exposure (<4 Gy) and insulin resistance in A-bomb survivors.

Objective

To examine the association between radiation dose and markers of inflammation and insulin resistance.

Methods

This study investigated 3152 survivors who underwent a health examination between 2008 and 2012 and who were younger than 15 years at exposure. Multivariate linear regression analyses were used to evaluate the radiation effects on levels of markers of inflammation and insulin resistance.

Results

Radiation dose was significantly and positively associated with levels of C-reactive protein, triglycerides, homeostasis model assessment of β-cell function (HOMA-β), and HOMA of insulin resistance (HOMA-IR) after adjustment for relevant covariates including sex, city, and age at exposure. Adiponectin and high-density lipoprotein cholesterol levels were also associated significantly and negatively with radiation dose. However, city was not a dose modifier of the radiation response on these markers of inflammation and insulin resistance.

Conclusion

Insulin resistance might be a possible factor in radiation-related diabetes incidence in A-bomb survivors.
Identification of Environmental Compounds That May Trigger Early Female Puberty by Activating Human GnRHR and KISS1R
Authors: Yang Shu , Zhang Li , Khan Kamal , Travers Jameson , Huang Ruili , Jovanovic Vukasin M , Veeramachaneni Rithvik , Sakamuru Srilatha , Tristan Carlos A , Davis Erica E , Klumpp-Thomas Carleen , Witt Kristine L , Simeonov Anton , Shaw Natalie D , Xia Menghang
Published: September 2024

There has been an alarming trend toward earlier puberty in girls, suggesting the influence of an environmental factor(s). As the reactivation of the reproductive axis during puberty is thought to be mediated by the hypothalamic neuropeptides kisspeptin and gonadotropin-releasing hormone (GnRH), we asked whether an environmental compound might activate the kisspeptin (KISS1R) or GnRH receptor (GnRHR). We used GnRHR or KISS1R-expressing HEK293 cells to screen the Tox21 10K compound library, a compendium of pharmaceuticals and environmental compounds, for GnRHR and KISS1R activation. Agonists were identified using Ca2+ flux and phosphorylated extracellularly regulated kinase (p-ERK) detection assays. Follow-up studies included measurement of genes known to be upregulated upon receptor activation using relevant murine or human cell lines and molecular docking simulation. Musk ambrette was identified as a KISS1R agonist, and treatment with musk ambrette led to increased expression of Gnrh1 in murine and human hypothalamic cells and expansion of GnRH neuronal area in developing zebrafish larvae. Molecular docking demonstrated that musk ambrette interacts with the His309, Gln122, and Gln123 residues of the KISS1R. A group of cholinergic agonists with structures similar to methacholine was identified as GnRHR agonists. When applied to murine gonadotrope cells, these agonists upregulated Fos, Jun, and/or Egr1. Molecular docking revealed a potential interaction between GnRHR and 5 agonists, with Asn305 constituting the most conservative GnRHR binding site. In summary, using a Tox21 10K compound library screen combined with cellular, molecular, and structural biology techniques, we have identified novel environmental agents that may activate the human KISS1R or GnRHR.