bluuebunny/crossref_metadata_2025 huggingface dataset:
How I individualize selection of JAK inhibitors for patients with myelofibrosis
Authors: Masarova Lucia , Chifotides Helen T
Published: October 2024

The advent of JAK inhibitors (JAKi) inaugurated a novel era in the treatment of myelofibrosis (MF), a myeloproliferative neoplasm with heterogeneous clinical manifestations. Four JAKi have been approved for intermediate or high-risk MF, in the US. Regulatory approval of the first JAK1/2 inhibitor, ruxolitinib, in 2011 transformed the landscape of MF by markedly controlling splenomegaly and constitutional symptoms, improving patients' lives, and prolonging survival. Fedratinib, the second approved JAKi, is preferred in the second-line setting. Ruxolitinib and fedratinib can cause myelosuppression and are recommended for patients with myeloproliferative MF. Approval of 2 less myelosuppressive JAKi, pacritinib and momelotinib, provided essential treatment options for patients with severe thrombocytopenia and anemia, respectively. Pacritinib and momelotinib are potent ACVR1 inhibitors, resulting in significant anemia benefits. Transfusion independence was achieved with momelotinib in severely anemic patients, and association of transfusion independence with prolonged overall survival was demonstrated. Judicious treatment decisions of JAKi can be made with in-depth understanding of the pivotal clinical trials on JAKi and their therapeutic attributes and should be guided by the dominant clinical manifestations and the type/degree of cytopenia(s). This article reviews our clinical approach to treatment with JAKi and their sequencing in MF patients by presenting 3 clinical vignettes.
Classification and risk stratification in T-lineage acute lymphoblastic leukemia
Authors: Pölönen Petri , Mullighan Charles G. , Teachey David Trent
Published: October 2024

Cure rates for patients with acute lymphoblastic leukemia (ALL) have improved markedly in recent decades, in part due to risk stratification incorporating leukemia genomics, response to treatment, and clinical features to be able to determine at diagnosis which patients are more likely to relapse or have refractory disease. While risk stratification is well-developed for patients with B lineage ALL (B-ALL), it remains challenging for those with T lineage ALL (T-ALL). Prognostic factors validated across clinical trials and real-world data in T-ALL include age, central nervous system (CNS) involvement, and minimal residual disease (MRD) response. Immunophenotype, including early T-cell precursor (ETP) ALL is widely used to classify T-ALL, but is not consistently associated with outcome in multivariable risk models. Historically, few genetic alterations have been consistently associated with outcome, but recent comprehensive, large-scale genomic profiling has identified multiple genetic subtypes and alterations associated with outcome independent of MRD. This review highlights ongoing efforts to identify reliable prognostic biomarkers and underscores the potential of genomics-based classification to guide future T-ALL treatment strategies.
Platelet generation in vivo and in vitro
Authors: Furniss Jonathan A. , Tarassova Nathalie , Poole Alastair W.
Published: October 2024

Platelets play crucial roles in hemostasis, thrombosis, and immunity, but our understanding of their complex biogenesis (thrombopoiesis) is currently incomplete. Deeper insight into the mechanisms of platelet biogenesis inside and outside the body is fundamental for managing hematological disorders and for the development of novel cell-based therapies. In this article, we address the current understanding of in vivo thrombopoiesis, including mechanisms of platelet generation from megakaryocytes (proplatelet formation, cytoplasmic fragmentation, and membrane budding) and their physiological location. Progress has been made in replicating these processes in vitro for potential therapeutic application, notably in platelet transfusion and bioengineering of platelets for novel targeted therapies. The current platelet-generating systems and their limitations, particularly yield, scalability, and functionality, are discussed. Finally, we highlight the current controversies and challenges in the field that need to be addressed to achieve a full understanding of these processes, in vivo and in vitro.
Biogenic synthesis and characterization of antimicrobial, antioxidant, and antihemolytic zinc oxide nanoparticles from Desertifilum sp. TN-15 cell extract
Authors: Nadeem Taswar , Kaleem Muhammad , Minhas Lubna Anjum , Batool Saima , Sattar Muhammad Muzamil , Bashir Rifat , Mumtaz Abdul Samad
Published: October 2024

Cyanobacteria, being a prominent category of phototrophic organism, exhibit substantial potential as a valuable source of bioactive compounds and phytonutrients, including liposomes, amino derivatives, proteins, and carotenoids. In this investigation, a polyphasic approach was employed to isolate and characterize a newly discovered cyanobacterial strain from a rice field in the Garh Moor district of Jhang. Desertifilum sp. TN-15, a unique and less explored cyanobacterial strain, holds significant promise as a novel candidate for the synthesis of nanoparticles. This noticeable research gap underscores the novelty and untapped potential of Desertifilum sp. TN-15 in the field of nanomedicine. The characterization of the biogenically synthesized ZnO–NPs involved the application of diverse analytical techniques. Ultraviolet–visible spectroscopy revealed a surface plasmon resonance peak at 298 nm. Fourier transform infrared spectral analysis was utilized to confirm the involvement of biomolecules in the biogenic synthesis and stability. Scanning electron microscopy was employed to probe the surface morphology of the biogenic ZnO–NPs unveiling their size of 94.80 nm and star-shaped. Furthermore, X-ray diffraction analysis substantiated the crystalline nature of ZnO–NPs, with a crystalline size measuring 46 nm. To assess the physical stability of ZnO–NPs, zeta potential and dynamic light scattering measurements were conducted, yielding values of + 31.6 mV, and 94.80 nm, respectively, indicative of favorable stability. The antibacterial capabilities of Desertifilum sp. TN-15 are attributed to its abundance of bioactive components, including proteins, liposomes, amino derivatives, and carotenoids. Through the synthesis of zinc oxide nanoparticles (ZnO–NPs) with this strain, we have effectively used these chemicals to generate nanoparticles that exhibit noteworthy antibacterial activity against Staphylococcus aureus (MIC: 30.05 ± 0.003 µg/ml). Additionally, the ZnO–NPs displayed potent antifungal activity and antioxidant properties, as well as significant antihemolytic effects on red blood cells (IC50: 4.8 µg/ml). Cytotoxicity assessment using brine shrimps revealed an IC50 value of 3.1 µg/ml. The multifaceted actions of the biogenically synthesized ZnO–NPs underscore their potential applications in pharmacological and therapeutic fields. This study proposes a novel method for ZnO–NPs production utilizing the recently identified cyanobacterial strain Desertifilum sp. TN-15, highlighting the growing significance of biological systems in the environmentally friendly fabrication of metallic oxide nanomaterials.
Creatinine clearance/eGFR ratio: a simple index for muscle mass related to mortality in ICU patients
Authors: Volbeda Meint , Zijlstra Hendrik W. , Post Adrian , Kootstra-Ros Jenny E. , van der Voort Peter H. J. , Franssen Casper F. M. , Nijsten Maarten W.
Published: October 2024

Introduction

In patients admitted to the intensive care unit (ICU), muscle mass is inversely associated with mortality. Although muscle mass can be estimated with 24-h urinary creatinine excretion (UCE), its use for risk prediction in individual patients is limited because age-, sex-, weight- and length-specific reference values for UCE are lacking. The ratio between measured creatinine clearance (mCC) and estimated glomerular filtration rate (eGFR) might circumvent this constraint. The main goal was to assess the association of the mCC/eGFR ratio in ICU patients with all-cause hospital and long-term mortality.

Methods

The mCC/eGFR ratio was determined in patients admitted to our ICU between 2005 and 2021 with KDIGO acute kidney injury (AKI) stage 0–2 and an ICU stay ≥ 24 h. mCC was calculated from UCE and plasma creatinine and indexed to 1.73 m2. mCC/eGFR was analyzed by categorizing patients in mCC/eGFR quartiles and as continuous variable.

Results

Seven thousand five hundred nine patients (mean age 61 ± 15 years; 38% female) were included. In-hospital mortality was 27% in the lowest mCC/eGFR quartile compared to 11% in the highest quartile (P < 0.001). Five-year post-hospital discharge actuarial mortality was 37% in the lowest mCC/eGFR quartile compared to 19% in the highest quartile (P < 0.001). mCC/eGFR ratio as continuous variable was independently associated with in-hospital mortality in multivariable logistic regression (odds ratio: 0.578 (95% CI: 0.465—0.719); P < 0.001). mCC/eGFR ratio as continuous variable was also significantly associated with 5-year post-hospital discharge mortality in Cox regression (hazard ratio: 0.27 (95% CI: 0.22—0.32); P < 0.001).

Conclusions

The mCC/eGFR ratio is associated with both in-hospital and long-term mortality and may be an easily available index of muscle mass in ICU patients.
Avian malaria in a feral-pet pigeon: a case report
Authors: Muchaamba Gillian , Venugopal Kannan , Gächter Bettina , Vogler Barbara , Hetzel Udo , Albini Sarah , Marti Matthias
Published: October 2024

Background

Avian malaria is caused by diverse parasite species of the genus Plasmodium, and it affects various bird species. The occurrence of this disease in some wild bird species is sparsely documented due to the scarce availability of samples. Hence the pathogenicity in some hosts is not completely known. In addition, feral birds may act as reservoirs bridging the transmission cycle from wild migratory birds to domestic and zoo-kept bird species.

Case presentation

An owner of pigeons adopted a feral pigeon (Columba livia forma domestica) and housed it together with his other pet-pigeons. The bird died unexpectedly a few weeks after a surgical procedure and necropsy revealed a severely anaemic carcass, with pale organs and hydropericardium. Histopathologic analysis revealed inflammatory infiltrates in the lung and liver, and monocytes and Kupffer cells contained haemozoin pigment indicative of phagocytosis of Plasmodium-infected erythrocytes. A high erythrocytic infection rate of 18% was evident in tissues and blood vessels in various organs. Furthermore, the thyroid had masses classified as thyroid carcinomas. Immunohistochemistry with anti- Plasmodium falciparum HSP70 antibody revealed positive signals in erythrocytes and intravascular leucocytes. Further microscopy analysis using a Hemacolor-stained impression smear revealed a high parasitaemia with an asynchronous infection showing all erythrocytic stages. Molecular diagnosis by PCR identified Plasmodium relictum, lineage GRW11 as the aetiological agent. The bird presented died most likely due to an acute infection as evidenced by the high blood parasitaemia, leading to major erythrocyte destruction. Further analyses of feral pigeons (n = 22) did not reveal any additional cases of Plasmodium infections.

Conclusion

This study reports the first mortality associated with P. relictum lineage GRW11. The study supports previous studies, suggesting that Plasmodium infections are not frequent in pigeons. Host conditions like immunosuppression due to the tumour may have influenced the infection outcome in this fatal case. Use of anti-P. falciparum HSP70 antibody for detection of P. relictum antigens for immune assays in blood and tissue samples will be a useful tool for future studies.
Cholinesterase inhibitor use in amyloid PET-negative mild cognitive impairment and cognitive changes
Authors: Pyun Jung-Min , Park Young Ho , Kang Min Ju , Kim SangYun
Published: October 2024

Background

Cholinesterase inhibitors (ChEIs) are prescribed for Alzheimer’s disease (AD) and sometimes for mild cognitive impairment (MCI) without knowing underlying pathologies and its effect on cognition. We investigated the frequency of ChEI prescriptions in amyloid-negative MCI and their association with cognitive changes in the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort.

Methods

We included participants with amyloid positron emission tomography (PET)-negative MCI from the ADNI. We analyzed the associations of ChEI use with cognitive changes, brain volume, and cerebrospinal fluid (CSF) total tau (t-tau), hyperphosphorylated tau181 (p-tau181), and p-tau181/t-tau ratio.

Results

ChEIs were prescribed in 27.4% of amyloid PET-negative MCI and were associated with faster cognitive decline, reduced baseline hippocampal volume and entorhinal cortical thickness, and a longitudinal decrease in the frontal lobe cortical thickness.

Conclusions

The association between ChEI use and accelerated cognitive decline may stem from underlying pathologies involving reduced hippocampal volume, entorhinal cortical thickness and faster frontal lobe atrophy. We suggest that ChEI use in amyloid PET-negative MCI patients might need further consideration, and studies investigating the causality between ChEI use and cognitive decline are warranted in the future.
Physiological provocation compared to acetazolamide in the assessment of cerebral hemodynamics: a case report
Authors: Henriksen Alexander Cuculiza , Thomsen Gerda Krog , Knudsen Gitte M. , Stavngaard Trine , Rosenbaum Sverre , Marner Lisbeth
Published: October 2024

Background

Severe large vessel disease may lead to cerebral hemodynamic failure that critically impairs cerebral blood flow (CBF) regulation elevating the risk of ischemic events. Assessment of the condition is often based on changes in CBF during vasodilatation; however, pharmacologically induced vasodilation does not reflect the physiological condition during an ischemic event caused by hemodynamic failure. We compared a [15O]H2O PET brain scan during vasodilation to a [99mTc]HMPAO SPECT brain scan during an ongoing transient ischemic attack (TIA).

Case presentation

A single patient presenting with limb-shaking TIA underwent CT, Digital Subtraction Angiography, and two different modalities of cerebral perfusion scans: [15O]H2O PET and [99mTc]HMPAO SPECT. Acetazolamide was used in the PET scan to induce vasodilatation, and during the SPECT scan physiological stress, standing up rapidly, was used to induce limb-shaking TIA. CT-angiography and Digital Subtraction Angiography revealed an occlusion in the distal part of the right A2 segment of the anterior cerebral artery, with a corresponding infarction in the watershed area. Collaterals supplied the main vascular territory of the anterior cerebral artery. During rest, neither perfusion modalities demonstrated reduced perfusion outside of the ischemic core. However, we found a pronounced difference between the PET utilizing acetazolamide and the SPECT during the TIA. The PET scan demonstrated relative hypoperfusion in vascular territory supplied by collaterals, while the area around the ischemic core was not affected. Contrary, the SPECT had only minor relative hypoperfusion in the collateral-supplied area, whereas the watershed area proximal to the infarct core had pronounced relative hypoperfusion.

Conclusions

The observed discrepancy in compromised areas during physiological provocation compared to pharmacological induced vasodilation questions the use of an unphysiological stressor for assessment of cerebrovascular hemodynamics. A physiological provocation test may achieve more clinically relevant evaluation.
CT-based conventional radiomics and quantification of intratumoral heterogeneity for predicting benign and malignant renal lesions
Authors: Yu Shuanbao , Yang Yang , Wang Zeyuan , Zheng Haoke , Cui Jinshan , Zhan Yonghao , Liu Junxiao , Li Peng , Fan Yafeng , Jia Wendong , Wang Meng , Chen Bo , Tao Jin , Li Yuhong , Zhang Xuepei
Published: October 2024

Background

With the increasing incidence of renal lesions, pretreatment differentiation between benign and malignant lesions is crucial for optimized management. This study aimed to develop a machine learning model utilizing radiomic features extracted from various regions of interest (ROIs), intratumoral ecological diversity features, and clinical factors to classify renal lesions.

Methods

CT images (arterial phase) of 1,795 renal lesions with confirmed pathology from three hospital sites were split into development (1184, 66%) and test (611, 34%) cohorts by surgery date. Conventional radiomic features were extracted from eight ROIs of arterial phase images. Intratumoral ecological diversity features were derived from intratumoral subregions. The combined model incorporating these features with clinical factors was developed, and its performance was compared with radiologists’ interpretation.

Results

Combining intratumoral and peritumoral radiomic features, along with ecological diversity features yielded the highest AUC of 0.929 among all combinations of features extracted from CT scans. After incorporating clinical factors into the features extracted from CT images, our combined model outperformed the interpretation of radiologists in the whole (AUC = 0.946 vs 0.823, P < 0.001) and small renal lesion (AUC = 0.935 vs 0.745, P < 0.001) test cohorts. Furthermore, the combined model exhibited favorable concordance and provided the highest net benefit across threshold probabilities exceeding 60%. In the whole and small renal lesion test cohorts, the AUCs for subgroups with predicted risk below or above 95% sensitivity and specificity cutoffs were 0.974 and 0.978, respectively.

Conclusions

The combined model, incorporating intratumoral and peritumoral radiomic features, ecological diversity features, and clinical factors showed good performance for distinguishing benign from malignant renal lesions, surpassing radiologists’ diagnoses in both whole and small renal lesions. It has the potential to save patients from unnecessary invasive biopsies/surgeries and to enhance clinical decision-making.
Trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone
Authors: Osborne Augustus , Bangura Camilla
Published: October 2024

Background

Sierra Leone has improved child health outcomes in recent decades. However, diarrhoeal diseases remain a public health concern, particularly among children under five. This study investigates the trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone in 2008, 2013 and 2019.

Methods

The analysis utilised data from the Sierra Leone Demographic Health Survey rounds conducted in 2008, 2013, and 2019. The software utilised for the calculation of various measures of inequality, including simple difference, ratio, population-attributable risk, and population-attributable fraction, was the World Health Organization Health Equity Assessment Toolkit. An inequality assessment was conducted for six stratifiers: maternal age, maternal economic status, maternal level of education, place of residence, sex of the child, and sub-national region.

Results

Our findings reveal that children under five with diarrhoea receiving oral rehydration therapy and continued feeding increased from 56.5% in 2008 to 59.7% in 2019 in Sierra Leone. Children of mothers aged 20–49 had more coverage over time than those with mothers aged 15–19. Children of mothers who are wealthy, more educated, and living in urban areas show a decrease in coverage with time compared to the poor, the lowly educated, and those residing in rural areas. Male children had higher coverage than female children. Regional inequality decreased slightly from 21.5 percentage points in 2008 to 21.2 percentage points in 2019.

Conclusion

The findings revealed a mixed picture of progress in oral rehydration therapy and continued feeding for children under five in Sierra Leone. While national coverage has increased, inequalities persist. Children of older mothers and those from disadvantaged backgrounds have experienced improvements, while children of younger, wealthier, and more educated mothers in urban areas have seen a decline in coverage. The gender and regional inequalities remain. Expanding community-based health programs, providing subsidised or free supplies, and strengthening health systems in underserved areas are key strategies to ensure equitable and effective healthcare for all children in Sierra Leone.
Genetic improvement of fiber quality in tetraploid cotton: an overview of major QTLs and genes involved in and edited for the quality of cotton fibers
Authors: Baghyalakshmi Kari , Priyanka Rajendran Ariyapalayam , Sarathapriya Govindaraj , Ramchander Selvaraj , Prakash Arkalgud Hiriyannaiah
Published: October 2024

Cotton, an important industrial crop cultivated in more than 70 countries, plays a major role in the livelihood of millions of farmers and industrialists. Cotton is mainly grown for its fiber, an economic component that can be differentiated from its epidermal cells in the outer integument of a developing seed. Fiber length, fiber strength, and fiber fineness are three main attributes that contribute to the quality of cotton fibers. Recent advancements in genomics have identified key genes, which are the most important factors that govern these three traits, can be introduced into cultivars of interest via gene editing, marker-assisted selection, and transgenics, thus the narrow genetic background of cotton can be addressed and its fiber quality traits can be enhanced. Over the past two decades, quantitative trait loci (QTLs) have been mapped for different fiber traits, approximately 1 850 QTLs have been mapped for fiber length, fiber strength, and fineness among which a few genes have been edited for quality improvement in cotton. In this background, the current review covers the development and the factors that influence these traits, along with the reported genes, QTLs, and the edited genomes for trait improvement.
From classroom learning to real-world skills: an autoethnographic account of school field trips and STEM work immersion program management
Authors: Acut Dharel P.
Published: October 2024

Quality science education is crucial in preparing students for real-world challenges by fostering scientific literacy and critical thinking skills. Field trips and work immersion programs support this goal by providing hands-on experiences and real-world applications of scientific concepts, thereby enhancing student engagement and understanding. This autoethnographic study explores the management of school field trips and work immersion programs, emphasising their impact on student engagement and learning outcomes. Through personal experiences and reflective practices, I examine the logistical planning, risk management, and curriculum alignment necessary for successful implementation. The findings highlight how these programs enhance students’ understanding of scientific principles, foster critical thinking, and encourage STEM career interests. Key strategies include collaborative planning, flexibility, and ongoing evaluation, providing insights into optimising educational programs and bridging the gap between classroom learning and real-world application.
The epidemiological declining in the human fertility rate in the arab world for 10 years period 2011–2021
Authors: Mahasneh Ihsan , Ebrahim Ferdos
Published: October 2024

Recently, there has been worldwide growing interest on profiling the human fertility of populations because there has been a noticeable global decline in fertility rate, leading to increased attention toward reproductive health and fertility.

The decline in fertility of population of the Arab World was investigated for the 10 years period between 2011–2021. The Arab World was classified into three regional blocks; Block-1 Arabian Peninsula countries: Bahrain, Kuwait, Saudi Arabia, Oman, Qatar, United Arab Emirates (UAE), Yemen. Block-2 Fertile Crescent Arab countries: Iraq, Jordan, Lebanon, Syria, West Bank and Gaza. Block-3 African Arab countries: Algeria, Comoros, Djibouti, Egypt, Libya, Mauritania, Morocco, Somalia, Sudan, Tunisia. Data on fertility rates for the 10 years period between 2011–2021 were collected from the World Bank for Arab countries. Statistical analysis along with decline in the fertility rates were determined. Results: Fertility rates varied across Arab countries in 2011 and 2021, with notable decline ranging from 24.3% to 3.8%, except for Algeria, with zero decline. Countries that exhibited significant decline were Jordan (24.3%) followed by Iraq (22.2%) then Yemen (19.1%); Whereas, countries that exhibited slight fertility decline were Libya (3.8%), followed by Tunisia (4.5%), Lebanon (4.5%) and Kuwait (4.5%). On another note, lowest fertility rate was observed in UAE as maintained between 1.7% and 1.5% and the highest fertility rate was observed in Somalia as maintained between 7.3% and 6.3% for 2011 and 2021 respectively. Conclusion: The present study reveals the declining-trend in fertility rate across Arab countries, influenced by variable factors. Therefore, we recommend to the Council of the Health Ministries in the Arab-League to focus on investigating the fertility decline as an important parameter for public health in the Arab world to maintain natural balanced fertility rate.

As some non-biological factors surrounding the Arabian region, such as instability, war, migration, the present study did not aim to include the influence of war and migration on fertility because both war and migration are non-biological external factors and both are not among the WHO criteria for fertility determination which based of the population growth rate of population under normal living conditions.
Blast resistance of CFRP composite strengthened masonry arch bridge under close-range explosion
Authors: Azar Amin Bagherzadeh , Sari Ali
Published: October 2024

Carbon fiber reinforced polymers (CFRP) are recognized for their exceptional strength-to-weight ratio. They offer a viable and effective solution for strengthening and retrofitting masonry bridges, helping to extend their service life, improve structural performance, and meet modern safety and load requirements. Wrapping of CFRP around masonry elements can enhance their confinement and ductility. This flexibility plays a crucial role in preventing sudden brittle failure, allowing for controlled deformation, which is essential for blast resistance. Additionally, CFRP materials possess the ability to flex and absorb energy, which proves beneficial in containing and redistributing forces generated during an explosion, consequently reducing the risk of catastrophic failure. This study employed the coupled Eulerian–Lagrangian (CEL) technique available in the finite element software Abaqus/Explicit to simulate the blast loads. Various detonation scenarios were considered, taking into account factors such as location and their impacts on bridge structures. A detailed micro-model was developed using finite element software and accurate geometric data acquired from FARO laser scanning of the case study. The properties of masonry units and backfill were characterized using the Johnson-Holmquist II damage model and Mohr–Coulomb criteria. The Jones-Wilkins-Lee equation of state (EOS) was applied to replicate the behavior of trinitrotoluene (TNT). In accordance with the JH-II model, the researchers formulated a VUMAT code. The study examined the distinct damage mechanisms and overall structural responses of bridges. By evaluating the blast resistance of individual bridge models, the most critical scenarios were pinpointed. Carbon Fiber Reinforced Polymer (CFRP) was then utilized as a method to fortify bridges against blast loads. A comparison was made between the damage propagation before and after the reinforcement.
Association Between Moyamoya Revascularization Surgery and Neurologic Events During Pregnancy: Systematic Review
Authors: Lai Pui Man Rosalind , Beazer Maggie , Frerichs Kai U. , Patel Nirav J. , Aziz-Sultan M. Ali , Du Rose
Published: October 2024

BACKGROUND AND OBJECTIVES:

The management of moyamoya disease during pregnancy and recommendations for the mode of delivery remain controversial. We investigated factors associated with neurologic events during pregnancy in women with moyamoya disease and its association with prepregnancy surgical revascularization.

METHODS:

We performed a literature search from January 1, 1970, through September 30, 2021, using Embase, Web of Science, Medline, and Cochrane to identify cases of moyamoya disease with pregnancy. Primary outcome was neurologic events during pregnancy and were subcategorized into antepartum, intrapartum (within 24 hours of delivery), and postpartum events. Univariate and multivariate regression analyses using pooled results were performed to assess risk factors associated with neurologic events.

RESULTS:

Fifty-two relevant studies with 182 individuals diagnosed with moyamoya before pregnancy, and 229 pregnancies were included in the study. 59% underwent surgical revascularization before pregnancy. Of the 229 pregnancies, 22 (9.6%) patients had ischemic events and 3 (1.3%) had hemorrhagic events. In addition, there were 7 (3%) seizures and 4 (1.7%) other neurologic events not associated with ischemia or hemorrhage. There were fewer neurologic events during pregnancy in patients treated with surgery than those without surgery (11% surgical vs 24% medical, P = .009). Multivariable regression analysis demonstrated prior surgical revascularization as the only factor associated with lower number of neurologic events during pregnancy (odds ratio 0.42 [95% CI 0.19-0.96]). Mode of delivery (vaginal vs cesarean section) was not associated with a difference in overall intrapartum and postpartum neurologic events.

CONCLUSION:

We found that prior revascularization surgery was the only factor associated with fewer neurologic events during pregnancy in women with moyamoya disease. Mode of delivery was not associated with increased neurologic events during or after delivery.
Risk Factors for In-Stent Stenosis After Flow Diverter Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 2350 Patients
Authors: Abramyan Arevik , Roychowdhury Sudipta , Tarasova Natalia , Sioutas Georgios , Samaan Mena , Mangla Sherry , Sundararajan Srihari , Gupta Gaurav
Published: October 2024

BACKGROUND AND OBJECTIVES:

Recent advances in flow diverter (FD) therapy for intracranial aneurysms have highlighted the need to evaluate risk factors for in-stent stenosis (ISS), a potentially serious complication. This meta-analysis aims to identify risk factors associated with an increased risk of ISS after FD treatment.

METHODS:

PubMed, Web of Science, Embase, and SCOPUS databases were systematically searched for studies reporting ISS rates and risk factors after FD therapy for intracranial aneurysms. Odds ratios were calculated using random-effects models to assess potential risk factors associated with ISS.

RESULTS:

Ten studies involving 2350 patients with 2441 aneurysms were included. Younger age (P = .006) and male sex (P = .003) were associated with higher ISS risk. Smoking also increased the risk (P = .02). Aneurysm location in the posterior circulation (P < .00001) and fusiform morphology (P < .00001) were significant risk factors for ISS, as were ruptured aneurysms (P = .05). Hypertension, hyperlipidemia, diabetes, allergies, and alcohol abuse, as well as aneurysm size, neck width, and parent artery diameter, did not affect ISS risk. Procedural factors like balloon angioplasty, multiple FDs, or FD/coil combinations were not significantly associated with ISS.

CONCLUSION:

This meta-analysis identified both nonmodifiable (younger age, male sex) and modifiable (smoking) patient factors, as well as high-risk aneurysm characteristics (posterior circulation, fusiform, ruptured), associated with an increased risk of ISS after FD treatment. These findings highlight the importance of tailored monitoring and management approaches for optimizing outcomes in FD therapy.
How does Public Financial Management (PFM) influence health system efficiency: A scoping review
Authors: Musiega Anita , Tsofa Benjamin , Barasa Edwine
Published: October 2024

Background Effective Public Financial Management (PFM) approaches are imperative in the quest for efficiency in health service delivery. Reviews conducted in this area have assessed the impact of PFM approaches on health system efficiency but have left out the mechanisms through which PFM influences efficiency. This scoping review aims to synthesize evidence on the mechanisms by which PFM influences health system efficiency. Methods We searched databases of PubMed and Google Scholar and websites of the World Health Organization (WHO), World Bank and Overseas Development Institute (ODI) for peer-reviewed and grey literature articles that provided data on the relationship between PFM and health system efficiency. Three reviewers screened the articles for eligibility with the inclusion criteria. Data on PFM and health system efficiency was charted and summarized. We then reported the mechanisms by which PFM influence efficiency. Results PFM processes and structures influence health system efficiency by influencing; the alignment of resources to health system needs, the cost of inputs, the motivation of health workers, and the input mix. Conclusion The entire budget process influences health system efficiency. However, most of the findings are drawn from studies that focused on aspects of the budget process. Studies that look at PFM in totality will help explore other cross-cutting issues within sections of the budget cycle; they will also bring out the relationship between the different phases of the budget cycle.
The genome sequence of the Heart and Dart moth, Agrotis exclamationis (Linnaeus, 1758)
Authors: Forrester Ronald , Wawman Denise C. ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: October 2024

We present a genome assembly from an individual female Heart and Dart moth, Agrotis exclamationis (Arthropoda; Insecta; Lepidoptera; Noctuidae). The genome sequence has a total length of 725.10 megabases. Most of the assembly is scaffolded into 32 chromosomal pseudomolecules, including the W and Z sex chromosomes. The mitochondrial genome has also been assembled and is 15.39 kilobases in length. Gene annotation of this assembly on Ensembl identified 20,008 protein-coding genes.
Trends in Women’s Educational Advantage and Divorce in East and West Germany
Authors: Mazzeo Flavia , Schwartz Christine , Scherer Stefani , Vitali Agnese
Published: October 2024

Couples in which wives have more education than their husbands have been found to be more likely than other couples to divorce. But this relationship varies across time and place. We compare the relationship between spouses’ relative education and marital dissolution across four birth cohorts born between 1951 and 1990 in East and West Germany using 37 waves of the German Socio-Economic Panel (1984-2021) and Cox proportional hazard models. The comparison between East and West Germany provides contrasting levels and trends in women’s education, employment, and gender cultures, with East Germany persistently being a more gender egalitarian context compared to West Germany. Our results show that marriages in which wives have more education than their husbands are less stable in West Germany, but not in East Germany, where the point estimates indicate that these couples are more stable than other couples, but this association is not statistically significant. We do not find evidence of cohort change in these associations in either East or West Germany. These findings are consistent with the idea that the consequences of non-traditional gender arrangements are weaker in more egalitarian contexts and confirm that notable differences between East and West Germany persist after reunification.
* This article belongs to a special issue on “Changes in Educational Homogamy and Its Consequences”.
Conflictos urbanos. Transformaciones, resistencias y producción del espacio en ciudades iberoamericanas
Authors: Barrero Rescalvo María , Díaz Parra Rubén Ibán , López Casado David , Roca Martínez Beltrán
Published: October 2024

Los diferentes casos que se abordan en este volumen sobre los estudios urbanos permiten conocer el papel de las políticas públicas en la transformación neoliberal de la ciudad, las dinámicas de estigmatización, precarización y securitización que acompañan el cambio, así como los conflictos y formas de resistencia que surgen en diferentes contextos. La variedad de circunstancias específicas procedentes de realidades radicalmente distintas que se presentan en el libro da cuenta de la diversidad actual de este tipo de trabajos en cuanto a perspectivas teóricas, temáticas y metodológicas. La transformación y los conflictos urbanos en España, Ecuador, México, Argentina, Chile, Uruguay y Venezuela permiten indagar sobre las diversas formas e impactos del urbanismo neoliberal, así como en el modo en que las diferentes poblaciones confrontan dichas dinámicas que generan enriquecimiento para una minoría a la vez que empobrecimiento y exclusión para una mayoría.
Kain i Abel to my
Authors: Walkiewicz Barbara
Published: October 2024

CAIN AND ABEL ARE US. INCLUSIVITY IN INTERMEDIAL TRANSLATIONInclusivity in the context of translation is most commonly associated with inclusive language, not excluding anyone regardless of age, gender, orientation, disability, or origin. However, this concept can also be interpreted as involving the audience to co-participate in creating meaning, especially – though not exclusively – in the context of art. This article is dedicated to inclusivity understood in this way in intermedial translation. Its goal is to reveal the mechanisms of translating the title of the 7th edition of the theatrical meetings ‘Bliscy Nieznajomi’ (Close Strangers) which was ‘Cain and Abel’ onto various visual objects: poster, festival newspaper, and 3D installation.
Problematyka przekładu gier planszowych na przykładzie tłumaczenia wybranych nazw własnych w grze Everdell na język polski i rosyjski
Authors: Seweryn Agnieszka
Published: October 2024

THE PROBLEMS OF TRANSLATING BOARD GAMES AS EXEMPLIFIED BY THE TRANSLATION OF SELECTED PROPER NAMES IN THE GAME EVERDELL INTO POLISH AND RUSSIAN
The main aim of this paper is to analyse the Polish and Russian translations of selected proper names from the board game Everdell and its expansions, issued by Starling Games in 2018-2020. The author focuses on the theory of translating (transcreating) board game as a multimodal text and potential translation issues, as well as on the translator’s competences. The analytic part of this work consists of seven selected proper names translated into Polish by Monika Żabicka and into Russian by Daniil Yakovenko, Evgeniia Nekrasova and Stanislav Zagorodnyi: Everdell, Ever Tree, Corrin Evertail, Fynn Nobletail, Poe, Prophet Foresight and Pristine Chapel. The author shows their etymological, historical, and cultural background presented in the source language and then discusses their Polish and Russian equivalents and strategies chosen by the translators. As a result, we can see that the proper names in the Polish version are mostly adapted and relate to the Polish culture and history, whereas in Russian language version most of the proper names are not translated, just transcribed.
NGAV (Next-Generation Antivirus) Especialista na Detecção de Cyber-Ataques
Authors: Lima Sidney Marlon Lopes de , Pinheiro Ricardo , Souza Danilo , Silva Sthéfano , Lopes Petrônio , Lima Rafael , Oliveira Jemerson , Monteiro Thyago , Murilo Sérgio , Albuquerque Edison
Published: October 2024

Quase todos os malwares executados em servidores web são códigos PHP. Este trabalho cria um NGAV (Next Generation Antivirus - Antivírus de Próxima Geração) especialista em detectar ameaças web em arquivos PHPs, em tempo real. Nosso antivírus monitora 11.777 comportamentos maliciosos que o cyber-ataque possa fazer quando executado diretamente de um servidor web malicioso para um serviço em um computador pessoal.  O nosso NGAV alcança uma precisão média de 97.50% na distinção entre scripts web benignos e malwares através de ciência dos dados, inteligência artificial e máquinas de aprendizado estatístico. O nosso antivírus tem a capacidade de suprir as limitações do antivírus comercias quanto à detecção de cyber-ataques oriundos de servidores web.
Avaliando a Detecção e o Tratamento de Flash Crowds Utilizando o SimGrid
Authors: Pinheiro Vitor , Sampaio Caio César A. , Santos Eduardo , Paula Ubiratam de
Published: October 2024

Este artigo propõe uma simulação, onde recursos da nuvem podem ser contratados dinamicamente com a finalidade de mitigar os efeitos dos eventos de flash crowds. Esta simulação foi desenvolvida através da integração do simulador SimGrid com soluções já existentes na literatura para a detecção e tratamento de flash crowds. Os testes iniciais foram satisfatórios e promissores. Futuramente, pretende-se realizar mais testes com cenários maiores.
Simulação e Avaliação de Desempenho de uma Rede Blockchain Utilizando Containers Docker
Authors: De Morais Anderson Melo , De Almeida Callou Gustavo Rau , Aires Lins Fernando Antonio
Published: October 2024

Com o desenvolvimento de novas tecnologias surgem novos desafios em relação a segurança das informações. Diante disso apresentam-se a tecnologia Blockchain, que possuem um alto nível de segurança, pois mantêm os dados distribuídos e descentralizados, e podem ser utilizadas em diferentes contextos. Neste artigo, foi realizada uma simulação de uma Blockchain utilizando containers Docker. Em seguida foi proposta uma metodologia para avaliar o desempenho da Blockchain e por fim, realizou-se um estudo de caso, aplicando a metodologia em uma série de testes sobre a aplicação. Foram executados diferentes testes de carga, e avaliada a vazão e o tempo de resposta da Blockchain, através da ferramenta de avaliação de desempenho JMeter
Métricas de Tamanho de Software com Métodos Ágeis no Setor Público: um Survey
Authors: Mendonça Alexandre , Alencar Fernanda
Published: October 2024

A administração pública tem utilizado cada vez mais métodos ágeis,adequando-se à realidade do mercado. Muito embora continue obrigada amensurar suas entregas através de alguma métrica de tamanho de software,a escolha adequada dessa métrica pode definir o nível de sucesso dos projetospúblicos. Neste artigo, identifica-se as métricas de tamanho de softwareem conjunto com métodos ágeis a serem utilizados no setor público. Um surveyé conduzido para coletar as métricas e método com maior probabilidadede sucesso no setor público. Como resultado, a métrica COSMIC e os métodosSCRUM, XP e Kanban se apresentam como os mais promissores para seremutilizados no setor público.
Padrões de Requisitos para Sistemas de Registro Eletrônico de Saúde
Authors: Martins Mariana Crisostomo , Kudo Taciana Novo , Bulcão-Neto Renato Freitas
Published: October 2024

Um catálogo de padrões de requisitos de software (CPRS) organiza requisitos comuns entre aplicações de um domínio para que sejam reusados e, assim, reduzir os esforços de elicitação, especificação e validação de requisitos de uma nova aplicação de mesmo domínio. O CPRS tem importante papel para a Engenharia de Requisitos e todo o ciclo de vida, pois mais de 50% dos defeitos identificados em projetos advêm de requisitos de baixa qualidade. Estudos recentes reforçam que o desenvolvimento de CPRS é uma das ações que promovem maior disseminação da adoção de padrões de requisitos na indústria. Além da baixa disponibilidade de CPRS, poucos estudos realizam a validação e a avaliação de CPRS. Assim, visa-se desenvolver um CPRS para Sistemas de Registro Eletrônico em Saúde (S-RES), validado e avaliado por especialistas desse domínio de aplicação. A construção do CPRS é apoiada pela ferramenta Terminal Model Editor (TMEd), e os conceitos e a estrutura do CPRS seguem as definições do metamodelo Software Pattern Metamodel (SoPaMM). A construção do CPRS apoia-se em requisitos usados na certificação de S-RES pela Sociedade Brasileira de Informática em Saúde (SBIS). O CPRS será então disponibilizado à SBIS para apoiar não somente a certificação, mas também o desenvolvimento de S-RES.
Synovial vancomycin and meropenem concentrations in periprosthetic joint infection treated by single-stage revision combined with intra-articular infusion
Authors: Zou Chen , Guo Wentao , Mu Wenbo , Wahafu Tuerhongjiang , Li Yicheng , Hua Long , Xu Boyong , Cao Li
Published: October 2024

Aims

We aimed to determine the concentrations of synovial vancomycin and meropenem in patients treated by single-stage revision combined with intra-articular infusion following periprosthetic joint infection (PJI), thereby validating this drug delivery approach.

Methods

We included 14 patients with PJI as noted in their medical records between November 2021 and August 2022, comprising eight hip and seven knee joint infections, with one patient experiencing bilateral knee infections. The patients underwent single-stage revision surgery, followed by intra-articular infusion of vancomycin and meropenem (50,000 µg/ml). Synovial fluid samples were collected to assess antibiotic concentrations using high-performance liquid chromatography.

Results

The peak concentrations of vancomycin and meropenem in the joint cavity were observed at one hour post-injection, with mean values of 14,933.9 µg/ml (SD 10,176.3) and 5,819.1 µg/ml (SD 6,029.8), respectively. The trough concentrations at 24 hours were 5,495.0 µg/ml (SD 2,360.5) for vancomycin and 186.4 µg/ml (SD 254.3) for meropenem. The half-life of vancomycin was 6 hours, while that of meropenem ranged between 2 and 3.5 hours. No significant adverse events related to the antibiotic administration were observed.

Conclusion

This method can achieve sustained high antibiotic concentrations within the joint space, exceeding the reported minimum biofilm eradication concentration. Our study highlights the remarkable effectiveness of intra-articular antibiotic infusion in delivering high intra-articular concentrations of antibiotics. The method provided sustained high antibiotic concentrations within the joint cavity, and no severe side-effects were observed. These findings offer evidence to improve clinical treatment strategies. However, further validation is required through studies with larger sample sizes and higher levels of evidence.

Cite this article: Bone Joint Res 2024;13(10):535–545.
Christian Interiority in the Wild
Authors: Frohlich Mary
Published: October 2024

Abstract: We live in an era of crisis when the Earth itself calls us to reconsider our most basic assumptions. Encounters with the wild world and with wild beings may impact us deeply, yet we rarely acknowledge them as sources for our own spirituality, let alone for our academic work as scholars of spirituality. By exploring how such encounters engage us at a more foundational level than that of articulated meaning, this essay strives to take another step toward thinking through the full implications of a participative epistemology and relational ontology.
Kierkegaard's Spirituality of Mortality: Beyond God as an Ultimate Rescuer
Authors: Swick Cassandra
Published: October 2024

Abstract: This essay explores the criticism that belief in the God of Christianity is an escape from facing death. Irvin Yalom claims that the faithful use God as an "ultimate rescuer" from death to avoid facing their mortality. This essay argues that Søren Kierkegaard's God is not an ultimate rescuer because the Kierkegaardian individual faces death head-on with earnestness. Kierkegaard's account of mortality actually lends more urgency to finite life because it provides a pressing task to be completed this very day.