bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibacterial thermoplastic starch/sepiolite bio-nanocomposite films: Effects of plasticizer type and starch source
Authors: Çokkuvvetli Ayşe Tuğçe , Deniz Sennur
Published: January 2025

The use of starch-based films as an alternative food packaging has gained prominence as part of efforts to ensure sustainability and manage post-user waste, aligning with European regulations and broader global sustainability goals. In this study, Thermoplastic starch (TPS) bio-nanocomposite hybrid films were developed by incorporating high purity sepiolite (HPS) and Turkish oregano extract (OE) as reinforcement and antimicrobial additives, respectively. The interactive effects of four experimental variables (temperature, time, plasticizer type, and ratio) on the mechanical characteristics of corn and potato starch-based films were evaluated using Box-Behnken response surface methodology. A three-level, three-factor Box-Behnken design was utilized to investigate the effects of the experimental variables on tensile strength (TS), elongation at break (EB), and E-modulus (EM) of the starch-based films. The potato-based TPS films using sorbitol rather than glycerol exhibited better mechanical properties than corn starch-based TPS films under the optimized experimental parameters of 70°C gelatinization temperature, 60 minutes gelatinization time, and 40% sorbitol plasticizer. The addition of 3% HPS slightly enhanced the mechanical (TS: 26.0 MPa, EB:11.3%, and EM:1817 MPa) and oxygen permeability characteristics (OTR: 25 cc/m2.day) of the potato-based bio-nanocomposite films. The hybrid films prepared with the addition of OE provided >99.7% antibacterial resistance to E. coli and S. aureus bacteria (in accordance with ASTM D3985). These findings suggest that starch-based hybrid films offer a promising approach to address both environmental and food safety concerns, raising the prospect of using such films as innovative active packaging materials in the future.
NEK8 promotes the progression of gastric cancer by reprogramming asparagine metabolism
Authors: Wang Mingliang , Yu Kexun , Meng Futao , Wang Huizhen , Li Yongxiang
Published: January 2025

Several members of the NIMA-related kinase (NEK) family have been implicated in tumor progression; however, the role and underlying mechanisms of NEK8 in gastric cancer (GC) remain unclear. This study revealed a significant upregulation of NEK8 in GC, identifying it as an independent prognostic marker in patients with GC. Consistent with these findings, NEK8 silencing substantially impeded GC aggressiveness both in vitro and in vivo, while its overexpression produced the opposite effect. Gene Ontology enrichment analysis and metabolic profiling indicated that the impact of NEK8 on GC is primarily associated with reprogramming asparagine metabolism and modulating the mTORC1 pathway. Specifically, NEK8 knockdown suppressed asparagine synthesis by downregulating asparagine synthetase (ASNS) expression in GC cells. A strong correlation was observed between NEK8 levels and ASNS expression in human GC cells and tissue samples. Mechanistically, NEK8 directly interacts with ASNS, phosphorylating it at the S349 site, which inhibits its ubiquitination and subsequent degradation. Moreover, substituting the ASNS-S349 site with alanine abrogated the pro-tumorigenic effects of ASNS-WT overexpression. Additionally, asparagine was identified as an activator of the mTORC1 pathway, with reintroducing asparagine after NEK8 silencing restoring mTORC1 activity. Collectively, these findings demonstrate that NEK8-mediated asparagine synthesis and activation of the mTORC1 pathway play a critical role in promoting GC progression.
Studies on the electrical and optical conductivity of barium-nickel ferrite nanoparticles doped with Zn
Authors: Khoreem Sadiq H. , AL-Hammadi A. H.
Published: January 2025

The study highlights the significant effects of Zn ions concentration on the optical properties of BaNi2-xZnxFe16O27 ferrites, emphasizing the tunability of the band gap through Zn doping and explores their potential to enhance their optical properties. The barium-nickel ferrite powder, with the composition BaNi2−xZnxFe16O27, was synthesized using the ceramic method. The effects of Zn doping were analyzed using X-ray diffraction (XRD) and UV‒visible (UV–Vis) spectroscopy. XRD confirmed a pure single-phase W-type hexagonal structure, with an increase in both grain size and lattice constant proportional to the Zn content. The optical properties were assessed through UV‒visible spectroscopy, revealing an increaseing of the band gap with increasing Zn concentration, confirming material’s semiconducting behavior.All optical constants, exhibited consistent variation with increasing Zn substitution.. Additionally, both electrical and optical conductivities increased with rising photon energy, while the conductivity peak decreased with higher Zn content. The electric susceptibility was found to decrease as Zn concentration increased. The results indicate that Zn doping leads to significant changes in lattice parameters, crystallite size, and bandgap energy, suggesting potential applications in optoelectronics, photonics devices, and energy storage."
Clinical diagnostic performance of droplet digital PCR for pathogen detection in patients with Escherichia coli bloodstream infection: a prospective observational study
Authors: Kitagawa Hiroki , Kojima Masato , Tadera Kayoko , Kogasaki Shuta , Omori Keitaro , Nomura Toshihito , Shigemoto Norifumi , Hiyama Eiso , Ohge Hiroki
Published: January 2025

Background

Droplet digital PCR (ddPCR) is a highly sensitive tool for detecting bacterial DNA in bacterial bloodstream infections (BSI). This study aimed to examine the sensitivity and specificity of ddPCR and the association between bacterial DNA load in whole blood and the time-to-positivity (TTP) of blood culture (BC) in patients with Escherichia coli BSI.

Methods

This prospective study enrolled patients with E. coli BSI confirmed via BC at the Hiroshima University Hospital from June 2023 to August 2024. The E. coli DNA load in whole blood, which was simultaneously obtained from two BC sets, was measured using ddPCR with E. coli specific primer and probe. Whole blood samples from 50 patients with BC positive for pathogens other than E. coli (n = 25) and BC negative (n = 25) were also evaluated using ddPCR.

Results

A total of 131 patient samples were analyzed in this study. Of the 81 patients with E. coli BSI, ddPCR detected E. coli DNA in 67 (82.7%). The results of ddPCR for E. coli had a sensitivity of 82.7% (95% CI: 73.1–89.4%), specificity 100% (95% CI: 93.0–100%). Patients with positive ddPCR results had significantly shorter TTP than those with negative results (median, 8.8 h vs. 10.7 h, p < 0.001). The positivity rate for both BC sets was significantly higher in patients with positive ddPCR results than in those with negative results (89.6% vs. 35.1%, p < 0.001). Among ddPCR-positive patients, septic shock was significantly associated with intestinal perforation, higher E. coli DNA load, higher 28-d mortality, shorter TTP, and higher positivity rate for four bottles of BC than those without septic shock. The E. coli DNA load in whole blood negatively correlated with TTP (p < 0.001, R2 = 0.38).

Conclusion

The E. coli DNA load in whole blood is inversely correlated with TTP. Notably, a higher E. coli DNA load is associated with septic shock.
Sedated and unsedated gastroscopy has no influence on the outcomes of patients with gastric cancer: a retrospective study
Authors: Yin Chengke , Sun Yiwu , Liang Jie , Sui Xin , He Zhaoyi , Song Ailing , Xu Wenjia , Zhang Lei , Sun Yufei , Zhao Jingshun , Han Fei
Published: January 2025

Background

Different anesthetic drugs and techniques may affect survival outcomes for gastric cancer (GC) after surgery. In this study, we investigated the association between sedated and unsedated gastroscopy on survival outcomes in patients with GC after surgery.

Methods

This was a retrospective study of patients who were diagnosed with GC by gastroscopy and underwent gastrectomy from January 2013 to December 2017. They were grouped based on the examination modality: propofol-based sedated gastroscopy or unsedated gastroscopy. Propensity score matching (PSM) was used to balance the baseline variables. Survival outcomes and distant metastases were compared between these two groups.

Results

Finally, 673 patients were enrolled, 160 in the sedated gastroscopy group and 513 in the unsedated gastroscopy group. After PSM, there were 160 patients in each group. There was no significant difference in overall survival outcomes in the sedated gastroscopy group compared to the unsedated gastroscopy group before PSM (HR = 0.761, 95% CI: 0.531–1.091, P = 0.139) or after PSM (HR = 0.874, 95% CI: 0.564–1.355, P = 0.547). There was no significant difference in the incidence of distant metastases between the two groups before PSM (16.9% vs. 20.7%, P = 0.294) or after PSM (16.9% vs. 23.8%, P = 0.126). To confirm that our patients behaved similarly to other studies, we performed a multivariate analysis and the results showed that sex, pathological TNM stage, Borrmann type, adjuvant treatment, and surgical resection range were all independent factors affecting survival outcomes in our patients.

Conclusion

Our results showed no significant difference in the effects of sedated gastroscopy vs. unsedated gastroscopy on survival outcomes or distant metastases of patients after gastrectomy for GC.
Investigating the causal effects of childhood and adulthood adiposity on later life mental health outcome: a Mendelian randomization study
Authors: Pathak Sweta , Richardson Tom G. , Sanderson Eleanor , Åsvold Bjørn Olav , Bhatta Laxmi , Brumpton Ben M.
Published: January 2025

Background

Obesity particularly during childhood is considered a global public health crisis and has been linked with later life health consequences including mental health. However, there is lack of causal understanding if childhood body size has a direct effect on mental health or has an indirect effect after accounting for adulthood body size.

Methods

Two-sample Mendelian randomization (MR) was performed to estimate the total effect and direct effect (accounting for adulthood body size) of childhood body size on anxiety and depression. We used summary statistics from a genome-wide association study (GWAS) of UK Biobank (n = 453,169) and large-scale consortia of anxiety (Million Veteran Program) and depression (Psychiatric Genomics Consortium) (n = 175,163 and n = 173,005, respectively).

Results

Univariable MR did not indicate genetically predicted effects of childhood body size with later life anxiety (beta = − 0.05, 95% CI = − 0.13, 0.02) and depression (OR = 1.06, 95% CI = 0.94, 1.20). However, using multivariable MR, we observed that the higher body size in childhood reduced the risk of later life anxiety (beta = − 0.19, 95% CI = − 0.29, − 0.08) and depression (OR = 0.83, 95% CI = 0.71, 0.97) upon accounting for the effect of adulthood body size. Both univariable and multivariable MR indicated that higher body size in adulthood increased the risk of later life anxiety and depression.

Conclusions

Higher body size in adulthood may increase the risk of anxiety and depression, independent of childhood higher body size. In contrast, higher childhood body size does not appear to be a risk factor for later life anxiety and depression.
Efficacy of brain-computer interface training with motor imagery-contingent feedback in improving upper limb function and neuroplasticity among persons with chronic stroke: a double-blinded, parallel-group, randomized controlled trial
Authors: Kim Myeong Sun , Park Hyunju , Kwon Ilho , An Kwang-Ok , Kim Hayeon , Park Gyulee , Hyung Wooseok , Im Chang-Hwan , Shin Joon-Ho
Published: January 2025

Background

Brain-computer interface (BCI) technology can enhance neural plasticity and motor recovery in persons with stroke. However, the effects of BCI training with motor imagery (MI)-contingent feedback versus MI-independent feedback remain unclear. This study aimed to investigate whether the contingent connection between MI-induced brain activity and feedback influences functional and neural plasticity outcomes. We hypothesized that BCI training, with MI-contingent feedback, would result in greater improvements in upper limb function and neural plasticity compared to BCI training, with MI-independent feedback.

Methods

This randomized controlled trial included persons with chronic stroke who underwent BCI training involving functional electrical stimulation feedback on the affected wrist extensor. Primary outcomes included the Medical Research Council (MRC) scale score for muscle strength in the wrist extensor (MRC-WE) and active range of motion in wrist extension (AROM-WE). Resting-state electroencephalogram recordings were used to assess neural plasticity.

Results

Compared to the MI-independent feedback BCI group, the MI-contingent feedback BCI group showed significantly greater improvements in MRC-WE scores (mean difference = 0.52, 95% CI = 0.03–1.00, p = 0.036) and demonstrated increased AROM-WE at 4 weeks post-intervention (p = 0.019). Enhanced functional connectivity in the affected hemisphere was observed in the MI-contingent feedback BCI group, correlating with MRC-WE and Fugl-Meyer assessment-distal scores. Improvements were also observed in the unaffected hemisphere’s functional connectivity.

Conclusions

BCI training with MI-contingent feedback is more effective than MI-independent feedback in improving AROM-WE, MRC, and neural plasticity in individuals with chronic stroke. BCI technology could be a valuable addition to conventional rehabilitation for stroke survivors, enhancing recovery outcomes.

Trial registration

CRIS (KCT0009013).
Alström syndrome: the journey to diagnosis
Authors: Sinha Akshat , Leeson-Beevers Kerry , Lewis Catherine , Loughery Elizabeth , Geberhiwot Tarekegn
Published: January 2025

Background

Alström syndrome (AS) is a recessively inherited genetic condition which is ultra-rare and extremely complex. Symptoms include retinal dystrophy, nystagmus, photophobia, hearing loss, obesity, insulin resistance, diabetes and cardiomyopathy. The condition is progressive, but it is important to note that not all the complications associated with AS occur in everyone affected. Symptoms can also present at different stages, making diagnosis difficult. There are currently 88 people diagnosed with AS in the UK.

Objectives

The aim of this report is to raise awareness of the key symptoms of AS, in order to promote a faster and more effective diagnosis. This involves identification of individual or a combination of ‘red flag’ symptoms. Overall the findings should improve the patient experience, and their long-term health outcomes.

Methods

Between August-October 2022 we conducted research into a sample of patients from the ASUK database. The process involved a combination of interviews with families, social care and education reviews. Interviews were semi-structured using open questions and a patient-centred approach.

Results

Seventeen newly diagnosed patients were included in our sample. Only 24% of patients were diagnosed within one year following the onset of AS symptoms. Patients with visual impairment and cardiomyopathy were diagnosed much more quickly, either in infancy or early childhood. 41% of our research participants waited over 5 years for a diagnosis. Insufficient research and treatment advances can further impede the diagnostic process and limit access to therapies or clinical trials, ultimately impacting patient outcomes.

Conclusion

While we welcome these developments, our findings, and the evidence we have gathered in this report suggests that more needs to be done to improve the experiences of people receiving a diagnosis of AS. Obesity rapidly developing in infancy should be flagged as a key symptom to be aware of where AS is a possible diagnosis. Visual impairment (88%) in combination with cardiomyopathy (59%) is a frequent first presentation for patients with AS. Most patients (7/17) are diagnosed many years after symptom onset (5–20 years).
Resolving the source of branch length variation in the Y chromosome phylogeny
Authors: Swiel Yaniv , Kelso Janet , Peyrégne Stéphane
Published: January 2025

Background

Genetic variation in the non-recombining part of the human Y chromosome has provided important insight into the paternal history of human populations. However, a significant and yet unexplained branch length variation of Y chromosome lineages has been observed, notably amongst those that are highly diverged from the human reference Y chromosome. Understanding the origin of this variation, which has previously been attributed to changes in generation time, mutation rate, or efficacy of selection, is important for accurately reconstructing human evolutionary and demographic history.

Results

Here, we analyze Y chromosomes from present-day and ancient modern humans, as well as Neandertals, and show that branch length variation amongst human Y chromosomes cannot solely be explained by differences in demographic or biological processes. Instead, reference bias results in mutations being missed on Y chromosomes that are highly diverged from the reference used for alignment. We show that masking fast-evolving, highly divergent regions of the human Y chromosome mitigates the effect of this bias and enables more accurate determination of branch lengths in the Y chromosome phylogeny.

Conclusion

We show that our approach allows us to estimate the age of ancient samples from Y chromosome sequence data and provide updated estimates for the time to the most recent common ancestor using the portion of the Y chromosome where the effect of reference bias is minimized.
Buprenorphine and postpartum contraception utilization among people with opioid use disorder: a multi-state analysis
Authors: Xu Kevin Y. , Bello Jennifer K. , Buss Joanna , Jones Hendrée E. , Bierut Laura J. , Stwalley Dustin , Szlyk Hannah S. , Martin Caitlin E. , Kelly Jeannie C. , Carter Ebony B. , Krans Elizabeth E. , Grucza Richard A.
Published: January 2025

Background

The postpartum period provides an opportunity for birthing people with opioid use disorder (OUD) to consider their future reproductive health goals. However, the relationship between the use of medication for opioid use disorder (MOUD) and contraception utilization is not well understood. We used multistate administrative claims data to compare contraception utilization rates among postpartum people with OUD initiating buprenorphine (BUP) versus no medication (psychosocial services receipt without MOUD (PSY)) in the United States (US).

Methods

In this retrospective cohort study, we analyzed data from the Merative™ MarketScan® Multi-State Medicaid Databases 2016–2021 among postpartum women with OUD who did and did not initiate BUP during pregnancy. Our primary outcome was the receipt of prescribed highly-effective or effective contraception by 90 days postpartum. Highly-effective contraception was defined as female sterilization and long-acting reversible contraception [LARC]). Effective contraception was defined as oral contraceptive pills [OCPs], the contraceptive patch, ring, or injection. We used multivariable Poisson regression models, adjusting for sociodemographic and clinical characteristics, to measure the association of BUP (vs. PSY) on postpartum contraception utilization.

Results

Our sample consisted of 11,118 postpartum people with OUD. Among those, 3,443 initiated BUP and 7,675 received PSY. By 90 days postpartum, 22.4% (n = 2,487) of the cohort were prescribed contraception (21.5% PSY vs. 24.3% BUP). Among these participants, most received LARC (41.0%), followed by female sterilization (27.3%), the contraceptive injection (17.3%), pills (8.6%), ring (4.7%), and patch (1.0%), Compared to people engaged in PSY, BUP receipt was associated with a greater use of prescribed contraceptive use by 90 days postpartum (adjusted relative risk [aRR] = 1.17[1.07–1.28]), including a modestly greater use of the patch, ring, and pills, (aRR = 1.13[1.08–1.18]), but a modestly lesser use of injection contraception (aRR = 0.95[0.91–0.99]). There was no relationship observed between BUP and LARC use (aRR = 1.00[0.95–1.04]) and female sterilization (aRR = 1.01[0.98–1.06]).

Conclusions

Only 22% of pregnant people with OUD in our cohort used effective or highly-effective postpartum contraception. BUP receipt during pregnancy, relative to PSY, was associated with modestly greater use of prescribed effective contraceptive methods but was not associated with greater use of provider-administered contraceptive methods, such as the contraceptive injection, LARC and female sterilization.
Comparison of different pain management strategies during the perioperative period of esophageal squamous cell carcinoma: a retrospective cohort study
Authors: Ma Yan , Wu Haiyan , Wei Xinqi , Yang Ying , Xu Zhiyun , Chen Yunyun
Published: January 2025

Objective

This retrospective cohort study aims to evaluate and compare different postoperative pain management strategies for esophageal squamous cell carcinoma (ESCC), in order to provide scientific evidence for clinical practice and decision-making.

Methods

A total of 274 ESCC patients who underwent surgery at the Affiliated Huai’an No. 1 People’s Hospital of Nanjing Medical University were included in the study. Of these, 127 received conventional nursing decisions for postoperative pain management, and 147 received the “5 + nursing” postoperative pain management strategy. The main observation indicators of both groups included postoperative pain score, analgesic dosage, postoperative analgesic side effects, and length of hospital stays.

Results

The “5 + nursing” postoperative pain management group showed significantly lower postoperative pain score and significantly shorter length of hospital stays than the conventional nursing group. There was no significant difference in postoperative analgesic side effects between the two groups. Multiple logistic regression analysis showed that the postoperative pain score is an independent risk factor for predicting postoperative arrhythmias in ESCC patients. When the daily average dose of opioids used postoperatively was between 37.5 and 50 mg, the patient’s postoperative pain score dropped the fastest.

Conclusion

The “5 + nursing” pain management strategy can effectively reduce the degree of postoperative pain and shorten the length of hospital stays, improving patient’s quality of life. Our research emphasizes the importance of opioids in postoperative pain management, as well as the need for individualized perioperative pain management strategies.
Quantity and quality of napping to mitigate fatigue and sleepiness among nurses working long night shifts: a prospective observational study
Authors: Watanabe Kazuhiro , Shishido Inaho , Ito Yoichi M. , Yano Rika
Published: January 2025

Background

Napping during night shifts is a countermeasure against fatigue and sleepiness, which both impact patient safety. However, there is insufficient evidence on how nurses nap, especially concerning their napping quality. This study explored night-shift napping and its associated factors among nurses, considering napping quantity and quality, to mitigate fatigue and sleepiness.

Methods

This month-long prospective observational study included 32 nurses working 16-h night shifts in a general ward. All nurses responded to questions on individual factors, while fatigue and sleepiness were checked four times during night shifts. Night-shift napping was measured using a wearable device and classified into six groups: time in bed [TIB] > 180 min and sleep efficiency [SE] ≥ 70%, TIB > 180 min and SE < 70%, TIB 120–180 min and SE ≥ 70%, TIB 120–180 min and SE < 70%, TIB < 120 min and SE ≥ 70%, and TIB < 120 min and SE < 70%.

Results

Most nurses (81.2%) worked four night shifts per month, and 105 night shifts in which nurses intended to nap were analyzed. The two nap conditions (TIB 120–180 min and SE ≥ 70%, TIB > 180 min and SE ≥ 70%) were not worse than other nap conditions in fatigue and sleepiness at the end of the night shift and change in fatigue from the start to the end of the night shift. Sleep reactivity, pre-nap time on electronic devices, and prophylactic naps taken before the night shift were each the common factors related to napping for TIB ≥ 120 min and SE ≥ 70%.

Conclusions

Nurses working long night shifts should consider both sufficient napping quantity and good napping quality. We suggest aiming for a TIB of at least 120 min and a SE of at least 70% to mitigate fatigue and sleepiness at the end of a night shift. Assessing sleep reactivity, pre-nap time on electronic devices, and prophylactic naps may be useful in achieving both quantity and quality effectively. Nurses and their managers should have a better understanding of napping and consider strategically taking naps during night shifts.
Visual detection of Staphylococcus aureus based on magnetic bead target enrichment and rolling circle amplification
Authors: Li Bingying , Yu Meng , Ma Siying , Huang Yingying , Zhang Nenghua , Chen Shaoyun
Published: January 2025

Development of rapid and simple detection method holds great significance for the prevention and control of Staphylococcus aureus. Herein, the SELEX method was utilized to screen new aptamers for S. aureus. The double aptamers combined recognition target strategy were adopted to enhance specificity, and magnetic bead target enrichment and the rolling circle amplification strategy were employed to improve sensitivity, thereby achieving a highly specific and highly sensitive visual detection of S. aureus. This method can specifically identify S. aureus and has high detection sensitivity, with a minimum detection limit of 10 CFU/mL. It also shows good repeatability, with a total time consumption of less than 9 h and can be used for the visual detection of actual samples.
Effect of nanogold incorporation into polymethyl methacrylate denture bases on microbial activity in implant-retained mandibular overdentures
Authors: Zidan Yasmin S. , Abdel-Hamid Reham H. , Elshiekh Reham M. , El Gohary Sara M.
Published: January 2025

Purpose

In this randomized clinical trial, we examined the incorporation of nanogold particles into polymethyl methacrylate denture bases and compared these modified bases with conventional ones in mandibular implant-retained overdentures, focusing on microbiological growth and adhesion characteristics.

Methods

In this study, twenty-two male patients who were completely edentulous participated in a rehabilitation program involving mandibular overdentures retained by two dental implants placed in the canine area. The subjects were categorized into two equal groups, each comprising eleven patients. Group I received mandibular overdentures fabricated from conventional acrylic denture bases, whereas Group II received mandibular overdentures with bases that had undergone nanogold treatment. Microbial growth and colonization were evaluated around the implant’s necks and the fitting surface of each patient’s mandibular dentures. Three types of bacteria were studied: Candida albicans, Escherichia coli, and Streptococcus mutans. The mean difference in the counts of bacteria before the denture was inserted and after two, four, and six months has been calculated and analyzed statistically.

Results

Regarding colony count (log 10 CFUs/mmL), there was a significant difference between the research groups. Group II had significantly lower values measured at 2, 4, and 6 months for Candida albicans, Escherichia coli, and Streptococcus mutans, respectively, than group I.

Conclusion

The addition of gold nanoparticles to PMMA denture bases was of greater benefit in inhibiting microbial growth than conventional acrylic resin bases.
Research on the cross-contagion between international stock markets and geopolitical risks: the two-layer network perspective
Authors: Gong Xiao-Li , Ning Hao-Yang , Xiong Xiong
Published: January 2025

As the international environment changes, frequent geopolitical crises continue to hinder the healthy development of global stock markets. To analyze in-depth the risk contagion path between the international stock market and geopolitics under the impact of extreme events, this paper explores the tail risk interactive contagion mechanism and dynamic effects of the double-layer network between the international stock market and geopolitics from the perspective of complex networks. Empirical research finds that geopolitical conflicts exacerbate risk contagion among international stock markets, and there are significant differences in risk contagion between developed and emerging economies. The analysis of the complex interaction effect in the double-layer network of the international stock market and geopolitics shows that the intralayer risk spillover effect of geopolitics in the short term is significantly higher than that of the stock price volatility network layer. Finally, the study on the dynamic changes of the double-layer network connectedness between the international stock market and geopolitics found that the shock of extreme events, such as military conflict and public health security, is an important factor in triggering the cross-contagion of risks. The research conclusions provide new ideas for preventing the cross-contagion of geopolitical risks in the stock markets of various countries under the evolution of the global political and economic pattern.
Developing archetypes for key roles in a pragmatic trial: implementing human-centered design to promote advance care planning in primary care
Authors: Abshire Saylor Martha , Scerpella Danny , Chapin Margo , Jajodia Anushka , Kadali Amrutha J. , Colburn Jessica L. , Cotter Valerie , Wolff Jennifer L.
Published: January 2025

Background

Archetypes are representations of a group of people with shared behaviors, attitudes, and characteristics. The design and use of archetypes have potential application to increase partnership and support when embedding and scaling interventions but methodological approaches have not been developed.

Objective

To describe the methodology of designing archetypes for use in a pragmatic trial of advance care planning in the primary care context, SHARING Choices ((NCT04819191). We present resulting archetypes representing three key roles (primary care champion, advance care planning facilitator, and patient) in our pragmatic trial.

Methods

Our process for developing archetypes involved 4 steps: 1) Identify roles for archetype development, 2) Identify Shareholders and Data Sources for Archetype Development, 3) Generate unique archetypes and their distinguishing traits, and 4) Iteratively refine archetypes through exposure, scrutiny, and shareholder input. We also developed a process map to communicate our methodology.

Results

We created 6 distinct archetypes for the primary care champion role, 5 archetypes for the advance care planning facilitator role and 6 archetypes for the patient role. For each archetype we described strengths, challenges, prevailing emotions, and successful approaches to collaboration (e.g., “what works for me”). Unique opportunities for synergy between archetypes (such as with facilitator and champion) and potential challenges between archetypes (such as for facilitator and patient) suggest ways to improve training and support of key roles.

Discussion

Our process for creating archetypes for use in implementation research was iterative and informative in discussion of implementation with shareholders. We expect this methodology to be useful for anticipating and analyzing many aspects of implementation.
Expression profile of FGF23, alpha klotho, microRNA-126, and wnt signaling pathway gene polymorphism in patients with acute or chronic kidney diseases: relation to dialysis requirements
Authors: Hassan Mohammed H. , Saleem Tahia H. , Abdallah Ahmed Alamir Mahmoud , Abdelhady Marwa , Salama Doha Abd-Elraheem , Elsaied Abdelrahman A. , Mohammed Abdallah Elaiw , Hashim Abdelkader Ahmed
Published: January 2025

The connection between chronic kidney disease (CKD) and acute kidney injury (AKI) is becoming more widely acknowledged, as the two conditions probably exacerbate one other. The purpose of the present study was to evaluate the circulating levels of fibroblast growth factor 23 (FGF23), αKlotho, and mircoRNA-126 (miR-126) and to explore the possible genetic role of single nucleotide polymorphisms (SNPs) in the klotho G-395A (rs1207568), C1818T (rs564481), and wnt signaling pathway AXIN-1 C > T (rs9921222) in AKI and CKD patients and their relation to progression of kidney disease and dialysis necessity. In this case–control study, there were 50 AKI patients, 100 CKD patients, and 50 healthy controls. ELISA assay kits were utilized to measure the plasma concentrations of FGF23 and α klotho, while reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) was used to measure the expression levels of miR-126. Using conventional PCR methods, rs1207568, rs564481 and rs9921222 SNPs were genetically analyzed. Patients with AKI and CKD had significantly higher median FGF23 levels than controls (P < 0.05), with the AKI group showing much higher levels than the CKD patients (P < 0.05). Patients with AKI and CKD had significantly lower median αKlotho levels than controls (P < 0.001). When CKD patients were compared to controls and AKI patients, the expression levels of miR-126 were significantly greater, while significantly lower in AKI patients compared to controls, (P < 0.05). AKI and CKD patients had a significantly greater frequency of GG genotype of rs1207568 than the control group (< 0.001, and = 0.021 respectively). However, for klotho rs564481, all participants had CT genotype. In the CKD group compared to controls, rs9921222 SNP revealed a considerably greater frequency of mutant heterozygous CT genotype with a significantly lower wild CC genotype, P = < 0.001. Area under the curve (AUC) value of 0.638 for miR-126 expression levels indicate modest efficacy in identifying dialysis necessity among AKI patients. While miR-126 and plasma FGF23 expression levels among CKD patients demonstrated high efficacy, with AUC values of 0.924 and 0.845, respectively. αKlotho's AUC of 0.786 indicated a moderate level of discriminatory ability. AKI and CKD may be associated with disrupted expression levels of FGF23, αKlotho, and miR-126, which may serve as possible biomarkers for CKD patients requiring dialysis. An increased risk of developing CKD was shown to be associated with the GG genotype of the Klotho rs1207568 SNP and the CT genotype of the wnt signaling pathway rs9921222 SNP.
The effect of varying pore pressure on carbonate reservoirs elastic response
Authors: Aghli Ghasem , Hafezi Moghaddas Naser , Saberi Mohammad Reza , Gholami Reza , Nikbin Mohammad , Ahsani Tahoura , Mehdi Ostadhassan
Published: January 2025

Among factors affecting mechanical response of carbonates, pore pressure is less understood. To address this deficiency, strain, and wave velocities in 11 carbonate core plugs were measured in different pore pressure conditions under three various in-situ hydrostatic conditions. First, these plugs were tested in dry (vacuum) conditions and confining pressure (PC) that was increased gradually up to 65 MPa. Next, the plugs were saturated with water while pore pressure was kept constant at 30 MPa, with confining pressure that was elevated from 35 MPa to 65 MPa. Finally, during the undrained phase, the effective stress was kept constant at 1 MPa, while pore pressure and confining pressure both were increased from 5 to 65 MPa. In order to better understand samples elastic behavior, porosity and texture heterogeneity were quantified and correlated with geomechanical data. Our results showed that the highest shear-wave (VS) velocity and the lowest VP/VS ratio was obtained in dry conditions (PP=0). Moreover, VS exhibited a more complex behavior when pore pressure was changed which was attributed to the sample heterogeneous texture and structural features such as fracture and stylolite. In contrast to the Vs, compressional-wave (VP) velocity was measured the largest in saturate conditions while its behavior was related to the increasing effective stress. It was observed that an increased pore pressure would reduce both VP and VS velocities as a function of pore space stiffness and test conditions being drained or undrained. Finally, minimum strain happened in drained conditions at 30 MPa pore pressure which confirms the positive effect of pore pressure on the strain behavior of carbonate reservoirs. Collectively, findings from this study can improve seismic and rock physics models in heterogenous carbonate strata for accurate reservoir characterization and real-time monitoring.
TRIGGERING MECHANISMS AND EVOLUTION OF DIFFERENT TYPES OF MASS TRANSPORT DEPOSITS: A CASE STUDY OF THE QUATENARY QIONGDONGNAN BASIN, SOUTH CHINA SEA
Authors: Ma Chang , Qu Hongjun , Liu Xian
Published: January 2025

Mass transport deposits (MTDs) have attracted widespread attention from scholars because of their powerful sediment transport ability and capping effect on shallow natural gas reservoirs. Due to the rich types and development of MTDs, the Qiongdongnan Basin (QDNB) is considered an excellent place to study the triggering mechanisms of MTDs. Based on 2D seismic data, the types, characteristics, distribution, and sources of the Quaternary MTDs in the QDNB are recorded. In addition, the triggering mechanisms and sedimentary evolutionary patterns. Three types of MTDs in the study area: shelf attached MTDs, slope attached MTDs, and magmatic intrusion triggered MTDs. The shelf attached MTDs developed in the northwestern slope of the basin, and they are thick and wide in scale. The slope attached MTDs developed in the northeastern slope area of the basin, and they are thin and wide in scale. A magmatic intrusion triggered MTDs to develop in the bulge area of the southern basin, and they are small in scale and have large thickness differences. The transport direction of these MTDs is mainly from the northwest‒southeast and southeast‒northwest. The analysis of the tectonic-sedimentary evolution of the QDNB reveals that the MTDs may have been controlled by the following five factors: first, the bottom configuration controlled the MTDs flow direction; second, the amplitude of the sea-level fluctuation and the reactivation intensity of the main fault in the basin may have triggered the large-scale attached MTDs in the northern slope area; third, the high sedimentation rate controlled attached MTDs, the shelf attached MTDs developed when the source supply was strong but the slope attached MTDs developed when the source supply was weak. Furthermore, magmatic activity controlled the development and distribution scale of magmatic intrusion triggered MTDs in the southern QDNB.
Treatment Patterns and Costs Among Patients With Metastatic Renal Cell Carcinoma in the United States: A Real-World Study Using Integrated Claims and Clinical Data
Authors: Geynisman Daniel M. , Hill Nathan R. , Rosenblatt Lisa C. , Yin Xin , Haley Valerie B. , Barron John J. , Nguyen Chi , Vilanova David , George Saby
Published: January 2025

PURPOSE

The treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved in recent years with the use of tyrosine kinase inhibitors (TKIs) and immuno-oncology (IO) therapies. This study examined patient characteristics, treatment patterns, health care resource utilization (HCRU), costs, and survival for individuals with mRCC who received either IO + IO or IO + TKI combinations as first-line (1L) regimens.

METHODS

This retrospective cohort study used integrated claims and clinical data from a commercial health plan to study adults with mRCC who began 1L treatment between April 1, 2018, and January 31, 2023. Patient characteristics, 1L and second-line (2L) regimens, and HCRU were described. Costs were summarized per patient per month over time. Survival time was analyzed overall and partitioned into time on 1L, treatment-free survival, and survival after 2L.

RESULTS

Patients receiving 1L IO + IO (n = 471) or IO + TKI (n = 353) regimens generally had similar baseline characteristics although among patients with risk data, 33% of IO-IO patients versus 23% of IO-TKI patients had poor risk scores. Treatment costs were higher for IO + IO in the first 3 months but lower in subsequent time intervals compared with IO + TKI. Total mean costs per patient were $720K in US dollars (USD) for IO + IO and $834K USD for IO + TKI over the course of 3 years. Medication costs represented 80% of total costs. IO + IO patients stayed on 1L therapy for a shorter duration, but cumulative survival time at 24 months was the same (63%) for both groups.

CONCLUSION

Patients receiving 1L IO + IO and IO + TKI regimens had similar baseline characteristics and comparable survival at 30 months. Although IO + IO was associated with higher treatment costs in the first 3 months, the subsequent monthly costs were lower compared with IO + TKI.
Prognostic Factors for Refractory Outcome in Localizing TIO: Experience in a Tertiary Center
Authors: Hoong Caroline Wei Shan , Sfeir Jad G , Tebben Peter , Clarke Bart Lyman
Published: January 2025

Context

Tumor-induced osteomalacia (TIO), a paraneoplastic disorder characterized by renal phosphate wasting, is cured by surgical removal of the culprit tumor. Despite correct localization, some remain refractory to intervention, resulting in substantial long-term medical complications.

Objective

We aim to identify risk factors associated with a refractory outcome.

Methods

This is a retrospective cohort of 44 patients with TIO diagnosed from 1998 to 2023 who underwent targeted intervention following successfully localization. Cure was defined as maintenance of normophosphatemia without supplementation for ≥1 month, maintained at last follow-up.

Results

Twenty-nine patients achieved cure and 15 had a refractory outcome. On univariate Cox regression, the HR for predicting cure was 3.43 (95% CI 1.45-8.11, P = .005) for patients diagnosed after 2013 (compared to before), and that for a negative surgical tumor margin was 2.56 (95% CI 1.20-5.45, P = .015) compared to positive/unspecified margins. After adjustment for year of diagnosis, tumors originating from soft tissue (HR 2.72 vs bone, 95% CI 1.22-6.09, P = .015) or located outside the spine (HR 0.22 for spine vs nonspine, 95% CI 0.05-0.96, P = .043) had higher chances of cure. Size of tumor, age, gender, or baseline biochemistry including levels of fibroblast growth factor (FGF)23, phosphorus, 1,25-dihydroxyvitamin D, or alkaline phosphatase were not predictive of cure. Postprocedural FGF23 was the best biochemical marker of cure (area under curve 0.899, 95% CI 0.764-1.00, P < .001).

Conclusion

Tumors diagnosed within the past decade with clear resection margins had more favorable prognoses. With regards to tumoral factors, baseline biochemistry was uninformative in predicting cure, while bone and/or spine localizations were associated with a refractory outcome.
Hip Fracture Intervention Study for Prevention of Hypotension Trial: a Pilot Randomized Controlled Trial
Authors: Luney Matthew S. , White Stuart M. , Moppett Iain K.
Published: January 2025

BACKGROUND:

Hypotension during anesthesia for surgery for hip fracture is common and associated with myocardial injury, stroke, acute kidney injury, and delirium. We hypothesized that maintaining intraoperative blood pressure close to patients’ preoperative values would reduce these complications compared to usual care.

METHODS:

A pilot feasibility patient- and assessor-blinded parallel group randomized controlled trial. People with unilateral hip fracture aged ≥70 years with capacity to give consent before surgery were eligible. Participants were allocated at random before surgery to either tight blood pressure control (systolic blood pressure ≥80% preoperative baseline and mean arterial blood pressure ≥75 mm Hg) or usual care. Feasibility outcomes were protocol adherence, primary outcome data completeness, and recruitment rate. The composite primary outcome was myocardial injury, stroke, acute kidney injury or delirium within 7 days of surgery.

RESULTS:

Seventy-six participants were enrolled, and 12 withdrew before randomization. Sixty-four participants were randomized, 30 were allocated to control, and 34 to intervention. There was no crossover, all 64 participants received their allocated treatment, primary outcome was known for all participants. The composite primary outcome occurred in 14 of 30 participants in the control group compared with 23 of 34 participants in the intervention group (P = .09), relative risk 1.45 (95% confidence interval [CI], 0.93–2.27).

CONCLUSIONS:

A randomized controlled trial of tight intraoperative blood pressure control compared to usual care to reduce major postoperative complications after fractured neck of femur surgery is possible. However, the data would suggest a large sample size would be required for a definitive trial.
Postanesthesia Sling Lift Transfer and Upright Extubation of an Adult Secured in a Motorized Wheelchair: A Case Report
Authors: Ellis Megan M. , Chen James
Published: January 2025

This case report describes a 29-year-old patient with cerebral palsy whose mother, for safety reasons, requested that before extubation in the postanesthesia care unit, her son be transferred from the padded stretcher to his personal motorized wheelchair. Using a sling lift, we safely transferred the anesthetized, intubated patient from a supine position to an upright sitting position. Although sling lifts are often used in critical care and rehabilitation environments, use in the perioperative space is rare. In this case report, we demonstrate how a sling lift can enhance safety for patients and perioperative staff.
Analyzing Aloe vera and Avocado Seed Extracts for Antioxidants, Saponins, Tannins, Flavonoids, and Alkaloids Using the UV-VIS Spectrophotometric Method
Authors: Nugrahani Nur Ariska , Anggraeni Cecilya Nella Yuppy , Widyastuti Noor Hafida , Kholifa Mahmud
Published: January 2025

Background This study sought to quantify the levels of saponins, alkaloids, flavonoids, and tannins, as well as the IC50 values of avocado seed and aloe vera extracts. Methods The materials included in the investigation consisted of 70% ethanol extracts derived from avocado seeds and Aloe vera. Both samples underwent quantitative phytochemical analyses to ascertain total component content and an antioxidant activity assessment utilizing the 2,2-Diphenyl-1-picrylhydrazyl (DPPH) technique to evaluate % inhibition and IC50 values. The absorbance of the samples was quantified using a UV-Vis spectrophotometer, which facilitated the calculation of total chemical content and antioxidant activity. Results The avocado seed extract comprised saponins, alkaloids, flavonoids, and tannins at concentrations of 0.21%, 0.0232%, 19.94%, and 10.66%, respectively, with an IC50 value of 135 μg/mL. The aloe vera extract comprises saponins, alkaloids, flavonoids, and tannins at concentrations of 0.74%, 0.0313%, 0.99%, and 4.68%, respectively, with an IC50 value of 4614 μg/mL. Conclusion Avocado seeds exhibited elevated levels of flavonoids and tannins, while aloe vera demonstrated increased concentrations of alkaloids and saponins. In the antioxidant activity assessment, avocado seeds demonstrated superior antioxidant efficacy.