bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of proton pump inhibitor use on clinical outcomes in East Asian patients receiving clopidogrel following drug-eluting stent implantation
Authors: Kim Ju Hyeon , Hong Soon Jun , Cha Jung-Joon , Lim Subin , Joo Hyung Joon , Park Jae Hyoung , Yu Cheol Woong , Ahn Tae Hoon , Jeong Young-Hoon , Kim Byeong-Keuk , Chang Kiyuk , Park Yongwhi , Song Young Bin , Ahn Sung Gyun , Suh Jung-Won , Lee Sang Yeub , Cho Jung Rae , Her Ae-Young , Kim Hyo-Soo , Kim Moo Hyun , Shin Eun-Seok , Lim Do-Sun
Published: August 2024

Background

Concomitant use of clopidogrel and proton pump inhibitor (PPI) is common, but PPI may reduce the antiplatelet effects of clopidogrel in patients undergoing percutaneous coronary intervention (PCI). We evaluated the impact of PPI use on clinical outcomes in post-PCI patients, by incorporating P2Y12 reaction unit (PRU) and CYP2C19 genotyping results.

Methods

From a multicenter registry of patients who underwent PCI with drug-eluting stent implantation and received clopidogrel-based dual antiplatelet therapy (DAPT), patients who were prescribed a PPI at the time of PCI (PPI users) were compared to those who were not (non-users). The primary outcome included all-cause death, myocardial infarction, stent thrombosis, or cerebrovascular accident at 12 months. Major bleeding (Bleeding Academic Research Consortium [BARC] types 3–5) and gastrointestinal (GI) bleeding (BARC types 3–5) were important secondary outcomes. The adjusted outcomes were compared using a 1:1 propensity-score (PS) matching and competing risk analysis.

Results

Of 13,160 patients, 2,235 (17.0%) were prescribed PPI, with an average age of 65.4 years. PPI users had higher on-treatment PRU levels than non-users. After PS matching, the primary outcome occurred in 51 patients who were PPI users (cumulative incidence, 4.7%) and 41 patients who were non-users (cumulative incidence, 3.7%; log-rank p = 0.27). In carriers of both CYP2C19 loss-of-function alleles, PPI use was linked to an increased risk of the primary outcome (hazard ratio, 3.22; 95% confidence interval, 1.18–8.78). The incidence of major bleeding and GI bleeding (BARC types 3–5) was comparable between PPI users and non-users in the PS-matched cohort.

Conclusions

In post-PCI patients receiving clopidogrel-based DAPT, PPI use was not linked to an increased risk of adverse cardiac and cerebrovascular events, but there was a small but significant increase in on-treatment PRU. Future research using a more individualized approach would further elucidate these interactions and guide evidence-based clinical practices.
Reducing asthma attacks in disadvantaged school children with asthma: study protocol for a type 2 hybrid implementation-effectiveness trial (Better Asthma Control for Kids, BACK)
Authors: Huebschmann Amy G. , Wagner Nicole M. , Gleason Melanie , Brinton John T. , Brtnikova Michaela , Brewer Sarah E. , Begum Anowara , Armstrong Rachel , DeCamp Lisa Ross , McFarlane Arthur , DeKeyser Heather , Coleman Holly , Federico Monica J. , Szefler Stanley J. , Cicutto Lisa C.
Published: August 2024

Background

Asthma is a leading cause of children’s hospitalizations, emergency department visits, and missed school days. Our school-based asthma intervention has reduced asthma exacerbations for children experiencing health disparities in the Denver Metropolitan Area, due partly to addressing care coordination for asthma and social determinants of health (SDOH), such as access to healthcare and medications. Limited dissemination of school-based asthma programs has occurred in other metropolitan and rural areas of Colorado. We formed and engaged community advisory boards in socioeconomically diverse regions of Colorado to develop two implementation strategy packages for delivering our school-based asthma intervention — now termed “Better Asthma Control for Kids (BACK)" — with tailoring to regional priorities, needs and resources.

Methods

In this proposed type 2 hybrid implementation-effectiveness trial, where the primary goal is equitable reach to families to reduce asthma disparities, we will compare two different packages of implementation strategies to deliver BACK across four Colorado regions. The two implementation packages to be compared are: 1) standard set of implementation strategies including Tailor and Adapt to context, Facilitation and Training termed, BACK-Standard (BACK-S); 2) BACK-S plus an enhanced implementation strategy, that incorporates network weaving with community partners and consumer engagement with school families, termed BACK-Enhanced (BACK-E). Our evaluation will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, including its Pragmatic Robust Implementation Sustainability Model (PRISM) determinants of implementation outcomes. Our central hypothesis is that our BACK-E implementation strategy will have significantly greater reach to eligible children/families than BACK-S (primary outcome) and that both BACK-E and BACK-S groups will have significantly reduced asthma exacerbation rates (“attacks”) and improved asthma control as compared to usual care.

Discussion

We expect both the BACK-S and BACK-E strategy packages will accelerate dissemination of our BACK program across the state – the comparative impact of BACK-S vs. BACK-E on reach and other RE-AIM outcomes may inform strategy selection for scaling BACK and other effective school-based programs to address chronic illness disparities.

Trial registration

Clinicaltrials.gov identifier: NCT06003569, registered on August 22, 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06003569.
Move-PCD—a multi-center longitudinal randomized controlled superiority trial on the effect of a 6-month individualized supported physical activity (PA) program on quality of life (QoL) in children, adolescents, and adults with primary ciliary dyskinesia
Authors: Hoffmann Anna Teresa , Mai Anna , Baum Klaus , Schlegtendal Anne , Maier Christoph , Stein Julien , Tokic Marianne , Dillenhöfer Stefanie , Lücke Thomas , Timmesfeld Nina , Brinkmann Folke
Published: August 2024

Background

Primary ciliary dyskinesia (PCD) is a rare genetical disease with malfunction of the motile cilia leading to impaired muco-ciliary clearance in the respiratory tract. There is no cure for PCD, only supportive therapy aimed at minimizing the progression of the disease and improving the patient’s quality of life (QoL). Physical activity (PA) is one of these recommended supportive therapies for people with PCD (pwPCD). However, there is no scientific evidence to support this recommendation. In addition, regular medical advice to increase PA remains largely ineffective in pwPCD.

Methods

To test the main hypothesis, that an individualized and supported PA program leads to a better QoL 6 months after randomization (QoL-PCD questionnaire) compared to usual recommendation in pwPCD, 158 pwPCD aged 7 to 55 years are to be included in this multi-center randomized controlled trial (RCT). After the screening visit, a 1:1 randomization stratified by age group and FEV1 will be performed. A QoL-PCD questionnaire, motor test, and lung function will be carried out at regular intervals in both groups. PA is recorded in both groups using activity trackers during the study period. The main aim of the trial is to estimate the difference in the change of QoL between the groups after 6 months. Therefore, our full analysis set consists of all randomized patients and analysis is performed using the intention-to-treat principle. Statistical software R (http://www.r-project.org) is used. Ethical approvement without any reservations: RUB Bochum Ethics Committee (No. 23–7938; December 4, 2023). Recruitment start: March 2024.

Discussion

Limitations result from the rarity of PCD with its broad disease spectrum and the large age range. These are reduced by stratified randomization and the measurement of the individual change in QoL as primary endpoint. In our view, only a PA program tailored to individual needs with close contact to trainers offers the chance to meet personal needs of pwPCD and to establish PA as a pillar of therapy in the long term. The study protocol explains all procedures and methods of recruitment, implementation of the study visits and intervention, measures for patient and data safety, and for minimizing risks and bias.

Trial registration

German Clinical Trials Register (DRKS) 00033030. Registered on December 7, 2023. Update 10 July 2024.

Study protocol version 10

Version 1.2; 12 June 2024
Prevalence of human filovirus infections in sub-Saharan Africa: A systematic review and meta-analysis protocol
Authors: Semancik Christopher S. , Cooper Christopher L. , Postler Thomas S. , Price Matt , Yun Heejin , Zaric Marija , Kuteesa Monica , Malkevich Nina , Kilianski Andrew , Gupta Swati B. , Francis Suzanna C.
Published: August 2024

Background

Recent outbreaks of Ebola virus disease (EVD) and Marburg virus disease (MVD) in sub-Saharan Africa illustrate the need to better understand animal reservoirs, burden of disease, and human transmission of filoviruses. This protocol outlines a systematic literature review to assess the prevalence of filoviruses that infect humans in sub-Saharan Africa. A secondary aim is to qualitatively describe and evaluate the assays used to assess prevalence.

Methods

The data sources for this systematic review include PubMed, Embase, and Web of Science. Titles, abstracts, and full texts will be reviewed for inclusion by a primary reviewer and then by a team of secondary reviewers, and data will be extracted using a pre-specified and piloted data extraction form. The review will include human cross-sectional studies, cohort studies, and randomized controlled trials conducted in sub-Saharan Africa up until March 13, 2024 that have been published in peer-reviewed scientific journals, with no language restrictions. Prevalence will be stratified by pathogen, population, assay, and sampling methodology and presented in forest plots with estimated prevalence and 95% confidence intervals. If there are enough studies within a stratum, I2 statistics will be calculated (using R statistical software), and data will be pooled if heterogeneity is low. In addition, assays used to detect infection will be evaluated. All studies included in the review will be assessed for quality and risk of bias using the JBI Prevalence Critical Appraisal Tool and for certainty using the GRADE certainty ratings.

Discussion

Accurately measuring the rate of exposure to filoviruses infecting humans in sub-Saharan Africa using prevalence provides an essential understanding of natural history, transmission, and the role of subclinical infection. This systematic review will identify research gaps and provide directions for future research seeking to improve our understanding of filovirus infections. Understanding the natural history, transmission, and the role of subclinical infection is critical for predicting the impact of an intervention on disease burden.

Systematic Review Registration

In accordance with the guidelines outlined in the PRISMA-P methodology, this protocol was registered with PROSPERO on April 7, 2023 (ID: CRD42023415358).
Assessment polarity or praxis parity? Uncovering the learning-oriented assessment (LOA) landscape of novice and experienced Iranian EFL teachers
Authors: Estaji Masoomeh , Kogani Maryam
Published: August 2024

Although learning-oriented assessment (LOA) has been recognized as an effective method of assessment, the literature on this concept in relation to teacher professionalism is limited. In response to this gap, the present study explored 16 Iranian novice and experienced EFL teachers’ beliefs and practices of LOA. Data were collected from self-reported practices and semi-structured interviews. Analysis of the data through MAXQDA revealed that the novice and experienced teachers’ LOA beliefs featured similarities and differences. While the novice teachers’ LOA beliefs were less sophisticated, experienced teachers highlighted a more central role for LOA in their integration of teaching and assessment. Moreover, while novice teachers preferred using self- and peer assessment, the experienced teachers used more portfolio and dynamic assessment for their LOA-related practices. The study provides implications for teachers and teacher educators to use LOA in professional development courses.
MRI-based habitat imaging in cancer treatment: current technology, applications, and challenges
Authors: Li Shaolei , Dai Yongming , Chen Jiayi , Yan Fuhua , Yang Yingli
Published: August 2024

Extensive efforts have been dedicated to exploring the impact of tumor heterogeneity on cancer treatment at both histological and genetic levels. To accurately measure intra-tumoral heterogeneity, a non-invasive imaging technique, known as habitat imaging, was developed. The technique quantifies intra-tumoral heterogeneity by dividing complex tumors into distinct sub- regions, called habitats. This article reviews the following aspects of habitat imaging in cancer treatment, with a focus on radiotherapy: (1) Habitat imaging biomarkers for assessing tumor physiology; (2) Methods for habitat generation; (3) Efforts to combine radiomics, another imaging quantification method, with habitat imaging; (4) Technical challenges and potential solutions related to habitat imaging; (5) Pathological validation of habitat imaging and how it can be utilized to evaluate cancer treatment by predicting treatment response including survival rate, recurrence, and pathological response as well as ongoing open clinical trials.
Subtraction of single-photon emission computed tomography (SPECT) in radioembolization: a comparison of four methods
Authors: Kerckhaert Camiel E. M. , de Jong Hugo W. A. M. , Meddens Marjolein B. M. , van Rooij Rob , Smits Maarten L. J. , Rakvongthai Yothin , Dietze Martijn M. A.
Published: August 2024

Background

Subtraction of single-photon emission computed tomography (SPECT) images has a number of clinical applications in e.g. foci localization in ictal/inter-ictal SPECT and defect detection in rest/stress cardiac SPECT. In this work, we investigated the technical performance of SPECT subtraction for the purpose of quantifying the effect of a vasoconstricting drug (angiotensin-II, or AT2) on the Tc-99m-MAA liver distribution in hepatic radioembolization using an innovative interventional hybrid C-arm scanner. Given that subtraction of SPECT images is challenging due to high noise levels and poor resolution, we compared four methods to obtain a difference image in terms of image quality and quantitative accuracy. These methods included (i) image subtraction: subtraction of independently reconstructed SPECT images, (ii) projection subtraction: reconstruction of a SPECT image from subtracted projections, (iii) projection addition: reconstruction by addition of projections as a background term during the iterative reconstruction, and (iv) image addition: simultaneous reconstruction of the difference image and the subtracted image.

Results

Digital simulations (XCAT) and phantom studies (NEMA-IQ and anthropomorphic torso) showed that all four methods were able to generate difference images but their performance on specific metrics varied substantially. Image subtraction had the best quantitative performance (activity recovery coefficient) but had the worst visual quality (contrast-to-noise ratio) due to high noise levels. Projection subtraction showed a slightly better visual quality than image subtraction, but also a slightly worse quantitative accuracy. Projection addition had a substantial bias in its quantitative accuracy which increased with less counts in the projections. Image addition resulted in the best visual image quality but had a quantitative bias when the two images to subtract contained opposing features.

Conclusion

All four investigated methods of SPECT subtraction demonstrated the capacity to generate a feasible difference image from two SPECT images. Image subtraction is recommended when the user is only interested in quantitative values, whereas image addition is recommended when the user requires the best visual image quality. Since quantitative accuracy is most important for the dosimetric investigation of AT2 in radioembolization, we recommend using the image subtraction method for this purpose.
Right upper lobectomy for lung cancer associated with a displaced anomalous bronchus: two case reports
Authors: Iijima Yoshihito , Mizoguchi Takaki , Ishikawa Masahito , Iwai Shun , Motono Nozomu , Uramoto Hidetaka
Published: August 2024

Background

Bronchial bifurcation abnormalities are often discovered incidentally on chest computed tomography or bronchoscopy. As this condition is asymptomatic, it has little effect on the disease course of patients with lung cancer. However, this abnormality must be considered when performing lung resection.

Case presentation

Patient 1 was a 73-year-old man with suspected simultaneous triple lung cancers [cT1c (3) N0M0, Stage IA3] in the right and left upper lobes. He was initially scheduled to undergo right upper lobectomy and systematic nodal dissection. Chest computed tomography revealed a displaced B3 that arose from the right middle lobe bronchus. V1+2 was transected first, followed by the superior truncus of the pulmonary artery, and B1+2, respectively. After the branches of V3 were ligated, B3 was identified smoothly. Finally, the incomplete interlobar fissure between the upper and middle lobes was separated using an auto-stapler. No vascular abnormalities were observed. Patient 2 was a 62-year-old woman with suspected lung cancer (cT1cN0M0, Stage IA3) in the right upper lobe, and was scheduled to undergo right upper lobectomy and lobe-specific nodal dissection. Chest computed tomography revealed a right top pulmonary vein and a displaced B1 that arose from the right main bronchus independently. Because V1+3 was resected simultaneously during upper and middle lobe resection during robot-assisted thoracic surgery, the procedure was cool-converted to video-assisted thoracic surgery. An independently A1 was observed, followed by A2b and A3, which branched off as a common stem. A right top pulmonary vein was smoothly detected. Each blood vessel was transected using an auto-stapler. B2+3 was transected first using an auto-stapler, followed by B1.

Conclusions

The displaced anomalous bronchus is often accompanied by pulmonary arterial or venous abnormalities and an incomplete interlobar fissure. A “hilum first, fissure last” technique is often useful. Preoperative evaluation and surgical planning are important.
‘Having skin in the game’: guiding principles for incorporating moulage into OSCEs
Authors: Korimbocus Bilal , Wilson Helen , McGuckin Aine , Gormley Gerard J.
Published: August 2024

Background

Dermatological conditions are a common reason for patients to seek healthcare advice. However, they are often under-represented in Objective Structured Clinical Examinations (OSCEs). Given the visual nature of skin conditions, simulation is suited to recreate such skin conditions in assessments such as OSCEs. One such technique often used in simulation is moulage—the art and science of using special effects make-up techniques to replicate a wide range of conditions on Simulated Participants or manikins. However, the contextual nature of OSCEs places additional challenges compared to using moulage in more general forms of simulated-based education.

Main body

OSCEs are high-stakes assessments and require standardisation across multiple OSCE circuits. In addition, OSCEs tend to have large numbers of candidates, so moulage needs to be durable in this context. Given the need to expand the use of moulage in OSCE stations and the unique challenges that occur in OSCEs, there is a requirement to have guiding principles to inform their use and development.

Conclusion

Informed by evidence, and grounded in experience, this article aims to provide practical tips for health profession education faculty on how best to optimise the use of moulage in OSCEs. We will describe the process of designing an OSCE station, with a focus on including moulage. Secondly, we will provide a series of important practice points to use moulage in OSCEs—and encourage readers to integrate them into their day-to-day practice.
Scalability study on [133La]LaCl3 production with a focus on potential clinical applications
Authors: Brühlmann Santiago Andrés , Walther Martin , Blei Magdalena Kerstin , Mamat Constantin , Kopka Klaus , Freudenberg Robert , Kreller Martin
Published: August 2024

Background

In recent years, targeted alpha therapy has gained importance in the clinics, and in particular, the alpha-emitter 225Ac plays a fundamental role in this clinical development. Nevertheless, depending on the chelating system no real diagnostic alternative has been established which shares similar chemical properties with this alpha-emitting radionuclide. In fact, the race to launch a diagnostic radionuclide to form a matched pair with 225Ac is still open, and 133La features attractive radiation properties to claim this place. However, in order to enable its translation into clinical use, upscaling of the production of this PET radionuclide is needed.

Results

A study on optimal irradiation parameters, separation conditions and an exhaustive product characterization was carried out. In this framework, a proton irradiation of 2 h, 60 µA and 18.7 MeV produced 133La activities of up to 10.7 GBq at end of bombardment. In addition, the performance of four different chromatographic resins were tested and two optimized purification methods presented, taking approximately 20 min with a 133La recovery efficiencies of over 98%, decay corrected. High radionuclide purity and apparent molar activity was proved, of over 99.5% and 120 GBq/µmol, respectively, at end of purification. Furthermore, quantitative complexation of PSMA-617 and mcp-M-PSMA were obtained with molar activities up to 80 GBq/µmol. In addition, both 133La-radioconjugates offered high stability in serum, of over (98.5 ± 0.3)% and (99.20 ± 0.08)%, respectively, for up to 24 h. A first dosimetry estimation was also performed and it was calculated that an 133La application for imaging with between 350 and 750 MBq would only have an effective dose of 2.1–4.4 mSv, which is comparable to that of 18F and 68Ga based radiopharmaceuticals.

Conclusions

In this article we present an overarching study on 133La production, from the radiation parameters optimization to a clinical dose estimation. Lanthanum-133 activities in the GBq range could be produced, formulated as [133La]LaCl3 with high quality regarding radiolabeling and radionuclide purity. We believe that increasing the 133La availability will further promote the development of radiopharmaceuticals based on macropa or other chelators suitable for 225Ac.

Graphical abstract
Understanding college students’ test anxiety in asynchronous online courses: the mediating role of emotional engagement
Authors: Lu Kaili , Zhu Jianrong , Pang Feng , Liu Zhi
Published: August 2024

While test anxiety is a problem in asynchronous online courses, few studies have systematically investigated learning factors influencing test anxiety in asynchronous online courses. Additionally, emotional engagement has been identified as a mediator between learning factors and test anxiety. Therefore, this study clarified the mediating role of emotional engagement between learning factors (i.e., self-efficacy, instructor-learner interaction, learner-learner interaction, perceived ease-of-use, and perceived usefulness) and test anxiety in college-level asynchronous online courses. Overall, 316 college students participated in this study. Structural equation modeling analysis examined the relationships between learning factors and test anxiety. Self-efficacy, instructor-learner interaction, and perceived ease of use had direct and significant negative influences on test anxiety. Self-efficacy, instructor-learner interaction, learner-learner interaction and perceived usefulness had indirect negative effects on test anxiety mediated by emotional engagement. The current findings indicated that instructors should consider self-efficacy, instructor-learner interaction, learner-learner interaction, perceived ease of use, and perceived usefulness when designing and conducting asynchronous online courses to reduce college students’ test anxiety.
Validity, reliability, responsiveness, and clinically meaningful change threshold estimates of the National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy-Breast Cancer Symptom Index (NFBSI-16)
Authors: Clarke Nathan A. , Wong Brendon , Lawrance Rachael , Ingelgård Anders , Griebsch Ingolf , Cella David , Trigg Andrew
Published: August 2024

Background

Breast cancer is one of the most common cancers in women. Patient-reported outcome measures are used to evaluate patients’ health-related quality of life in clinical breast cancer studies. This study evaluated the structure, validity, reliability, and responsiveness of the National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy-Breast Cancer Symptom Index (NFBSI-16) subscales in a clinical trial featuring patients with advanced/metastatic breast cancer (aBC), and estimated NFBSI-16 meaningful change thresholds.

Methods

Data from 101 patients with aBC enrolled in a phase II trial (Xenera-1) were included for psychometric evaluation of the NFBSI-16. Subscale structure was evaluated by assessing inter-item correlations, item-total correlations, and internal consistency (cycles 2 and 5). Validity was assessed using scale-level convergent validity (cycles 2 and 5) and known-groups (Baseline). Reliability was analysed via test-retest at cycles 3–4, and responsiveness to improvement and worsening was evaluated at cycles 5, 7, and 9. Meaningful change thresholds were estimated using anchor-based methods (supported by distribution-based methods) at cycles 5, 7, and 9.

Results

NFBSI-16 internal consistency was acceptable, but item-total correlations suggested that its subscales and the GP5 item (side-effect of treatment) scores may be preferred over a total score. Convergent and known-groups evidence supported NFBSI-16 validity. Test-retest reliability was good to excellent for Total and DRS-P (disease-related symptoms: physical) scales, and moderate for the GP5 item. Responsiveness to worsening was generally demonstrated, but responsiveness to improvement could not be demonstrated due to limited observed improvement. Anchor-based meaningful change thresholds were estimated for DRS-P and Total scores.

Conclusion

This study provides evidence that the NFBSI-16 has desirable psychometric properties for use in clinical studies in aBC. It also provides estimates of group- and individual-level meaningful change thresholds to facilitate score interpretation in future aBC research.
Benefits of a Juvenile Arthritis Support Program (JASP-1) for children recently diagnosed with Juvenile Idiopathic Arthritis and their parents
Authors: Mördrup Karina , Jungner Johanna Granhagen , Broström Eva , Palmblad Karin , Bartholdson Cecilia
Published: August 2024

Background

Medical treatment for children with Juvenile Idiopathic Arthritis (JIA) has improved radically since the development of biological disease-modifying antirheumatic drugs. However, children suffer from pain and anxiety, and parents often experience loneliness and lack of support. Some parents reported that information provided at the time their child was diagnosed could be difficult to assimilate. Therefore, the aim of this study was to develop a Juvenile Arthritis Support Program (JASP-1) for children recently diagnosed with JIA and their parents. Moreover, the aim was to explore patients´ and parents´ experiences with JASP-1 and its potential impact on patients´ physical health.

Methods

JASP-1 included seven patient- and family-centered clinical visit from time of diagnose and one year ahead. Data were collected from a study-specific questionnaire answered by children and their parents after participation in JASP-1 and from the pediatric rheumatology register. The study-specific questionnaire explored participants´ experience with the care they received during their first year with JIA. Registry and questionnaire data from the intervention (JASP-1) group was compared to a control group.

Results

The analysis revealed that children and parents who completed JASP-1 were more satisfied with the care they had received during their first year with JIA than the control group. The results also showed that children who completed JASP-1 were assessed as having better overall health after 12 months, than children in the control group (JASP-1 = mean 4.33, 95% Confidence Interval (CI) 4.17 − 4.46), (Control = mean 3.68, 95% CI 3.29 − 4.06), (p = 0.002). Moreover, children in the JASP-1 group had less disease impact on daily life (JASP-1 = mean 0.15, 95% CI 0.07 − 0.24) (Control = mean 0.40, 95% CI 0.13 − 0.67), (p = 0.017) and less active joints than the control group (JASP-1 = mean 0.62, 95% CI 0.35 − 1.58), (Control = mean 0.87, 95% CI 0.18 − 1.56), (p = 0.054).

Conclusion

A support program like JASP-1 could be an effective way of not only supporting children newly diagnosed with JIA and their parents psychologically but may also increase children’s overall physical health and improve quality of care within pediatric rheumatology.

Trial registration

Retrospectively registered in ClinicalTrials.gov, the 13th of February with ID NCT06284616.
Optical steelyard: high-resolution and wide-range refractive index sensing by synergizing Fabry–Perot interferometer with metafibers
Authors: Zhang Lei , Shang Xinggang , Cao Simin , Jia Qiannan , Wang Jiyong , Yan Wei , Qiu Min
Published: August 2024

Refractive index (RI) sensors play an important role in various applications including biomedical analysis and food processing industries. However, developing RI sensors with both high resolution and wide linear range remains a great challenge due to the tradeoff between quality (Q) factor and free spectral range (FSR) of resonance mode. Herein, the optical steelyard principle is presented to address this challenge by synergizing resonances from the Fabry–Perot (FP) cavity and metasurface, integrated in a hybrid configuration form on the end facet of optical fibers. Specifically, the FP resonance acting like the scale beam, offers high resolution while the plasmonic resonance acting like the weight, provides a wide linear range. Featuring asymmetric Fano spectrum due to modal coupling between these two resonances, a high Q value (~ 3829 in liquid) and a sensing resolution (figure of merit) of 2664 RIU−1 are experimentally demonstrated. Meanwhile, a wide RI sensing range (1.330–1.430 in the simulation and 1.3403–1.3757 in the experiment) is realized, corresponding to a spectral shift across several FSRs (four and two FSRs in the simulation and experiment, respectively). The proposed steelyard RI sensing strategy is promising in versatile monitoring applications, e.g., water salinity/turbidity and biomedical reaction process, and could be extended to other types of sensors calling for both high resolution and wide linear range.
Iron status and anemia as predictors for acute bronchiolitis severity
Authors: Ragab Shereen A. , Razik Ahmed Abdel , Sharaby Radwa El , Elmeazawy Rehab
Published: August 2024

Background

The aim of this study was to determine the effect of iron deficiency anemia (IDA) on the severity of symptoms in infants hospitalized for acute bronchiolitis.

Methods

This is a case–control study, which was carried out on 80 infants from November 2022 to April 2023. The study involved 60 infants ranging in age from 2 months to 2 years, who were admitted to the Pediatric Pulmonology Unit and met the diagnostic criteria for acute bronchiolitis. Furthermore, a control group of 20 apparently healthy infants was incorporated into the study.

Results

This study showed that patients with moderate and severe bronchiolitis exhibited notably reduced levels of hemoglobin, HCT, MCV, MCH, and MCHC. Concerning the iron status, a substantial decrease in serum iron and increase in TIBC in the severe group (P = 0.012, 0.001, respectively). No substantial correlation was detected between the severity of acute bronchiolitis and serum ferritin levels. Hemoglobin and serum iron were found to be independent predictors of the severity of acute bronchiolitis.

Conclusions

Infants suffering from IDA exhibit increased vulnerability to acute bronchiolitis. The low levels of hemoglobin and serum iron may function as prognostic indicators for the severity of the condition in infants with acute bronchiolitis.
Exploring the Relationship Among Financial Hardship, Anxiety, and Depression in Patients With Cancer: A Longitudinal Study
Authors: Yanez Betina , Perry Laura M. , Peipert John Devin , Kuharic Maja , Taub Chloe , Garcia Sofia F. , Diaz Alma , Buitrago Diana , Mai Quan , Gharzai Laila A. , Cella David , Kircher Sheetal M.
Published: August 2024

PURPOSE

Financial hardship (FH) is a complex issue in cancer care, affecting material conditions, well-being, and coping behaviors. This study aimed to longitudinally examine FH, anxiety, depressive symptoms, and their associations while incorporating social determinants of health and health care cost covariates in a sample of patients diagnosed with cancer.

METHODS

This prospective, longitudinal cohort study analyzed data from 2,305 participants from the Northwestern University Improving the Management of Symptoms during and following Cancer Treatment trial. Outcomes assessed at baseline and at 3, 6, 9, and 12 months postbaseline included depressive symptoms, anxiety, and FH. Analysis involved random intercept cross-lagged panel models to explore between- and within-person effects, incorporating factors such as age, sex, insurance status, neighborhood area deprivation, health care charges, out-of-pocket costs, and health literacy.

RESULTS

The cohort had a mean age of 60.7 (standard deviation [SD] = 12.7) years and was mostly female (64.9%) and White (86.2%). Correlations were found between FH and depressive symptoms (
r
= 0.310) and anxiety (
r
= 0.289). A predictive relationship was observed between FH and depressive symptoms, with baseline and 6-month depressive symptom levels predicting later FH (baseline β = .079,
P
= .070; 6-month β = .072,
P
= .081) and 9-month FH significantly predicting 12-month depressive symptoms (β = .083,
P
= .025), even after accounting for health care charges and out-of-pocket costs. Baseline and 9-month anxiety showed a predictive relationship with subsequent FH (baseline β = .097,
P
= .023; 9-month β = .071,
P
= .068).

CONCLUSION

FH emerged as a prominent issue, with nearly half of participants experiencing some level of FH. Depressive symptoms and anxiety were related to FH. These findings underscore the need for a comprehensive approach in cancer care that concurrently addresses anxiety, depressive symptoms, and FH, recognizing their interconnected impact.
Liver Fat Accumulation Is Associated With Increased Insulin Secretion Independent of Total, Visceral, and Pancreatic Fat
Authors: Sandby Karoline , Krarup Thure , Chabanova Elizaveta , Geiker Nina R W , Magkos Faidon
Published: August 2024

Context

Studies in heterogeneous groups of people with respect to sex, body mass index (BMI), and glycemic status (normoglycemia, impaired glucose tolerance, diabetes), indicate no relationship between liver fat accumulation and pancreatic insulin secretion.

Objective

This work aimed to better understand the association of liver fat with insulin secretion.

Methods

A cross-sectional analysis was conducted of 61 men with abdominal obesity who had high liver fat (HLF, ≥ 5.6% by magnetic resonance spectroscopy, n = 28) or low liver fat (LLF, n = 33), but were balanced on BMI, total body fat, visceral adipose tissue (VAT), and pancreatic fat. A frequently sampled 5-hour oral glucose tolerance test with 11 samples, in conjunction with mathematical modeling, was used to compute indices of insulin sensitivity and insulin secretion (oral minimal model).

Results

Compared to individuals with LLF, those with HLF had significantly greater fasting glucose, insulin, C-peptide, and triglycerides; lower high-density lipoprotein cholesterol; but similar glycated hemoglobin A1c. Areas under the 5-hour curve for glucose, insulin, and C-peptide were greater in the HLF group than the LLF group (by ∼10%, ∼38%, and ∼28%, respectively); fasting and total postprandial insulin secretion rates were approximately 37% and approximately 50% greater, respectively (all P < .05); whereas the insulinogenic index was not different. HLF participants had lower whole-body and hepatic insulin sensitivity, disposition index, and total insulin clearance than LLF participants (all P < .05).

Conclusion

Accumulation of liver fat is associated with increased insulin secretion independently of total adiposity, abdominal fat distribution, and pancreatic fat. Thereby, hyperinsulinemia in fatty liver disease is partly because of insulin hypersecretion and partly because of impaired insulin clearance.
Variations in Volume: Breast Size in Trans Women in Relation to Timing of Testosterone Suppression
Authors: Boogers Lidewij S , Sardo Infirri Sebastiaan A , Bouchareb Asma , Dijkman Benthe A M , Helder Danithsia , de Blok Christel J M , Liberton Niels P T J , den Heijer Martin , van Trotsenburg A S Paul , Dreijerink Koen M A , Wiepjes Chantal M , Hannema Sabine E
Published: August 2024

Context

Breast development is an important outcome for trans women receiving gender-affirming hormone therapy (GAHT). Limited breast development has been reported, possibly because of testosterone exposure during puberty. The impact of puberty suppression (PS) on breast development is unclear.

Objective

To investigate the impact of PS and timing of PS prior to GAHT on breast volume and satisfaction.

Methods

In a cross-sectional study at a tertiary gender identity clinic, 60 trans women (aged 17-57 years) after 4.5 ± 1.7 years of GAHT were included, of whom 23 initiated PS early in puberty (Tanner stage G2-3), 17 late in puberty (Tanner stage G4-5), and 20 started GAHT in adulthood without prior PS. Breast volume was measured with a 3D scanner and breast satisfaction measured with a questionnaire. Comparisons of breast volumes were adjusted for fat percentage.

Results

Median breast volume was 115 mL (IQR, 68; 203), ie, bra cup size < A. Breast volume was 47 mL (95% CI, −9; 104) larger in the late PS group compared to early PS but this difference was only 4 mL (95% CI, −67; 75) after correction for fat percentage. Breast volume in the adult group was comparable to the early and late PS groups (adult vs early PS 27 mL [95% CI, −28; 83] and adult vs late PS −20 mL [95% CI, −80; 40]). In total, 68% of subjects were satisfied with breast size (57% of early PS, 76% of late PS, and 70% of adult group).

Conclusion

Early start of PS was not associated with larger breast volume, suggesting that pubertal testosterone exposure does not affect breast volume after subsequent GAHT. Despite limited breast size, most trans women were satisfied with their breast development.
Controversy in mechanotransduction – the role of endothelial cell–cell junctions in fluid shear stress sensing
Authors: X Shaka , Aitken Claire , Mehta Vedanta , Tardajos-Ayllon Blanca , Serbanovic-Canic Jovana , Zhu Jiayu , Miao Bernadette , Tzima Ellie , Evans Paul , Fang Yun , Schwartz Martin A.
Published: August 2024

Fluid shear stress (FSS) from blood flow, sensed by the vascular endothelial cells (ECs) that line all blood vessels, regulates vascular development during embryogenesis, controls adult vascular physiology and determines the location of atherosclerotic plaque formation. Although a number of papers have reported a crucial role for cell–cell adhesions or adhesion receptors in these processes, a recent publication has challenged this paradigm, presenting evidence that ECs can very rapidly align in fluid flow as single cells without cell–cell contacts. To address this controversy, four independent laboratories assessed EC alignment in fluid flow across a range of EC cell types. These studies demonstrate a strict requirement for cell–cell contact in shear stress sensing over timescales consistent with previous literature and inconsistent with the newly published data.
Effects of electroacupuncture on cognitive symptoms in major depressive disorder: a pilot study and randomized controlled trial
Authors: Boontra Yindee , Thanetnit Chommakorn , Phanasathit Muthita
Published: August 2024

Objectives To investigate the impact of electroacupuncture on cognitive function, quality of life (QoL), and depression severity in patients with major depressive disorder (MDD). Methods This double-blinded randomized controlled trial included 60 participants aged 18-55 with cognitive symptoms related to MDD at Thammasat University Hospital. Participants were divided into two groups: the electroacupuncture group combined with standard pharmacological treatment (EG; n=30) and the control group receiving standard pharmacological treatment with placebo acupuncture (CG; n=30). The study assessed 1) executive functions using the Trail making test- B and Stroop Color and Word Test, 2) delayed recall, and 3) subjective cognitive complaint and Quality of life (QoL) using WHODAS 2.0. Depressive symptoms were measured using the Thai version of the Patient Health Questionnaire (PHQ-9). Baseline and post-intervention assessments were conducted over 10 weeks. Mann-Whitney U test analyzed treatment effects by comparing median differences between groups. Results Both groups exhibited similar demographics and cognitive traits. Cognitive improvement was observed in both groups at the endpoint. Intention-to-treat analysis revealed significantly higher median scores for subjective cognitive complaints in the EG compared to the CG (EG: Median = 5.5, CG: Median = 0.0, p=0.049). No serious side effects were identified from either electroacupuncture or placebo acupuncture. Conclusions Electroacupuncture improved subjective complaints in MDD patients with cognitive symptoms, but did not show effects on specific cognitive functions, QoL, or depressive symptoms. This study provides initial evidence supporting the potential of electroacupuncture in MDD patients with cognitive symptoms, suggesting opportunities for further research. Trial registration NCT06239740, February 2, 2024, ClinicalTrials.gov.
Uncaria nervosa Elmer, a new herbal source for betulinic acid and ursolic acid: Metabolites profiling, isolation, and in vitro cytotoxicity studies against T47D breast cancer
Authors: Rahmawati Noveri , Ismail Nor Hadiani , Wahyuni Fatma Sri , Hamidi Dachriyanus
Published: August 2024

Abstract* Background Uncaria nervosa Elmer is an Indonesian herbal plant that is traditionally used for breast cancer. The results of phytochemical screening contained alkaloids, flavonoids, and terpenoids in the ethanol extract of this plant. Based on literature searches, reports regarding the bioactive compounds responsible for breast cancer have not been found. Further research is needed to understand the potential of Uncaria nervosa Elmer as a breast cancer treatment and to identify the specific compounds responsible for its effects Methods This study aims to determine the metabolite profiling of ethanol extract, the isolation, characterization of bioactive compounds, and their bioactivity in T47D breast cancer cells. The research began by extracting the leaves by maceration using 70% ethanol, and then solid phase extraction was carried out using the solid phase extraction (SPE) method. In this study, the sorbent used was polyamide. The extract was analyzed using a tandem analysis technique based on LCMS using the MZmine and SIRIUS platforms. Isolation was carried out using column chromatography, and preparative recycling HPLC. Bioactive compounds were characterized using UV, HPLC, NMR, and 2D NMR, as well as bioactivity tests using the MTT method. Results The results show that the extract contained N-[(1,3-dimethyl-2,6-dioxo-7-prop-2-ynylpurin-8-yl) amino] formamide, N-(3-phenylbutyl)hexan-2-amine, 1,1-Dichloro-1-nitrosopropane, ceratodictyol, betulinic acid, ursolic acid, 7-methyl-N-[6-[(7-methyl-6-oxooctanoyl) amino] hexyl]-6-oxononanamide, Nervisterol and 3,5,10-tris (acetyloxy)-2-hydroxy-4,14,16,16-tetramethyl-8-methylidene-13-oxo-15oxatetracyclo [9.4.1.01,14.04,9] hexadecan-7-yl 3-phenylprop-2-enoate. The ethanol extract of Uncaria nervosa Elmer leaves contains nine compounds consisting of alkaloids, terpenoids, and fatty acid. The bioactive compounds that were successfully isolated were betulinic acid, and ursolic acid, with IC50 values of ˃100 and 14,70±4,50 μg/ml, respectively. These compounds were reported in this plant for the first time. Conclusion Betulinic acid, and ursolic acid have been successfully isolated from leaves Uncaria nervosa Elmer, and ursolic acid have moderate cytotoxic activity on T47D breast cancer cells.
The genome sequence of an ichneumonid wasp, Ophion ventricosus Gravenhorst, 1829
Authors: Crowley Liam M. , Broad Gavin ,   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: August 2024

We present a genome assembly from an individual female Ophion ventricosus (ichneumonid wasp; Arthropoda; Insecta; Hymenoptera; Ichneumonidae). The genome sequence spans 436.80 megabases. Most of the assembly is scaffolded into 16 chromosomal pseudomolecules. The mitochondrial genome has also been assembled and is 27.71 kilobases in length.
Abigail Botelho Reis
Authors: Oliveira Paloma Rezende , Costa Nailda Marinho
Published: August 2024

Este estudo busca trazer considerações sobre a construção de uma trajetória. Neste artigo, o foco será a atuação profissional de Abigail Botelho Reis, entre os anos de 1910 e 1935, período em que ela atuou como educadora e também na imprensa, nos municípios de Leopoldina – MG e no Rio de Janeiro – RJ. Neste sentido, busca-se perceber se sua participação na imprensa confere a ela o lugar do mediador cultural, que na acepção de Gomes e Hansen (2016) inclui sujeitos que produzem conhecimentos e comunicam ideias por meio da imprensa e de outras ações vinculadas à intervenção política e social. A pesquisa documental teve como fontes os jornais nos quais há indícios de que Abigail foi colaboradora: Gazeta de Leopoldina, O Paiz e Jornal do Brasil, e os dicionários biográficos, que indicaram que além de professora primária e da Escola Normal, ela foi escritora, editora e membro da Damas da Cruz Verde. Estas experiências levaram à necessidade de refletir sobre os limites e possibilidades de atuação de uma mulher que cresceu em uma região com uma estrutura marcadamente patriarcal, sem, contudo, abrir mão da análise sob a perspectiva intersecional de gênero, raça e classe, a fim de problematizar quais mulheres puderam ocupar os espaços públicos. A trajetória profissional de Abigail nos revela redes de sociabilidade entre as mulheres e seus espaços de atuação, sendo representativa para o campo da história das mulheres e para a história da educação.