bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjustable Sawdust Stove for Optimal Pot Placement and Improved Insulation Materials
Authors: Musonda Kabaso E. , Mutembo Steven
Published: June 2024

This study investigates the performance of a novel, single‐pot sawdust stove prototype designed for extended use applications requiring steady heat, such as daylong hot water provision, room heating, or bulk cooking for large gatherings. The prototype utilizes the rocket stove concept and prioritizes long burn times with minimal refuelling. The stove features a double‐walled, cylindrical combustion chamber made of mild steel (primary material) for efficient burning and heat retention. Fiberglass insulation (10 mm thick) is sandwiched between the walls to minimize heat transfer. An adjustable cooking platform, constructed with rods, pipes, and clamps, allows users to control the gap between the pot and the combustion chamber (currently set at 35 mm for a typical 200 mm diameter pot suitable for 3–5 people). This adjustability optimizes heat transfer for various pot sizes, improving overall cooking efficiency for a wider range of users. A heat spreader lid distributes heat evenly across the pot, while a sliding air inlet tray facilitates fire starting and airflow control. The combustion chamber dimensions (270 mm internal diameter and 420 mm height) are based on a prominent design by the Kisangani Smith Group’s Sawdust Stove Design of Tanzania Kisangani. The overall external stove diameter is 280 mm, with a mild steel outer wall (2.0 mm thick) surrounding the insulated combustion chamber. Controlled tests compared the prototype to a traditional charcoal stove. The prototype achieved significantly higher thermal efficiency (20.6% vs. 13%), faster rice cooking time (24.8 minutes vs. 31 minutes), and lower specific fuel consumption during cooking (0.55 vs. 0.62). This novel design, with its adjustable features and improved insulation, offers a more efficient, user‐friendly, and sustainable cooking solution for regions with limited access to conventional fuels and abundant sawdust. This research contributes to the development of efficient and sustainable biomass cookstoves, particularly in sawdust‐rich areas of Zambia.
Photochemical Reactions of Benzene with Chlorine Radicals in Atmospheric Aqueous Phase
Authors: Dong Linchang , Lei Yu , Lu Jun , He Han , Yang Yue , Zhu Chengzhu
Published: June 2024

The chlorine radicals (Cl• and Cl2•−) have profound impacts on the photochemical processes in the atmospheric aqueous phase (e.g., marine clouds). However, current literature lacks information on the Cl•/Cl2•−‐induced transformation of organics under sunlit irradiation. In this work, the reaction mechanism of chlorine radicals with benzene (a representative VOC) in the atmospheric aqueous phase was investigated by using 355 nm laser flash photolysis, 365 nm UV light steady state, and real sunlight experiment. The results showed that Cl•/Cl2•−‐initiated reactions were crucial steps for the consumption and transformation of C6H6, where the conversion rate of benzene decreases with the increase of pH and initial species concentration. Cl• attacked benzene ring to produce the Cl‐CHD (6‐chlorocyclohexadienyl radical) with a second‐order rate constant of (1.2 ± 0.3) × 1010 M−1·s−1, while the rate constant for Cl2•− was much lower ((4.5 ± 0.3) × 106 M−1·s−1). The addition of Cl• and Cl2•− to benzene generated chlorobenzene and dichlorobenzene and ring‐opening substances during the further oxidation reaction, which had been also demonstrated in the real sunlit experiments. This work provides fundamental kinetic and mechanistic insights into benzene’s photochemical transformation by Cl•/Cl2•−, facilitating the understanding of VOC transformation in atmospheric waters.
Upregulation of miR‐486 Expression in the Corpus Cavernosum of Spontaneously Hypertensive Rats Improves Erectile Function
Authors: Kong XiangJun , Liu Jing , Liu QinWen , Li Ge , Cheng Yong , Jiang Rui
Published: June 2024

This study aims to investigate whether transfection of miR‐486 in the corpus cavernosum of spontaneously hypertensive rats (SHR) can improve erectile function and its mechanism. SHR penile cavernous smooth muscle cells were divided into control group, mimic negative control transfection group, inhibitor negative control transfection group, miR‐486 mimic transfection group, and miR‐486 inhibitor transfection group. miR‐486 mimic (50 nM), miR‐486 inhibitor (100 nM), and corresponding negative control preparation were transfected into the corresponding groups of cells. The mRNA expressions of miR‐486, TGF‐β1, Collagen I, and Collagen III in each group were detected after transfection. Twelve 12‐week‐old healthy male SHR and 12 WKY rats were randomly divided into WKY control group, SHR control group, SHR + Agomir negative control (NC) group, and SHR + miR‐486 Agomir group. In the SHR + miR‐486 Agomir group, penile cavernosa was transfected with miR‐486 agonist. Penile sponge internal pressure (ICPmax)/mean arterial pressure (MAP), the expression of miR‐486, the ratio of smooth muscle to collagen (SM/C), and the expression of TGF‐β1, Collagen I, and Collagen III in penile cavernosum tissues were determined. Compared with the control group, the expressions of TGF‐β1, Collagen I, and Collagen Ⅲ in the miR‐486 mimic transfection group of SHR rat corpus cavernosum smooth muscle cells were significantly decreased, while those in the miR‐486 inhibitor transfection group were significantly increased (P  < 0.05). The ratios of ICPmax/MAP and SM/C in the SHR group were significantly lower than those in the WKY group and in the SHR + miR‐486 Agomir group were significantly higher than those in the SHR group and the SHR + Agomir NC group (P  < 0.05). The expressions of TGF‐β1, Collagen I, and Collagen Ⅲ in SHR group were significantly increased compared with those in WKY group, while those in SHR + miR‐486 Agomir group were significantly lower than those in SHR group and SHR + Agomir NC group (P  < 0.05). The upregulation of the expression of miR‐486 in the corpus cavernosum of SHR rats can inhibit fibrosis of the corpus cavernosum and improve erectile function.
Mental Health and Other Factors Associated with COVID‐19 Vaccination Intention toward Children of Military Parents in Lambayeque, Peru
Authors: Valladares-Garrido Mario J. , Alvarez-Risco Aldo , Rojas-Alvarado Annel B. , Picón-Reátegui Cinthia Karina , Dawson Aguila Franccesca , Del-Aguila-Arcentales Shyla , Davies Neal M. , Failoc-Rojas Virgilio E. , Pereira-Victorio César Johan , Valladares Garrido Danai , Vera-Ponce Víctor J. , Yáñez Jaime A.
Published: June 2024

There is evidence that vaccine acceptability is strongly associated with mental health. However, no studies assessing intention to vaccinate (ITV) intention toward children of military parents have been documented. The current research aimed to establish the prevalence and factors of ITV children against COVID‐19 in military parents in Lambayeque‐Peru, 2021. Analysis was conducted with the dependent variable ITV children reported by military parents. The independent variables were history of mental health, searching for mental health support, food insecurity, resilience, anxiety, depression, burnout, posttraumatic stress, and suicidal risk. Prevalence ratios and 95% confidence intervals were estimated. Of 201 military personnel evaluated, 92.5% were male, 82.5% were of the Catholic faith, and the median age was 40.9% of respondents reported seeking mental health help during the COVID‐19 pandemic. It was reported anxiety (20.3%), depression (6.5%), and posttraumatic stress disorder (6.5%). Most reported ITV in children against COVID‐19 (93%). In the multiple models, we found that Catholics had a 23% higher prevalence of ITV in the children where PR = prevalence ratios and CI = confidence intervals (PR = 1.23; 95% CI: 1.01–1.50). Likewise, seeking mental health support increased the prevalence of ITV by 8% (PR = 1.08; 95% CI: 1.00–1.15). Seeking mental health support and belonging to the Catholic faith had a higher ITV of children of Peruvian military personnel. Finding mental health support, experiencing burnout syndrome, having a relative who suffers from mental health problems, and being part of the Catholic religion were associated with a higher willingness to immunize the children of Peruvian military members.
Supplementary Figure 3 from Reshaping the Tumor Microenvironment of KRASG12D Pancreatic Ductal Adenocarcinoma with Combined SOS1 and MEK Inhibition for Improved Immunotherapy Response
Authors: Norgard Robert J. , Budhani Pratha , O'Brien Sarah A. , Xia Youli , Egan Jessica N. , Flynn Brianna , Tagore Joshua R. , Seco Joseph , Peet Gregory W. , Mikucka Ania , Wasti Ruby , Chan Li-Chuan , Hinkel Melanie , Martinez-Morilla Sandra , Pignatelli Jeanine , Trapani Francesca , Corse Emily , Feng Di , Kostyrko Kaja , Hofmann Marco H. , Liu Kang , Kashyap Abhishek S.
Published: June 2024

Supplementary Figure 3
FIGURE 3 from Reshaping the Tumor Microenvironment of KRASG12D Pancreatic Ductal Adenocarcinoma with Combined SOS1 and MEK Inhibition for Improved Immunotherapy Response
Authors: Norgard Robert J. , Budhani Pratha , O'Brien Sarah A. , Xia Youli , Egan Jessica N. , Flynn Brianna , Tagore Joshua R. , Seco Joseph , Peet Gregory W. , Mikucka Ania , Wasti Ruby , Chan Li-Chuan , Hinkel Melanie , Martinez-Morilla Sandra , Pignatelli Jeanine , Trapani Francesca , Corse Emily , Feng Di , Kostyrko Kaja , Hofmann Marco H. , Liu Kang , Kashyap Abhishek S.
Published: June 2024

scRNA-seq reveals tumor-intrinsic mechanisms and cellular and molecular cross-talk in the TME in response to SOS1i+MEKi treatment. A, Experiment design of scRNA-seq experiments. B, UMAP visualization (left) of 153,678 KPCY TME cells from n = 20 mice across all conditions (TC3, TC4, and TC5 TME after treatment of vehicle or SOS1i+MEKi). Major cell types identified through graph-based clustering are indicated by color. Heat map (right) showing the relative average expression of common cell type–specific marker genes for each cluster for annotation. C, Bar graph showing cell proportion/composition of indicated cell type in the TME of each mouse (mean ± 95% confidence interval). D, Pathway enrichment analysis of upregulated and downregulated genes in epithelial/tumor cells in response to SOS1i+MEKi treatment across all mice (n = 20). E, Dot plot showing gene expression of Cxcl9, Cxcl10, and Ccl3 across conditions.
FIGURE 2 from Reshaping the Tumor Microenvironment of KRASG12D Pancreatic Ductal Adenocarcinoma with Combined SOS1 and MEK Inhibition for Improved Immunotherapy Response
Authors: Norgard Robert J. , Budhani Pratha , O'Brien Sarah A. , Xia Youli , Egan Jessica N. , Flynn Brianna , Tagore Joshua R. , Seco Joseph , Peet Gregory W. , Mikucka Ania , Wasti Ruby , Chan Li-Chuan , Hinkel Melanie , Martinez-Morilla Sandra , Pignatelli Jeanine , Trapani Francesca , Corse Emily , Feng Di , Kostyrko Kaja , Hofmann Marco H. , Liu Kang , Kashyap Abhishek S.
Published: June 2024

SOS1i+MEKi combination treatment suppresses KPCY tumor growth in vivo and alters T cell infiltration in the TME. A, Experiment design of treatment schedule. B, Tumor volume (mm3) of individual tumors in mice for indicated tumor clone. TGI is indicated comparing vehicle with SOS1i+MEKi for each tumor clone at day 5. Unpaired Student t test performed with SD shown, n = 3–5 per group (*<0.05, **<0.01, ***<0.001). C, Representative IHC images of formalin-fixed paraffin-embedded section of each KPCY lines harvested at day 10 showing CD8+ staining. D, Scatter dot plots/graph showing density of IHC CD8+ in the KPCY TME (as in C) of individual mice harvested at day 5 and day 10 after treatment of vehicle (blue n = 2) and SOS1i+MEKi (red, n = 3). Student t test performed (**<0.01). E, Growth curves showing tumor volume of TC5 in vivo after start of treatment of vehicle, SOS1i, MEKi, or combination of SOS1i+MEKi. Arrows indicate days of treatment. TGI is indicated comparing vehicle with all other treatments. Multiple comparison ANOVA performed with SD shown, n = 5 per group (*<0.05). F, Bar graph showing composition of CD8+ T cells in CD45+ cells in TC5 clone after 8 days of treatment with vehicle, SOS1i, MEKi, or combination of SOS1i+MEKi (n = 5). Multiple comparison ANOVA performed (* = 0.05). G, Bar plot summarizing CD8+ T cell composition as �45+ in indicated tumor. L = left flank, R = right flank. Multiple comparison ANOVA performed with SD shown (ns = nonsignificant, ** = 0.01).
Endovascular Mechanical Thrombectomy for Ischemic Stroke Treatment in the setting of Aortic Dissection
Authors: Cruz-Saavedra Luis Alberto , Patel Jeet , Siragusa Daniel , Silliman Scott L.
Published: June 2024

Introduction: Acute ischemic stroke can occur in the setting of aortic dissection. Information concerning the utility of endovascular mechanical thrombectomy as an intervention for patients with aortic dissection who are experiencing an acute stroke due to large vessel occlusion is limited to a few case reports. Case series of patients presenting with this clinical situation are needed to further investigate the potential utility of this procedure when patients with acute ischemic stroke and aortic dissection are encountered.
Case presentation: We report a patient with a chronic Stanford type A aortic dissection with dissection extension into the left common carotid artery and left internal carotid artery who had a good clinical outcome following mechanical thrombectomy for a symptomatic middle cerebral artery occlusion. We also review other cases in which endovascular mechanical thrombectomy was conducted in patients with aortic dissection and acute ischemic stroke, and discuss the potential risks and benefits of carotid artery stenting in this clinical situation.
Conclusion: The rate of successful arterial recanalization in patients with aortic dissection, large vessel occlusion and acute ischemic stroke treated with mechanical thrombectomy is high. The intervention has been associated with good neurological outcomes and a low rate of procedure-related complications. Additional case series are needed to help discern if our observations are present in a broader array of patients in order to identify which patients are most likely to benefit from mechanical thrombectomy.
Efficacy and Safety of Atezolizumab plus Bevacizumab versus Sorafenib in Hepatocellular Carcinoma with Main Trunk and/or Contralateral Portal Vein Invasion in IMbrave150
Authors: Finn Richard S. , Galle Peter R. , Ducreux Michel , Cheng Ann-Lii , Reilly Norelle , Nicholas Alan , Hernandez Sairy , Ma Ning , Merle Philippe , Salem Riad , Li Daneng , Breder Valeriy
Published: June 2024

Introduction: Atezolizumab plus bevacizumab significantly improved overall survival (OS) and progression-free survival (PFS) versus sorafenib in patients with unresectable hepatocellular carcinoma (HCC) in IMbrave150. Efficacy and safety in patient subpopulations with Vp4 portal vein tumor thrombosis (PVTT) and other high-risk prognostic factors are reported. Methods: IMbrave150 was a global, randomized (2:1), open-label, phase 3 study in systemic treatment–naive patients with unresectable HCC; OS and PFS were co-primary endpoints. Exploratory analyses compared the efficacy and safety of atezolizumab 1,200 mg plus bevacizumab 15 mg/kg every 3 weeks versus sorafenib 400 mg twice daily in patients (i) with and without Vp4 PVTT alone and (ii) with and without high-risk prognostic factors. Results: In patients with Vp4 PVTT, median OS was 7.6 months (95% CI: 6.0–13.9) with atezolizumab plus bevacizumab (n = 48) and 5.5 months (95% CI: 3.4–6.7) with sorafenib (n = 25; HR 0.62 [95% CI: 0.34–1.11]; descriptive p = 0.104). Median PFS in the respective arms was 5.4 months (95% CI: 3.6–6.9) and 2.8 months (95% CI: 1.5–5.3; HR 0.62 [95% CI: 0.35–1.09]; descriptive p = 0.094). In patients without Vp4, median OS was 21.1 months (95% CI: 18.0–24.6) with atezolizumab plus bevacizumab (n = 288) and 15.4 months (95% CI: 12.6–18.6) with sorafenib (n = 140; HR 0.67 [95% CI: 0.51–0.88]; descriptive p = 0.003). Median PFS in the respective arms was 7.1 months (95% CI: 6.1–9.6) and 4.7 months (95% CI: 4.2–6.1; HR 0.64 [95% CI: 0.51–0.81]; descriptive p < 0.001). The high-risk versus non–high-risk populations had similar outcome patterns. In the respective treatment arms, grade ≥3 treatment-related adverse events occurred in 43% and 48% of patients with Vp4 and 46% and 47% of patients without Vp4. Conclusion: Regardless of VP4 PVTT or other high-risk features of unresectable HCC, which have often resulted in exclusion from other front-line trials, patients benefited from atezolizumab and bevacizumab versus sorafenib.
Short‐Term Statin Treatment Reduces, and Long‐Term Statin Treatment Abolishes, Chronic Vascular Injury by Radiation Therapy
Authors: Ait‐Aissa Karima , Guo Xutong , Klemmensen Madelyn , Juhr Denise , Leng Linette N. , Koval Olha M. , Grumbach Isabella M.
Published: June 2024

Background

The incidental use of statins during radiation therapy has been associated with a reduced long‐term risk of developing atherosclerotic cardiovascular disease. We examined whether irradiation causes chronic vascular injury and whether short‐term administration of statins during and after irradiation is sufficient to prevent chronic injury compared with long‐term administration.

Methods and Results

C57Bl/6 mice were pretreated with pravastatin for 72 hours and then exposed to 12 Gy X‐ray head‐and‐neck irradiation. Pravastatin was then administered either for an additional 24 hours or for 1 year. Carotid arteries were tested for vascular reactivity, altered gene expression, and collagen deposition 1 year after irradiation. Treatment with pravastatin for 24 hours after irradiation reduced the loss of endothelium‐dependent vasorelaxation and protected against enhanced vasoconstriction. Expression of markers associated with inflammation (NFκB p65 [phospho‐nuclear factor kappa B p65] and TNF‐α [tumor necrosis factor alpha]) and with oxidative stress (NADPH oxidases 2 and 4) were lowered and subunits of the voltage and Ca
2+
activated K
+
BK channel (potassium calcium‐activated channel subfamily M alpha 1 and potassium calcium‐activated channel subfamily M regulatory beta subunit 1) in the carotid artery were modulated. Treatment with pravastatin for 1 year after irradiation completely reversed irradiation‐induced changes.

Conclusions

Short‐term administration of pravastatin is sufficient to reduce chronic vascular injury at 1 year after irradiation. Long‐term administration eliminates the effects of irradiation. These findings suggest that a prospective treatment strategy involving statins could be effective in patients undergoing radiation therapy. The optimal duration of treatment in humans has yet to be determined.
Prognostic Value of Serial Risk Stratification in Adult and Pediatric Pulmonary Arterial Hypertension: A Systematic Review
Authors: Lokhorst Chantal , van der Werf Sjoukje , Berger Rolf M. F. , Douwes Johannes M.
Published: June 2024

Background

In pulmonary arterial hypertension, it is recommended to base therapeutic decisions on risk stratification. This systematic review aims to report the prognostic value of serial risk stratification in adult and pediatric pulmonary arterial hypertension and to explore the usability of serial risk stratification as treatment target.

Methods and Results

Electronic databases PubMed, Embase, and Web of Science were searched up to January 30, 2023, using terms associated with pulmonary arterial hypertension, pediatric pulmonary hypertension, and risk stratification. Observational studies and clinical trials describing risk stratification at both baseline and follow‐up were included. Sixty five studies were eligible for inclusion, including only 2 studies in a pediatric population. C‐statistic range at baseline was 0.31 to 0.77 and improved to 0.30 to 0.91 at follow‐up. In 53% of patients, risk status changed (42% improved, 12% worsened) over 168 days (interquartile range, 137–327 days; n=22 studies). The average proportion of low‐risk patients increased from 18% at baseline to 36% at a median follow‐up of 244 days (interquartile range, 140–365 days; n=40 studies). In placebo‐controlled drug studies, risk statuses of the intervention groups improved more and worsened less compared with the placebo groups. Furthermore, a low‐risk status, but also an improved risk status, at follow‐up was associated with a better outcome. Similar results were found in the 2 pediatric studies.

Conclusions

Follow‐up risk stratification has improved prognostic value compared with baseline risk stratification, and change in risk status between baseline and follow‐up corresponded to a change in survival. These data support the use of serial risk stratification as treatment target in pulmonary arterial hypertension.
1. The Cases of Riley and Rooney
Authors: Placzynta Karolina
Published: June 2024

Despite the benefits of the intersectional approach to antisemitism studies, it seems to have been given little attention so far. This chapter compares the online reactions to two UK news stories, both centred around the common theme of cultural boycott of Israel in support of the BDS movement, both with a well-known female figure at the centre of media coverage, only one of which identifies as Jewish. In the case of British television presenter Rachel Riley, a person is attacked for being female as well as Jewish, with misogyny compounding the antisemitic commentary. In the case of the Irish writer Sally Rooney, misogynistic discourse is used to strengthen the message countering antisemitism. The contrastive analysis of the two datasets, with references to similar analyses of media stories centred around well-known men, illuminates the relationships between the two forms of hate, revealing that—even where the antisemitic attitudes overlap— misogynistic insults and disempowering or undermining language are being weaponised on both sides of the debate, with additional characterisation of Riley as a “grifter” and Rooney as “naive”.

More research comparing discourses around Jewish and non-Jewish women is needed to ascertain whether this pattern is consistent; meanwhile, the many analogies in the abuse suffered by both groups can perhaps serve a useful purpose: shared struggles can foster understanding needed to then notice the particularised prejudice. By including more than one hate ideology in the research design, intersectionality offers exciting new approaches to studies of antisemitism and, more broadly, of

hate speech or discrimination.
Posttraumatic Growth Following Adverse Childhood Experiences: “My Creative Arts Teacher Got Me Through It”
Authors: Pliske Michelle , Werner-Lin Allison , Stauffer Sarah
Published: June 2024

Background: Childhood trauma results in long-term health and economic complications. The original Adverse Childhood Experiences (ACE) inventory provided researchers and health experts a lens to explore the implications of early experiences of trauma on human development. The ACE inventory has been evaluated over the last two decades to include societal and community factors, however gaps in assessment warrant a further need for revision. The ACE-EX was built to combine current research and social determinants of health with data obtained directly from people who experienced trauma but were unable to be accounted for in the original or recent modified measures. This study demonstrates how relationships serve as a fundamental protective factor for traumatized children to experience post-traumatic growth. Objective: The authors examined creative art expression, in context with nurturing relationships, as a protective factor against long term negative outcomes associated with ACEs. Method: The researchers used grounded theory methodology and recruited 10 adult participants who reported having four or more experiences on an expanded trauma inventory (ACE-EX) and did not report significant negative health conditions. Participants completed two qualitative retrospective interviews regarding important relationships and the arts. Data analysis used the constant comparative method to complete both iterative and theoretical coding. Findings: Data supported the importance of nurturing relationships, combined with expressive arts, as protective factors against ACEs. Relationships and the arts provided a context for integrating experiences in relation to early trauma. Conclusion: The implications of chronic traumatic stress necessitate the need for building protective factors into the fabric of societal systems. Identifying variables such as creative expression within the context of supportive relationships with caring adults, and inclusive communities, suggest comprehensive prevention programs are possible and social policy reform is needed to aide in mitigating the long-term effects of childhood trauma.
Education or indoctrination? An exploration of the resistance towards making policing a degree-level profession
Authors: Andrews Tom
Published: June 2024

Following a governmental U-turn on the requirement for new police officers to have degrees, this article examines what happened within just 7 years to cause this; specifically from the perspective of chief constables. This is contextualised through social learning and followership, and examining best practice in police leadership. It concludes that with unambiguous buy-in of ideas - such as the requirement for professionalisation through education - officers accept them; but that in this example that was not the case. It demonstrates that where chief constables supported the entry routes, satisfaction rates were higher; but chiefs who obstructed their delivery ensured its failure.
Genotype-phenotype correlations in chronic granulomatous disease: insights from a large national cohort
Authors: Wolach Baruch , Gavrieli Ronit , Wolach Ofir , Salamon Pazit , de Boer Martin , van Leeuwen Karin , Abuzaitoun Omar , Broides Arnon , Gottesman Giora , Grisaru-Soen Galia , Hagin David , Marcus Nufar , Rottem Menachem , Schlesinger Yechiel , Stauber Tali , Stepensky Polina , Dinur-Schejter Yael , Zeeli Tal , Hanna Suheir , Etzioni Amos , Frizinsky Shirly , Somech Raz , Roos Dirk , Lachover-Roth Idit
Published: June 2024

Neutrophils are the first line of defense against invading pathogens. Neutrophils execute and modulate immune responses by generating reactive oxygen species (ROS). Chronic granulomatous disease (CGD) is a primary immune deficiency disorder of phagocytes, caused by inherited mutations in the genes of the nicotinamide adenine dinucleotide phosphate reduced oxidase enzyme. These mutations lead to failure of ROS generation followed by recurrent bacterial and fungal infections, frequently associated with hyperinflammatory manifestations. We report a multicenter cumulative experience in diagnosing and treating patients with CGD. From 1986 to 2021, 2918 patients experiencing frequent infections were referred for neutrophil evaluation. Among them, 110 patients were diagnosed with CGD: 56 of Jewish ancestry, 48 of Arabic ancestry, and 6 of non-Jewish/non-Arabic ancestry. As opposed to other Western countries, the autosomal recessive (AR) CGD subtypes were predominant in Israel (71/110 patients). Thirty-nine patients had X-linked CGD, in most patients associated with severe infections (clinical severity score ≥3) and poor outcomes, presenting at a significantly earlier age than AR-CGD subtypes. The full spectrum of infections and hyperinflammatory manifestations is described. Six patients had hypomorphic mutations with significantly milder phenotype, clinical severity score ≤2, and better outcomes. Hematopoietic stem cell transplantation was implemented in 39 of 110 patients (35.5%). Successful engraftment was achieved in 92%, with 82% long-term survival and 71% full clinical recovery. CGD is a complex disorder requiring a multiprofessional team. Early identification of the genetic mutation is essential for prompt diagnosis, suitable management, and prevention.
Impact of proficiency in the transcatheter aortic valve implantation procedure on clinical outcomes: a single center retrospective study
Authors: Miyoshi Hirotsugu , Kamiya Satoshi , Ikeda Tsuyoshi , Narasaki Soshi , Kondo Takashi , Syourin Daiki , Sumii Ayako , Kido Kenshiro , Otsuki Sachiko , Kato Takahiro , Nakamura Ryuji , Tsutsumi Yasuo M.
Published: June 2024

Background

We used transcatheter aortic valve implantation (TAVI) procedure time to investigate the association between surgical team maturity and outcome.

Methods

Among patients who underwent TAVI between October 2015 and November 2019, those who had Sapien™ implanted with the transfemoral artery approach were included in the analysis. We used TAVI procedure time and surgery number to draw a learning curve. Then, we divided the patients into two groups before and after the number of cases where the sigmoid curve reaches a plateau. We compared the two groups regarding the surveyed factors and investigated the correlation between the TAVI procedure time and survey factors.

Results

Ninety-nine of 149 patients were analysed. The sigmoid curve had an inflection point in 23.2 cases and reached a plateau in 43.0 cases. Patients in the Late group had a shorter operating time, less contrast media, less radiation exposure, and less myocardial escape enzymes than the Early group. Surgical procedure time showed the strongest correlation with the surgical case number.

Conclusion

The number of cases required for surgeon proficiency for isolated Sapien™ valve implantation was 43. This number may serve as a guideline for switching the anesthesia management of TAVI from general to local anesthesia.
Dietary patterns and micronutrients in respiratory infections including COVID-19: a narrative review
Authors: Salehi Zahra , Askari Mohammadreza , Jafari Alireza , Ghosn Batoul , Surkan Pamela J. , Hosseinzadeh-Attar Mohammad Javad , Pouraram Hamed , Azadbakht Leila
Published: June 2024

Background

COVID-19 is a pandemic caused by nCoV-2019, a new beta-coronavirus from Wuhan, China, that mainly affects the respiratory system and can be modulated by nutrition.

Methods

This review aims to summarize the current literature on the association between dietary intake and serum levels of micronutrients, malnutrition, and dietary patterns and respiratory infections, including flu, pneumonia, and acute respiratory syndrome, with a focus on COVID-19. We searched for relevant articles in various databases and selected those that met our inclusion criteria.

Results

Some studies suggest that dietary patterns, malnutrition, and certain nutrients such as vitamins D, E, A, iron, zinc, selenium, magnesium, omega-3 fatty acids, and fiber may have a significant role in preventing respiratory diseases, alleviating symptoms, and lowering mortality rates. However, the evidence is not consistent and conclusive, and more research is needed to clarify the mechanisms and the optimal doses of these dietary components. The impact of omega-3 and fiber on respiratory diseases has been mainly studied in children and adults, respectively, and few studies have examined the effect of dietary components on COVID-19 prevention, with a greater focus on vitamin D.

Conclusion

This review highlights the potential of nutrition as a modifiable factor in the prevention and management of respiratory infections and suggests some directions for future research. However, it also acknowledges the limitations of the existing literature, such as the heterogeneity of the study designs, populations, interventions, and outcomes, and the difficulty of isolating the effects of single nutrients from the complex interactions of the whole diet.
Accessibility to palliative care services in Colombia: an analysis of geographic disparities
Authors: Sánchez-Cárdenas Miguel Antonio , León Marta Ximena , Rodríguez-Campos Luisa Fernanda , Vargas-Escobar Lina María , Cabezas Laura , Tamayo-Díaz Juan Pablo , Piñeros Angela Cañon , Mantilla-Manosalva Nidia , Fuentes-Bermudez Genny Paola
Published: June 2024

Objectives

Due to the increase in the prevalence of non-communicable diseases and the Colombian demographic transition, the necessity of palliative care has arisen. This study used accessibility and coverage indicators to measure the geographic barriers to palliative care.

Methods

Population-based observational study focused on urban areas and adult population from Colombia, which uses three measurements of geographic accessibility to services: a) density of palliative care services per 100,000 inhabitants, b) analysis of geographic distribution by territorial nodes of the country, and c) spatial analysis of palliative care services using Voronoi diagrams. ArcGIS Pro software was used to map services’ locations and identify geographic disparities.

Results

A total of 504 palliative care services were identified, of which 77% were primary health care services. The density of palliative care services in Colombia is 1.8 primary care services per 100,000 inhabitants and 0.4 specialized services per 100,000 inhabitants. The average palliative care coverage is 41%, two regions of the country have a coverage below 30%. Twenty-eight percent of the services provide care for a population greater than 50,000 inhabitants within their coverage area, exceeding the acceptable limit by international standards.

Conclusions

Palliative care services are concentrated in three main regions (Bogotá D.C., the Center, and the Caribbean) and are limited in the Orinoquia and Amazonia nodes. Density of specialized palliative care services is extremely low and there are regions without palliative services for adults with palliative needs.
Exploring moral competence regression: a narrative approach in medical ethics education for medical students
Authors: Zielina Martin , Škoda Jaromír , Ivanová Kateřina , Dostál Daniel , Juríčková Lubica , Anthony Procházka David , Straka Barbora , Doležal Adam
Published: June 2024

Background

Studies from different countries report a stagnation or regression of moral competence in medical students between the first and the last year of their studies, and the value of various educational interventions remains uncertain.

Methods

We used Moral Competence Test (MCT) to measure C-scores of moral competence to determine the change in the MCT C-scores between the first- and the fifth-year medical students from two medical schools in the Czech Republic in the academic year 2022/2023 and to analyze factors associated with the C-scores (observational study). In addition, for the first-year students, we compared the results of the MCT before and after an intervention in medical ethics curriculum (interventional study). We used a cross-sectional and descriptive design for the observational study. Students completed the MCT, consisting of two moral dilemmas (Worker´s Dilemma and Doctor´s Dilemma), the results measured by the C-score, which represents moral competence.

Results

In total, 685 students participated in the observational study. Objective 1: based on the analysis of the C-score, we observed a decrease in moral competence between the first and the fifth-year medical students (p < .001). Objective 2: we did not observe a statistically significant effect of gender (p = .278), or self-rated religiosity (p = .163). Objective 3: in the interventional study, 440 students participated in the pretest and 422 students participated in the posttest. The test of statistical significance found no improvement in students’ moral competence after the intervention (p = .253).

Conclusion

Medical students show a regression in moral competence during medical education; it was lower in medical students in their fifth year, compared to the first-year medical students without the effect of gender, or self-rated religiosity. Although educational intervention consisting of multiple tools of medical ethics teaching (PBL, CBL, KMDD and StorED) did not lead to increase in moral competence, the longitudinal effect of such intervention remains to be seen.
Using a smartphone-based self-management platform to study sex differences in Parkinson’s disease: multicenter, cross-sectional pilot study
Authors: Xu Zhiheng , Jin Lirong , Chen Weijie , Hu Tianyu , Li Shiyu , Liang Xiaoniu , Han Xixi , Chen Yi , Tang Yilin , Wang Jian , Wu Danhong
Published: June 2024

Background

Patient-reported outcome (PRO) is a distinct and indispensable dimension of clinical characteristics and recent advances have made remote PRO measurement possible. Sex difference in PRO of Parkinson’s disease (PD) is hardly extensively researched.

Methods

A smartphone-based self-management platform, offering remote PRO measurement for PD patients, has been developed. A total of 1828 PD patients, including 1001 male patients and 827 female patients, were enrolled and completed their PRO submission through this platform.

Results

Sex differences in PROs have been identified. The female group had a significantly lower height, weight, and body mass index (BMI) than the male group (P < 0.001). For motor symptoms, a higher proportion of patients reporting dyskinesia was observed in the female group. For non-motor symptoms, there is a higher percentage (P < 0.001) as well as severity (P = 0.016) of depression in the female group. More male patients reported hyposmia, lisp, drooling, dysuria, frequent urination, hypersexuality, impotence, daytime sleepiness, and apathy than females (P < 0.05). In contrast, more female patients reported headache, palpation, body pain, anorexia, nausea, urinal incontinence, anxiety, insomnia (P < 0.05) than males.

Conclusions

We provide evidence for sex differences in PD through the data collected from our platform. These results highlighted the importance of gender in clinical decision-making, and also support the feasibility of remote PRO measurement through a smartphone-based self-management platform in patients with PD.
Well-being approaches targeted to improve child and youth health post-COVID-19 pandemic: a scoping review
Authors: Moss Stephana Julia , Sriskandarajah Cynthia , Brundin-Mather Rebecca , Cherak Michal S. , Mizen Sara J. , Stelfox Maia , Halperin Donna , Halperin Scott , Ahmed Sofia B. , Lorenzetti Diane L. , Smith Stacie , Harley Micaela , Tutelman Perri R. , Birnie Kathryn A. , Anglin Melanie C. , Stelfox Henry T. , Fiest Kirsten M. , Racine Nicole , Parsons Leigh Jeanna
Published: June 2024

Background

Our previous work synthesized published studies on well-being interventions during COVID-19. As we move into a post-COVID-19 pandemic period there is a need to comprehensively review published strategies, approaches, and interventions to improve child and youth well-being beyond deleterious impacts experienced during COVID-19.

Methods

Seven databases were searched from inception to January 2023. Studies were included if they: (1) presented original data on an approach (i.e., approach applied) or (2) provided recommendations to inform development of a future approach (i.e., approach suggested), (3) targeted to mitigate negative impacts of COVID-19 on child and youth (≤18 year) well-being, and (4) published on or after December 2019.

Results

39 studies (n = 4/39, 10.3% randomized controlled trials) from 2021 to 2023 were included. Twenty-two studies applied an approach (n = 22/39, 56.4%) whereas seventeen studies (n = 17/39, 43.6%) suggested an approach; youth aged 13–18 year (n = 27/39, 69.2%) were most frequently studied. Approach applied records most frequently adopted an experimental design (n = 11/22, 50.0%), whereas approach suggested records most frequently adopted a cross-sectional design (n = 13/22, 59.1%). The most frequently reported outcomes related to good health and optimum nutrition (n = 28/39, 71.8%), followed by connectedness (n = 22/39, 56.4%), learning, competence, education, skills, and employability (n = 18/39, 46.1%), and agency and resilience (n = 16/39, 41.0%).

Conclusions

The rapid onset and unpredictability of COVID-19 precluded meaningful engagement of children and youth in strategy development despite widespread recognition that early engagement can enhance usefulness and acceptability of interventions. Published or recommended strategies were most frequently targeted to improve connectedness, belonging, and socialization among children and youth.
Impact of pretransplant T2DM on left ventricular deformation and myocardial perfusion in heart transplanted recipients: a 3.0 T cardiac magnetic resonance study
Authors: Cao Liqi , Liu Chang , Ou Chulan , Ma Quanmei , Xu Huanwen , Li Xiaodan , Bao Yingying , Chen Rui , Yang Yuelong , Wu Min , Liu Hui
Published: June 2024

Background

Pretransplant type 2 diabetes mellitus (T2DM) is associated with increased cardiovascular and all-cause mortality after heart transplant (HT), but the underlying causes of this association remain unclear. The purpose of this research was to examine the impact of T2DM on left ventricular (LV) myocardial deformation and myocardial perfusion following heart transplantation using cardiovascular magnetic resonance imaging.

Methods

We investigated thirty-one HT recipients with pretransplant T2DM [HT(DM+)], thirty-four HT recipients without pretransplant T2DM [HT(DM−)] and thirty-six controls. LV myocardial strains, including the global longitudinal, radial, and circumferential strain (GLS, GRS and GCS, respectively), were calculated and compared among groups, as were resting myocardial perfusion indices, which included time to peak myocardial signal intensity (TTM), maximum signal intensity (MaxSI), and Upslope. The relationships between LV strain parameters or perfusion indices and biochemical indicators were determined through Spearman’s analysis. The impact of T2DM on LV strains in HT recipients was assessed using multivariable linear regression analyses with backward stepwise selection.

Results

In the HT(DM+) group, the LV GLS, GRS, and GCS exhibited significantly lower magnitudes than those in both the HT(DM−) and control groups. TTM was higher in the HT(DM+) group than in both the HT(DM−) and control groups, while no significant differences were observed among the groups regarding Upslope and MaxSI. There was a negative correlation between glycated hemoglobin and the magnitude of strains (longitudinal, r = − 0.399; radial, r = − 0.362; circumferential, r = − 0.389) (all P < 0.05), and a positive correlation with TTM (r = 0.485, P < 0.001). Regression analyses that included both pretransplant T2DM and perfusion indices revealed that pretransplant T2DM, rather than perfusion indices, was an independent determinant of LV strain (β = longitudinal, − 0.508; radial, − 0.370; circumferential, − 0.371) (all P < 0.05).

Conclusion

In heart transplant recipients, pretransplant T2DM has a detrimental effect on subclinical left ventricular systolic function and could potentially impact myocardial microcirculation following HT.
Metabolic engineering of Saccharomyces cerevisiae for chelerythrine biosynthesis
Authors: Zhu Jiawei , Zhang Kai , He Yuanzhi , Zhang Qi , Ran Yanpeng , Tan Zaigao , Cui Li , Feng Yan
Published: June 2024

Background

Chelerythrine is an important alkaloid used in agriculture and medicine. However, its structural complexity and low abundance in nature hampers either bulk chemical synthesis or extraction from plants. Here, we reconstructed and optimized the complete biosynthesis pathway for chelerythrine from (S)-reticuline in Saccharomyces cerevisiae using genetic reprogramming.

Results

The first-generation strain Z4 capable of producing chelerythrine was obtained via heterologous expression of seven plant-derived enzymes (McoBBE, TfSMT, AmTDC, EcTNMT, PsMSH, EcP6H, and PsCPR) in S. cerevisiae W303-1 A. When this strain was cultured in the synthetic complete (SC) medium supplemented with 100 µM of (S)-reticuline for 10 days, it produced up to 0.34 µg/L chelerythrine. Furthermore, efficient metabolic engineering was performed by integrating multiple-copy rate-limiting genes (TfSMT, AmTDC, EcTNMT, PsMSH, EcP6H, PsCPR, INO2, and AtATR1), tailoring the heme and NADPH engineering, and engineering product trafficking by heterologous expression of MtABCG10 to enhance the metabolic flux of chelerythrine biosynthesis, leading to a nearly 900-fold increase in chelerythrine production. Combined with the cultivation process, chelerythrine was obtained at a titer of 12.61 mg per liter in a 0.5 L bioreactor, which is over 37,000-fold higher than that of the first-generation recombinant strain.

Conclusions

This is the first heterologous reconstruction of the plant-derived pathway to produce chelerythrine in a yeast cell factory. Applying a combinatorial engineering strategy has significantly improved the chelerythrine yield in yeast and is a promising approach for synthesizing functional products using a microbial cell factory. This achievement underscores the potential of metabolic engineering and synthetic biology in revolutionizing natural product biosynthesis.
Changes in temporal lobe activation during a sound stimulation task in patients with sensorineural tinnitus: a multi-channel near-infrared spectroscopy study
Authors: Fan Xiaoli , Gong Bin , Yang Hao , Yang Juanjuan , Qi Gaowei , Wang Zheng , Sun Jie , Fang Yu
Published: June 2024

Background

The subjective sign of a serious pandemic in human work and life is mathematical neural tinnitus. fNIRS (functional near-infrared spectroscopy) is a new non-invasive brain imaging technology for studying the neurological activity of the human cerebral cortex. It is based on neural coupling effects. This research uses the fNIRS approach to detect differences in the neurological activity of the cerebral skin in the sound stimulation mission in order to better discriminate between the sensational neurological tinnitus.

Methods

In the fNIRS brain imaging method, 14 sensorineural tinnitus sufferers and 14 healthy controls listened to varied noise and quiet for fNIRS data collection. Linear fitting was employed in MATLAB to eliminate slow drifts during preprocessing and event-related design analysis. The false discovery rate (FDR) procedure was applied in IBM SPSS Statistics 26.0 to control the false positive rate in multiple comparison analyses.

Results

When the ill group and the healthy control group were stimulated by pink noise, there was a significant difference in blood oxygen concentration (P < 0.05), and the healthy control group exhibited a high activation, according to the fNIRS measurement data. The blood oxygen concentration level in the patient group was dramatically enhanced after one month of acupuncture therapy under the identical stimulation task settings, and it was favorably connected with the levels of THI and TEQ scales.

Conclusions

Using sensorineural tinnitus illness as an example, fNIRS technology has the potential to disclose future pathological study on subjective diseases throughout time. Other clinical disorders involving the temporal lobe and adjacent brain areas may also be examined, in addition to tinnitus-related brain alterations.