bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripherally administered vasopressors in critically ill adult patients: A survey of UK healthcare professional practices, attitudes and experiences
Authors: Hussain Nauman , Jovaisa Tomas , Puthucheary Zudin , Pearse Rupert , Phull Mandeep K
Published: July 2024

Background:

Peripherally administered vasopressor infusions are used to support critically ill patients. The Intensive Care Society recently published guidelines supporting their use. Preliminary evidence suggests variability in peripheral vasopressor infusion use. We aimed to characterise current practice in the use of peripheral vasopressor infusions in the UK National Health Service and to capture the views of healthcare professionals caring for critically ill adult patients.

Method:

We conducted an online survey of healthcare professionals from December 2022 to March 2023. Our survey used Google Forms and was shared via email, X (formerly twitter), and mobile phone messaging within the UK. Health Research Authority approval was sought, and ethical approval was not required.

Results:

We received 227 responses and our survey showed variation in the use of peripherally administered vasopressor infusions in critically ill patients across UK National Health Service hospitals. About 87.7% of healthcare professionals initiated peripheral vasopressor infusions in their clinical role. Peripheral vasopressor use was limited to low dose, short durations of infusions, however, there was variability. Metaraminol was the most used peripheral vasopressor (90.3%). Only 22.5% of healthcare professionals used peripherally administered noradrenaline in practice. Our respondents agreed that equipoise exists.

Conclusion:

Our survey found variability in the use of peripheral vasopressors and in care delivered to critically ill patients in the UK. Our survey shows there are ongoing concerns regarding safety, dosing ranges and durations of use. Future research is required to explore the optimal role that peripheral vasopressor infusions can play in the care of critically ill patients.
A rare adverse effect in inebilizumab therapy for neuromyelitis optica spectrum disorder: a case report
Authors: Chen Xuefen , Shi Ziyan , Wang Rui , Zhou Hongyu
Published: July 2024

Inebilizumab is one of the monoclonal antibodies approved as maintenance therapy for aquaporin-4 immunoglobulin G-seropositive neuromyelitis optica spectrum disorder (NMOSD). It is a humanized monoclonal antibody targeting cluster of differentiation 19 (CD19). Common adverse reactions include urinary tract infections, nasopharyngitis, arthralgia, infusion reactions, headaches and a decrease in immunoglobulin levels. Here, we present a case of an NMOSD patient who experienced transient hyperCKaemia after the use of inebilizumab. The adverse reactions of this very rare monoclonal antibody drug improved after discontinuation.
Racial disparity in postoperative complications following shoulder arthroplasty (SA): A systematic review and meta-analysis
Authors: Sumbal Ramish , Devi Uooja , Ashraf Saad , Sumbal Anusha
Published: July 2024

Introduction

There has been an emphasis on racial disparities in orthopedic surgery. Recently, literature suggested Black and Hispanic patients at increased risk for adverse outcomes after Shoulder Arthroplasty (SA), but data regarding it is sparse and inconclusive. Therefore, we aim to conduct a meta-analysis to assess the role of racial disparity in causing adverse outcomes after SA.

Methods

Following PRISMA guidelines, electronic databases PubMed, Scopus, Cochrane, and Google Scholar were queried. Studies meeting inclusion criteria were included. Results were analyzed by pooling Odds ratios along 95% Confidence interval, using random-effects model on RevMan 5.3.

Results

A total of 14 selected studies evaluated 1,781,783 patients. We found Black patients at higher risk of post-SA complications than White patients (OR 1.32(95% CI 1.25–1.39; p < 0.00001; I2 = 0%). No significant risk in Hispanics compared to white patients (OR 0.94(95% CI 0.81–1.09); p = 0.41; I2 = 65%). Compared to whites, black patients were at higher risk of an extended length of stay, postoperative blood transfusion, sepsis, venous thromboembolism, and non-home discharge. Compared to white patients, Hispanics were at higher risk for postoperative blood transfusion. Whites showed increased risk for readmission.

Conclusion

Following SA, Black patients were likely to develop complications compared to White patients but no significant risk in Hispanics compared to Whites.
Isolation and Characterization of Meniscus Progenitor Cells From Rat, Rabbit, Goat, and Human
Authors: Yan Wan-Ting , Wang Jing-Song , Guo Shu-Yang , Zhu Jia-Hao , Zhang Zheng-Zheng
Published: July 2024

Objective

Meniscus progenitor cells (MPCs) have been identified as promising candidates for meniscus regeneration, and it is crucial for us to understand meniscus injury repair mechanism at the cellular level. In this study, we investigate the biological properties of MPCs isolated from different species using the differential adhesion to fibronectin (DAF) technique. We aim to characterize MPCs in different species and evaluate the feasibility of these models for future meniscal investigation.

Design

MPCs were isolated from freshly digested meniscus from rat, rabbit, goat, and human cells using DAF. Biological properties, including proliferation, colony-forming, multilineage differentiation, and migration abilities, were compared in MPCs and their corresponding mixed meniscus cell (MCs) population in each species.

Results

MPCs were successfully isolated by the DAF technique in all species. Rat MPCs appeared cobblestone-like, rabbit MPCs were more polygonal, goat MPCs had a spindle-shaped morphology, human MPCs appear more fibroblast-like. Compared with MCs, isolated MPCs showed progenitor cell characteristics, including multilineage differentiation ability and MSC (mesenchymal stem cells) markers (CD166, CD90, CD44, Stro-1) expression. They also highly expressed fibronectin receptors CD49e and CD49c. MPCs also showed greater proliferation capacity and retained colony-forming ability. Except for goat MPCs showed greater migration abilities than MCs, no significant differences were found in the migration ability between MPCs and MCs in other species.

Conclusion

Our study shows that DAF is an effective method for isolating MPCs from rat, rabbit, goat, and human. MPCs in these species demonstrated similar characteristics, including greater proliferation ability and better chondrogenic potential.
Polymers from renewable resources: Drug delivery platforms for transdermal delivery
Authors: Makvandi Pooyan , Moradialvand Madineh , Nazarzadeh Zare Ehsan
Published: July 2024

The stratum corneum layer of skin poses a major barrier for transdermal drug delivery. Recently, nanocarriers and microneedles fabricated from renewable polymers have emerged as promising platforms to enhance permeation across this barrier. This letter highlights recent progress in using biocompatible nanocarriers and microneedle arrays to improve transdermal drug delivery.
From oxen to tourists: The management history of subalpine grasslands in the Sudeten mountains and its significance for nature conservation
Authors: Szabó Péter , Bobek Přemysl , Dudová Lydie , Hédl Radim
Published: July 2024

Grasslands above the timberline in European high mountains, such as the Alps, have been used as summer pasture for millennia, creating diverse ecosystems of high conservation value. However, the historical ecology of natural grasslands in middle mountains is much less known. We combined archival and palaeoecological sources to understand the management history of subalpine grasslands in the Hrubý Jeseník Mountains (Czechia) and evaluated the results in view of current nature conservation efforts. The analysis showed that people managed these grasslands for at least seven centuries in a highly dynamic system. Following the abandonment of management in the mid-20th century, this socioecological knowledge was lost and current nature conservation relies on non-intervention to protect areas seen as analogues to nordic tundra. While this is justified for some parts, the encroachment of shrubby vegetation in other parts signifies that the reintroduction of management based on historical parallels can be a valid approach in nature protection.
Inspiring an Early Passion for Science: The Impact of Hands-on Activities on Children's Motivation
Authors: Yilmaz Melek Merve , Bekirler Asli , Sigirtmac Ayperi Dikici
Published: July 2024

Purpose

The aim of this research is to determine the impact of hands-on science activities on preschool children's motivation for science.

Design/Approach/Methods

The study group of the research, in which the quasi-experimental design with pretest–posttest control group was used, consists of 25 children aged 60–72 months who are continuing their preschool education. While the experimental group implemented hands-on science activities, the control group continued with the regular preschool education program. Science Motivation Scale for Preschool Children was used as a data collection tool. In the analysis of the data, independent samples t-test, Mann–Whitney U test, and Wilcoxon signed-rank test were used.

Findings

Within the scope of the research, it was concluded that science activities based on hands-on activities were effective in increasing children's science motivation. In addition, it was observed that science motivation did not differ according to gender, and there was an increase in the science motivation of both girls and boys in the experimental group.

Originality/Value

The results obtained from the study show that children's science motivation can be shaped through hands-on activities.
Diabetes and Hospitalizations Among Mexican Americans Aged 75 Years and Older
Authors: Coleman Garrett T. , Al Snih Soham
Published: July 2024

Objective:

To examine factors associated with hospitalization among Mexican Americans aged 75 years and older with diabetes (with and without complications) and without diabetes over 12 years of follow up.

Methods:

Participants (N = 1454) were from the Hispanic Established Population for the Epidemiologic Study of the Elderly (2004/2005-2016) residing in Arizona, California, Colorado, New Mexico, and Texas. Measures included socio-demographics, medical conditions, falls, depressive symptoms, cognitive function, disability, physician visits, and hospitalizations. Participants were categorized as no diabetes (N = 1028), diabetes without complications (N = 180), and diabetes with complications (N = 246).

Results:

Participants with diabetes and complications had greater odds ratio (1.56, 95% Confidence Interval = 1.23-1.98) over time of being admitted to the hospital in the prior year versus those without diabetes. Participants with diabetes had greater odds of hospitalization if they had heart failure, falls, amputation, and insulin treatment.

Conclusions:

In Mexican American older adults, diabetes and diabetes-related complications increased the risk of hospitalization.
Promoting pro-environmental behaviours at work: the role of green organizational climate and supervisor support / Fomentando las conductas proambientales en el trabajo: el papel del clima organizacional verde y el apoyo del supervisor
Authors: Leitão Patrícia , Mouro Carla , Duarte Ana Patrícia , Luís Sílvia
Published: July 2024

Employees’ pro-environmental behaviours at work can contribute to reducing organizations’ environmental impacts through the integration of environmental practices into daily routines. This study explored how a green climate at the organizational and co-worker level and supervisor support help predict employees’ voluntary green behaviours at work, particularly regarding waste separation. Organizational identification’s mediating role in these relationships was also examined. Cross-sectional, correlational research was conducted at a Portuguese higher education institution in which 164 employees responded to an online survey. The results reveal a significant positive association between workers’ perceptions of a green organizational climate and their reported pro-environmental behaviours, but organizational identification does not mediate the green climate–pro-environmental behaviours relationship. In addition, supervisor support’s effect on pro-environmental behaviours was only marginally significant. These findings underline the importance of organizational-level initiatives as a way to promote green behaviours at work, but a better understanding of the processes generating these relationships is still needed. The practical implications include the need for more investment in initiatives that focus on making environmental concerns part of organizations’ daily procedures and routines.
The Effect of Flap Thickness on Major Complications of Prepectoral Breast Reconstruction Without Using ADM in Radiotherapy Patients
Authors: Altuntaş Zeynep , Zuhour Moath , Uyanık Orkun
Published: July 2024

Objectives: Recent studies have started to question the need for acellular dermal matrix (ADM) in immediate implant-based prepectoral breast reconstruction. However, most of the patients in these studies did not receive postoperative radiotherapy. In this study, it was aimed to investigate the major complication rate after immediate prepectoral breast reconstruction without the use of ADM and to find the optimal cutoff value of the mastectomy flap thickness. Methods: Patients who underwent immediate prepectoral breast reconstruction and received postoperative radiotherapy between 2020 and 2022 were included in this retrospective study. The correlation between mastectomy flap thickness and major complications was investigated. Results: A total of 77 patients, corresponding to 81 breasts were included in this study. Major complications were encountered in 18 (22%) breasts. The thickness of mastectomy flaps ranged from 0.31 mm to 1.2 cm, with an average thickness of 6.6 ± 2.1 mm. No capsule contracture was encountered in any of the patients during the follow-up period (21.1 ± 4.3 M). A flap thickness of ≤5.5 mm is the cutoff value for developing major complications in patients who will receive radiotherapy ( P < .05). Conclusion: Immediate prepectoral breast reconstruction without using ADM is a reliable and safe method for breast reconstruction. However, if radiotherapy is planned, care must be taken when mastectomy flap thickness is equal or below 5.5 mm to avoid major complications. Prepectoral reconstruction with transverse mastectomy incision provides the ability to complete the reconstruction in a single session with a high cost-effective way.
Parsing Coaching Practice: A Systematic Framework for Describing Coaching Discourse
Authors: Boguslav Arielle
Published: July 2024

Despite the common title of “coach,” definitions of high-quality coaching vary tremendously across models and programs. Yet few studies make comparisons between different models to understand what is most helpful, for whom, and under what circumstances. As a result, practitioners are left with many options and little evidence-based direction. This is exacerbated by the literature’s focus on more abstract features of coaching practice (e.g., building trust), leaving practitioners to figure out what concrete discourse strategies support these goals. This article begins to address these challenges by introducing a taxonomy of coaching “moves,” parsing the concrete details of coach discourse. While the taxonomy is informed by the literature, it highlights conceptual possibilities rather than providing a list of empirically grounded or “evidence-based” strategies. In doing so, this taxonomy may serve as a common language to guide future work exploring how coach discourse shapes teacher development, synthesizing across studies, and supporting coach practice.
Using Cupcake Decorating to Teach Shared and Emerging Leadership
Authors: Swab R. Gabrielle
Published: July 2024

Shared and emergent leadership are frequently taught as theoretical concepts in management courses but with little context or application on how these considerations materialize or exist in an organization. During this in-class, 50- to 70-minute exercise, which can be completed in one to two class periods depending on the instructor’s preference, a scenario is created in which multiple levels of an organization must communicate and collaborate to build their cupcake decorating business successfully. Throughout this process, shared and emergent leadership surfaces, allowing for the application of essential work processes.
Instructional approach and acquisition of mathematical proficiency: Theoretical insights from learning by comparison and cognitive load theory
Authors: Ngu Bing Hiong , Phan Huy P.
Published: July 2024

Quality mathematics learning is more than just the acquisition of mastery in different topical themes; rather, it involves successful acquisition of mathematical proficiency, which espouses a number of cognitive attributes—for example, a student's critical insight of a mathematical concept (e.g., productive disposition). Despite the pivotal role of mathematical proficiency in mathematics curriculum, syllabus requirements fall short of highlighting the design of appropriate instructional approaches that could specifically facilitate the acquisition of different mathematical proficiency strands. The present conceptual analysis article discusses the design of comparative instructional approaches that are based on two well-documented learning theories: (1) learning by comparison theory, such as the active comparison of isomorphic example pairs, and (2) cognitive load theory, such as the use of worked examples to reduce the negative impact of cognitive load imposition on learning. We premise that appropriate instructional approaches, informed by the use of both learning by comparison theory and cognitive load theory, may help to facilitate successful acquisition of multifaceted proficiency strands in mathematics learning. As revealed in the latter sections of the article, our proposed theoretical contention is significant, potentially establishing grounding for future research development and to help complement constructivist learning in the acquisition of mathematical proficiency strands.
The Formation Mechanism of Construction Safety Resilience in Railway Infrastructure Projects
Authors: Liu Kai , Kou Yuanyuan , Liu Yuming , Yang Xiaoxu
Published: July 2024

A conceptual framework has been formulated based on an extensive literature review to elucidate the formation mechanism of construction safety resilience. The hypotheses of the construction safety resilience model are statistically validated using questionnaires collected from 361 respondents with experience in railway infrastructure construction projects. The results indicate that both internal and external factors have a positive effect on construction safety resilience. Internal factors play a partially mediating role between external factors and construction safety resilience. Furthermore, it was observed that construction safety risk uncertainty and informatization level moderate the relationships among internal factors, external factors, and construction safety resilience.
Hodgkin lymphoma involving the extra-axial CNS: an AHOD1331, PHL-C1, and PHL-C2 report from the COG and EuroNet-PHL
Authors: Pabari Reena , McCarten Kathleen , Flerlage Jamie , Lai Hollie , Mauz-Körholz Christine , Dieckmann Karin , Palese Monica , Kaste Sue , Castellino Sharon M. , Kelly Kara M. , Stoevesandt Dietrich , Kurch Lars
Published: July 2024

Hodgkin lymphoma (HL) involving the central nervous system (CNS) is exceedingly rare. Information regarding the presentation, management, treatment, and outcome of patients with CNS HL is limited to case reports or small series. We describe 45 pediatric patients with 55 extra-axial CNS lesions at diagnosis with HL from a cohort of 4995 patients enrolled on Children’s Oncology Group AHOD1331 and the European Network for Pediatric Hodgkin lymphoma C1 and C2 trials, with an overall incidence of 0.9%. Up to 82.2% of patients had a single CNS lesion in the thoracic, lumbar, or sacral spine. In the evaluated cohort, HL did not occur within the CNS parenchyma. Lesions extended into the extra-axial CNS space from adjacent soft tissue or bone and never directly infiltrated through the dura into the brain or spinal cord. Patients with CNS involvement had a twofold greater incidence of extranodal lesions than previously reported cohorts without CNS involvement. After 2 cycles of chemotherapy, 89.1% of CNS lesions demonstrated a complete metabolic response and >75% decrease in volume. Thirteen CNS lesions (23.6%) received irradiation; none were sites of disease relapse. Relapse occurred at the site of 2 lesions involving the CNS, both of which had an adequate interim response to chemotherapy. In summary, we present, to our knowledge, the largest reported cohort of systemic HL involving the CNS at diagnosis, demonstrating that these lesions originate from surrounding tissues, extend into the extra-axial CNS space, and respond similarly to other nodal and extranodal disease. The trials were registered at www.clinicaltrials.gov as #NCT02166463, #NCT00433459, and #NCT02684708.
Molecular mechanisms promoting long-term cytopenia after BCMA CAR-T therapy in multiple myeloma
Authors: Palacios-Berraquero Maria Luisa , Rodriguez-Marquez Paula , Calleja-Cervantes Maria Erendira , Berastegui Nerea , Zabaleta Aintzane , Burgos Leire , Alignani Diego , San Martin-Uriz Patxi , Vilas-Zornoza Amaia , Rodriguez-Diaz Saray , Inoges Susana , Lopez-Diaz de Cerio Ascensión , Huerga Sofia , Tamariz Esteban , Rifon Jose , Alfonso-Pierola Ana , Lasarte Juan Jose , Paiva Bruno , Hernaez Mikel , Rodriguez-Otero Paula , San-Miguel Jesus , Ezponda Teresa , Rodriguez-Madoz Juan Roberto , Prosper Felipe
Published: July 2024

Hematologic toxicity is a common side effect of chimeric antigen receptor T-cell (CAR-T) therapies, being particularly severe among patients with relapsed or refractory multiple myeloma (MM). In this study, we characterized 48 patients treated with B-cell maturation antigen (BCMA) CAR-T cells to understand kinetics of cytopenia, identify predictive factors, and determine potential mechanisms underlying these toxicities. We observed that overall incidence of cytopenia was 95.7%, and grade >3 thrombocytopenia and neutropenia, 1 month after infusion, was observed in 57% and 53% of the patients, respectively, being still present after 1 year in 4 and 3 patients, respectively. Baseline cytopenia and high peak inflammatory markers were highly correlated with cytopenia that persisted up to 3 months. To determine potential mechanisms underlying cytopenias, we evaluated the paracrine effect of BCMA CAR-T cells on hematopoietic stem and progenitor cell (HSPC) differentiation using an ex vivo myeloid differentiation model. Phenotypic analysis showed that supernatants from activated CAR-T cells (spCAR) halted HSPC differentiation, promoting more immature phenotypes, which could be prevented with a combination of interferon γ, tumor necrosis factor α/β, transforming growth factor β, interleukin-6 (IL-6) and IL-17 inhibitors. Single-cell RNA sequencing demonstrated upregulation of transcription factors associated with early stages of hematopoietic differentiation in the presence of spCAR (GATA2, RUNX1, CEBPA) and a decrease in the activity of key regulons involved in neutrophil and monocytic maturation (ID2 and MAFB). These results suggest that CAR-T activation induces HSPC maturation arrest through paracrine effects and provides potential treatments to mitigate the severity of this toxicity.
CHRONOS-4: phase 3 study of copanlisib plus rituximab-based immunochemotherapy in relapsed indolent B-cell lymphoma
Authors: Zinzani Pier Luigi , Wang Huaqing , Feng Jifeng , Kim Tae Min , Tao Rong , Zhang Huilai , Fogliatto Laura , Maluquer Artigal Clara , Özcan Muhit , Yanez Eduardo , Kim Won Seog , Kirtbaya Dmitry , Kriachok Iryna , Maciel Felipe , Xue Hongwei , Bouabdallah Krimo , Phelps Charles , Chaturvedi Shalini , Weispfenning Anke , Morcos Peter N. , Odongo Fatuma , Buvaylo Viktoriya , Childs Barrett H. , Dreyling Martin , Matasar Matthew , Ghione Paola
Published: July 2024

Copanlisib, a pan-class I phosphatidylinositol 3-kinase inhibitor with predominant activity against the α and δ isoforms, previously demonstrated durable responses as monotherapy and improved progression-free survival (PFS) in combination with rituximab in patients with relapsed indolent non-Hodgkin lymphoma (iNHL). CHRONOS-4 was a phase 3, randomized, double-blind, placebo-controlled study to investigate the efficacy and safety of copanlisib in combination with standard immunochemotherapy in patients with relapsed iNHL. Patients (n = 524) were randomized (1:1) to copanlisib (60 mg IV) plus immunochemotherapy (rituximab and bendamustine [R-B] or placebo plus R-B). Copanlisib/placebo were administered with R-B (days 1, 8, and 15 of each 28-day cycle) for ≤6 cycles and as monotherapy from cycle 7 up to 12 months. The primary study end point was PFS. Median exposure was 8.5 months (0.2-12.9) for copanlisib plus R-B and 11.4 months (0.1-12.6) for placebo plus R-B. Median PFS was 32.9 months (95% confidence interval [CI], 24.4-38.6) for copanlisib plus R-B and 33.3 months (95% CI, 27.8-42.8) for placebo plus R-B (hazard ratio, 1.13; 95% CI, 0.88-1.44; P = .83). No differences between treatment arms were observed in overall survival (data not yet mature), objective response rate, and duration of response for the overall population or individual histology types. Overall, copanlisib plus R-B was associated with higher rates of serious treatment-emergent adverse events (TEAEs), grade 4 and 5 TEAEs, and treatment discontinuation. A number of serious TEAEs were infections. Overall, copanlisib plus R-B did not provide clinical benefit vs placebo plus R-B and was associated with worse tolerability in patients with relapsed iNHL. This trial was registered at www.ClinicalTrials.gov as #NCT02626455.
Benralizumab for allergic asthma: a randomised, double-blind, placebo-controlled trial
Authors: Gauvreau Gail M. , Sehmi Roma , FitzGerald J. Mark , Leigh Richard , Cockcroft Donald W. , Davis Beth E. , Mayers Irvin , Boulet Louis-Philippe , Al-Sajee Dhuha , Salter Brittany M. , Cusack Ruth P. , Ho Terence , Whetstone Christiane E. , Alsaji Nadia , Satia Imran , Killian Kieran J. , Mitchell Patrick D. , Magee Iain P. , Bergeron Celine , Bhutani Mohit , Werkström Viktoria , Durżyński Tomasz , Shoemaker Kathryn , Katial Rohit K. , Jison Maria , Newbold Paul , McCrae Christopher , O'Byrne Paul M.
Published: July 2024

Background

Benralizumab induces rapid and near-complete depletion of eosinophils from blood and lung tissue. We investigated whether benralizumab could attenuate the allergen-induced late asthmatic response (LAR) in participants with allergic asthma.

Methods

Participants with allergic asthma who demonstrated increased sputum eosinophils and LAR at screening were randomised to benralizumab 30 mg or matched placebo given every 4 weeks for 8 weeks (3 doses). Allergen challenges were performed at weeks 9 and 12 when blood, sputum, bone marrow and bronchial tissue eosinophils and LAR were assessed.

Results

46 participants (mean age 30.9 years) were randomised to benralizumab (n=23) or placebo (n=23). Eosinophils were significantly reduced in the benralizumab group compared with placebo in blood at 4 weeks and sputum and bone marrow at 9 weeks after treatment initiation. At 7 h after an allergen challenge at week 9, sputum eosinophilia was significantly attenuated in the benralizumab group compared to placebo (least squares mean difference −5.81%, 95% CI −10.69– −0.94%; p=0.021); however, the LAR was not significantly different (least squares mean difference 2.54%, 95% CI 3.05–8.12%; p=0.363). Adverse events were reported for seven (30.4%) and 14 (60.9%) participants in the benralizumab and placebo groups, respectively.

Conclusion

Benralizumab administration over 8 weeks resulted in a significant attenuation of blood, bone marrow and sputum eosinophilia in participants with mild allergic asthma; however, there was no change in the LAR, suggesting that eosinophils alone are not a key component of allergen-induced bronchoconstriction.
Transcription factor 7 like 2 promotes metastasis in hepatocellular carcinoma via NEDD9-mediated activation of AKT/mTOR signaling pathway
Authors: Tang Linsong , Xu Shengjun , Wei Rongli , Fan Guanghan , Zhou Junbin , Wei Xuyong , Xu Xiao
Published: July 2024

Background

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of the digestive system, and the exact mechanism of HCC is still unclear. Transcription factor 7 like 2 (TCF7L2) plays a pivotal role in cell proliferation and stemness maintenance. However, the exact mechanism of TCF7L2 in HCC remains unclear.

Methods

Clinical samples and public databases were used to analyze the expression and prognosis of TCF7L2 in HCC. The function of TCF7L2 in HCC was studied in vitro and in vivo. ChIP and luciferase assays were used to explore the molecular mechanism of TCF7L2. The relationship between TCF7L2 and NEDD9 was verified in HCC clinical samples by tissue microarrays.

Results

The expression of TCF7L2 was upregulated in HCC, and high expression of TCF7L2 was associated with poor prognosis of HCC patients. Overexpression of TCF7L2 promoted the metastasis of HCC in vitro and in vivo, while Knockdown of TCF7L2 showed the opposite effect. Mechanically, TCF7L2 activated neural precursor cell expressed developmentally downregulated protein 9 (NEDD9) transcription by binding to the -1522/-1509 site of the NEDD9 promoter region, thereby increasing the phosphorylation levels of AKT and mTOR. The combination of TCF7L2 and NEDD9 could distinguish the survival of HCC patients.

Conclusions

This study demonstrated that TCF7L2 promotes HCC metastasis by activating AKT/mTOR pathway in a NEDD9-dependent manner, suggesting that potential of TCF7L2 and NEDD9 as prognostic markers and therapeutic targets for HCC.
Deployment Dynamic Modeling and Driving Schemes for a Ring-Truss Deployable Antenna
Authors: He Baiyan , Jia Lijun , Li Kangkang , Nie Rui , Fan Yesen , Wang Guobiao
Published: July 2024

Mesh reflector antennas are widely used in space tasks owing to their light weight, high surface accuracy, and large folding ratio. They are stowed during launch and then fully deployed in orbit to form a mesh reflector that transmits signals. Smooth deployment is essential for duty services; therefore, accurate and efficient dynamic modeling and analysis of the deployment process are essential. One major challenge is depicting time-varying resistance of the cable network and capturing the cable-truss coupling behavior during the deployment process. This paper proposes a general dynamic analysis methodology for cable-truss coupling. Considering the topological diversity and geometric nonlinearity, the cable network’s equilibrium equation is derived, and an explicit expression of the time-varying tension of the boundary cables, which provides the main resistance in truss deployment, is obtained. The deployment dynamic model is established, which considers the coupling effect between the soft cables and deployable truss. The effects of the antenna’s driving modes and parameters on the dynamic deployment performance were investigated. A scaled prototype was manufactured, and the deployment experiment was conducted to verify the accuracy of the proposed modeling method. The proposed methodology is suitable for general cable antennas with arbitrary topologies and parameters, providing theoretical guidance for the dynamic performance evaluation of antenna driving schemes.
Ultrasound-based deep learning radiomics nomogram for differentiating mass mastitis from invasive breast cancer
Authors: Wu Linyong , Li Songhua , Wu Chaojun , Wu Shaofeng , Lin Yan , Wei Dayou
Published: July 2024

Background

The purpose of this study is to develop and validate the potential value of the deep learning radiomics nomogram (DLRN) based on ultrasound to differentiate mass mastitis (MM) and invasive breast cancer (IBC).

Methods

50 cases of MM and 180 cases of IBC with ultrasound Breast Imaging Reporting and Data System 4 category were recruited (training cohort, n = 161, validation cohort, n = 69). Based on PyRadiomics and ResNet50 extractors, radiomics and deep learning features were extracted, respectively. Based on supervised machine learning methods such as logistic regression, random forest, and support vector machine, as well as unsupervised machine learning methods using K-means clustering analysis, the differences in features between MM and IBC were analyzed to develop DLRN. The performance of DLRN had been evaluated by receiver operating characteristic curve, calibration, and clinical practicality.

Results

Supervised machine learning results showed that compared with radiomics models, especially random forest models, deep learning models were better at recognizing MM and IBC. The area under the curve (AUC) of the validation cohort was 0.84, the accuracy was 0.83, the sensitivity was 0.73, and the specificity was 0.83. Compared to radiomics or deep learning models, DLRN even further improved discrimination ability (AUC of 0.90 and 0.90, accuracy of 0.83 and 0.88 for training and validation cohorts), which had better clinical benefits and good calibratability. In addition, the information heterogeneity of deep learning features in MM and IBC was validated again through unsupervised machine learning clustering analysis, indicating that MM had a unique features phenotype.

Conclusion

The DLRN developed based on radiomics and deep learning features of ultrasound images has potential clinical value in effectively distinguishing between MM and IBC. DLRN breaks through visual limitations and quantifies more image information related to MM based on computers, further utilizing machine learning to effectively utilize this information for clinical decision-making. As DLRN becomes an autonomous screening system, it will improve the recognition rate of MM in grassroots hospitals and reduce the possibility of incorrect treatment and overtreatment.
Risk factors for nonidiopathic and idiopathic facial nerve palsies: findings of a retrospective study
Authors: Kirchgässner Milena , Böhm-Gonzalez Samuel , von Fraunberg Johannes , Kleiser Benedict , Liebe Stefanie , Kessler Christoph , Sulyok Mihaly , Grimm Alexander , Marquetand Justus
Published: July 2024

Background

Idiopathic (IF) and nonidiopathic facial (NIF) nerve palsies are the most common forms of peripheral facial nerve palsies. Various risk factors for IF palsies, such as weather, have been explored, but such associations are sparse for NIF palsies, and it remains unclear whether certain diagnostic procedures, such as contrast agent-enhanced cerebral magnetic resonance imaging (cMRI), are helpful in the differential diagnosis of NIF vs. IF.

Methods

In this retrospective, monocentric study over a five-year period, the medical reports of 343 patients with peripheral facial nerve palsy were analysed based on aetiology, sociodemographic factors, cardiovascular risk factors, consultation time, diagnostic procedures such as cMRI, and laboratory results. We also investigated whether weather conditions and German Google Trends data were associated with the occurrence of NIF. To assess the importance of doctors’ clinical opinions, the documented anamneses and clinical examination reports were presented and rated in a blinded fashion by five neurology residents to assess the likelihood of NIF.

Results

A total of 254 patients (74%) had IF, and 89 patients (26%) had NIF. The most common aetiology among the NIF patients was the varicella zoster virus (VZV, 45%). Among the factors analysed, efflorescence (odds ratio (OR) 17.3) and rater agreement (OR 5.3) had the highest associations with NIF. The day of consultation (Friday, OR 3.6) and the cMRI findings of contrast enhancement of the facial nerve (OR 2.3) were also risk factors associated with NIF. In contrast, the local weather, Google Trends data, and cardiovascular risk factors were not associated with NIF.

Conclusion

The findings of this retrospective study highlight the importance of patient history and careful inspections to identify skin lesions for the differential diagnosis of acute facial nerve palsy. Special caution is advised for hospital physicians during the tick season, as a surge in NIF cases can lead to a concomitant increase in IF cases, making it challenging to choose adequate diagnostic methods.
Delivery and postnatal care among women in 71 low- and middle-income countries: analyzing coverage gaps using household surveys
Authors: Wilson Emily B. , Niehaus Lori , Jiwani Safia S. , Hazel Elizabeth A. , Maïga Abdoulaye , Amouzou Agbessi
Published: July 2024

Background

High levels of maternal morbidity and mortality persist in low- and middle-income countries, despite increases in coverage of facility delivery and skilled assistance at delivery. We compared levels of facility birth to a summary delivery care measure and quantified gaps.

Methods

We approximated a delivery care score from type of delivery (home, lower-level facility, or hospital), skilled attendant at delivery, a stay of 24-or-more-hours after delivery, and a health check within 48-h after delivery. Data were obtained from 333,316 women aged 15–49 who had a live birth in the previous 2 years, and from 71 countries with nationally representative surveys between 2013 and 2020. We computed facility delivery and delivery care coverage estimates to assess the gap. We stratified the analysis by country characteristics, including the national maternal mortality ratio (MMR), to assess the size of coverage gaps, and we assessed missed opportunities through coverage cascades. We looked at the association between MMR and delivery care coverage.

Results

Delivery care coverage varied by country, ranging from 24% in Sudan to 100% in Cuba. Median coverage was 70% with an interquartile range of 30 percentage points (55% and 85%). The cascade showed that while 76% of women delivered in a facility, only 41% received all four interventions. Coverage gaps exist across all MMR levels. Gaps between highest and lowest wealth quintiles were greatest in countries with MMR levels of 100 or higher, and the gap narrowed in countries with MMR levels below 100. The delivery care indicator had a negative association with MMR.

Conclusions

In addition to providing high-quality evidenced-based care to women during birth and the postpartum period, there is also a need to address gaps in delivery care, which occur within and between countries, wealth quintiles, and MMR phases.
Clusters of long COVID among patients hospitalized for COVID-19 in New York City
Authors: Venkatraman Sara , Salinero Jesus Maria Gomez , Scheinfeld Adina , Houghton Sean , Redmond David , Safford Monika , Rajan Mangala
Published: July 2024

Background

Recent studies have demonstrated that individuals hospitalized due to COVID-19 can be affected by “long-COVID” symptoms for as long as one year after discharge.

Objectives

Our study objective is to identify data-driven clusters of patients using a novel, unsupervised machine learning technique.

Methods

The study uses data from 437 patients hospitalized in New York City between March 3rd and May 15th of 2020. The data used was abstracted from medical records and collected from a follow-up survey for up to one-year post-hospitalization. Hospitalization data included demographics, comorbidities, and in-hospital complications. The survey collected long-COVID symptoms, and information on general health, social isolation, and loneliness. To perform the analysis, we created a graph by projecting the data onto eight principal components (PCs) and running the K-nearest neighbors algorithm. We then used Louvain’s algorithm to partition this graph into non-overlapping clusters.

Results

The cluster analysis produced four clusters with distinct health and social connectivity patterns. The first cluster (n = 141) consisted of patients with both long-COVID neurological symptoms (74%) and social isolation/loneliness. The second cluster (n = 137) consisted of healthy patients who were also more socially connected and not lonely. The third cluster (n = 96) contained patients with neurological symptoms who were socially connected but lonely, and the fourth cluster (n = 63) consisted entirely of patients who had traumatic COVID hospitalization, were intubated, suffered symptoms, but were socially connected and experienced recovery.

Conclusion

The cluster analysis identified social isolation and loneliness as important features associated with long-COVID symptoms and recovery after hospitalization. It also confirms that social isolation and loneliness, though connected, are not necessarily the same. Physicians need to be aware of how social characteristics relate to long-COVID and patient’s ability to cope with the resulting symptoms.
Cost of cardiovascular disease events in patients with and without type 2 diabetes and factors influencing cost: a retrospective cohort study
Authors: Puteh Sharifa Ezat Wan , Kamarudin Noor ‘Adilah , Hussein Zanariah , Adam Noorlita , Shahari Mohd Ridzwan
Published: July 2024

Background

Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are non-communicable diseases that impose a significant economic burden on healthcare systems, particularly in low- and middle-income countries. The purpose of this study was to evaluate the hospital treatment cost for cardiovascular disease events (CVDEs) in patients with and without diabetes and identify factors influencing cost.

Method

We conducted a retrospective, cross-sectional study using administrative data from three public tertiary hospitals in Malaysia. Data for hospital admissions between 1 March 2019 and 1 March 2020 with International Classification of Diseases 10th Revision (ICD-10) codes for acute myocardial infarction (MI), ischaemic heart disease (IHD), hypertensive heart disease, stroke, heart failure, cardiomyopathy, and peripheral vascular disease (PVD) were retrieved from the Malaysian Disease Related Group (Malaysian DRG) Casemix System. Patients were stratified by T2DM status for analyses. Multivariate logistic regression was used to identify factors influencing treatment costs.

Results

Of the 1,183 patients in our study cohort, approximately 60.4% had T2DM. The most common CVDE was acute MI (25.6%), followed by IHD (25.3%), hypertensive heart disease (18.9%), stroke (12.9%), heart failure (9.4%), cardiomyopathy (5.7%) and PVD (2.1%). Nearly two-thirds (62.4%) of the patients had at least one cardiovascular risk factor, with hypertension being the most prevalent (60.4%). The treatment cost for all CVDEs was RM 4.8 million and RM 3.7 million in the T2DM and non-T2DM group, respectively. IHD incurred the largest cost in both groups, constituting 30.0% and 50.0% of the total CVDE treatment cost for patients with and without T2DM, respectively. Predictors of high treatment cost included male gender, non-minority ethnicity, IHD diagnosis and moderate-to-high severity level.

Conclusion

This study provides real-world cost estimates for CVDE hospitalisation and quantifies the combined burden of two major non-communicable disease categories at the public health provider level. Our results confirm that CVDs are associated with substantial health utilisation in both T2DM and non-T2DM patients.
Acceptance of euthanasia by students of selected study disciplines at universities in Lublin, Poland
Authors: Lachowski Stanisław , Lachowska Bogusława , Florek-Łuszczki Magdalena
Published: July 2024

Background

In the context of discussions between supporters and opponents of euthanasia, and legal regulations regarding this type of practices, the attitude of young people with respect to this phenomenon is a very interesting issue. According to Polish law, euthanasia is prohibited. The aim of this study was to determine the degree of acceptance of euthanasia among students from Polish universities across three different fields of study: psychology, medicine, and economic-technical disciplines, and to identify the factors associated with the acceptance of this phenomenon.

Methods

The study included 627 persons studying in Lublin, Poland: medicine (280), psychology (170), and economic-technical studies (177). The study was conducted as a survey using questionnaire containing items concerning students’ attitudes towards euthanasia. The analysis of the collected data was conducted using the SPSS software (version 29) with the following methods: Chi2, Student’s t-test, Phi test, Cramer’s V test, Kolmogorov-Smirnov test, one-way ANOVA with Dunnett’s post hoc test, linear regression analysis, and categorical regression analysis using optimal scaling (CATREG).

Results

Nearly half of the students participating in the study (45.9%) rated the practice of euthanasia as decidedly negative. The highest number of strongly negative evaluations was found among psychology students, and the least among students of economic-technical disciplines. The level of acceptance of euthanasia is significantly associated with religious involvement and studying psychology. Being religious and being a psychology student both contribute to lower acceptance of euthanasia and a lower willingness to consent to euthanasia. Consent to euthanasia is more commonly declared by individuals with experience of living with elderly people.

Conclusions

Although nearly half of the respondents expressed a negative attitude towards euthanasia, considering the secularization process among Polish youth, it can be assumed that the level of acceptance of euthanasia in this social group will increase. The lower level of acceptance of euthanasia among psychology and medical students compared to students of economic-technical disciplines suggests that the curricula of these studies present alternative solutions to the problems of terminally ill patients other than euthanasia.