bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconfigurable local-resonance elastic waveguides in piezoelectric phononic crystals plate
Authors: Sun Xiao-Wei , Xu Gang-Gang , Li Ren-Sheng , Tan Mao-Ting , Gao Xing-Lin , Sun Wei-Bin
Published: February 2024

A local-resonance piezoelectric phononic crystal consisting of a quadrangular prism piezoelectric scatterer polarized along the z-axis and wrapped by a plexiglass layer is proposed in this work. The short-circuit external electrical boundary condition is selectively added to the upper and lower surfaces of the piezoelectric scatterer to tune the distribution of polarized charges generated by the localized vibration modes. The band structures of the unit cell are calculated using the finite element method, where the upper boundary of the second complete bandgap is replaced by a passband of type of quadrupole local resonance mode. This passband lies entirely in the second bandgap under the open-circuit external electrical condition. The results of the band structures are verified by the transmission loss of the semi-infinite structure in the frequency domain. Two piezoelectric waveguides with complex paths are designed, showing that elastic waves propagate completely along the given waveguide paths at a particular frequency range. The proposed phononic crystals without additional circuit elements can be assembled into waveguides with arbitrary reconfigurable paths, transmitting elastic waves.
A Resource-Acquisition Perspective: Examining the Effects of Downsizing on Work-Related Relationships and Performance
Authors: Moore Ozias A. , Susskind Alex M. , Margolin Drew , Hanna Andrew A.
Published: February 2024

Today’s corporations increasingly use downsizing as a change strategy to improve organizational performance. Although downsizing and employee networks have garnered attention from both scholars and practitioners, few studies have investigated the influence of downsizing on the temporal dynamics of communication networks among surviving employees or how changes in communication patterns in organizations affect performance. To study how downsizing affects layoff survivors—extending Conservation of Resources theory to longitudinal network and employee-performance data—we examine the impact of downsizing on both the behavioral and structural consequences in an organizational network and test whether temporal changes in network members’ degree centrality predict how employees who survive a downsizing event perform in their jobs. Results indicate that, during the period immediately following a downsizing event, survivors’ new tie-seeking behavior results in gains in degree centrality when compared with degree centrality before the downsizing or after organization routines stabilize. Moreover, survivors with lower pre-downsizing degree centrality achieved greater gains in degree centrality than those with higher degree centrality. We find that substantial gains in degree centrality are positively related to post-downsizing performance. Efforts to regain degree centrality are abandoned during the stabilization period, and changes in degree centrality are no longer positively related to post-downsizing performance. Our results demonstrate that dynamic changes in degree centrality during disruption and stabilization periods following a downsizing event have differential effects on work-related relationships and performance. We discuss the theoretical and managerial implications of these results and suggest future research directions.
MMP12 is a Potential Predictive and Prognostic Biomarker of Various Cancers Including Lung Adenocarcinoma
Authors: Li Guo-Sheng , Tang Yu-Xing , Zhang Wei , Li Jian-Di , Huang He-Qing , Liu Jun , Fu Zong-Wang , He Rong-Quan , Kong Jin-Liang , Zhou Hua-Fu , Chen Gang
Published: February 2024

Objective

This study sought to explore the clinical value of matrix metalloproteinases 12 ( MMP12) in multiple cancers, including lung adenocarcinoma (LUAD).

Methods

Using >10,000 samples, this retrospective study demonstrated the first pan-cancer analysis of MMP12. The expression of MMP12 between cancer groups and their control groups was analyzed using Wilcoxon rank-sum tests. The clinical significance of MMP12 expression in multiple cancers was assessed using receiver operating characteristic curves, Kaplan–Meier curves, and univariate Cox analysis. A further LUAD-related analysis based on 4565 multi-center and in-house samples was performed to verify the findings regarding MMP12 in pan-cancer analysis partly.

Results

MMP12 mRNA is highly expressed in 13 cancers compared to their controls, and the MMP12 protein level is elevated in some of these cancers (e.g., colon adenocarcinoma) ( P < .05). MMP12 expression makes it feasible to distinguish 21 cancer tissues from normal tissues (AUC = 0.86). A high MMP12 expression is a prognosis risk factor in eight cancers, such as adrenocortical carcinoma (hazard ratio >1, P < .05). The elevated MMP12 expression is also a prognosis protective factor in breast-invasive carcinoma and colon adenocarcinoma (hazard ratio <1, P < .05). Some pan-cancer findings regarding MMP12 are verified in LUAD—MMP12 expression is upregulated in LUAD at both the mRNA and protein levels ( P < .05), has the potential to distinguish LUAD with considerable accuracy (AUC = .91), and plays a risk prognosis factor for patients with the disease ( P < .05).

Conclusions

MMP12 is highly expressed in most cancers and may serve as a novel biomarker for the prediction and prognosis of numerous cancers.
Regulation, Automated Technologies, and Competitiveness in the Hospitality Industry
Authors: Webster Craig , Cain Lisa
Published: February 2024

This conceptual paper examines the interplay between Porter’s Diamond, the role of government, and varying political ideologies on automated technology regulation in the global hospitality industry. The way in which these factors influence a global organization’s ability to achieve competitive advantage through the use of technology are examined. Specifically, mercantilist, liberal, social democratic, and communist ideologies are explored in relation to how they support or dissuade regulation, and their respective and collective impacts on competition. Additionally, the sources of government regulation, including global, bloc, country-level, and sub-country levels are discussed in relation to automated technology regulations. Ultimately, this study offers suggestions for competition as a result of existing and potential automated technology regulations for the hospitality industry, and suggests areas of study and questions for further consideration.
Small-Incision new generation implantable miniature telescope surgical technique and patient outcomes
Authors: Romano Mario R. , Sorrentino Tania , Allegrini Davide , Tripepi Domenico , Stradiotto Elisa , Raimondi Raffaele
Published: February 2024

Background

Various ocular implants were suggested as a means of enhancing vision in patients with advanced age related macular degeneration. Recently, a new generation of implantable telescopes has been released. The purpose of this study is to report the surgical technique of implantation along with patient outcomes.

Methods

This work focuses on the surgical technique. Crucial surgical steps are carefully reported along with discussion on main drawbacks and limitations.

Results

This approach uses a preloaded delivery system with improved features and requires a smaller incision. First patient outcomes are also reported.

Conclusions

Surgical steps to implant this preloaded intraocular telescope are easier than previous versions, however this remains a complex procedure. Initial patient functional outcomes look promising.
Dissemination in time as a requirement for diagnosis of multiple sclerosis: Time for a change?
Authors: Miller Aaron E
Published: February 2024

The requirement to demonstrate dissemination in time (DIT) in order to diagnose multiple sclerosis (MS) has been enshrined in the literature since earliest efforts to establish diagnostic critera. However, various diagnostic criteria over the years, including the 2017 McDonald criteria, have inconsistently utilized this concept. This Viewpoint contends that current criteria for DIT are inadequate and sometimes inappropriate. It recommends continuing to consider DIT in the diagnosis of MS, but advocates utilizing all available information with high specificity for the disease, including the presence of large numbers of typical lesions, to make the diagnosis. This approach enables early initiation of disease-modifying treatment in situations with a favorable risk-benefit ratio.
Application of covariance statistical method for damage identification on railway truss bridge using acceleration response: experimental and numerical validation
Authors: Faridi Md. Arif , Roy Koushik , Singhal Vaibhav
Published: February 2024

This paper presents a novel statistical analysis-based approach to non-parametric damage detection in truss bridges. The method utilizes the normalized acceleration response time histories (NARTHs) of a bridge under random excitation. The coefficients of variation matrices are calculated using NARTHs for the truss bridge in both its baseline and damaged states. The results are shown as the difference in covariance matrices (DCMs) between the two conditions (pristine and damaged). The row or column-wise summation of the DCM matrix yields a summation of the difference in covariance matrix (SDCM) bar plot having one distinct peak for the damaged member. The location and relative severity of the damage can be determined by examining the DCM matrix and the SDCM bar plot. The variation in magnitude of the coefficients demonstrates the relative severity of damage. Experimental investigation of the proposed method for detecting damage on the truss bridge shows promising results. The approach is then numerically validated using a finite element model of a truss bridge. The proposed method effectively identified, located, and evaluated damage, even when the acceleration time histories are contaminated with noise. The case of multiple-member damage detection in the truss structure is further investigated in the study. The early detection of damage and monitoring of its progression through this method can assist in creating efficient maintenance strategies for truss bridge infrastructure.
Nursing students’ lived experiences of temporality in dementia care: A phenomenological study
Authors: Kulla Gunilla , Sarvimäki Anneli
Published: February 2024

Temporality, i.e. the concept of lived time, is important for understanding and encountering older individuals with dementia. Lived time is, however, sparsely studied among nurses when it comes to caring for people with dementia. This also seems to be the case with nursing students. We are not aware of any studies on the topic that have been conducted with nursing students. Thus, the aim of the present study was to answer the research question of what lived time is about when nursing students are caring for older persons with dementia in a nursing home. A phenomenological design inspired by van Manen's hermeneutical phenomenological approach was employed to analyse 11 interviews with seven nursing students. The study was reported in accordance with the COREQ checklist. Three themes were obtained: ‘the meaning of the older person's past in the present’, ‘moments of connectedness’ and ‘living in different temporalities – when time dimensions collide’. This study has practical implications for the care of older individuals with dementia. The findings suggest seeing older people with dementia living their time in the past and the present. The future, however, requires more attention in nursing. The meaning of the various moments illuminating lived time between the students and the older individuals with dementia is further discussed.
Primary Care and Community-Based Partnerships to Enhance HPV Vaccine Delivery
Authors: Carney Patricia A. , Engstrom Marie B. , Barnes Chrystal , Ramalingam NithyaPriya , Dickinson Caitlin , Cox Cort , Ferrara Laura K. , Darden Paul M. , Fagnan Lyle J. , Marino Miguel , Hatch Brigit A.
Published: February 2024

Introduction/Objectives:

With growing vaccination misinformation and mistrust, strategies to improve vaccination communication across community-based settings are needed.

Methods:

The Rural Adolescent Vaccine Enterprise (RAVE), a 5-year (2018-2022) stepped-wedge cluster randomized study, tested a clinic-based practice facilitation intervention designed to improve HPV vaccination. An exploratory aim sought to explore the use of partnerships between primary care clinics and a community partner of their choosing, to implement a social marketing campaign related to HPV immunization. We assessed perceptions about the value and success of the partnership, and barriers and facilitators to its implementation using a 29-item community partner survey, key informant interviews, and field notes from practice facilitators.

Results:

Of the initial 45 clinics participating in RAVE, 9 were unable to either start or complete the study, and 36 participants (80.0%) were actively engaged. Of these, 16/36 clinics (44.4%) reported establishing successful partnerships, 10 reported attempting to develop partnerships (27.8%), and another 10 reported not developing a partnership (27.8%), which were often caused by the COVID-19 pandemic. The most common partnership was with public health departments at 27.3%. Other partnerships involved libraries, school districts, and local businesses. More than half (63.7%) reported that creating messages regarding getting HPV vaccination was moderately to very challenging. Just under half reported (45.5%) that messaging was hard because of a lack of understanding about the seriousness of diseases caused by HPV, parents being against vaccines because of safety concerns, and religious values that result in a lack of openness to HPV vaccines. Community partners’ health priorities changed as a result of RAVE, with 80% prioritizing childhood immunizations as a result of the RAVE partnership.

Conclusions:

Community groups want to partner with primary care organizations to serve their patients and populations. More research is needed on how best to bring these groups together.
Analysis of the Past, Present and the Future of International Student Mobility: A Retrospective Review
Authors: Khamisu Muhammad Sani , Paluri Ratna Achuta , Sonwaney Vandana
Published: February 2024

Globalization has led academics to realize the value of broadening classrooms beyond the typical school atmosphere to a place where students can engage in cross-cultural interaction. Despite being discussed in academic literature since the nineteenth century, international student mobility (ISM) did not become prominent until 2003. However, it has emerged as a global phenomenon throughout the last few decades. The present research aims to illustrate the broad patterns and developments in the relevant literature during the past six decades of ISM research. This review is a hybrid form of systematic literature review as it employs a dual approach to address its research questions, i.e., bibliometric and thematic analysis. The present study analysed 1,497 ISM article publications in 867 Scopus-indexed journals from 1964 to 2023. In doing this, the ‘Scientific Procedures and Rationales for Systematic Literature Reviews’ (SPAR-4-SLR) protocol is followed. The findings present a retrospective description of the ISM literature by spotting the key contributors in authorship, articles, journals and countries alongside the past, present and future research patterns. Although the field is not completely novel, surprisingly, the bibliometric analysis technique has not been efficiently used in past ISM studies. By addressing the gaps found in the few past reviews, this article thoroughly describes ISM’s knowledge foundation, production and future direction.
Prevalence of chronic kidney disease in Tunisian diabetics: the TUN-CKDD survey
Authors: Labidi Jannet , Harzallah Amel , Kaab Badereddine Ben , Mami Ikram , Agrebi Sahar , Azzabi Awatef , Chargui Soumaya , Hadj-Brahim Mayssa , Hammouda Mouna , Azaiez Saifeddine , Tlili Syrine , Lajili Olfa , Antit Hela , Hasni Yosra , Chenik Sarra , Chelbi Farhat , Rais Lamia , Skhiri Habib
Published: February 2024

Background

In Tunisia, the prevalence of diabetes mellitus increased from 15.5% on 2016 to 23% by 2023. While Chronic Kidney Disease (CKD) stills the most dreaded complications of diabetes, studies on the prevalence of chronic kidney disease non-dialysis diet are scarce. The aim of this study was to assess the prevalence of chronic kidney disease among the Tunisian diabetic population based on investigators’ specialty, demographic criteria (gender, age, duration of diabetes and geographic distribution) and diagnosis criteria (albuminuria and/or eGFR).

Methods

This observational, multicentric, and cross-sectional study enrolled all diabetic subjects from all regions of Tunisia with at least 3 months of follow-up before the inclusion date, from 09 January to 08 February 2023. CKD diagnosis was established based on the KDIGO guidelines. The study was carried out at medical departments and ambulatory clinics of different healthcare providers. Baseline data were collected by investigators using an electronic case report form (eCRF). Continuous variables were described by means, median, standard deviation, and quartiles. Categorical data were tabulated in frequencies and percentages.

Results

The overall prevalence of CKD among the 10,145 enrolled patients with diabetes mellitus was 38.7% with a 95%CI [37.8-39.6%]. 50.9% were male, with a mean age of 67.5 (± 11.3) years. The mean diabetes duration was 16.1 years (± 8.9). The highest CKD prevalence was noted among nephrologists (82.2%), while it was similar between the cardiologists and the primary care physicians (30.0%). CKD prevalence was highest among males (43.0% versus 35.1%) and increased proportionally with patients’ age and diabetes duration. CKD was more frequent in the Mid-East Area when compared to other regions (49.9% versus 25.3 to 40.1% in other regions). Albuminuria was present within 6.6% of subjects with CKD, and it was found an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² within 13.3% of subjects wit h CKD. 18.9% had both criteria.

Conclusions

In Tunisia, CKD among diabetics had a prevalence of 38.7%, approaching European prevalence. The prevalence discrepancy worldwide of CKD can be improved with a larger population size and by implementing standardized practices.
Exploring medical students’ perceptions of individual and group-based clinical reasoning with virtual patients: a qualitative study
Authors: Gonullu Ipek , Bayazit Alper , Erden Sengul
Published: February 2024

Background

Virtual Patients are computer-based simulations used to teach and evaluate patient interviews, medical diagnoses, and treatment of medical conditions. It helps develop clinical reasoning skills, especially in undergraduate medical education. This study aimed to and investigate the medical students’ perceptions of individual and group-based clinical reasoning and decision-making processes by using Virtual Patients.

Methods

The study group comprised 24 third-year medical students. Body Interact®software was utilized as a VP tool. The students’ readiness and the courses’ learning goals were considered when choosing the scenarios. Semi-structured interview forms were employed for data collection. MAXQDA 2020 qualitative analysis software was used to analyze the data. The students’ written answers were analyzed using content analysis.

Results

The participants perceived individual applications as beneficial when making clinical decisions with Virtual Patients, but they suggested that group-based applications used with the same cases immediately following individual applications were a more appropriate decision-making method. The results indicated that students learn to make decisions through trial and error, based on software scoring priorities, or using clinical reasoning protocols.

Conclusion

In group-based reasoning, the discussion-conciliation technique is utilized. The students stated that the individual decision-making was advantageous because it provided students with the freedom to make choices and the opportunity for self-evaluation. On the other hand, they stated that the group based decision-making process activated their prior knowledge, assisted in understanding misconceptions, and promoted information retention. Medical educators need to determine the most appropriate method when using Virtual Patients, which can be structured as individual and/or group applications depending on the competency sought.
Development and evaluation of virtual simulation games to increase the confidence and self-efficacy of healthcare learners in vaccine communication, advocacy, and promotion
Authors: Doucette Emily J. , Fullerton Madison M. , Pateman Margaret , Lip Alyssa , Houle Sherilyn K. D. , Kellner James D. , Leal Jenine , MacDonald Shannon E. , McNeil Deborah , Tyerman Jane , Luctkar-Flude Marian , Davidson Sandra , Constantinescu Cora
Published: February 2024

Background

Although healthcare providers (HCPs) are the most trusted source of vaccine information, there is a paucity of easily accessible, multidisciplinary educational tools on vaccine communication for them. Virtual simulation games (VSGs) are innovative yet accessible and effective tools in healthcare education. The objectives of our study were to develop VSGs to increase HCP confidence and self-efficacy in vaccine communication, advocacy, and promotion, and evaluate the VSGs’ effectiveness using a pre-post self-assessment pilot study.

Methods

A multidisciplinary team of experts in medicine, nursing, pharmacy, and simulation development created three VSGs for HCP learners focused on addressing conversations with vaccine hesitant individuals. We evaluated the VSGs with 24 nursing students, 30 pharmacy students, and 18 medical residents who completed surveys and 6-point Likert scale pre-post self-assessments to measure changes in their confidence and self-efficacy.

Results

There were no significant differences in baseline confidence and self-efficacy across the three HCP disciplines, despite varied levels of education. Post-VSG confidence and self-efficacy (median: 5) were significantly higher than pre-VSG (median: 4–5) for all three HCP disciplines (P ≤ 0.0005), highlighting the effectiveness of the VSGs. Medical residents reported significantly lower post-VSG confidence and self-efficacy than nursing and pharmacy learners despite completing the most significant amount of education.

Conclusions

Following the completion of the VSGs, learners in medicine, nursing, and pharmacy showed significant improvement in their self-assessed confidence and self-efficacy in holding vaccine conversations. The VSGs as an educational tool, in combination with existing clinical immunization training, can be used to increase HCP confidence and engagement in vaccine discussions with patients, which may ultimately lead to increased vaccine confidence among patients.
Assessment and evaluation of online education and virtual simulation technology in dental education: a cross-sectional survey
Authors: Fu Yu , Chu Fengqing , Lu Xiaoqing , Wang Chenxing , Xiao Na , Jiang Jiajia , Zheng Jue , Jiang Hongbing
Published: February 2024

Background

The global outbreak of coronavirus disease (COVID-19) has led medical universities in China to conduct online teaching. This study aimed to assess the effectiveness of a blended learning approach that combines online teaching and virtual reality technology in dental education and to evaluate the acceptance of the blended learning approach among dental teachers and students.

Methods

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed in this study. A total of 157 students’ perspectives on online and virtual reality technology education and 54 teachers’ opinions on online teaching were collected via questionnaires. Additionally, 101 students in the 2015-year group received the traditional teaching method (TT group), while 97 students in the 2017-year group received blended learning combining online teaching and virtual reality technology (BL group). The graduation examination results of students in the two groups were compared.

Results

The questionnaire results showed that most students were satisfied with the online course and the virtual simulation platform teaching, while teachers held conservative and neutral attitudes toward online teaching. Although the theoretical score of the BL group on the final exam was greater than that of the TT group, there was no significant difference between the two groups (P = 0.805). The skill operation score of the BL group on the final exam was significantly lower than that of the TT group (P = 0.004). The overall score of the BL group was lower than that of the TT group (P = 0.018), but the difference was not statistically significant (P = 0.112).

Conclusions

The blended learning approach combining online teaching and virtual reality technology plays a positive role in students’ learning and is useful and effective in dental education.
Assessment of advanced paediatric dentistry education programmes in Egypt: a survey of programme directors
Authors: Yassa MK , Khattab NM
Published: February 2024

Background

Advanced paediatric dentistry education programmes (APDEPs) should follow specific standards to produce competent specialists. The current study assessed APDEPs in Egypt via an online questionnaire to programme directors.

Subjects and methods

An online questionnaire was distributed to the directors of fully operational degree-granting APDEPs in Egypt in June 2023. The survey instrument was based on the Accreditation Standards for Advanced Dental Education Programmes in Paediatric Dentistry developed by the Commission on Dental Accreditation (CODA).

Results

Directors of the sixteen fully operational APDEPs answered the questionnaire giving a 100% response rate. APDEPs, in Egypt, varied regarding the adequacy of teaching staff, facilities and resources, didactic instruction, clinical requirements, and research activities.

Conclusion

The current survey provides information about the strengths and weaknesses of fully operational degree-granting APDEPs in Egypt. This information can help maintain and improve the quality of these programmes.
Altered gut mycobiome in patients with end-stage renal disease and its correlations with serum and fecal metabolomes
Authors: Ren Yi , Chen Lei , Guo Ruochun , Ma Shiyang , Li Shenghui , Zhang Yue , Jiang Hongli , Shi Haitao , Zhang Pan
Published: February 2024

Background

The relationship between the gut mycobiome and end-stage renal disease (ESRD) remains largely unexplored.

Methods

In this study, we compared the gut fungal populations of 223 ESRD patients and 69 healthy controls (HCs) based on shotgun metagenomic sequencing data, and analyzed their associations with host serum and fecal metabolites.

Results

Our findings revealed that ESRD patients had a higher diversity in the gut mycobiome compared to HCs. Dysbiosis of the gut mycobiome in ESRD patients was characterized by a decrease of Saccharomyces cerevisiae and an increase in various opportunistic pathogens, such as Aspergillus fumigatus, Cladophialophora immunda, Exophiala spinifera, Hortaea werneckii, Trichophyton rubrum, and others. Through multi-omics analysis, we observed a substantial contribution of the gut mycobiome to host serum and fecal metabolomes. The opportunistic pathogens enriched in ESRD patients were frequently and positively correlated with the levels of creatinine, homocysteine, and phenylacetylglycine in the serum. The populations of Saccharomyces, including the HC-enriched Saccharomyces cerevisiae, were frequently and negatively correlated with the levels of various toxic metabolites in the feces.

Conclusions

Our results provided a comprehensive understanding of the associations between the gut mycobiome and the development of ESRD, which had important implications for guiding future therapeutic studies in this field.
SKP alleviates the ferroptosis in diabetic kidney disease through suppression of HIF-1α/HO-1 pathway based on network pharmacology analysis and experimental validation
Authors: Yan Yangtian , Yuan Ningning , Chen Yuchi , Ma Yun , Chen Ali , Wang Fujing , Yan Shihua , He Zhuo’en , He Jinyue , Zhang Chi , Wang Hao , Wang Mingqing , Diao Jianxin , Xiao Wei
Published: February 2024

Background

Diabetic kidney disease (DKD) represents a microvascular complication of diabetes mellitus. Shenkang Pills (SKP), a traditional Chinese medicine formula, has been widely used in the treatment of DKD and has obvious antioxidant effect. Ferroptosis, a novel mode of cell death due to iron overload, has been shown to be associated with DKD. Nevertheless, the precise effects and underlying mechanisms of SKP on ferroptosis in diabetic kidney disease remain unclear.

Methods

The active components of SKP were retrieved from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database. Protein–protein interaction (PPI) network and Herb-ingredient-targets gene network were constructed using Cytoscape. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted utilizing the Metascape system database. Additionally, an in vivo model of DKD induced by Streptozotocin (STZ) was established to further investigate and validate the possible mechanisms underlying the effectiveness of SKP.

Results

We retrieved 56 compounds and identified 223 targets of SKP through the TCMSP database. Key targets were ascertained using PPI network analysis. By constructing a Herb-Ingredient-Targets gene network, we isolated the primary active components in SKP that potentially counteract ferroptosis in diabetic kidney disease. KEGG pathway enrichment analysis suggested that SKP has the potential to alleviate ferroptosis through HIF signaling pathway, thereby mitigating renal injury in DKD. In animal experiments, fasting blood glucose, 24 h urine protein, urea nitrogen and serum creatine were measured. The results showed that SKP could improve DKD. Results from animal experiments were also confirmed the efficacy of SKP in alleviating renal fibrosis, oxidative stress and ferroptosis in DKD mice. These effects were accompanied by the significant reductions in renal tissue expression of HIF-1α and HO-1 proteins. The mRNA and immunohistochemistry results were the same as above.

Conclusions

SKP potentially mitigating renal injury in DKD by subduing ferroptosis through the intricacies of the HIF-1α/HO-1 signaling pathway.
Clinical efficacy of metformin in familial adenomatous polyposis and the effect of intestinal flora
Authors: Zhou Linxin , Zheng Linfu , Xu Binbin , Ye Zhou , Li Dazhou , Wang Wen
Published: February 2024

Background and aims

Metformin has been reported to inhibit the occurrence and development of colorectal cancer (CRC) by mediating changes in intestinal flora. Studies have also indicated that the occurence of familial adenomatous polyposis (FAP) may also be associated with changes in the intestinal flora. Therefore, we investigated the efficacy and safety of metformin in treating FAP and the association with intestinal flora.

Results

Compared with the baseline, the mean number and load of polyps in the areas of nanocarbon labeling and postoperative residuals in the test group were lower than those in the placebo group, while the diversity of intestinal flora species was increased. At the genus level, the relative abundance of g_Ruminococcus in the test group was lower than that at baseline, whereas the relative abundance of g_Lactobacillus was higher. These changes were statistically significant (P < 0.05).

Conclusion

One-year metformin therapy for FAP is safe and effective, potentially mediated by modulating the intestinal flora. This study provides new insights and strategies for preventing adenomatous polyp carcinogenesis in FAP and explores possible preventive action.
A pregnant woman with long-standing, retained intraabdominal glass shards who gave birth to a live infant with no complications: a case report
Authors: Inoue Kenta , Yabe Shinichiro , Kashiwabara Soichiro , Itaya Yukiko , Era Sumiko , Kikuchi Akihiko , Takai Yasushi
Published: February 2024

Background

Most cases of traumatic injury during pregnancy involve blunt trauma, with penetrating trauma being uncommonly rare. In glass shard injuries, fragments often penetrate deeply, and multiple injuries may occur simultaneously; attention must be paid to the possibility of organ injury from the residual fragments. However, no case of this occurring during pregnancy has been reported yet.

Case presentation

We present the case of a 34-year-old pregnant Cameroonian woman who retained intraabdominal glass shards following a penetrating injury at 13 weeks gestation and not diagnosed until 22 weeks gestation. Notably, this patient continued the pregnancy without complications and gave birth via cesarean section at 36 weeks gestation.

Conclusion

In pregnant women sustaining a penetrating glass trauma during pregnancy, careful attention should be paid to the fragments; in that case, computed tomography is a useful modality for accurately visualizing any remaining fragments in the body. Essentially, the foreign bodies in glass shard injuries during pregnancy should be removed immediately, but conservative management for term delivery is an important choice for patients at risk for preterm delivery.
Comparisons of oxbow lake fish assemblages in relation to bigheaded carp establishment in the lower White River, Arkansas
Authors: Eggleton Michael A. , Salzmann Cody J. , Kaiser Joseph E. , Smith Shannon C. F.
Published: February 2024

Background

Since the late 1990s, bigheaded carps (largely silver carp [Hypophthalmichthys molitrix] but also bighead carp [H. nobilis]) have established throughout the lower Mississippi River basin. Using previously studied oxbow lakes in the lower White River basin, Arkansas, we compared current (2017, “post-carp” establishment) fish assemblages to historical (2002, “pre-carp” establishment) fish assemblages. Fish assemblages were comprehensively assessed using multiple gears, including boat electrofishing, mini-fyke nets, and experimental small-mesh gill nets.

Results

T-tests suggested that fish assemblage indices of richness, diversity, evenness, and dominance were often greater (P < 0.05) during the post-carp period as reflected by boat electrofishing and experimental gill nets. However, all indices were generally similar (P > 0.05) between the pre-carp and post-carp period with fish assemblages depicted using mini-fyke nets. Nonmetric multidimensional scaling analyses indicated that fish assemblages differed structurally between pre-carp and post-carp periods. Assemblage differences were linked to both small and large abundance changes for more than 20 species. Abundances of gizzard shad (Dorosoma cepedianum), emerald shiner (Notropis atherinoides), pugnose minnow (Opsopoeodus emiliae), crappies (Pomoxis spp.), bluegill (Lepomis macrochirus), orangespotted sunfish (L. humilis), and yellow bass (Morone mississippiensis) declined between the pre-carp and post-carp periods. Conversely, abundances of weed shiner (N. texanus), pallid shiner (Hybopsis amnis), longear sunfish (L. megalotis), buffalofishes (Ictiobus spp.), and gars (Lepisosteus spp.) generally increased during the same period.

Conclusions

Although not possible to conclude assemblage shifts were entirely related to bigheaded carps due to the absence of an appropriate reference system where carps did not establish, the wide establishment of these carps is one of the most pervasive changes to have occurred in the lower White River ecosystem during the past two decades. Thus, it is probable to conclude that post-carp establishment observations from this study were at least, in part, attributable to bigheaded carp establishment. Impacts of further range expansions by bigheaded carps in the White River and other lower Mississippi River sub-basins are unclear, though this study suggests probable effects on native fish assemblages, underscoring the need for further research and monitoring.
China: legacy collieries versus renewable energy
Authors: Chu Zhaoxiang , Wang Yiming , Ji Yukun , Li Xiaozhao
Published: February 2024

The findings of the major strategic consulting project of Chinese Academy of Engineering ‘Research on the strategy of coal mine safety and abandoned mine resources development and utilization in China’ suggest that almost 13,000 discarded collieries in China will provide abundant surface lands and massive underground heritages to not only develop but also store renewable energy within the Earth’s Critical Zone, thus helping attain its net-zero energy goal.
Social determinants of health and diabetes: using a nationally representative sample to determine which social determinant of health model best predicts diabetes risk
Authors: Cooper Zach W. , Mowbray Orion , Johnson Leslie
Published: February 2024

Objectives

Social determinants of health (SDOH) research demonstrates poverty, access to healthcare, discrimination, and environmental factors influence health outcomes. Several models are commonly used to assess SDOH, yet there is limited understanding of how these models differ regarding their ability to predict the influence of social determinants on diabetes risk. This study compares the utility of four SDOH models for predicting diabetes disparities.

Study design

We utilized The National Longitudinal Study of Adolescent to Adulthood (Add Health) to compare SDOH models and their ability to predict risk of diabetes and obesity.

Methods

Previous literature has identified the World Health Organization (WHO), Healthy People, County Health Rankings, and Kaiser Family Foundation as the conventional SDOH models. We used these models to operationalize SDOH using the Add Health dataset. Add Health data were used to perform logistic regressions for HbA1c and linear regressions for body mass index (BMI).

Results

The Kaiser model accounted for the largest proportion of variance (19%) in BMI. Race/ethnicity was a consistent factor predicting BMI across models. Regarding HbA1c, the Kaiser model also accounted for the largest proportion of variance (17%). Race/ethnicity and wealth was a consistent factor predicting HbA1c across models.

Conclusion

Policy and practice interventions should consider these factors when screening for and addressing the effects of SDOH on diabetes risk. Specific SDOH models can be constructed for diabetes based on which determinants have the largest predictive value.
Rust HUBB: DNA barcode-based identification of Pucciniales
Authors: Kaishian Patricia , Layug Christopher R. K. , Anderson Mark , Berg Diane R. , Aime M. Catherine
Published: February 2024

Rust fungi (Pucciniales, Basidiomycota) are a species-rich (ca. 8000 species), globally distributed order of obligate plant pathogens. Rust species are host-specific, and as a group they cause disease on many of our most economically and/or ecologically significant plants. As such, the ability to accurately and rapidly identify these fungi is of particular interest to mycologists, botanists, agricultural scientists, farmers, quarantine officials, and associated stakeholders. However, the complexities of the rust life cycle, which may include production of up to five different spore types and alternation between two unrelated host species, have made standard identifications, especially of less-documented spore states or alternate hosts, extremely difficult. The Arthur Fungarium (PUR) at Purdue University is home to one of the most comprehensive collections of rust fungi in the world. Using material vouchered in PUR supplemented with fresh collections we generated DNA barcodes of the 28S ribosomal repeat from > 3700 rust fungal specimens. Barcoded material spans 120 genera and > 1100 species, most represented by several replicate sequences. Barcodes and associated metadata are hosted in a publicly accessible, BLAST searchable database called Rust HUBB (Herbarium-based Universal Barcode Blast) and will be continuously updated.
Two-stage surgical treatment of Stanford type B acute aortic dissection associated with aberrant right subclavian artery dissection complicated by distal arch aortic aneurysm and abdominal aortic aneurysm: a case report
Authors: Shintani Yusuke , Tobinaga Satoru , Saisho Hiroyuki , Kono Takanori , Tayama Eiki , Aoyagi Shigeaki , Yasunaga Hiroshi
Published: February 2024

Background

An aberrant right subclavian artery (ARSA) is the most common congenital variant of the aortic arch and occurs in 0.5–1.8% of the population. Most patients with ARSA remain asymptomatic; however, symptoms associated with ARSA include dysphagia, esophageal compression, and airway obstruction. Surgical intervention is indicated if the ARSA becomes symptomatic or is related to aneurysmal dilatation. Even without symptoms, it carries the risk of rupture or dissection, and aggressive surgical therapy is recommended. The coexistence of type B dissection and ARSA is relatively rare, and the cause of this anomaly is unclear; however, some authors have reported that the acute angle of the ARSA weakens the aortic wall, inducing aortic dissection. Several surgical methods, such as thoracic endovascular aortic repair (TEVAR), the frozen elephant trunk method, and open surgery, have been used to manage this lesion. Reconstruction of ARSA is challenging in any surgical procedure.

Case presentation

We present an uncommon case of coexistent type B aortic dissection and aberrant right subclavian artery (ARSA) in a 72-year-old man. Left anterolateral thoracotomy was chosen to treat the enlarged descending thoracic aortic aneurysm in this case; in situ reconstruction was difficult because the dissection involved the ARSA. Hence, preoperatively, a right common carotid artery (RCCA)-to-ARSA bypass was performed via the right supraclavicular approach, followed by thoracic descending aortic artery reconstruction. The prior RCCA-to-ARSA bypass allowed ligation of the central side of the ARSA, thereby securing a bloodless field in the distal anastomosis.

Conclusion

This lesion can be successfully repaired by open surgery with a two-stage approach: right common carotid artery-to-ARSA bypass followed by thoracic aortic replacement.
Changes in Practices After Implementation of a Patient Blood Management Program in French Surgical Departments: The National Multicenter Observational PERIOPES Study
Authors: Lasocki Sigismond , Belbachir Anissa , Mertes Paul-Michel , Le Pelley Eric , Bosch Laetitia , Bezault Clémence , Belarbia Samia , Capdevila Xavier
Published: February 2024

BACKGROUND.

Patient blood management (PBM) is an evidence-based approach recommended to improve patient outcomes. Change in practices is often challenging. We report here data from French surgical departments before and after a standardized implementation of a PBM program.

METHODS.

This was a national, multicenter, observational study in surgical centers (“expert” centers with an already established protocol for preoperative anemia or “pilot” centers). Data from consecutive surgical patients of different specialties were retrieved before and after the implementation of a PBM program. Primary outcome variables (preoperative anemia treatment rates, transfusion rates, and length of hospital stay) before and after the implementation of a PBM program were analyzed with segmented regression adjusted on confounders (American Society of Anesthesiologists [ASA] scores and centers).

RESULTS.

A total of 1618 patients (ASA physical status III and IV, 38% in the first period and 45% in the second period) were included in expert (N = 454) or pilot (N = 1164) centers during the first period (January 2017–August 2022) and 1542 (N = 440 and N = 1102, respectively) during the second period (January 2020–February 2023). After implementation of the PBM program, the rate of preoperative anemia treatment increased (odds ratio, 2.37; 95% confidence interval [CI], 1.20–4.74; P = .0136) and length of hospital stay in days decreased (estimate, −0.11; 95% CI, −0.21 to −0.02; P = .0186). Transfusion rate significantly decreased only in expert centers (odds ratio, 0.17; 95% CI, 0.03–0.88; P = .0354).

CONCLUSIONS.

PBM practices in various surgical specialties improved significantly after the implementation of a PBM program. However, too many patients with preoperative anemia remained untreated.
Permutation Entropy Does Not Track the Electroencephalogram-Related Manifestations of Paradoxical Excitation During Propofol-Induced Loss of Responsiveness: Results From a Prospective Observational Cohort Study
Authors: Ostertag Julian , Zanner Robert , Schneider Gerhard , Kreuzer Matthias
Published: February 2024

BACKGROUND:

During the anesthetic-induced loss of responsiveness (LOR), a “paradoxical excitation” with activation of β-frequencies in the electroencephalogram (EEG) can be observed. Thus, spectral parameters—as widely used in commercial anesthesia monitoring devices—may mistakenly indicate that patients are awake when they are actually losing responsiveness. Nonlinear time-domain parameters such as permutation entropy (PeEn) may analyze additional EEG information and appropriately reflect the change in cognitive state during the transition. Determining which parameters correctly track the level of anesthesia is essential for designing monitoring algorithms but may also give valuable insight regarding the signal characteristics during state transitions.

METHODS:

EEG data from 60 patients who underwent general anesthesia were extracted and analyzed around LOR. We derived the following information from the power spectrum: (i) spectral band power, (ii) the spectral edge frequency as well as 2 parameters known to be incorporated in monitoring systems, (iii) beta ratio, and (iv) spectral entropy. We also calculated (v) PeEn as a time-domain parameter. We used Friedman’s test and Bonferroni correction to track how the parameters change over time and the area under the receiver operating curve to separate the power spectra between time points.

RESULTS:

Within our patient collective, we observed a “paradoxical excitation” around the time of LOR as indicated by increasing beta-band power. Spectral edge frequency and spectral entropy values increased from 19.78 [10.25–34.18] Hz to 25.39 [22.46–30.27] Hz (P = .0122) and from 0.61 [0.54–0.75] to 0.77 [0.64–0.81] (P < .0001), respectively, before LOR, indicating a (paradoxically) higher level of high-frequency activity. PeEn and beta ratio values decrease from 0.78 [0.77–0.82] to 0.76 [0.73–0.81] (P < .0001) and from −0.74 [−1.14 to −0.09] to −2.58 [−2.83 to −1.77] (P < .0001), respectively, better reflecting the state transition into anesthesia.

CONCLUSIONS:

PeEn and beta ratio seem suitable parameters to monitor the state transition during anesthesia induction. The decreasing PeEn values suggest a reduction of signal complexity and information content, which may very well describe the clinical situation at LOR. The beta ratio mainly focuses on the loss of power in the gamma-band. PeEn, in particular, may present a single parameter capable of tracking the LOR transition without being affected by paradoxical excitation.