bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding K-12 In-service EFL Teachers’ Online Assessment Practices and Assessor Identity: A Chinese Study
Authors: Shao Siyuan
Published: December 2023

After the outbreak of the COVID-19 pandemic, distance teaching brought on unforeseen challenges around the world, including classroom-based assessment practice. However, little attention has been paid to teachers’ assessment practice and their identity as assessor in the new teaching situation. This study examines Chinese K-12 in-service EFL teachers’ assessment practice and their identity as assessor in the pandemic. Three rounds of semi-structured interviews were used to probe six in-service teachers. The findings revealed that three major online assessment practices were implemented in response to the challenges: (1) remaining unaltered in online assessment practice; (2) being proactive in formative assessment; (3) provision of online feedback. Results also showed that there were three types of assessment identity that could be identified, namely, positive negotiator, flexible facilitator and struggling follower. The findings indicated assessment practice and assessment identity reciprocally influenced each other in a new assessment context. Different identities might lead to different assessment practice with varied and mixed emotions attached to it. Moreover, varying identities interacted with each other on medicating their online assessment practice.
Perceived Justice and Customer Loyalty in the Situation of Beauty Service Failure
Authors: Choi Hyun-Kyung , Kim Sang-Soo , Kim Bum-Seok
Published: December 2023

The hair salons industry has seen many players coming into the market due to low entry barriers and thus it is getting harder to attract new customers in a highly competitive market. As a result, operators are competing more on delivering better services. Like other service businesses, hair salons understand the importance of maintaining high-quality customer service. Since it is nearly impossible to cater to all customer needs as they prefer, handling service failures effectively is considered to be vital. This study aims to examine the processes in which perceived justice of service recovery influences recovery satisfaction and thus this leads to customer loyalty. To achieve this purpose, an online survey was administered to 434 people who reside in the greater Seoul metropolitan area, South Korea, and have visited hair salons for hair care services. The results indicated that customers’ perceived service recovery justice affects satisfaction and finally contributes to customer loyalty, which reconfirms the finding of prior studies that appropriate compensation and the customer-service provider-relationship positively influence customers’ recovery satisfaction. This study also provides hair care service providers with directions on how to restore customers’ recovery justice following service failures.
Deep Learning Artificial Intelligence Tool for Automated Radiographic Determination of Posterior Tibial Slope in Patients With ACL Injury
Authors: Lu Yining , Pareek Ayoosh , Yang Linjun , Rouzrokh Pouria , Khosravi Bardia , Okoroha Kelechi R. , Krych Aaron J. , Camp Christopher L.
Published: December 2023

Background:

An increased posterior tibial slope (PTS) corresponds with an increased risk of graft failure after anterior cruciate ligament (ACL) reconstruction (ACLR). Validated methods of manual PTS measurements are subject to potential interobserver variability and can be inefficient on large datasets.

Purpose/Hypothesis:

To develop a deep learning artificial intelligence technique for automated PTS measurement from standard lateral knee radiographs. It was hypothesized that this deep learning tool would be able to measure the PTS on a high volume of radiographs expeditiously and that these measurements would be similar to previously validated manual measurements.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

A deep learning U-Net model was developed on a cohort of 300 postoperative short-leg lateral radiographs from patients who underwent ACLR to segment the tibial shaft, tibial joint surface, and tibial tuberosity. The model was trained via a random split after an 80 to 20 train-validation scheme. Masks for training images were manually segmented, and the model was trained for 400 epochs. An image processing pipeline was then deployed to annotate and measure the PTS using the predicted segmentation masks. Finally, the performance of this combined pipeline was compared with human measurements performed by 2 study personnel using a previously validated manual technique for measuring the PTS on short-leg lateral radiographs on an independent test set consisting of both pre- and postoperative images.

Results:

The U-Net semantic segmentation model achieved a mean Dice similarity coefficient of 0.885 on the validation cohort. The mean difference between the human-made and computer-vision measurements was 1.92° (σ = 2.81° [ P = .24]). Extreme disagreements between the human and machine measurements, as defined by ≥5° differences, occurred <5% of the time. The model was incorporated into a web-based digital application front-end for demonstration purposes, which can measure a single uploaded image in Portable Network Graphics format in a mean time of 5 seconds.

Conclusion:

We developed an efficient and reliable deep learning computer vision algorithm to automate the PTS measurement on short-leg lateral knee radiographs. This tool, which demonstrated good agreement with human annotations, represents an effective clinical adjunct for measuring the PTS as part of the preoperative assessment of patients with ACL injuries.
Culturally Safe Practices in the Co-creation of Medical Education Curriculum with Indigenous Animators: Outcomes From an Indigenous Learning Circle
Authors: Bessette Nicole , Reade Maurianne , McGregor Lorrilee , Berti Joahnna , Naokwegijig Bruce , Maar Marion
Published: December 2023

OBJECTIVES

To explore the experiences of Indigenous patient actors who co-created and enacted Indigenous patient scenarios in collaboration with medical school faculty. We critically examine the structures and systems in a medical school that mediate cultural safety for Indigenous patient actors. The Truth and Reconciliation Commission of Canada has called on medical schools and healthcare institutions to help address the intergenerational harms inflicted on Indigenous people by the Indian residential school (IRS) system. Institutions are striving to incorporate cultural competency, conflict resolution, human rights, and anti-racism education into their curricula. However, the structural inequities within undergraduate, postgraduate, and continuing medical education practices must be identified and challenged to ensure that medical education is authentic and culturally safe for those involved in the development and delivery of the Indigenous health curriculum. To explore potential structural inequities in the co-creation process of simulated cultural communication scenarios (SCCS), the Indigenous animators at Debajehmujig Storytellers and collaborating faculty and professional staff at the Northern Ontario School of Medicine University (NOSM U) examined cultural safety in their curriculum design and delivery process.

METHODS

We utilized the qualitative Indigenous research methodology of the Learning Circle to deconstruct the co-creation process and to explore the experience of cultural safety from the Indigenous animators’ perspective throughout the curriculum design and delivery process.

RESULTS

A framework for culturally safe co-creation practices with Indigenous people, rooted within Indigenous teachings of the Medicine Wheel, emerged from the qualitative data.

CONCLUSIONS

This framework has the potential to guide the practice of culturally safe co-creation of Indigenous patient simulations in medical education and healthcare workplace learning. While the Medicine Wheel teachings are held by specific Indigenous nations, we anticipate that the results and recommendations of this study will apply to Indigenous co-creators and academic medical educators internationally.
Disease Awareness Among Patients With Age-Related Macular Degeneration: Patterns and Predictors
Authors: Cheng Brian T. , Kim Anne B. , Lyon Alice T. , Mirza Rukhsana G.
Published: December 2023

Purpose: To examine the prevalence and predictors of patient awareness of their disease in adults with age-related macular degeneration (AMD). Methods: This study analyzed 5553 adults 40 years or older in the 2005–2008 National Health and Nutrition Examination Survey who underwent retinal imaging. AMD was determined based on retinal images. Patient awareness of their AMD was assessed by a self-reported AMD diagnosis. Multivariable logistic regression models were constructed to examine the association of patient awareness of their AMD with sociodemographic characteristics and specific AMD lesion types on retinal imaging. Results: AMD was identified in 425 of the adults surveyed (6.5%) (95% confidence interval [CI], 5.5%-7.5%), including 87.7% (95% CI, 82.9%-92.5%) with early AMD and 12.3% (95% CI, 7.5%-17.1%) with late AMD. Among adults with either type of AMD on retinal imaging, 17.5% (95% CI, 13.1%-22.0%) were aware of their disease, which included 11.6% (95% CI, 8.4%-14.9%) with early AMD and 59.2% (95% CI, 43.1%-75.3%) with late AMD ( P < .0001). In the same group, those aged 60 years or older (odds ratio [OR], 33.46; 95% CI, 7.67-146.03) and with a best-corrected visual acuity of 20/40 or worse (OR, 4.63; 95% CI, 2.95-7.26) had higher awareness of their AMD diagnosis, whereas Hispanic (OR, 0.28; 95% CI, 0.09-0.88) vs White adults and those who did not speak English at home (OR, 0.05; 95% CI, 0.01-0.41) had lower awareness of their diagnosis. Conclusions: Fewer than 1 in 5 adults with AMD were aware of their personal diagnosis, including fewer than 3 in 5 adults with late AMD. Older adults and those with worse vision were more likely to know they have AMD, whereas Hispanic adults and those who did not speak English at home were less likely. Efforts to increase patients’ awareness of their AMD may improve rates of follow-up and prevent vision loss.
Factors influencing aqueous flare after cataract surgery and its evaluation with laser flare photometry
Authors: Way Christopher , Swampillai Andrew J. , Lim Kin Sheng , Nanavaty Mayank A.
Published: December 2023

Despite the refinement of modern cataract surgery, postoperative inflammation still constitutes a substantial amount of visual morbidity worldwide. A surrogate for intraocular inflammation and blood–aqueous barrier breakdown can be objectively quantified by Laser flare photometry (LFP). This review outlines the utility of LFP in assessing the assessment of post-cataract surgery inflammation. It highlights the impact of preoperative pathological states such as uveitis and diabetes, intraoperative techniques, including efficient phacoemulsification and direct comparisons between postoperative anti-inflammatory regimes. There is a large interobserver variation in the subjective flare measurement after cataract surgery and the continued use of LFP amongst other objective, noninvasive measurements of intraocular inflammation, particularly in the further development of cataract surgery, is recommended.
The rupture of relationships: Holocaust survivors on complicit bystanders
Authors: Klein Dennis
Published: December 2023

The second half of the 20th century has seen the emergence of bystanders from the background into the center of conflict narratives. Managing conflicts increasingly refers to onlookers’ responsibilities. This article seeks to ask why: Why have bystanders become a subject of concern and debate? What hinge events have centered bystanders in conflict narratives? How did bystanders evolve into potential agents of humanity after atrocity?
Comparative Outcomes of Magnetic Sphincter Augmentation and Fundoplication in Revisional Surgery
Authors: Bell Reginald , Buckley F. Paul , Lipham John , Parajuli Subigya , Heidrick Rachel
Published: December 2023

Background:

Outcomes of laparoscopic revisional surgery involving Magnetic Sphincter Augmentation (MSA) have not been clearly delineated, whether MSA was the presenting or the revisional surgery. We compared safety and clinical outcomes of 4 main categories: fundoplication revised to fundoplication (F-F); fundoplication to MSA (F-M), MSA to fundoplication (M-F) and MSA to MSA (M-M).

Methods:

Analysis of prospective data from 10 U.S. sites participating in the Registry of Outcomes of Anti-Reflux Surgery (ROARS). Patients had undergone at least one prior procedure on the esophagogastric junction with subsequent need for revisional surgery.

Results:

Between 2/1/2005 and 1/19/23, 742 patients underwent 819 revisional surgeries, of which 645 patients had 722 surgeries in the 4 main categories. Seventy-six percent had their prior operation elsewhere. Indications for reoperation (GERD, hiatal hernia, dysphagia, gas-bloat) were similar across categories. Preoperative and intraoperative findings disclosed disruption of prior hernia repair in 80% and 97% of patients respectively. Hernia size was larger with an antecedent fundoplication (13% >5 cm, 37% 3-5 cm) compared to patients with prior MSA (1.5% >5 cm, 18% 3-5 cm ( P < .0001). Revision of fundoplication resulted in 11% intraoperative complication rate, versus 2% for MSA. Six hundred patients (73.2%) were followed a mean of 2.7 years. Subsequent operation was performed on 77 (12.7%) a mean of 2.5 years; no difference between categories. Kaplan-Meier analysis showed equivalent subsequent reoperation rates at 5 years (20% ± 5%). Similar improvements in GERD-HRQL, bloating, dysphagia scores, ability to belch or vomit were seen.

Conclusions:

Over 95% of patients had disruption of the hiatus requiring repair, though prior MSA was associated with far fewer >3 cm hernias than prior fundoplication. Patients with an antecedent MSA can be revised with similar safety and outcomes as those having an antecedent fundoplication. MSA has equivalent results to fundoplication when used as a revisional procedure post antecedent fundoplication.
An updated strong-motion database of Türkiye (SMD-TR)
Authors: Sandıkkaya M Abdullah , Güryuva Baran , Kale Özkan , Okçu Oğuz , İçen Abdullah , Yenier Emrah , Akkar Sinan
Published: December 2023

We updated the earthquake strong-motion database of Türkiye (SMD-TR) that is initially compiled by Akkar et al. The updated data set consists of of 9244 earthquakes of magnitudes 3.0 ≤ M ≤ 7.8 that occurred between 1976 and 2023. It includes 95,890 three-component waveforms recorded at 1022 stations (55,375 records that are processed from 6710 events and 974 stations). The database is disseminated under research-oriented website DesignSafe ( https://doi.org/10.17603/ds2-f21x-s189 ) and is compiled to provide ground-motion flatfile, which will be updated periodically until 2025. The released version includes events occurred in Türkiye until 28 February 2023, and hence, it comprises of the mainshocks and a great portion of aftershocks from the February 6th, 2023, Kahramanmaraş earthquakes. The database includes event metadata compiled from national and international seismological agencies as well as the literature. We classified events according to their tectonic environments (i.e. active crustal and subduction) and identified the aftershocks. The station information provided by AFAD1 was used to compute the major site parameters, including time-based average of shear-wave velocity of uppermost 30 m (VS30) and depth-to-rock horizon at which the shear-wave velocity (VS) attains 1 km/s (Z1). We also computed the finite-fault distance metrics and flagged the stations located on the hanging-wall side of the rupture, as well as identified pulse-like records. We developed an automatic processing algorithm to determine the waveform quality, apply appropriate filtercut-offs to remove low- and high-frequency noise, and compute ground-motion parameters. The automatic processing was applied to small-magnitude (M < 5.5) events, whereas manual processing scheme is preferred for waveforms recorded from larger events (M ≥ 5.5). The peak ground-motion values, spectral ordinates, and ground-motion duration are provided along with the key data processing parameters in the flatfile.
Incidence and Cause of Occupational Burnout Syndrome Among Sonographers
Authors: Tran My
Published: December 2023

Objective:

To investigate the level of occupational burnout syndrome in a cohort of sonographers and to determine any associations between sex, number of hours worked per week, and burnout.

Materials and Methods:

This study used a cross-sectional approach that replicated the Oldenburg Burnout Inventory and surveyed a convenience sample of sonographers who are members of the Society for Diagnostic Medical Sonography.

Results:

The study survey offered the total scores of occupational burnout, disengagement, and exhaustion, with a potential minimum score of 16 and a maximum score of 64. The results yielded a minimum score of 17 and a maximum score of 64. The mean score was 43.11 (SD = 7.02), indicating a moderate level of burnout.

Conclusion:

This cohort of sonographers demonstrated moderate levels of burnout, so it is important to acknowledge that preventing occupational burnout is necessary to ensure that workplace stress is managed to avoid significant issues. Further research is needed to assess how occupational burnout syndrome affects retention in the profession.
Transcranial Sonography Used as a Valuable Diagnostic Tool for Detecting a Hemoventricle, in an Intensive Care Unit Patient
Authors: Cheong Issac , Tamagnone Francisco Marcelo
Published: December 2023

A hemoventricle is a rare and life-threatening condition, characterized by blood accumulating in the brain ventricles. Computed tomography (CT) is commonly used in the diagnosis of hemoventricle. However, the use of CT is limited in the intensive care unit. This has prompted the exploration of alternative imaging techniques. Sonography offers a noninvasive, portable, and cost-effective option for assessing the ventricular system. A case study is presented of a 64-year-old female patient with a ruptured aneurysm who underwent endovascular coiling and the placement of an external ventricular drain. Point-of-care ultrasonography revealed ventricular dilatation that was associated with hyperechoic content and that was consistent with hemoventricle. The CT examination confirmed the diagnosis, and the patient received appropriate treatment. This case highlights the value of sonography as a complementary diagnostic imaging tool in situations where CT may be limited.
Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL): A Case Study
Authors: Nanni Danielle
Published: December 2023

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are slow-growing cancers that affect the immune system by disrupting the normal function of B-cells. The patient symptoms associated with CLL and SLL can be vague; therefore, many cases go undiagnosed for years. Diagnostic medical sonography is an imaging technique that can determine the abnormal appearance of lymph nodes and guide medical providers in the appropriate direction when investigating a questionable case of lymphoma. This case study presents a superficial left-neck sonogram of a 65-year-old Caucasian man complaining of left supraclavicular pain and swelling. This initial sonogram was the first phase in a sequence of examinations that led to the patient’s diagnosis of CLL/SLL.
Cord blood transplantation for adult mature lymphoid neoplasms in Europe and Japan
Authors: Watanabe Mizuki , Kanda Junya , Volt Fernanda , Ruggeri Annalisa , Suzuki Ritsuro , Rafii Hanadi , Kimura Fumihiko , Cappelli Barbara , Kondo Eisei , Scigliuolo Graziana Maria , Takahashi Satoshi , Kenzey Chantal , Rivera-Franco Monica M. , Okamoto Shinichiro , Rocha Vanderson , Chevallier Patrice , Sanz Jaime , Fürst Sabine , Cornelissen Jan , Milpied Noel , Uchida Naoyuki , Sugio Yasuhiro , Kimura Takafumi , Ichinohe Tatsuo , Fukuda Takahiro , Mohty Mohamad , Peffault de Latour Régis , Atsuta Yoshiko , Gluckman Eliane
Published: December 2023

To clarify the different characteristics and prognostic factors of cord blood transplantation (CBT) in adult patients with lymphoid neoplasms in Europe and Japan, we conducted a collaborative study. Patients aged 18-75 years receiving their first CBT (Europe: single CBT, n = 192; double CBT, n = 304; Japan: single CBT, n = 1150) in 2000-2017 were analyzed. Fewer patients with Hodgkin lymphoma (Europe vs Japan, 26% vs 5%), and older patients (≥50 years) (39% vs 59%) with a higher refined disease risk index (rDRI) (high-very high: 49% vs 14%) were included in the Japanese registry. High-very high rDRI was associated with inferior overall survival (OS) (vs low rDRI, Europe: hazard ratio [HR], 1.87; P = .001; Japan: HR, 2.34; P < .001) with higher progression/relapse risks. Total body irradiation (TBI)–containing conditioning contributed to superior OS both in Europe (vs TBI–reduced-intensity conditioning [RIC], non-TBI-RIC: HR, 1.93; P < .001; non-TBI–Myeloablative conditioning [MAC]: HR, 1.90; P = .003) and Japan (non–TBI-RIC: HR, 1.71; P < .001; non–TBI-MAC: HR 1.50, P = .007). The impact of HLA mismatches (≥2) on OS differed (Europe: HR, 1.52; P = .007; Japan: HR, 1.18; P = .107). CBT for lymphoid neoplasms, especially in those with high rDRI showed poor outcomes despite all the different characteristics in both registries. TBI should be considered in conditioning regimens to improve these outcomes. The different impacts of HLA mismatches call attention to the fundamental differences among these populations.
The modified Medical Research Council scale misclassifies exertional breathlessness among people referred for exercise testing
Authors: Gustafsson David , Elmberg Viktor , Schiöler Linus , Jensen Dennis , Ekström Magnus
Published: December 2023

Background

Exertional breathlessness is a major symptom in cardiorespiratory disease and is often assessed using the modified Medical Research Council (mMRC) questionnaire. The mMRC might underestimate exertional breathlessness in people with impaired exercise capacity who have reduced their physical activity to avoid the symptom. We aimed to evaluate the ability of mMRC to detect abnormally high exertional breathlessness or abnormally low exercise capacity during incremental cycle exercise testing (IET).

Methods

A secondary analysis of data from a randomised controlled trial of outpatients aged 18 years or older referred for IET was carried out. Participants completed the mMRC before IET. Abnormally high exertional breathlessness was defined as a breathlessness (Borg 0–10) intensity response more than the upper limit of normal. Abnormally low exercise capacity was defined using published reference equations. The sensitivity, specificity, accuracy and discriminative ability of each mMRC rating to detect each outcomewas calculated.

Results

92 participants were included; the mean age was 59 years, 61% were male, and 64% and 15% had mMRC 1 and ≥2, respectively. An mMRC ≥2 had the highest accuracy (71%) to detect abnormally high exertional breathlessness, with a specificity of 93% but a sensitivity of only 28%, failing to identify 72% of people with abnormally high exertional breathlessness. The accuracy, specificity and sensitivity for abnormally low exercise capacity was 64%, 88% and 19%, respectively.

Conclusion

Among people referred for clinical exercise testing, the mMRC dyspnoea scale misclassified exertional breathlessness and exercise capacity assessed using cycle IET, with substantial underdetection. A mMRC dyspnoea rating of 0–1 does not preclude the presence of abnormally high exertional breathlessness or abnormally low exercise capacity.
Realized Genetic Gain in Rice: Achievements from Breeding Programs
Authors: Seck Fallou , Covarrubias-Pazaran Giovanny , Gueye Tala , Bartholomé Jérôme
Published: December 2023

Genetic improvement is crucial for ensuring food security globally. Indeed, plant breeding has contributed significantly to increasing the productivity of major crops, including rice, over the last century. Evaluating the efficiency of breeding strategies necessitates a quantification of this progress. One approach involves assessing the genetic gain achieved through breeding programs based on quantitative traits. This study aims to provide a theoretical understanding of genetic gain, summarize the major results of genetic gain studies in rice breeding, and suggest ways of improving breeding program strategies and future studies on genetic gain. To achieve this, we present the concept of genetic gain and the essential aspects of its estimation. We also provide an extensive literature review of genetic gain studies in rice (Oryza sativa L.) breeding programs to understand the advances made to date. We reviewed 29 studies conducted between 1999 and 2023, covering different regions, traits, periods, and estimation methods. The genetic gain for grain yield, in particular, showed significant variation, ranging from 1.5 to 167.6 kg/ha/year, with a mean value of 36.3 kg/ha/year. This translated into a rate of genetic gain for grain yield ranging from 0.1% to over 3.0%. The impact of multi-trait selection on grain yield was clarified by studies that reported genetic gains for other traits, such as plant height, days to flowering, and grain quality. These findings reveal that while breeding programs have achieved significant gains, further improvements are necessary to meet the growing demand for rice. We also highlight the limitations of these studies, which hinder accurate estimations of genetic gain. In conclusion, we offer suggestions for improving the estimation of genetic gain based on quantitative genetic principles and computer simulations to optimize rice breeding strategies.
Hydrological response of tropical rivers basins to climate change using the GR2M model: the case of the Casamance and Kayanga-Géva rivers basins
Authors: Sadio Cheikh Abdoul Aziz Sy , Faye Cheikh , Pande Chaitanya B. , Tolche Abebe Debele , Ali Mohd Sajid , Cabral-Pinto Marina M. S. , Elsahabi Mohamed
Published: December 2023

The main objective of this research is to evaluate the effects of climate change first on precipitation and temperature, and then on the runoff characteristics of two tropical watersheds located in Senegal and Guinea-Bissau. To achieve this, eighteen General Circulation Models (GCMs) were selected to measure various climate change scenarios under the Shared Socioeconomic Pathways (SSP) SSP1-2.6 and SSP5-8.5, using the reference period of 1985–2014. The GR2M hydrological model was employed to replicate past monthly surface runoff patterns for the Casamance and Kayanga-Géva watersheds. After calibrating and validating the GR2M model, the researchers simulated the predictable effect of climate change on the flow for the near future (2021–2040), medium future (2041–2060), and distant future (2081–2100) for each watershed, using the GCM multi-model ensemble mean. The quantile method was used to correct bias in temperature and precipitation data. The results of bias correction give a correlation coefficient greater than 0.9% for temperatures and 0,6% precipitation between the outputs of the multi-model ensemble and observations used. The results indicate also that all watersheds are expected to experience drier conditions in the near-future, mid-future, and far-future periods under both the SSP1-2.6 and SSP5-8.5 scenarios. Furthermore, the predictable temperature trends consistently show a warmer situation with growing radiative making in the future times. However, the primary factor influencing changes in flow for all watersheds is the projected precipitation changes. The anticipated drier conditions in the near-future, mid-future, and far-future horizons under both scenarios would lead to significantly reduced runoff volumes at the beginning and middle of the rainy season. Consequently, the projected seasonal changes in river flow for all catchments (e.g., under SSP5-8.5 scenario, a decline of -34.47%, -56.01%, and -68.01% was noted, respectively, for the horizons 2050, 2070, and 2090 for the Casamance basin) could lead to new frequent occurrences of drought and water scarcity associated with past hydrological regimes. These scenarios enhance the necessity of improving water management, water prizing, and water recycling policies, to ensure water supply and to reduce tensions among regions and countries.
Association between human blood metabolome and the risk of hypertension
Authors: Dai Nannan , Deng Yujuan , Wang Baishi
Published: December 2023

Hypertension, commonly referred to as high blood pressure, is a chronic medical condition characterized by persistently elevated blood pressure levels. It is a prevalent global health issue, affecting a significant portion of the population worldwide. Hypertension is often asymptomatic, making it a silent but potentially dangerous condition if left untreated. Genetic instruments for 1,091 were from a recent comprehensive metabolome genome-wide association study (GWAS). Summary statistics of diastolic blood pressure (DBP) and systolic blood pressure (SBP) involving 757,601 sample size were analyzed. Two-sample Mendelian Randomization (MR) was conducted to assess causal effect of metabolites on DBP and SBP risk, and reverse MR analysis was performed to identify the DBP/SBP causal effect on blood metabolites. Twelve and twenty-two metabolites were identified to be associated with DBP and SBP, respectively. Sensitive analysis showed four metabolites had robustness association on BP. Reverse MR demonstrated DBP and SBP could decrease the tricosanoyl sphingomyelin (d18:1/23:0)* level and increase the 2-hydroxyhippurate (salicylurate) level in blood, respectively. Our findings reveal an association between blood metabolites and blood pressure (DBP and SBP), suggesting potential therapeutic targets for hypertension intervention.
Valorization of Chlorella thermophila biomass cultivated in dairy wastewater for biopesticide production against bacterial rice blight: a circular biorefinery approach
Authors: Mohanty Satya Sundar , Mohanty Kaustubha
Published: December 2023

Biopesticides offer a sustainable and efficient alternative to synthetic pesticides, providing a safer and more eco-friendly solution to pest management. The present work proposes an innovative approach that integrates crop protection and wastewater treatment using thermophilic microalgal strain Chlorella thermophila (CT) cultivated in nutrient-rich dairy wastewater as a growth medium. The microalgae was cultivated mixotrophically and was able to reduce both organic carbon as well as nutrient load of the dairy wastewater efficiently. The integrated circular biorefinery approach combines biomass cultivation, extraction of biopesticide compounds, and conversion to biocrude. The antimicrobial activity of the biopesticidal extracts against Xanthomonas oryzae and Pantoea agglomerans, the causative agent of bacterial rice blight, is assessed through in vitro studies. The biomass extract obtained is able to inhibit the growth of both the above-mentioned plant pathogens successfully. Mass spectroscopy analysis indicates the presence of Neophytadiene that has previously been reported for the inhibition of several pathogenic bacteria and fungi. Several other value-added products such as linoleic acid and nervonic acids were also been detected in the microalgal biomass which have extremely high nutraceutical and medicinal values. Furthermore, the study investigates the potential for co-production of biocrude from the biorefinery process via hydrothermal liquefaction. Overall, the findings of this present work represent an innovative and sustainable approach that combines wastewater treatment and crop protection using microalgal biomass.
Study protocol on effectiveness of yoga practice on composite biomarker age predictors (yBioAge) in an elderly Indian cohort- two-armed open label randomized controlled trial
Authors: Majumdar Vijaya , Manjunath N. K. , Snigdha Atmakur , Chakraborty Prosenjeet , Majumdar Robin
Published: December 2023

Introduction

The recent development of robust indices to quantify biological aging, along with the dynamic epidemiological transitions of population aging generate the unmet need to examine the extent up to which potential interventions can delay, halt or temporarily modulate aging trajectories.

Methods and analysis

The study is a two-armed, open label randomised controlled trial. We aim to recruit 166 subjects, aged 60–75 years from the residential communities and old age clubs in Bangalore city, India, who will undergo randomisation into intervention or control arms (1:1). Intervention will include yoga sessions tailored for the older adults, 1 h per day for 5 days a week, spread for 12 months. Data would be collected at the baseline, 26th week and 52nd week. The primary outcome of the study is estimation in biological age with yoga practice. The secondary outcomes will include cardinal mechanistic indicators of aging- telomere length, interleukin-6 (IL-6), tumor necrosis factor receptor II (TNF-RII), high sensitivity c-reactive protein (hsCRP)], insulin signaling [insulin and IGF1], renal function [cystatin], senescence [growth differentiating factor 15 (GDF-15)] and cardiovascular function [N-terminal B-type natriuretic peptides (NT-proBNP)]. Analyses will be by intention-to-treat model.

Ethics & dissemination

The study is approved by the Institutional Ethics Committee of Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore (ID:RES/IEC-SVYASA/242/2022). Written informed consent will be obtained from each participant prior to inclusion.

Trial registration number

CTRI/2022/07/044442.
Thiazide-associated hyponatremia increases the risk of major adverse cardiovascular events among elderly Taiwanese patients
Authors: Yang Hsun , Hsu Jane Lu , Kuo Yu-Hung , Liao Kuan-Fu
Published: December 2023

Background

Thiazide-associated hyponatremia (TAH) has been supposed to increase the risk of major adverse cardiovascular events (MACE) in the elderly. Therefore, this study aimed to evaluate the association of TAH with the risk of MACE in elderly Taiwanese patients.

Methods

Data from the longitudinal generation tracking database (LGTD 2010) of the Health and Welfare Data Science Center (HWDC) were retrospectively assessed. The TAH study group was defined as using > 30 cumulative daily defined doses (CDDDs) thiazide diuretics within one year before diagnosis of hyponatremia. The control group (1:3 propensity score matching) had no diagnosis of hyponatremia but had used > 30 CDDDs thiazide diuretics within one year. Data on MACE were extracted using International Classification of Diseases codes. Outcomes were assessed using a multivariable Cox proportional hazard model and Kaplan-Meier analysis.

Results

A total of 1155 and 3465 individuals were enrolled in the TAH and the control groups, respectively. The rates of MACE (11.1% vs. 7.3%) and death (22.8% vs.12.2%) were significantly higher in the TAH group than the control group. In the TAH group, the adjusted HRs were 1.29 (CI 1.01 ‒ 1.65) for MACE, 1.39 (CI 1.19 ‒ 1.63) for all-cause death, and 1.61 (CI 0.90 ‒ 2.92) for stroke.

Conclusion

TAH in patients above 65-years-old is associated with a 29% higher risk of MACE, 39% higher risk of all-cause death, and 61% higher risk of stroke. This work suggests that thiazides prescription in elderly patients should be more careful. However, further research is required to confirm our findings.
The effect of Saccharomyces boulardii supplementation on Helicobacter pylori eradication in children: a systematic review and meta-analysis of Randomized controlled trials
Authors: Liu Lian-Hua , Han Bin , Tao Jing , Zhang Kai , Wang Xi-Ke , Wang Wen-Yu
Published: December 2023

Background

It is unclear whether Saccharomyces boulardii (S. boulardii) supplementation in standard triple therapy (STT) is effective in eradicating Helicobacter pylori (H. pylori) infection in children. We therefore conducted a meta-analysis of randomized controlled trials (RCTs) to assess the effect of S. boulardii supplementation on H. pylori eradication in children.

Methods

We conducted electronic searches in PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure and Wanfang database from the beginning up to September 2023. A random-effects model was employed to calculate the pooled relative risk (RR) with 95% confidence intervals (CI) through a meta-analysis.

Results

Fifteen RCTs (involving 2156 patients) were included in our meta-analysis. Results of the meta-analysis indicated that S. boulardii in combination with STT was more effective than STT alone (intention-to-treat analysis : 87.7% vs. 75.9%, RR = 1.14, 95% CI: 1.10–1.19, P < 0.00001; per-protocol analysis : 88.5% vs. 76.3%, RR = 1.15, 95% CI: 1.10–1.19, P < 0.00001). The S. boulardii supplementation group had a significantly lower incidence of total adverse events (n = 6 RCTs, 9.2% vs. 29.2%, RR = 0.32, 95% CI: 0.21–0.48, P < 0.00001), diarrhea (n = 13 RCTs, 14.7% vs. 32.4%, RR = 0.46, 95% CI: 0.37–0.56, P < 0.00001), and nausea (n = 11 RCTs, 12.7% vs. 21.3%, RR = 0.53, 95% CI: 0.40–0.72, P < 0.0001) than STT group alone. Similar results were also observed in the incidence of vomiting, constipation, abdominal pain, abdominal distention, epigastric discomfort, poor appetite and stomatitis.

Conclusions

Current evidence indicated that S. boulardii supplementing with STT could improve the eradication rate of H. pylori, and concurrently decrease the incidence of total adverse events and gastrointestinal adverse events in children.
Effect of iron administration on the aortic iron content and vascular calcification in phosphorus-loaded chronic kidney disease rats
Authors: Nakanishi Masa , Goto Ayako , Iwasaki Takahide , Nakanishi Takeshi , Kuma Akihiro , Nanami Masayoshi , Kuragano Takahiro
Published: December 2023

Background

Cardiovascular disease (CVD) is a major cause of morbidity and mortality in patients with chronic kidney disease (CKD) and could be related to oxidative stress. Vascular calcification (VC) has been established as a critical risk factor for accelerated CVD. In CKD, phosphorus (Pi), iron (Fe) and Nrf2 are modulators of VC and important agonists and antagonists of oxidative stress. The aim of this study was to determine whether Fe administration, which is commonly used to treat renal anemia, affects aortic Fe overload and VC, and whether Nrf2 and its related genes, ferritin H and HIF-1α, are involved in the development of VC.

Methods

A CKD model was created in rats by administering adenine and simultaneously feeding a high-Pi diet. In addition to control and CKD rats without Fe administration (No-Fe group), Fe was administered orally (PO-Fe group) or intraperitoneally (IP-Fe group) to CKD animals to clarify the effects of Fe administration on the aortic Fe and calcium (Ca) contents and the involvement of Nrf2 and its induced antioxidative proteins, ferritin H and HIF-1α, in VC.

Results

The aortic Fe content increased significantly in the IP-Fe group, which was closely correlated with liver HAMP (hepcidin) expression in all animals. Fe administration had no significant effect on the aortic Ca and Pi contents regardless of the route of Fe administration. The aortic mRNA level of Nrf2 was significantly increased in the IP-Fe group and correlated with serum Pi levels and aortic Fe contents, which could respond to oxidative stress. Notably, the mRNA level of Nrf2 was also significantly correlated with the mRNA levels of ferritin H and HIF-1α. Since we could not measure Nrf2 protein levels in this study, we confirmed the upregulation of HMOX1 and NQO1 mRNA expression in parallel with Nrf2 mRNA.

Conclusion

Parenteral Fe administration increased aortic Fe in parallel with the liver HAMP mRNA level but did not affect VC. Aortic Nrf2 mRNA levels correlated significantly with aortic Fe and serum Pi levels and with aortic mRNA levels of ferritin H and HIF-1α as well as HMOX1 and NQO1.
Efficacy and safety of eptinezumab in patients with chronic migraine and medication-overuse headache: a randomized, double-blind, placebo-controlled study
Authors: Yu Shengyuan , Zhou Jiying , Luo Guogang , Xiao Zheman , Ettrup Anders , Jansson Gary , Florea Ioana , Ranc Kristina , Pozo-Rosich Patricia
Published: December 2023

Background

For some people with migraine, despite taking greater amounts of acute headache medication (AHM), they develop an increase in monthly headache days. This cycle of increasing headache days, and in turn AHM use, can lead to a secondary headache disorder called medication-overuse headache (MOH). Preventive medications can prevent migraine from occurring and reduce reliance on AHMs, thereby preventing the cycle of MOH. This study was performed to evaluate the efficacy and safety of eptinezumab to prevent migraine/headache in a mainly Asian patient population with a dual diagnosis of chronic migraine and MOH.

Methods

SUNLIGHT was a phase 3, multicenter, double-blind, parallel-group, placebo-controlled trial. Patients aged 18−75 years with ≥ 8 migraine days/month and a diagnosis of MOH were randomly allocated (1:1) to one of two treatment groups: eptinezumab 100 mg or placebo. Monthly migraine days (MMDs) were captured using a daily electronic diary; the change from baseline in the number of MMDs over Weeks 1−12 was the primary efficacy endpoint.

Results

Patients were randomized to eptinezumab 100 mg (n = 93) or placebo (n = 100). Over Weeks 1−12, eptinezumab reduced mean MMDs more than placebo (difference between treatments was -1.2; p = 0.1484). Differences between treatment groups with p-values below 0.05 favoring eptinezumab were observed in 3 out of the 6 key secondary endpoints.

Conclusion

All endpoints numerically favored eptinezumab treatment when compared to placebo; however, this study did not meet its primary endpoint and is therefore negative. No new safety signals were identified in this study, like previous reports that confirmed the safety and tolerability of eptinezumab treatment.

Trial registration

ClinicalTrials.gov identifier: NCT04772742 (26/02/2021).
Modification of the height of a weight drop traumatic brain injury model that causes the formation of glial scar and cognitive impairment in rats
Authors: Wardhana Donny Wisnu , Yudhanto Hendy Setyo , Riawan Wibi , Khotimah Husnul , Permatasari Happy Kurnia , Nazwar Tommy Alfandy , Nurdiana Nurdiana
Published: December 2023

Objective

Traumatic brain injury (TBI) is a chronic, progressive condition associated with permanent disabilities, particularly cognitive impairments. Glial scar formation following TBI is considered a contributing factor to these persistent disabilities. Currently, limited research exists on pharmacological interventions targeting glial scar prevention that require a standard weight drop TBI model for glial scar formation. Since there is no established standard TBI model for glial scar formation, this study aims to validate and modify the height of the weight drop model to identify glial scar formation and cognitive impairments.

Methods

Fifteen male Sprague Dawley rats were randomly divided into sham, WD1, and WD2 groups. The weight drop model with a 10 g load was applied to the right exposed brain of the rats from a height of 5 cm (WD1) and 10 cm (WD2) using a modified Feeney’s weight drop device. Cognitive impairments were confirmed using the novel object recognition (NOR) test with ethovision software on day 15. Subsequently, the rats were decapitated on day 16, and GFAP immunohistochemical staining was performed to confirm the presence of glial scarring.

Results

The WD1 and WD2 groups exhibited a significant increase in glial scar formation compared to the sham group, with the WD2 group resulting in even more pronounced glial scar formation. Only the WD2 model caused statistically significant cognitive damage. The negative correlation coefficient indicates that an increase in GFAP + cells will decrease the cognitive function.

Conclusion

Modification of the height of the weight drop model, by dropping a weight of 10 g from a height of 10 cm (WD2 group) onto the right brain exposed of the rat has been proven to induce the formation of a glial scar and cognitive impairment.
Immune checkpoint inhibitors enhanced the antitumor efficacy of disitamab vedotin for patients with HER2-positive or HER2-low advanced or metastatic gastric cancer: a multicenter real-world study
Authors: Nie Caiyun , Xu Weifeng , Guo Yanwei , Gao Xiaohui , Lv Huifang , Chen Beibei , Wang Jianzheng , Liu Yingjun , Zhao Jing , Wang Saiqi , He Yunduan , Chen Xiaobing
Published: December 2023

Background

Novel ADC drugs provide a new therapeutic strategy for gastric cancer.The present study aimed to analyze the clinical efficacy and drug toxicities of disitamab vedotin (RC48) plus immune checkpoint inhibitors(ICIs) and RC48 as third-line therapies and beyond for advanced and metastatic gastric cancer patients.

Methods

This was an observational multicenter real-world study.From August 2021 to January 2022,patients with HER2-positive or HER2-low advanced and metastatic gastric cancer and failed from two or more lines of prior therapy were enrolled and treated with RC48 plus ICIs or RC48. In this study, progression free survival(PFS) was the primary end point. Other evaluation indicators were objective response rate(ORR),disease control rate(DCR),overall survival(OS) and drug toxicities.

Results

45 patients were enrolled,of which 25 patients received RC48 plus ICIs,20 patients received RC48.Patients who received RC48 plus ICIs obtained better ORR (36.0% vs. 10.0%, P = 0.044) and DCR (80.0% vs. 50.0%, P = 0.034) compared with RC48,and simultaneously,the median PFS in RC48 plus ICIs group were superior to RC48 group(6.2 m vs. 3.9 m).The median OS was not reached.No statistically differences were found between HER2-positive and HER2-low group with respect to ORR (27.3% vs. 16.7%, P = 0.464),DCR (66.7% vs. 66.7%, P = 1.000),median PFS(5.7 m vs. 4.3 m, P = 0.299).The most common adverse events (AEs) were decreased white blood count,decreased neutrophil count,fatigue,hypoaesthesia and alopecia.Grade 3–4 AEs occurred in 7(35.0%) patients of RC48 group and 10(40.0%) patients of RC48 plus ICIs group,respectively.

Conclusion

Compared with RC48 monotherapy, ICIs plus RC48 demonstrated superior third-line and beyond therapeutic efficacy for HER2-positive or HER2-low advanced and metastatic gastric cancer patients with manageable safety.