bluuebunny/crossref_metadata_2025 huggingface dataset:
Teleworking Dynamics in Spain: Pre and Post-Pandemic Insights
Authors: Rubino Nicola , Clemente Javier Garcia , Quesada Odra
Published: September 2024

Significant advances in teleworking have received a lot of attention, particularly in the post-COVID-19 age. This research aims to shed light on the teleworking landscape in Spain, providing a comprehensive analysis from 2017 to 2020. Using data from the Spanish Labor Force Survey (SLFS), our study investigates the likelihood of teleworking, with a strong emphasis on individual characteristics. Our findings are varied. Notably, we discover a potential short-term increase in teleworking between 2017 and 2019, a phenomenon that assumes significant significance in the context of the global pandemic in 2020. We use probabilistic regressions that control for a variety of sociodemographic factors to identify the determinants of telework. Surprisingly, we discover that family composition, including the presence of children, has only a minor impact on the likelihood of teleworking. Furthermore, our research indicates a significant shift in gender dynamics, with women showing an increased proclivity to telework in the critical year 2020. Occupation emerges as a key factor, with highly skilled, educated workers in telework-friendly roles experiencing a significant increase in teleworking likelihood in 2020. Gender differences in teleworking, on the other hand, persist, implying more complex occupational dynamics such as contract type, sectoral differences, and work commitment. Our research differentiates three occupational categories: jobs that are naturally suited to teleworking, jobs that require physical presence, and jobs with untapped teleworking potential. We contribute valuable insights to the ongoing debate on remote work in a rapidly changing world by delving into the nuances of telework adoption. While our study offers valuable insights, it’s important to consider these limitations when interpreting findings and implications for telework legislation and practices. Telecommuting, like any labor market regulation, requires thorough scrutiny due to its dual nature.
Combined genomic evaluation of Merino and Dohne Merino Australian sheep populations
Authors: Wicki Marine , Brown Daniel J. , Gurman Phillip M. , Raoul Jérôme , Legarra Andrés , Swan Andrew A.
Published: September 2024

Background

The Dohne Merino sheep was introduced to Australia from South Africa in the 1990s. It was primarily used in crosses with the Merino breed sheep to improve on attributes such as reproduction and carcass composition. Since then, this breed has continued to expand in Australia but the number of genotyped and phenotyped purebred individuals remains low, calling into question the accuracy of genomic selection. The Australian Merino, on the other hand, has a substantial reference population in a separate genomic evaluation (MERINOSELECT). Combining these resources could fast track the impact of genomic selection on the smaller breed, but the efficacy of this needs to be investigated. This study was based on a dataset of 53,663 genotypes and more than 2 million phenotypes. Its main objectives were (1) to characterize the genetic structure of Merino and Dohne Merino breeds, (2) to investigate the utility of combining their evaluations in terms of quality of predictions, and (3) to compare several methods of genetic grouping. We used the ‘LR-method’ (Linear Regression) for these assessments.

Results

We found very low Fst values (below 0.048) between the different Merino lines and Dohne breed considered in our study, indicating very low genetic differentiation. Principal component analysis revealed three distinct groups, identified as purebred Merino, purebred Dohne, and crossbred animals. Considering the whole population in the reference led to the best quality of predictions and the largest increase in accuracy (from ‘LR-method’) from pedigree to genomic-based evaluations: 0.18, 0.14 and 0.16 for yearling fibre diameter (YFD), yearling greasy fleece weight (YGFW) and yearling liveweight (YWT), respectively. Combined genomic evaluations showed higher accuracies than the evaluation based on the Dohne reference only (accuracies increased by 0.16, 0.06 and 0.07 for YFD, YGFW, and YWT, respectively). For the combined genomic evaluations, metafounder models were more accurate than Unknown Parent Groups models (accuracies increased by 0.04, 0.04 and 0.06 for YFD, YGFW and YWT, respectively).

Conclusions

We found promising results for the future transition of the Dohne breed from pedigree to genomic selection. A combined genomic evaluation, with the MERINOSELECT evaluation in addition to using metafounders, is expected to enhance the quality of genomic predictions for the Dohne Merino breed.
Efficacy and safety of direct-acting antiviral regimen for patients with hepatitis C virus genotype 2: a systematic review and meta-analysis
Authors: Lei Pek Kei , Liu Zicheng , Ung Carolina Oi Lam , Hu Hao
Published: September 2024

Background

Direct-acting antivirals (DAAs) show high cure rates in treating chronic hepatitis C virus (HCV). However, the effect of DAAs on patients infected with genotype 2 (GT2) is difficult to determine despite the availability of several DAA regimens.

Methods

A systematic search of six databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Clinicaltrial.gov) was conducted through April 20, 2022. We considered the sustained virological response 12 weeks after treatment (SVR12) as the efficacy outcome, and adverse events (AEs) as the safety outcome. By calculating the mean SVR12 and the proportion of AEs among patients, we considered the intervention effect for each DAA regimen. The random effect model was then used in all meta-analyses. This systematic review and meta-analysis aimed to summarize the evidence on efficacy and safety of DAAs in patients infected with HCV GT2. The Bayesian Markov Chain Monte Carlo (MCMC) network metanalysis was used to indirectly compare regimen in GT2 patients.

Results

Among 31 articles included (2,968 participants), consisting of 1,387 treatment-naive patients and 354 patients with cirrhosis. The overall pooled SVR12 rate was 94.62% (95% CI: 92.43-96.52%) among the participants who received all doses of treatment. Meta-analysis results of AEs revealed that fatigue was the most common AE (14.0%, 95% CI: 6.4-21.6%), followed by headache (13.1%, 95% CI: 9.2-17.1%), whereas death and serious adverse events were uncommon.

Conclusions

We compared DAA-based treatments indirectly using meta-analysis and found the combination of Sofosbuvir plus Velpatasvir and Glecaprevir plus Pibrentasvir, each administered over a 12-week period, were identified as the most effective and relatively safe in managing chronic hepatitis C virus genotype 2 (HCV GT2) infection. Both treatments achieved a SVR12 of 100% (95% CI 99–100%).
Is chemodenervation with incobotulinumtoxinA an alternative to invasive chronic anal fissure treatments?
Authors: Calderón T. , Arriero L. , Cruz P. , Gómez L. , Asanza J. , Santiago J. C. , Garrido R. , Bustamante C. , Balsa T.
Published: September 2024

Background

Botulinum toxin type A is currently strongly recommended for the treatment of anal fissures (AFs). However, there is still no consensus on dosage or injection technique. This study provides further efficacy and safety evidence in a 2-year follow-up.

Method

Prospective, open-label, single-arm, single-center study carried out in adult patients with AFs non-responsive to previous treatments. Patients were treated with incobotulinumtoxinA (incoBoNT/A) injected in both laterals and posterior intersphincteric groove. Healing rate at 2 years was the primary endpoint. Secondary endpoints included internal anal sphincter pressures, incontinence, and safety.

Results

A total of 49 patients were treated with a mean incoBoNT/A dose of 40.5 U (spread across three locations). Healing rate at 2 years was 83.9% with a 24.5% of recurrence throughout the study. Only 7 patients (14.3%) reported adverse events (AEs) that were mild and temporary. Mean reduction in anal resting pressure was -9.1 mmHg at 3 months (p = 0.001). Mean reduction in voluntary squeeze pressure was -27.5 mmHg at 3 months (p < 0.001). Mean pain perception measured with a visual analog scale decreased by -6.5 points at 2 years (p < 0.001). There was an incontinence increase at 1 month of 1.3 points (p = 0.006), but baseline values were restored at 6 months.

Conclusion

We present results that support the use of incoBoNT/A as a second line for AFs that do not respond to ointment therapy. IncoBoNT/A injection is a less invasive treatment that should be considered before surgery due to its efficacy and its safety which includes no permanent impairment.

Trial registration

ISRCTN90354265; Registered on 16th February 2024. Retrospectively registered.
Calling for allied efforts to strengthen digital health literacy in Sweden: perspectives of policy makers
Authors: Bywall Karin Schölin , Norgren Therese , Avagnina Beatrice , Gonzalez Marta Pisano , Andersson Sarah Wamala ,   IDEAHL consortium
Published: September 2024

Background

A more digitalised world comes with the promise to improve people’s lives. Therefore, it is essential that policymakers also align digital interventions with initiatives to empower citizens and strengthen their digital health literacy. The aim of this study was to explore the views of Swedish policymakers regarding the potential and barriers of a European strategy to strengthen digital health literacy.

Method

Representatives from Swedish governmental agencies and regions were purposively approached by email to ask them to participate in online workshops to discuss the potential and barriers of developing a European strategy to strengthen digital health literacy.

Results

The results highlight the need for a national strategy to strengthen digital health literacy. The findings point to critical areas for improvement, ethical and social considerations, and the importance of inclusive and accessible health information online. Participants identified vulnerable groups requiring targeted support to enhance their digital health literacy, particularly those at risk of digital exclusion. Participants emphasised the importance of considering various combinations of conditions or problems that people may have, urging policymakers to adopt a nuanced approach to enhance digital literacy.

Conclusions

There is a critical need for policymakers to strengthen digital health literacy in the population to ensure health equity in relation to digitalisation opportunities. Policymakers advocate for a dedicated national strategy, supporting policymakers to prioritize digital health literacy. Tailoring information, enhancing digital support for prevention, and considering ethical implications are reported as important aspects to improve digital health literacy.
Clinical, radiographic and biochemical assessment of proximal cavities restored with composite resin using incremental vs. bulk packing techniques: One-year randomized clinical trial
Authors: Abdelaziz Monaliza Maher , Fathy Shereen , Alaraby Amany Ahmed , Shehab Wessam Ibrahim , Temirek Marwa Mohamed
Published: September 2024

Background

Bulk-fill resin composites may suffer from recurrent caries around compound proximal restorations in posterior teeth, especially at the proximo-gingival interface.Over 12 months, will the bulk fill technique affect the caries recurrence rate at gingival margins when compared to the conventional incremental packing technique? How early will the first clinical, radiographical, and biochemical evidence of caries recurrence occur?

Methods

After randomization, in 30 patients with two compound (OM or OD) supragingival lesions, one tooth was restored using the bulk fill technique on one side (group 1) (n = 15). In contrast, the other tooth on the other side was restored utilizing the incremental layering technique (group 2) (n = 15). Both teeth received restorative material (X-tra fil, Voco, Cuxhaven, Germany). The FDI criteria were used to evaluate restorations. As for the periodontal assessment, the gingival index, plaque index, papillary bleeding scoring index and periodontal pocket depth were evaluated. The gingival crevicular fluid (GCF) specimens were gathered, and MMP-9 was extracted and quantitated by ELISA. A customized radiographic template was designed, and 3D printed digital bitewing radiographs were taken. Assessments were done clinically, radiographically and biochemically at baseline (1 week) and after 3, 6 and 12 months. Data was statistically analyzed.

Results

The null hypothesis was accepted clinically; no statistically significant differences appeared between bulk and incrementally filled posterior restorations. As for the radiographic assessment, the null hypothesis was accepted except for increased periodontal ligament width at 3 months. The null hypothesis for the biochemical evaluation was rejected as there were significant changes in levels of MMP-9 at different testing times.

Conclusions

1. With similar results but less sensitivity and significant time saving, the bulk fill technique can be considered an efficient alternative to the incremental fill technique in restoring proximal cavities. 2. Early evidence of caries recurrence can be correlated to an increase in the MMP-9 level in gingival crevicular fluid, followed by an increase in radiographic periodontal ligament width measurement.

Trial registration

An ethical approval from the Research Ethics Committee at the Faculty of Dentistry, October 6 University, (Approval No. RECO6U/5-2022). The study was registered at the Pan African Clinical Trials Registry on 24/07/2023 with an identification number (PACTR202307573531455).
Strengths, weaknesses, opportunities, and threats (SWOT) of the electronic prescribing systems executed in Iran from the physician’s viewpoint: a qualitative study
Authors: Jebraeily Mohamad , Naji Shahryar , Nourani Aynaz
Published: September 2024

Background

Electronic prescribing (e-prescribing) is an essential technology in the modern health system. This technology has made many changes in the prescription process, which have advantages and disadvantages and have created opportunities for transforming the health system. This study aimed to investigate the strengths, weaknesses, opportunities, and threats of the e-prescribing system implemented in Iran from the physician’s viewpoint.

Methods

This phenomenological qualitative study was conducted in 2022. The participants were 15 Iranian specialist physicians working at Urmia University of Medical Sciences, selected purposively and deliberately. Data was collected through in-depth semi-structured interviews using an interview guide comprising 16 questions. Interviews were conducted until data saturation was reached. The audio data was transcribed into text and analyzed using the thematic analysis. To ensure the validity and reliability of the findings, the criteria introduced by Lincoln and Guba were employed.

Results

The results of this study showed that the e-prescribing system executed in Iran has diverse and multidimensional strengths, weaknesses, opportunities, and threats. In the strengths section, the analysis of the interviews led to the extraction of semantic units in the categories of prescription process, prescriber, patient, technical, economic, communication, and insurance. Also, the weaknesses in the three categories of the prescriber, patient, and technical were debatable. The opportunities extracted from the narratives of the interviewees were placed in four categories including technical, national macro policies, Ministry of Health macro-policies, and socio-cultural issues. Finally, the discussed threats are classified into two technical and macro policies of the Ministry of Health categories. On the other hand, technical issues played an effective role in all aspects of the SWOT model.

Conclusion

The e-prescribing system in Iran has strengths, weaknesses, opportunities, and threats. An overarching factor across all aspects of the SWOT model was technical infrastructure. A robust technical infrastructure is considered a strength and an opportunity for the growth of the electronic prescribing system in Iran. Conversely, any shortcomings in these systems are viewed as weaknesses and pose a threat to the system’s sustainability.
Mediator complex subunit 1 promotes oral squamous cell carcinoma progression by activating MMP9 transcription and suppressing CD8+ T cell antitumor immunity
Authors: Li Zhe , Sun Mengke , Yang Ruimeng , Wang Zheng , Zhu Qianyu , Zhang Yue , Yang Haosun , Meng Zhaosong , Hu Lizhi , Sui Lei
Published: September 2024

Background

The role of Mediator complex subunit 1 (MED1), a pivotal transcriptional coactivator implicated in diverse biological pathways, remains unexplored in the context of oral squamous cell carcinoma (OSCC). This study aims to elucidate the contributory mechanisms and potential impact of MED1 on the progression of OSCC.

Methods

The expression and clinical significance of MED1 in OSCC tissues were evaluated through the bioinformatics analyses. The effects of MED1 on the biological behavior of OSCC cancer cells were assessed both in vitro and in vivo. Dual-luciferase reporter assay, chromatin immunoprecipitation (ChIP) assay, bioinformatic analysis, CD8+ T cell isolation experiment, coculture experiment, enzyme-linked immunosorbent assay (ELISA), and flow cytometric analysis were employed to elucidate the underlying mechanism through which MED1 operates in the progression of OSCC.

Results

MED1 exhibited upregulation in both OSCC tissues and multiple OSCC cell lines, which correlated with decreased overall survival in patients. In vitro experiments demonstrated that knockdown of MED1 in metastatic OSCC cell lines SCC-9 and UPCI-SCC-154 hindered cell migration and invasion, while overexpression of MED1 promoted these processes. Whereas, MED1 knockdown had no impact on proliferation of cell lines mentioned above. In vivo studies further revealed that downregulation of MED1 effectively suppressed distant metastasis in OSCC. Mechanistically, MED1 enhanced the binding of transcription factors c-Jun and c-Fos to the matrix metalloprotein 9 (MMP9) promoters, resulting in a significant upregulation of MMP9 transcription. This process contributes to the migration and invasion of SCC-9 and UPCI-SCC-154 cells. Furthermore, MED1 modulated the expression of programmed death-ligand 1 (PD-L1) through the Notch signaling pathway, consequently impacting the tumor-killing capacity of CD8+ T cells in the tumor microenvironment.

Conclusions

Our findings indicate that MED1 plays a pivotal role in OSCC progression through the activation of MMP9 transcription and suppression of CD8+ T cell antitumor immunity, suggesting that MED1 may serve as a novel prognostic marker and therapeutic target in OSCC.
BAP1 regulates HSF1 activity and cancer immunity in pancreatic cancer
Authors: Yuan Weiwei , Zhang Qiyue , Zhao Yuhan , Xia Wentao , Yin Shilin , Liang Xueyi , Chen Taoyu , Li Gaofeng , Liu Yanshen , Liu Zhiqiang , Huang Jinxi
Published: September 2024

Background

The vast majority of pancreatic cancers have been shown to be insensitive to single-agent immunotherapy. Exploring the mechanisms of immune resistance and implementing combination therapeutic strategies are crucial for PDAC patients to derive benefits from immunotherapy. Deletion of BAP1 occurs in approximately 27% of PDAC patients and is significantly correlated with poor prognosis, but the mechanism how BAP1-deletion compromises survival of patients with PDAC remain a puzzle.

Methods

Bap1 knock-out KPC (KrasG12D/+; LSLTrp53R172H/+; Pdx-1-Cre) mice and control KPC mice, syngeneic xenograft models were applied to analysis the correlation between BAP1 and immune therapy response in PDAC. Immunoprecipitation, RT-qPCR, luciferase and transcriptome analysis were combined to revealing potential mechanisms. Syngeneic xenograft models and flow cytometry were constructed to examine the efficacy of the inhibitor of SIRT1 and its synergistic effect with anti-PD-1 therapy.

Result

The deletion of BAP1 contributes to the resistance to immunotherapy in PDAC, which is attributable to BAP1’s suppression of the transcriptional activity of HSF1. Specifically, BAP1 competes with SIRT1 for binding to the K80 acetylated HSF1. The BAP1-HSF1 interaction preserves the acetylation of HSF1-K80 and promotes HSF1-HSP70 interaction, facilitating HSF1 oligomerization and detachment from the chromatin. Furthermore, we demonstrate that the targeted inhibition of SIRT1 reverses the immune insensitivity in BAP1 deficient PDAC mouse model.

Conclusion

Our study elucidates an unrevealed mechanism by which BAP1 regulates immune therapy response in PDAC via HSF1 inhibition, and providing promising therapeutic strategies to address immune insensitivity in BAP1-deficient PDAC.
Consensus on innovations and future directions of community first responder schemes in United Kingdom: a national nominal group technique study
Authors: Patel Gupteswar , Botan Vanessa , Phung Viet-Hai , Trueman Ian , Hosseini Mehrshad Parvin , Smith Murray D. , Ørner Roderick , Pattinson Julie , Asghar Zahid , Rowan Elise , Spaight Robert , Mortimer Craig , Brewster Amanda , Mountain Pauline , Miller Joshua , Brown Martina , Siriwardena Aloysius Niroshan
Published: September 2024

Aim

We aimed to achieve consensus among NHS and community stakeholders to identify and prioritise innovations in Community First Responder (CFR) schemes.

Methods

We conducted a mixed-methods study, adopting a modified nominal group technique with participants from ambulance services, CFR schemes and community stakeholders. The 1-day consensus workshop consisted of four sessions: introduction of innovations derived from primary research; round-robin discussions to generate new ideas; discussion and ranking of innovations; feedback of ranking, re-ranking and concluding statements. Innovations were ranked on a 5-point Likert scale and descriptive statistics of median and interquartile range calculated. Discussions were recorded, transcribed, and analysed thematically.

Results

The innovations found were classified into two categories: process innovations and technological innovations. The process innovations included six types of innovations: roles, governance, training, policies and protocols, recruitment, and awareness. The technological innovations included three aspects: information and communication; transport; and health technology. The descriptive statistics revealed that innovations such as counselling and support for CFRs (median: 5 IQR 5,5), peer support [5 (4,5)], and enhanced communication with control room [5 (4,5)] were essential priorities. Contrastingly, innovations such as the provision of dual CFR crew [1.5 (1,3)], CFR responsibilities in patient transport to hospital [1 (1,2)], and CFR access to emergency blue light [1 (1,1.5)] were deemed non-priorities.

Conclusions

This article established consensus on innovations in the CFR schemes and their ranking for improving the provision of care delivered by CFRs in communities. The consensus-building process also informed policy- and decision-makers on the potential future change agenda for CFR schemes.
A systematic review on blockchain-based access control systems in cloud environment
Authors: Punia Aarti , Gulia Preeti , Gill Nasib Singh , Ibeke Ebuka , Iwendi Celestine , Shukla Piyush Kumar
Published: September 2024

The widespread adoption of cloud computing has dramatically altered how data is stored, processed, and accessed in an era. The rapid development of digital technologies characterizes all this. The widespread adoption of cloud services has introduced new obstacles to guaranteeing secure and expeditious access to sensitive data. Organizations of all types find user-friendly and cost-effective solutions crucial, which is why they consider cloud services essential. The availability of the cloud hampers access control security in systems that are constantly and remotely changing. Conventional methods of access control are efficient, but the advanced world of technology exposes them to more threats. Applying blockchain technology to cloud access control systems, which are decentralized, transparent, and tamper-proof, has overcome these challenges. This paper aims to discuss the potential of blockchain in enhancing access management, security and trust in cloud computing. Besides, this scholarly article reviews the evolving area of blockchain-based access control systems and synthesizes the findings of 118 selected papers from various academic repositories. Based on this systematic review of the studies, twelve different types of blockchain-based access control paradigms can be identified. This work provides a critical analysis of the research on blockchain technology in access control systems, with a focus on scalability, compatibility, and security challenges. It also highlights areas that require further research and proposes directions for future research to advance this rapidly growing area of scholarship.
Anatomical parameters do not determine linear breaking strength or dimensions of the porcine biliary system
Authors: Ginghina R. Catalina , Kronberg Anne-Sophie , Dauvergne Jan , Kratz Tobias , Katzer David , Ganschow Rainer , Bernhardt Marit , Westeppe Sarah , Vilz Tim O. , Bierbach Benjamin , Oetzmann von Sochaczewski Christina
Published: September 2024

Background

The porcine gall bladder and cystic duct gained attention in experimental research aimed at improving human clinical care. While the common bile duct has been investigated before, there is almost no data on the porcine cystic duct. Its relevance for research originates from its potential use in xenotransplantation.

Methods

We included 10 consecutive pigs (1♀, 9♂) that had been sacrificed after participation in another study. At necropsy, the distance from the biliary papilla to the gall bladder (gall bladder distance) was measured. The cystic duct was then subjected to linear traction. Ethical approval for the study was granted. Associations between force measurements and anatomical parameters were tested by correlation analysis.

Results

The pigs had a mean body weight of 21.9 kg (standard deviation 2 kg), a mean liver weight of 590 g (standard deviation 88 g), and a mean crown rump length of 67.3 cm (standard deviation 3 cm). The gall bladder distance was 8.2 cm (95% confidence interval: 7.6–8.7 cm). The cystic duct withstood mean linear traction forces of 4.8 N (95% confidence interval: 3.7–5.8 N) and could be elongated by a mean of 6 mm (95% confidence interval: 3.9–8 mm). Linear breaking strength was neither correlated to gall bladder distance (R = 0.3, 95% confidence interval: − 0.41 to 0.78, P = 0.406) or crown rump length (R = 0.42, 95% confidence interval: − 0.28 to 0.83, P = 0.222) nor liver weight (R = 0.02, 95% confidence interval: − 0.62 to 0.64, P = 0.954) or body weight (R = 0.36, 95% confidence interval: − 0.35 to 0.81, P = 0.304). This was also true for gall bladder distance.

Conclusions

Our study indicates that allometric parameters were not associated with the gall bladder distance or its resistance to traction forces. Consequently, substantial variation of these parameters can be expected in these surgically important parameters, which cannot be derived from easily accessible anatomical parameters.
Anime watching: is a new kind of addiction? Evaluation of psychopathologies and psychosocial factors associated with problematic anime watching among adolescents
Authors: Harputlu Yamak Yağmur , Işık Yasemen
Published: September 2024

Background

In recent years, with the rapid development of technology, research on behavioral addiction concepts such as digital gaming disorders and problematic internet use has increased. As anime-watching has become widespread worldwide, it is thought that this behavior may be one of the areas of problematic technology use, especially in adolescence. However, studies evaluating problematic anime-watching behaviors within the framework of behavioral addictions are quite limited in the literature. In this study, problematic anime-watching behaviors, comorbid psychiatric disorders, and possible psychosocial factors were evaluated in 86 anime watchers aged between 12 and 18 years. Problematic anime-watching behaviors were evaluated according to the diagnostic criteria of other defined disorders related to addictive behaviors in ICD-11. A semi-structured interview tool was used to assess psychiatric comorbidities, and the IGDS9-SF adapted form for anime-watching, the Self-Efficacy Scale for Children, KIDCOPE, and the Social Anxiety Scale for Adolescents were used to collect other data.

Results

It was determined that 36.8% of the 86 adolescents in our study had problematic anime-watching behavior. Compared to other adolescents, the problematic anime-watching group had significantly lower self-efficacy scores and significantly higher social anxiety and avoidant coping scores. A significant relationship was found between social anxiety disorder and watching problematic anime.

Conclusions

The present study showed that problematic watching of anime may be a variant of behavioral addiction. In conclusion, the relationship between problematic anime-watching behaviors and mental health warrants further examination.
Serum uric acid level can predict asymptomatic brain metastasis at diagnosis in patients with small cell lung cancer
Authors: Agtas Gizem , Alkan Ali , Tanriverdi Özgür
Published: September 2024

Background

The aim of this study was to determine the relationship between serum uric acid level at diagnosis and asymptomatic brain metastasis in patients with extensive-stage small cell lung cancer.

Methods

A total of 69 patients with extensive-stage small cell lung cancer without symptomatic brain metastases, whose serum uric acid level was measured at the time of diagnosis, were included in this retrospective cross-sectional study. The patients were divided into two groups as those with and without asymptomatic brain metastases. The Mann–Whitney U test was used for comparison between groups, and Spearman’s correlation test was used for correlation analysis. The cut-off level of serum uric acid level was analyzed, and sensitivity, specificity, and accuracy rates were determined for brain metastasis. Independent factors affecting asymptomatic brain metastasis were determined by multivariate Cox regression analysis.

Results

The median serum uric acid level of all patients was 6.9 mg/dL. Twenty-two percent of patients had asymptomatic brain metastases, and serum uric acid levels were significantly higher in these patients (P = 0.0014). The cut-off value for serum uric acid level was calculated as 6.2 mg/dL. The sensitivity, specificity, and accuracy of this value for brain metastasis were 84%, 76%, and 78%, respectively. High serum uric acid level was an independent risk factor for asymptomatic brain metastasis (OR 3.446 95% CI 1.337–5.480; P = 0.005).

Conclusion

In conclusion, a serum uric acid level of 6.2 mg/dL and above at the time of diagnosis may predict asymptomatic brain metastasis in patients.
Preparation of bee venom-loaded chitosan nanoparticles for treatment of streptozotocin-induced diabetes in male Sprague Dawley rats
Authors: Farid Alyaa , Mohamed Adham , Ahmed Ayten , Mehanny Farah , Safwat Gehan
Published: September 2024

Background

Diabetes mellitus (DM) can be defined as an increase in the blood sugar level and a disturbance in protein, fat and carbohydrate metabolism. Bee venom (BV) is useful for treating and preventing diabetic rats’ histological and biochemical problems. Although the medical advantages of BV have been identified, its safety has remained a substantial barrier for its application. Consequently, the goal of our work was to prepare bee venom-loaded chitosan (BV-CS) nanoparticles (NPs), which would then be physically characterized. This was followed by examining the effect of the synthetized BV-CS NPs on oxidation, inflammation and coagulation in vitro. In diabetic rats’ model [induced by streptozotocin (STZ)], the produced BV-CS NPs were tested as an anti-diabetic medication.

Results

In vivo testing on pancreatic tissue homogenates showed that BV-CS NPs have antioxidant and anti-inflammatory properties. The results showed that BV-CS NPs can be used as a safe and efficient therapy for diabetes. Up to a concentration of 250 µg/ml, the generated NPs demonstrated potential antioxidant, membrane stabilizing, and non-cytotoxic capabilities. Our findings indicated that the administration of BV-CS NPs significantly controlled blood glucose levels and metabolic abnormalities that accompanied diabetes induction.

Conclusions

BV-CS NPs were successful in treating STZ-induced diabetes in rats, stimulated insulin secretion and were safe to be used in vivo.

Graphical abstract
Outcomes of tracheal resection and anastomosis in patients with tracheal stenosis: a clinical perspective
Authors: Muthukumar R. , Kumari RMahesh , Shenbagavalli S. , Kumar JPraveen , Semmanaselvan K. , Swarna Durai
Published: September 2024

Background

Tracheal stenosis results from an altered inflammatory response to mucosal damage, which leads to impairment of breathing and can even be fatal if not treated promptly (Ind J Otolaryngol Head Neck Surg 73(4):447–454, 2020). ENT and head and neck surgeons face difficulties while treating tracheal stenosis. Mechanical stress from extended endotracheal intubation or tracheostomy, combined with hypoxic metabolic disturbances during an underlying event, is the most frequent cause of tracheal stenosis (Al-Azhar Int Med J 3(10):149-57, 2022). The main objective of the study is to assess the outcomes of tracheal resection and anastomosis in patients who presented with tracheal stenosis. This emphasizes the need for proper case selection and timely surgical intervention to relieve the airway obstruction and to ensure the effectiveness of tracheal resection and anastomosis as the less morbid approach by avoiding a midline sternotomy.

The study was conducted in a tertiary care center on 25 patients who were admitted in ENT ward from the year 2011 to year 2021. Case records of those patients who underwent tracheal resection and anastomosis were analyzed on a retrospective basis. Detailed history taking and clinical examination with appropriate investigations like flexible bronchoscopy, computed tomography with 3-dimensional reconstruction, video laryngoscopy, direct laryngoscopy, and lung function tests were carried out for all the patients in the study as required. An evaluation of GERD was also done. Appropriate surgical procedure was done with regular post-operative follow-up for 18 months.

Results

In our study, 92% of patients had satisfactory outcomes following tracheal resection and anastomosis, while some patients experienced minor complications. In 8% of patients, the primary surgery failed, among whom one patient underwent revision surgery and is doing well. The other patient with post-traumatic stenosis with a long stenotic segment underwent Shiann Yann Lee procedure in an outside center which resulted in failure following which T tube insertion was done. The patient showed improvement and was decannulated after a month.

In our study of 25 patients with tracheal stenosis, postoperative complications occurred and were managed accordingly. However, there was no significant correlation between these complications and patient age, sex, extent of stenosis, preoperative Cotton-Myer grading, or the type of surgical procedure performed. This lack of correlation may be attributed to the limited sample size.

Conclusion

Tracheal resection and anastomosis are challenging procedures and should be done only in centers with experience. Standard treatment consists of resection of the stenotic segment with end-to-end anastomosis. The geometry of the ends to be anastomosed is matched properly to avoid gaps or weak points and for air-tight seal anastomosis.
Management of analgosedation during noninvasive respiratory support: an expert Delphi consensus document developed by the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI)
Authors: Spinazzola G. , Spadaro S. , Ferrone G. , Grasso S. , Maggiore S. M. , Cinnella G. , Cabrini L. , Cammarota G. , Maugeri J. G. , Simonte R. , Patroniti N. , Ball L. , Conti G. , De Luca D. , Cortegiani A. , Giarratano A. , Gregoretti C.
Published: September 2024

Background

Discomfort can be the cause of noninvasive respiratory support (NRS) failure in up to 50% of treated patients. Several studies have shown how analgosedation during NRS can reduce the rate of delirium, endotracheal intubation, and hospital length of stay in patients with acute respiratory failure. The purpose of this project was to explore consensus on which medications are currently available as analgosedatives during NRS, which types of patients may benefit from analgosedation while on NRS, and which clinical settings might be appropriate for the implementation of analgosedation during NRS.

Methods

The Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) selected a panel of experts and asked them to define key aspects of the use of analgesics and sedatives during NRS treatment. The methodology applied is in line with the principles of the modified Delphi and RAND-UCLA methods. The experts developed statements and supportive rationales which were then subjected to blind votes for consensus.

Results

The use of an analgosedation strategy in adult patients with acute respiratory failure of different origins may be useful where there is a need to manage discomfort. This strategy should be considered after careful assessment of other potential factors associated with respiratory failure or inappropriate noninvasive respiratory support settings, which may, in turn, be responsible for NRS failure. Several drugs can be used, each of them specifically targeted to the main component of discomfort to treat. In addition, analgosedation during NRS treatment should always be combined with close cardiorespiratory monitoring in an appropriate clinical setting.

Conclusions

The use of analgosedation during NRS has been studied in several clinical trials. However, its successful application relies on a thorough understanding of the pharmacological aspects of the sedative drugs used, the clinical conditions for which NRS is applied, and a careful selection of the appropriate clinical setting.
Impact of early risk factors on schizophrenia risk and age of diagnosis: A Danish population-based register study
Authors: Lemvigh Cecilie K. , Ambrosen Karen S. , Ebdrup Bjørn H. , Glenthøj Birte Y. , Osler Merete , Fagerlund Birgitte
Published: September 2024

Background

While several risk factors for schizophrenia have been identified, their individual impacts are rather small. The relative independent and cumulative impacts of multiple risk factors on disease risk and age of onset warrant further investigation.

Study design

We conducted a register-based case–control study including all individuals receiving a schizophrenia spectrum disorder in Denmark from 1973 to 2018 (N = 29,142), and a healthy control sample matched 5:1 on age, sex, and parental socioeconomic status (N = 136,387). Register data included parental history of psychiatric illness, birth weight, gestational age, season of birth, population density of birthplace, immigration, paternal age, and Apgar scores. Data were analysed using logistic regression and machine learning.

Results

Parental history of psychiatric illness (OR = 2.32 [95%CI 2.21–2.43]), high paternal age (OR = 1.30 [1.16–1.45]), and low birth weight (OR = 1.28 [1.16–1.41]) increased the odds of belonging to the patient group. In contrast, being a second-generation immigrant (OR = 0.65 [0.61–0.69]) and high population density of the birthplace (OR = 0.92 [0.89–0.96]) decreased the odds. The findings were supported by a decision tree analysis where parental history, paternal age, and birth weight contributed most to diagnostic classification (ACCtest = 0.69, AUCtest = 0.59, p < 0.001). Twenty percent of patients were child-onset cases. Here, female sex (OR = 1.82 [1.69–1.97]) and parental psychiatric illness (OR = 1.62 [1.49–1.77]) increased the odds of receiving the diagnosis <18 years.

Conclusion

Multiple early factors contribute independently to a higher psychosis risk, suggesting cumulative effects leading to symptom onset. Routine assessments of the most influential risk factors could be incorporated into clinical practise. Being female increased the risk of diagnosis during childhood, suggesting sex differences in the developmental trajectories of the disorder.
Informatics and Artificial Intelligence–Guided Assessment of the Regulatory and Translational Research Landscape of First-in-Class Oncology Drugs in the United States, 2018-2022
Authors: Ronquillo Jay G. , South Brett , Naik Prakash , Singh Rominder , De Jesus Magdia , Watt Stephen J. , Habtezion Aida
Published: September 2024

PURPOSE

Cancer drug development remains a critical but challenging process that affects millions of patients and their families. Using biomedical informatics and artificial intelligence (AI) approaches, we assessed the regulatory and translational research landscape defining successful first-in-class drugs for patients with cancer.

METHODS

This is a retrospective observational study of all novel first-in-class drugs approved by the US Food and Drug Administration (FDA) from 2018 to 2022, stratified by cancer versus noncancer drugs. A biomedical informatics pipeline leveraging interoperability standards and ChatGPT performed integration and analysis of public databases provided by the FDA, National Institutes of Health, and WHO.

RESULTS

Between 2018 and 2022, the FDA approved a total of 247 novel drugs, of which 107 (43.3%) were first-in-class drugs involving a new biologic target. Of these first-in-class drugs, 30 (28%) treatments were indicated for patients with cancer, including 19 (63.3%) for solid tumors and the remaining 11 (36.7%) for hematologic cancers. A median of 68 publications of basic, clinical, and other relevant translational science preceded successful FDA approval of first-in-class cancer drugs, with oncology-related treatments involving fewer median years of target-based research than therapies not related to cancer (33
v
43 years;
P
< .05). Overall, 94.4% of first-in-class drugs had at least 25 years of target-related research papers, while 85.5% of first-in-class drugs had at least 10 years of translational research publications.

CONCLUSION

Novel first-in-class cancer treatments are defined by diverse clinical indications, personalized molecular targets, dependence on expedited regulatory pathways, and translational research metrics reflecting this complex landscape. Biomedical informatics and AI provide scalable, data-driven ways to assess and even address important challenges in the drug development pipeline.
Low-dose immunotherapy for patients with cancer in low- and middle-income countries (LMIC): A needs assessment.
Authors: Meraz-Brenez Andres , Soto Pérez de Celis Enrique , Demichelis Roberta , Verduzco-Rodriguez Leonardo , Gupta Arjun , Ragavan Meera Vimala , Chino Fumiko , Verduzco-Aguirre Haydee Cristina
Published: September 2024

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Background:
Immune checkpoint inhibitors are unavailable or unaffordable to many patients in LMIC, including Mexico. Some proposed strategies to improve access include weight-based dosing, vial sharing, or using low-dose IO (immunotherapy) schedules. Despite the potential advantages of low-dose IO to increase access and improve outcomes, there is limited information regarding the use of low-dose IO in real-world clinical practice in LMICs.
Methods:
We conducted a cross-sectional online survey of medical oncologists and hematologists practicing in Mexico. The survey was distributed via email using databases from the Mexican Society of Oncology and the Mexican Society of Hematology, and through physician Whatsapp groups in April and May 2024. The primary objective was to examine the prevalence and reasons of low-dose IO use in real-world clinical practice across Mexico. The survey assessed provider characteristics, prevailing attitudes, and potential barriers to low-dose IO adoption.
Results:
A total of 154 specialists answered the online survey, of which 77 completed it. The median age was 41 years (range 30-73); forty-five (58.4%) were men, thirty-one were women (40.2%), and two were non-binary. Fifty-nine (77%) were medical oncologists and 18 (23%) were hematologists. Twenty-two (29.3%) worked in private practice, nine (12%) in public institutions, and forty-four (58.7%) practiced in both. Seventy-two percent of respondents reported barriers in acquiring IO and forty-eight percent reported utilizing low-dose IO. For low-dose IO users, nivolumab was the most frequently prescribed drug (76%), followed by pembrolizumab (43%). The most frequent reason for using low-dose IO was reducing treatment-related cost (83% of respondents). Common barriers to low-dose IO use included concerns regarding the efficacy and safety of lower doses and a lack of knowledge about dosing protocols. Fifty respondents (67%) reported complete or moderate confidence in the efficacy of low-dose IO for patients with advanced disease, while only 36 respondents (49%) reported confidence on its efficacy for patients with localized disease.
Conclusions:
Despite its potential benefits of low-dose IO and a need to improve access to treatment, there are concerns about the efficacy and safety of this strategy among Mexican cancer specialists. Addressing these barriers and identifying facilitators could improve the acceptability of prospective trials studying low-dose IO in Mexico.
Stereotactic radiosurgery practice patterns for treatment of brain metastases: A large national cancer database study.
Authors: Shih Jonathan , Jain Bhav , Patel Manali I. , Taparra Kekoa A.
Published: September 2024

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Background:
Brain metastases (BM) portend high mortality rates. While whole brain radiation therapy (WBRT) is a commonly used treatment strategy for BM, stereotactic radiosurgery (SRS) has less neurocognitive toxicity with comparable survival. The objective of this study was to compare treatment practice patterns for SRS vs WBRT using a large national hospital database.
Methods:
The National Cancer Database (NCDB) was queried for patients ≥18 years treated with radiotherapy (RT) for a BM diagnosis between 2004-2020 and with known follow-up. Twelve cancers were included based on highest prevalence: breast, colorectal, kidney/bladder, liver, lung, lymphoma, melanoma, oral cavity, pancreas, prostate, and thyroid. Patients were grouped by first course RT modality (SRS vs WBRT) confirmed by fraction number (SRS: 1-5; WBRT: 5-15). Multivariable logistic regression assessed predictors of SRS as adjusted odds ratios (aOR) with 95% confidence intervals (95%CI). Analyses were adjusted for patient and cancer characteristics.
Results:
Of 112,232 patients with BM, 30,805 (27%) received SRS. Median age was 64 years. Most patients were White (84%), diagnosed in 2012-2020 (64%), with a higher income (56%), more education (55%), and Medicare/Medicaid (60%). The most common cancer treated with RT for BM was lung (85%). Patients were less likely to be treated with SRS if they were Korean (aOR=0.68; 95%CI=0.47-0.95), lower income (aOR=0.88; 95%CI=0.84-0.91), lower education (aOR=0.88; 95%CI=0.85-0.91), with Medicare/Medicaid (aOR=0.86; 95%CI=0.83-0.89) or no insurance (aOR=0.48; 95%CI=0.44-0.53), at a Midwest hospital (aOR=0.79; 95%CI=0.76-0.83; vs Northeast), and at a community (aOR=0.31; 95%CI=0.28-0.33; vs academic) or comprehensive community cancer program (aOR=0.56; 95%CI=0.54-0.58). Patients were more likely to be treated with SRS if they were Asian Indian or Pakistani (aOR=1.41; 95%CI =1.08-1.85), older (aOR=1.01; 95%CI=1.01-1.01), diagnosed in 2012-2020 (aOR=3.92; 95%CI=3.78-4.07; vs 2004-2011), lived farther from the hospital (aOR=1.00; 95%CI=1.00-1.00), and received chemotherapy (aOR=1.17; 95%CI=1.13-1.21).
Conclusions:
In one of the largest BM studies with over 110,000 US patients, disparities in SRS treatment patterns were identified. On adjusted analysis, SRS was less likely to be used for patients who were lower income, lower educational attainment, without private insurance, and treated at community centers. The data highlight populations with cancer and BM who may benefit from increased access to SRS.