bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of flavored e-cigarette use among adult vapers in the USA: an online cross-sectional survey of 69,233 participants
Authors: Farsalinos Konstantinos , Russell Christopher , Polosa Riccardo , Poulas Konstantinos , Lagoumintzis George , Barbouni Anastasia
Published: October 2023

Background

Flavored e-cigarettes remain a controversial topic with regulators planning or already implementing restrictions worldwide. In this study, we examined patterns of flavor use in e-cigarettes among a convenience sample of US adult vapers.

Methods

Participants aged ≥ 18 years who reported ever using an e-cigarette were included in the study (N = 69,233) and responded to an online questionnaire. Their smoking status was recorded as well as patterns of flavor use at e-cigarette use initiation, at the time of the survey and at the time of smoking cessation (for participants who used to smoke and were using e-cigarettes at the time of quitting).

Results

The most popular flavors at e-cigarette use initiation were fruit (82.8%), followed by dessert/pastry/bakery (68.6%) and candy/chocolate/sweet (52.2%). Slightly higher prevalence of using fruit and dessert/pastry/bakery flavors was observed in those who never smoked compared to those who were currently and formerly smoking. Tobacco flavors were used by 20.8% of the participants and was by far the least prevalent among participants who never smoked. Similar patterns were observed with participants’ choices at the time of the survey, but tobacco flavor use was substantially reduced (7.7%). Only 2.1% reported tobacco as the single most often used flavor. The most prevalent flavor at the time of quitting smoking was again fruit (83.3%), followed by dessert/pastry/bakery (68.0%) and candy/chocolate/sweet (44.5%). These flavors were considered the most helpful for quitting smoking. Tobacco flavor use at the time of smoking cessation was reported by 15.0%, while 9.3% considered it helpful for quitting smoking.

Conclusion

Non-tobacco flavors were popular among the US adult vapers who participated in the study, and were popular choices at the time of quitting smoking for those who formerly smoked. Tobacco flavor use prevalence was low and was further reduced over time. Regulators should consider the flavor choice of adult consumers, especially those who quit smoking, when preparing legislation on flavored e-cigarettes.
Effect of open versus video-assisted thoracoscopy on perioperative outcomes and survival for cases of thymic carcinomas and thymic neuroendocrine tumors
Authors: Li Gaiyan , Chang Hao , Wang Zhuangzhuang , He Dongjie , Qu Lin , Shao Qiuju , Wang Qiming
Published: October 2023

Background

The oncology-related indices between open and video-assisted thoracoscopic surgery (VATS) procedures for thymic carcinomas (TCs) and thymic neuroendocrine tumors (TNETs) remain unclear.

Methods

Propensity score matching (PSM) and multivariate Cox proportional risk models were used to evaluate the perioperative outcomes and survival rates of patients undergoing open and VATS for TCs and TNETs at the Second Affiliated Hospital of Air Force Military Medical University Hospital, between 2009 and 2018.

Results

Of the total 126 cases of TCs and TNETs, VATS treatment was used in 39 (30.9%). Advanced age and Masaoka-Koga staging were found to be independent prognostic factors for both TCs and TNETs, through a multifactorial Cox regression analysis. There was no significant difference in survival between the VATS and open groups before and after PSM; however, the VATS group had better perioperative-related indicators. There were no significant differences between the groups in terms of mortality at 30 days, mortality at 90 days, R0 resection rate, and 5-year survival rate (67.5% vs. 58.5% [P = 0.260] in the VATS group compared to the open group, in a PSM analysis of the 27 VATS and 27 open groups). Compared to the open group, the VATS group had a shorter length of hospital stay (13 days vs. 16 days, P = 0.015), a shorter level I care (0 days vs. 1 day, P = 0.016), and less intraoperative bleeding (50 mL vs. 300 mL, P < 0.001).

Conclusions

In this single-center retrospective study of TCs and TNETs, survival rates were comparable between the VATS group and the open group, and the VATS group showed improved perioperative-related parameters.
Insights into the diverse mechanisms and effects of variant CUL3-induced familial hyperkalemic hypertension
Authors: Sharma Prashant , Chatrathi Harish E.
Published: October 2023

Familial hyperkalemic hypertension (FHHt), also known as Pseudohypoaldosteronism type II (PHAII) or Gordon syndrome is a rare Mendelian disease classically characterized by hyperkalemia, hyperchloremic metabolic acidosis, and high systolic blood pressure. The most severe form of the disease is caused by autosomal dominant variants in CUL3 (Cullin 3), a critical subunit of the multimeric CUL3-RING ubiquitin ligase complex. The recent identification of a novel FHHt disease variant of CUL3 revealed intricacies within the underlying disease mechanism. When combined with studies on canonical CUL3 variant-induced FHHt, these findings further support CUL3’s role in regulating renal electrolyte transport and maintaining systemic vascular tone. However, the pathophysiological effects of CUL3 variants are often accompanied by diverse systemic disturbances in addition to classical FHHt symptoms. Recent global proteomic analyses provide a rationale for these systemic disturbances, paving the way for future mechanistic studies to reveal how CUL3 variants dysregulate processes outside of the renovascular axis.
Personalized radiomics signature to screen for KIT-11 mutation genotypes among patients with gastrointestinal stromal tumors: a retrospective multicenter study
Authors: Zhang Qing-Wei , Zhang Ran-Ying , Yan Zhi-Bo , Zhao Yu-Xuan , Wang Xin-Yuan , Jin Jing-Zheng , Qiu Qi-Xuan , Chen Jie-Jun , Xie Zhen-Hui , Lin Jiang , Cao Hui , Zhou Yan , Chen Hui-Min , Li Xiao-Bo
Published: October 2023

Objectives

Gastrointestinal stromal tumors (GISTs) carrying different KIT exon 11 (KIT-11) mutations exhibit varying prognoses and responses to Imatinib. Herein, we aimed to determine whether computed tomography (CT) radiomics can accurately stratify KIT-11 mutation genotypes to benefit Imatinib therapy and GISTs monitoring.

Methods

Overall, 1143 GISTs from 3 independent centers were separated into a training cohort (TC) or validation cohort (VC). In addition, the KIT-11 mutation genotype was classified into 4 categories: no KIT-11 mutation (K11-NM), point mutations or duplications (K11-PM/D), KIT-11 557/558 deletions (K11-557/558D), and KIT-11 deletion without codons 557/558 involvement (K11-D). Subsequently, radiomic signatures (RS) were generated based on the arterial phase of contrast CT, which were then developed as KIT-11 mutation predictors using 1408 quantitative image features and LASSO regression analysis, with further evaluation of its predictive capability.

Results

The TC AUCs for K11-NM, K11-PM/D, K11-557/558D, and K11-D ranged from 0.848 (95% CI 0.812–0.884), 0.759 (95% CI 0.722–0.797), 0.956 (95% CI 0.938–0.974), and 0.876 (95% CI 0.844–0.908), whereas the VC AUCs ranged from 0.723 (95% CI 0.660–0.786), 0.688 (95% CI 0.643–0.732), 0.870 (95% CI 0.824–0.918), and 0.830 (95% CI 0.780–0.878). Macro-weighted AUCs for the KIT-11 mutant genotype ranged from 0.838 (95% CI 0.820–0.855) in the TC to 0.758 (95% CI 0.758–0.784) in VC. TC had an overall accuracy of 0.694 (95%CI 0.660–0.729) for RS-based predictions of the KIT-11 mutant genotype, whereas VC had an accuracy of 0.637 (95%CI 0.595–0.679).

Conclusions

CT radiomics signature exhibited good predictive performance in estimating the KIT-11 mutation genotype, especially in prediction of K11-557/558D genotype. RS-based classification of K11-NM, K11-557/558D, and K11-D patients may be an indication for choice of Imatinib therapy.
Cardiovascular and microvascular outcomes according to vitamin D level and genetic variants among individuals with prediabetes: a prospective study
Authors: Zhong Pingting , Zhu Zhuoting , Wang Yunlong , Huang Wenyong , He Mingguang , Wang Wei
Published: October 2023

Background

Whether serum vitamin D mediate vascular diseases in prediabetic populations remains unclear. This study aimed to determine the associations between circulating 25-hydroxyvitamin D [25(OH)D] levels and vitamin D receptor (VDR) polymorphisms with the risk of macrovascular complications, including myocardial infarction and stroke, and microvascular complications such as diabetic nephropathy and retinopathy, among adults with prediabetes.

Methods

Participants with prediabetes in UK Biobank were included (N = 56,387). Multivariable dose–response and Cox proportion models were used to explore the relationship of serum 25(OH)D status and the risks of vascular complications. The interaction of VDR polymorphisms with serum 25(OH)D level on risks of vascular events was also assessed.

Results

During a median follow-up of 12 years, higher levels of 25(OH)D were significantly and nonlinearly associated with a lower risk of macrovascular diseases among prediabetic individuals. The adjusted hazard ratios (95% confidential interval) of serum 25(OH)D levels of ≥ 75.0 nmol/L versus < 25 nmol/L were 0.75 (0.63–0.88) for myocardial infarction, 0.74 (0.55–1.00) for stroke, 1.02 (0.60–1.74) for diabetic nephropathy, and 1.30 (0.92–1.84) for diabetic retinopathy, respectively. The rs2228570 (FokI) polymorphisms significantly interacted with 25(OH)D on incident myocardial infarction (P-interaction = 0.042) and stroke (P-interaction = 0.033). The individuals with serum 25(OH)D level of 50.0–74.9 nmol/L and rs2228570 (FokI) homozygotes had the lowest risks of vascular complications.

Conclusions

Lower serum 25(OH)D levels are significantly and nonlinearly associated with an increased risk of cardiocerebrovascular diseases in prediabetic individuals, with VDR polymorphisms of rs2228570 (FokI) modify such associations. Monitoring a safe 25(OH)D concentration is suggested to prevent the vascular complications for prediabetes.
A narrative review of the literature on illness uncertainty in hypermobile ehlers-danlos syndrome: implications for research and clinical practice
Authors: Feldman Estée C.H. , Homan Kendra J. , Williams Sara E. , Ting Tracy V. , Goldschneider Kenneth R. , Kashikar-Zuck Susmita
Published: October 2023

Background

Hypermobile Ehlers-Danlos syndrome (hEDS) is characterized by joint and skin laxity, and often accompanied by chronic pain, dysautonomia, increased distress and, functional limitations. The journey to accurate diagnosis is often prolonged due to unclear etiology of symptoms. This manuscript is a narrative review of the literature on illness uncertainty (IU) in hEDS, highlighting the unique facets of IU in this population, as compared to the broader chronic pain population (given symptom overlap between these two disease groups), that warrant additional investigation. Additionally, we considered the unique challenges associated with IU in the context of the developmental nuances of pediatric populations. Specifically, we aimed to (1) map the extant literature of the IU experience in chronic pain conditions broadly including the pediatric and adult research to identify key concepts related to IU and incorporate potential developmental considerations in IU; (2) delineate and describe the IU experience specifically in patients with hEDS, with the goal of identifying gaps in the literature based on aspects of presentation in hEDS that do and do not differ from the broader chronic pain population; and (3) elucidate the potential areas of adverse impact of IU in both general chronic pain populations, and those with hEDS specifically, to provide actionable areas for future research and clinical care of individuals with hEDS. Results of this review indicate that IU has been well-studied in chronic pain generally, but inadequately evaluated in hEDS specifically. Specific features of hEDS (complexity of the disorder, involvement of multiple bodily systems, contribution of organic pathology) may uniquely contribute to IU in this population. This review suggests that ambiguities surrounding the diagnosis of hEDS, symptom course, and treatment recommendations, along with misdiagnosis, perceived dismissal of symptoms, or attribution of symptoms to mental health concerns might increase risk for IU and related distress in patients.

Conclusion

Findings from the present review suggest that distinct features of hEDS yield a set of driving factors for IU that may be somewhat different than those faced by patients with chronic pain or other medical conditions. The development of a validated measure of IU to appropriately assess this construct in patients with hEDS is a research priority. In the clinical setting, providers should be attentive to the potentially aversive diagnostic and treatment experiences reported by patients and attempt to provide clear explanations based on the extant knowledge of hEDS, and implement best-practice recommendations for multidisciplinary treatment.
Oblique lateral interbody fusion combined with unilateral versus bilateral posterior fixation in patients with osteoporosis
Authors: Ma Xiang , Lin Longwei , Wang Jian , Meng Lin , Zhang Xingze , Miao Jun
Published: October 2023

Purpose

To compare the clinical efficacy of oblique lateral interbody fusion (OLIF) combined with unilateral (UPSF) and bilateral pedicle screw internal fixation (BPSF) in patients with osteoporosis.

Methods

Clinical data of 57 patients who underwent single-segment OLIF surgery with a clear diagnosis of osteoporosis from December 2018 to May 2021 were retrospectively analyzed, of which 27 patients underwent OLIF + UPSF and 30 patients underwent OLIF + BPSF. Surgical technique-related indexes were recorded, including operative time, operative blood loss and postoperative hospital stay; clinical outcome-related indexes included postoperative complications, Visual analogue scale (VAS) and Oswestry disability index (ODI) at preoperative, 1 week, 1 month, 3 months, and 12 months postoperative follow-up; and imaging outcome-related indexes included the measurement of preoperative and postoperative segmental lordosis (SL), and observation of the degree of cage subsidence and bone graft fusion.

Results

The surgery was successfully performed in 57 patients, and there was no statistical difference in operative blood loss and postoperative hospital stay between UPSF group and BPSF group (P > 0.05). In terms of operative time, there was a significant difference (UPSF group: 92.30 ± 11.03 min, BPSF group: 119.67 ± 16.41, P < 0.05). Postoperative VAS and ODI scores exhibited significant improvement (P < 0.05). At the 12 months postoperative follow-up, the VAS and ODI scores in the BPSF group were significantly better than those in the UPS group (P < 0.05). Compared with the preoperative images, the SL was significantly improved in both groups after surgery (P < 0.05). At 6 months postoperatively, the fusion rate in the UPSF group was significantly lower than that in the BPSF group (P < 0.05). At 1 year postoperatively, the fusion rate in the UPSF group was not significantly different from that in the BPSF group (P > 0.05). At 1 year postoperatively, the rate and degree of cage subsidence was higher in the UPSF group than in the BPSF group (P < 0.05).

Conclusion

In the long term, OLIF combined with bilateral posterior fixation applied to the osteoporosis patients is superior to OLIF surgery combined with unilateral posterior fixation in terms of clinical and imaging outcomes. It is effective in improving pain relief and functional improvement, accelerating bone graft fusion, and reducing cage subsidence compared with UPSF.
Recruiting women with ductal carcinoma in situ to a randomised controlled trial: lessons from the LORIS study
Authors: Wheelwright Sally , Matthews Lucy , Jenkins Valerie , May Shirley , Rea Daniel , Fairbrother Pat , Gaunt Claire , Young Jennie , Pirrie Sarah , Wallis Matthew G. , Fallowfield Lesley ,   on behalf of the LORIS Trial Management Group, Bartlett John M. S. , Billingham Lucinda , Bowden Sarah , Brace-McDonnell Samantha , Brookes Cassandra , Cain Henry , Dodwell David , Evans Andrew , Fairbrother Patricia , Ferguson Douglas , Francis Adele , Hanby Andrew , Hoar Fiona , Holt Simon , Kirwan Cliona , McIntosh Stuart , Pinder Sarah E. , Reed Malcolm , Roberts Tracy , Rusby Jennifer , Sharma Nisha , Sibley Pauline , Thomas Jeremy , Wilcox Maggie
Published: October 2023

Background

The LOw RISk DCIS (LORIS) study was set up to compare conventional surgical treatment with active monitoring in women with ductal carcinoma in situ (DCIS). Recruitment to trials with a surveillance arm is known to be challenging, so strategies to maximise patient recruitment, aimed at both patients and recruiting centres, were implemented.

Methods

Women aged ≥ 46 years with a histologically confirmed diagnosis of non-high-grade DCIS were eligible for 1:1 randomisation to either surgery or active monitoring. Prior to randomisation, all eligible women were invited to complete: (1) the Clinical Trials Questionnaire (CTQ) examining reasons for or against participation, and (2) interviews exploring in depth opinions about the study information sheets and film. Women agreeing to randomisation completed validated questionnaires assessing health status, physical and mental health, and anxiety levels. Hospital site staff were invited to communication workshops and refresher site initiation visits to support recruitment. Their perspectives on LORIS recruitment were collected via surveys and interviews.

Results

Eighty percent (181/227) of eligible women agreed to be randomised. Over 40% of participants had high anxiety levels at baseline. On the CTQ, the most frequent most important reasons for accepting randomisation were altruism and belief that the trial offered the best treatment, whilst worries about randomisation and the influences of others were the most frequent most important reasons for declining. Most women found the study information provided clear and useful. Communication workshops for site staff improved knowledge and confidence but only about half said they themselves would join LORIS if eligible. The most common recruitment barriers identified by staff were low numbers of eligible patients and patient preference.

Conclusions

Recruitment to LORIS was challenging despite strategies aimed at both patients and site staff. Ensuring that recruiting staff support the study could improve recruitment in similar future trials.

Trial registration

ISRCTN27544579, prospectively registered on 22 May 2014
Single-cell RNA sequencing distinctly characterizes the wide heterogeneity in pediatric mixed phenotype acute leukemia
Authors: Mumme Hope L. , Raikar Sunil S. , Bhasin Swati S. , Thomas Beena E. , Lawrence Taylor , Weinzierl Elizabeth P. , Pang Yakun , DeRyckere Deborah , Gawad Chuck , Wechsler Daniel S. , Porter Christopher C. , Castellino Sharon M. , Graham Douglas K. , Bhasin Manoj
Published: October 2023

Background

Mixed phenotype acute leukemia (MPAL), a rare subgroup of leukemia characterized by blast cells with myeloid and lymphoid lineage features, is difficult to diagnose and treat. A better characterization of MPAL is essential to understand the subtype heterogeneity and how it compares with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Therefore, we performed single-cell RNA sequencing (scRNAseq) on pediatric MPAL bone marrow (BM) samples to develop a granular map of the MPAL blasts and microenvironment landscape.

Methods

We analyzed over 40,000 cells from nine pediatric MPAL BM samples to generate a single-cell transcriptomic landscape of B/myeloid (B/My) and T/myeloid (T/My) MPAL. Cells were clustered using unsupervised single-cell methods, and malignant blast and immune clusters were annotated. Differential expression analysis was performed to identify B/My and T/My MPAL blast-specific signatures by comparing transcriptome profiles of MPAL with normal BM, AML, and ALL. Gene set enrichment analysis (GSEA) was performed, and significantly enriched pathways were compared in MPAL subtypes.

Results

B/My and T/My MPAL blasts displayed distinct blast signatures. Transcriptomic analysis revealed that B/My MPAL profile overlaps with B-ALL and AML samples. Similarly, T/My MPAL exhibited overlap with T-ALL and AML samples. Genes overexpressed in both MPAL subtypes’ blast cells compared to AML, ALL, and healthy BM included MAP2K2 and CD81. Subtype-specific genes included HBEGF for B/My and PTEN for T/My. These marker sets segregated bulk RNA-seq AML, ALL, and MPAL samples based on expression profiles. Analysis comparing T/My MPAL to ETP, near-ETP, and non-ETP T-ALL, showed that T/My MPAL had greater overlap with ETP-ALL cases. Comparisons among MPAL subtypes between adult and pediatric samples showed analogous transcriptomic landscapes of corresponding subtypes. Transcriptomic differences were observed in the MPAL samples based on response to induction chemotherapy, including selective upregulation of the IL-16 pathway in relapsed samples.

Conclusions

We have for the first time described the single-cell transcriptomic landscape of pediatric MPAL and demonstrated that B/My and T/My MPAL have distinct scRNAseq profiles from each other, AML, and ALL. Differences in transcriptomic profiles were seen based on response to therapy, but larger studies will be needed to validate these findings.
A phase 3 randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of sarilumab in patients with giant cell arteritis
Authors: Schmidt Wolfgang A. , Dasgupta Bhaskar , Sloane Jennifer , Giannelou Angeliki , Xu Yuqing , Unizony Sebastian H. , Mackie Sarah L. , Gonzalez-Gay Miguel A. , Spiera Robert , Warrington Kenneth J. , Villiger Peter M. , Nivens Michael C. , Akinlade Bolanle , Lin Yong , Buttgereit Frank , Stone John H.
Published: October 2023

Background

Giant cell arteritis (GCA) is primarily treated with glucocorticoids (GCs), which have substantial toxicity. Tocilizumab, an interleukin-6-receptor inhibitor (IL-6Ri), showed beneficial effects in GCA, leading to its approval. This study investigated the efficacy and safety of sarilumab (another IL-6Ri) in GCA.

Methods

This Phase 3, double-blind study comprised a 52-week treatment period and a 24-week follow-up phase. Eligible GCA patients were randomized to receive sarilumab 200 mg (SAR200 + 26W) or 150 mg (SAR150 + 26W) with a 26-week GC taper, or placebo with a 52-week (PBO + 52W) or 26-week (PBO + 26W) GC taper. The primary efficacy endpoint was sustained remission (SR) at week 52. Additional endpoints were SR at week 24, cumulative GC dose, and safety. The study was discontinued prematurely due to protracted recruitment timelines, because of the impact of COVID-19. Therefore, only descriptive statistics were summarized.

Results

Of the planned 360 subjects, only 83 were randomized and 36 were included in the week 52 analysis. At week 52, 46% (n = 6/13) of patients in SAR200 + 26W, 43% (n = 3/7) in SAR150 + 26W, 30% (n = 3/10) in PBO + 52W, and 0 (n = 0/6) in PBO + 26W taper groups achieved SR. Sensitivity analyses, excluding acute-phase reactants from the SR definition, showed similar results for SAR groups, but 60% (n = 6/10) in PBO + 52W and 17% (n = 1/6) in PBO + 26W taper groups achieved SR at week 52. Similar findings were noted at week 24. The proportions of patients who adhered to GC taper from week 12 through week 52 in each group were as follows: 46% (n = 6/13, SAR200 + 26W), 43% (n = 3/7, SAR150 + 26W), 60% (n = 6/10, PBO + 52W), and 33% (n = 2/6, PBO + 26W). The median actual cumulative GC dose received in the SAR200 + 26W group was lower than other groups. Most patients (80–100%) experienced treatment-emergent adverse events, with similar incidences reported across groups.

Conclusions

Owing to the small sample size due to the early termination, it is difficult to draw clear conclusions from this study. There were no unexpected safety findings.

Trial registration

ClinicalTrials.gov NCT03600805. Registered on July 26, 2018.
Trade-offs among leaf toughness, constitutive chemical defense, and growth rates in oaks are influenced by the level of leaf mass per area
Authors: Sancho-Knapik Domingo , Martín-Sánchez Rubén , Alonso-Forn David , Peguero-Pina José Javier , Ferrio Juan Pedro , Gil-Pelegrín Eustaquio
Published: October 2023

Key message

Among the variety of leaf defensive strategies to counteract herbivory attacks, the oak species analyzed in this study maximize investment in no more than one, with high-LMA oaks developing very tough leaves and low-LMA oaks favoring between high concentrations of condensed tannins or high growth rates.

Context

Plants develop a variety of defense strategies to counteract herbivory attacks, from physical and chemical defenses to tolerance strategies. Tradeoffs between strategies have been widely assessed from a resource allocation perspective, but there is a need to consider eventual interactions among them.

Aim

We evaluate the among-species tradeoff between three main constitutive plant defense traits, while considering the leaf mass per area ratio (LMA) as a proxy of leaf construction investment on area basis.

Methods

Leaf toughness measured as work of fracture, condensed tannins, and relative growth rate (RGR) were analyzed in a set of 19 Quercus L. species with contrasting LMA.

Results

Most species had low values either in two or in the three traits analyzed. Moreover, the highest values of work of fracture appeared in the species with high LMA; the highest values of condensed tannins were found in the species with the lowest LMA; and high values of RGR were measured in species with intermediate or lower values of LMA.

Conclusion

Oaks showed a trade-off among leaf defensive strategies influenced by LMA. Oaks with high LMA developed very tough leaves while oaks with low LMA presented lower values of toughness but favored between one of the two other strategies.
Giaccardi inequality for generalized convex functions and related results
Authors: Iqbal Wasim , Rehman Atiq ur
Published: October 2023

In this article, the famous Giaccardi inequality is generalized for modified $(h,m)$
(
h
,
m
)
-convex functions under the condition that h is a multiplicative positive function. The results are also discussed for different values of h and m. Also, Lagrange and Cauchy type mean value theorems for the functional due to Giaccardi’s inequality are obtained.
Moderation modelling of COVID-19 digital health literacy and sense of coherence across subjective social class and age among university students in Ghana
Authors: Amoako Isaac , Srem-Sai Medina , Quansah Frank , Anin Stephen , Agormedah Edmond Kwesi , Hagan Jnr John Elvis
Published: October 2023

Background

The study assessed the moderation modelling of digital health literacy and sense of coherence across subjective social class and age among university students in Ghana during the COVID-19 pandemic.

Methods

A total of 1160 students were conveniently sampled from two universities namely, the University of Education, Winneba and University of Cape Coast, using the descriptive cross-sectional survey design. Preliminary analysis was performed using descriptive statistics, whilst multivariate multiple regression and moderation analyses (Haye’s Model) were employed to analyze the main data.

Results

The study revealed that COVID-19 digital health literacy is directly and positively associated with sense of coherence among university students. Further, higher subjective social class positively and strongly moderated the relationship between COVID-19 digital health literacy and sense of coherence among university students. Additionally, the relationship between COVID-19 digital health literacy and sense of coherence was indirectly prominent among relatively older university students than younger ones.

Conclusions

The findings have implications for university management/authorities and public health agencies to organize effective orientation and self-management training programmes for university students.
Modeling the movement of Oecophylla smaragdina on short-length scales in an unfamiliar environment
Authors: Charoonratana L. , Thiwatwaranikul T. , Paisanpan P. , Suksombat S. , Smith M. F.
Published: October 2023

The movement of individual weaver ants, of Oecophylla smaragdina, was previously tracked within an unfamiliar arena. We develop an empirical model, based on Brownian motion with a linear drag and constant driving force, to explain the observed distribution of ants over position and velocity. Parameters are fixed according to the isotropic, homogeneous distribution observed near the middle of the arena. Then, with no adjustable parameters, the model accounts for all features of the measured population distribution. The tendency of ants to remain near arena edges is largely explained as a statistical property of bounded stochastic motion though evidence for active wall-following behavior appears in individual ant trajectories. Members of this ant species are capable of impressive feats of collective action and long-range navigation. But we argue that they use a simplistic algorithm, captured semi-quantitatively by the model provided, to navigate within the confined region.
Using AI-based detectors to control AI-assisted plagiarism in ESL writing: “The Terminator Versus the Machines”
Authors: Ibrahim Karim
Published: October 2023

The release of ChatGPT marked the beginning of a new era of AI-assisted plagiarism that disrupts traditional assessment practices in ESL composition. In the face of this challenge, educators are left with little guidance in controlling AI-assisted plagiarism, especially when conventional methods fail to detect AI-generated texts. One approach to managing AI-assisted plagiarism is using fine-tuned AI classifiers, such as RoBERTa, to identify machine-generated texts; however, the reliability of this approach is yet to be established. To address the challenge of AI-assisted plagiarism in ESL contexts, the present cross-disciplinary descriptive study examined the potential of two RoBERTa-based classifiers to control AI-assisted plagiarism on a dataset of 240 human-written and ChatGPT-generated essays. Data analysis revealed that both platforms could identify AI-generated texts, but their detection accuracy was inconsistent across the dataset.
Simultaneous determination of seven bile acids to study the effect of ivermectin on their plasma levels in rat by UHPLC–MS/MS
Authors: Mullapudi T. V. Radhakrishna , Ravi Punna Rao , Thipparapu Ganapathi
Published: October 2023

Bile acids (BAs) are considered to be important diagnostic biomarkers to understand the pathophysiology of hepatobiliary and metabolic diseases. BAs regulate lipid and glucose metabolism by binding to farnesoid X receptor (FXR). To date, there were no reports on the effect of an exogenous FXR modulator, ivermectin (IVM), on the plasma BA profiles in rats. To explore the effect of IVM on plasma BA levels in rat, an ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC–MS/MS) method was developed and validated for simultaneous determination of seven major BAs in rat plasma. The developed method was selective, specific, accurate and precise for the quantification of plasma BAs. Sprague–Dawley rats were orally administered with IVM at a dose of 5 mg/kg once a day for 14 days and the plasma BAs were determined before and after IVM exposure using developed UHPLC–MS/MS method. Once-daily administration of IVM for 14 days resulted in significant reduction in cholic acid and deoxycholic acid levels while glycodeoxycholic acid and taurodeoxycholic acid levels were not affected. Interestingly, tauro-α-muricholic acid and tauro-β-muricholic acid levels were significantly increased. This study revealed that IVM has an important effect on plasma BA profiles in rats. This report provides an analytical methodology that can be applied to investigate the effect of drugs or pathophysiological factors on plasma BA levels.
Why Humble Farmers May in Fact Grow Bigger Potatoes: A Call for Street-Smart Decision-Making in Sport
Authors: Hecksteden Anne , Keller Niklas , Zhang Guangze , Meyer Tim , Hauser Thomas
Published: October 2023

Background

The main task of applied sport science is to inform decision-making in sports practice, that is, enabling practitioners to compare the expectable outcomes of different options (e.g. training programs).

Main Body

The “evidence” provided may range from group averages to multivariable prediction models. By contrast, many decisions are still largely based on the subjective, experience-based judgement of athletes and coaches. While for the research scientist this may seem “unscientific” and even “irrational”, it is important to realize the different perspectives: science values novelty, universal validity, methodological rigor, and contributions towards long-term advancement. Practitioners are judged by the performance outcomes of contemporary, specific athletes. This makes out-of-sample predictive accuracy and robustness decisive requirements for useful decision support. At this point, researchers must concede that under the framework conditions of sport (small samples, multifactorial outcomes etc.) near certainty is unattainable, even with cutting-edge methods that might theoretically enable near-perfect accuracy. Rather, the sport ecosystem favors simpler rules, learning by experience, human judgement, and integration across different sources of knowledge. In other words, the focus of practitioners on experience and human judgement, complemented—but not superseded—by scientific evidence is probably street-smart after all. A major downside of this human-driven approach is the lack of science-grade evaluation and transparency. However, methods are available to merge the assets of data- and human-driven strategies and mitigate biases.

Short Conclusion

This work presents the challenges of learning, forecasting and decision-making in sport as well as specific opportunities for turning the prevailing “evidence vs. eminence” contrast into a synergy.
Perceptions of indigenous ugandan men on the use of long acting reversible contraceptives (LARCs) by rural women
Authors: Kibonire Ronald Arineitwe , Mphuthi David D.
Published: October 2023

Worldwide, unintended pregnancies remain a critical public health challenge, with 74 million women in low- and middle-income countries getting these pregnancies yearly. The African continent alone contributes about 25% of all unintended pregnancies globally. Even though not all unintended pregnancies are unwanted, they can lead to many health problems for mothers and children, like malnutrition, sickness, neglect, or abuse, as well as maternal and infant morbidities and mortalities. Globally, many women die due to complications related to childbirth, either during or after pregnancy. Contraceptives, especially for long-acting reversible Contraceptive methods (LARCs), are among the best interventions to reduce maternal death. LARCs help the mother delay pregnancy and allow for longer intervals in childbirth spacing. However, utilising LARCs globally and in Uganda remains low because of limited male partner support.

The purpose of this phenomenological qualitative research study was to elicit an understanding of the perceptions and beliefs of rural indigenous Ugandan men towards the use of LARCs by rural women. Ultimately the study designed strategies to enhance the uptake of those methods. Purposive sampling was used to identify 65 participants for focus group interviews and 30 for individual interviews comprising married men aged 20 to 49 years. The study was conducted in the Rubanda and Kiboga Districts of Uganda. The researcher used semi-structured questions for individual and focus group interviews.

The data analysis was done by transcribing the interviews, sorting the field notes, organising, and storing the data, listening to recordings, and reading field notes and interviews to look for patterns related to the perceptions and belief systems. Using the identified patterns, the researcher coded and categorised the data to build themes emerging on the phenomenon.

The study established negative perceptions and belief systems among rural indigenous Ugandan men regarding the use of LARCs by their rural women, which acted as barriers to utilisation. These perceptions included side effects, fears, desires, and cultural and religious beliefs. The study recommends strengthening social and behavioural change communication, strengthening service provision for LARCs, and monitoring and evaluation systems for LARCs. Additionally, policymakers should provide a conducive environment for LARC services provision, and the Ministry of Education and Sports, through health training institutions and universities, should prepare pre-service and in-service healthcare workers to provide LARC services.
Pulsed radiofrequency in the management of lumbar radicular pain: initial experience
Authors: Habib Hosam Eldin Abdel Azim , Abdo Sameh Fathy , El Nagar Ahmed Gabry
Published: October 2023

Background

Lumbar radicular pain (LRP) is one of the most encountered complaints in neurosurgical practice that pose a challenge in its management as adequate pain control, which is not always achieved.

Objective

The aim of this study was to evaluate the role of pulsed radiofrequency as a minimally invasive tool in the management of lumbar radicular pain of lumbar discogenic origin.

Methods

This is a prospective study that included 20 patients with lumbar radicular pain with radiological evidence of lumbar disc prolapse, who have been subjected to pulsed radiofrequency.

Results

The mean preoperative visual analogue score was 71 ± 14.38 dropped to a mean of 43.5 ± 21.47 at six-month follow-up. Seventy percentage of the study population had a satisfactory outcome, which did not correlate with the age, sex, or body mass index of the patients.

Conclusions

Pulsed radiofrequency is a safe and useful tool that may be used in the management of lumbar radicular pain.
Efficacy and safety of different Janus kinase inhibitors combined with methotrexate for the treatment of rheumatoid arthritis: a single-center randomized trial
Authors: Liao Xiaoling , Huo Wang , Zeng Wen , Qin Fang , Dong Fei , Wei Wanling , Lei Ling
Published: October 2023

Objective

To compare the efficacy and safety between baricitinib (BARI) and tofacitinib (TOFA) for the treatment of the rheumatoid arthritis (RA) patients receiving methotrexate (MTX) in clinical practice.

Methods

This retrospective study recruited 179 RA patients treated with BARI (2–4 mg/d) or TOFA (10 mg/d) at The First Affiliated Hospital of Guangxi Medical University from September 2019 to January 2022. The rate of low disease activity (LDA) was used as the primary end point. Secondary end points included the Disease Activity Scale-28 (DAS-28)-C-reactive protein (CRP); the rate of DAS28-CRP remission; visual analogue scale (VAS) for pain, swollen joint, and tender joint counts; and adverse events at the 6-month follow-up. Several factors affecting LDA achievement were also analyzed.

Results

Seventy-four patients were treated with BARI and 105 were treated with TOFA, including 83.24% females, with a median (IQR) age of 56.0 (53.0–56.0) years old and disease duration of 12.0 (6.0–12.0) months. There was no difference of the rate of LDA between the BARI and TOFA treatment groups. All disease indices in the two groups were significantly improved, including a significantly lower VAS in the BARI group (P < 0.05), reflecting the drug efficacy after 1 and 6 months of treatment. The incidence of adverse reactions was similar in these two groups.

Conclusion

The treatment efficacy and safety of BARI and TOFA in the RA patients were similar, but BARI was more effective in pain relief than TOFA. An older baseline age was more likely to achieve LDA in the BARI group, while a low baseline erythrocyte sedimentation rate (ESR) was more likely to achieve LDA in the TOFA group.
Positron emission mammography (PEM): a potentially promising one-stop shop for local staging of ILC
Authors: Hussein Samar Ahmed , Deabes Aya , Taha Sherif Nasser , Mokhtar Omnia , Moustafa Amr Farouk Ibrahim
Published: October 2023

Background

Invasive lobular cancer (ILC) has a high propensity for multiplicity, along with a high probability of incomplete surgical excision. Due to its insidious proliferative pattern, it tends to be clinically silent and radiologically elusive. We assess the performance characteristics of PEM in the detection and local staging of ILC.

Methods

A retrospective study evaluated a total of 193 patients who underwent PEM examination, including 44 patients with ILC. Image analysis of PEM examinations included morphological criteria, uptake pattern, lesion to background ratio (LTB) and maximum PEM uptake value (PUV max) assessment. The findings were correlated with the histopathological results.

Results

PEM showed high performance in surgical planning and detection of additional ILC lesions with sensitivity of 90.6% and specificity 82%. The mean PUV max and LTB of ILC lesions were significantly different from those of benign lesions and IDC lesions. The cutoff average LTB and PUVmax values to differentiate ILC from benign lesions were ≥ 3.3 & ≥ 2.2, respectively.

Conclusions

The inclusion of PEM provides a functional image that can improve the diagnostic accuracy of the conventional studies, decreasing the rates of false results and improving the detection of multicentric ILC lesions identification and their differentiation from other benign breast lesions.

Advance in knowledge

PEM is a promising new imaging technique that further improves the pretherapeutic assessment of ILC and facilitates the assessment of patients with renal impairment.
Ultrafast dissipative soliton generation in anomalous dispersion achieving high peak power beyond the limitation of cubic nonlinearity
Authors: Gene Jinhwa , Kim Seung Kwan , Do Lim Sun , Jeon Min Yong
Published: October 2023

The maximum peak power of ultrafast mode-locked lasers has been limited by cubic nonlinearity, which collapses the mode-locked pulses and consequently leads to noisy operation or satellite pulses. In this paper, we propose a concept to achieve mode-locked pulses with high peak power beyond the limitation of cubic nonlinearity with the help of dissipative resonance between quintic nonlinear phase shifts and anomalous group velocity dispersion. We first conducted a numerical study to investigate the existence of high peak power ultrafast dissipative solitons in a fiber cavity with anomalous group velocity dispersion (U-DSAD) and found four unique characteristics. We then built long cavity ultrafast thulium-doped fiber lasers and verified that the properties of the generated mode-locked pulses match well with the U-DSAD characteristics found in the numerical study. The best-performing laser generated a peak power of 330 kW and a maximum pulse energy of 80 nJ with a pulse duration of 249 fs at a repetition rate of 428 kHz. Such a high peak power exceeds that of any previous mode-locked pulses generated from a single-mode fiber laser without post-treatment. We anticipate that the means to overcome cubic nonlinearity presented in this paper can give insight in various optical fields dealing with nonlinearity to find solutions beyond the inherent limitations.
Adapting to uncertainty: navigating the pandemic with green and traditional HR practices
Authors: Sumayya Ume , Amen Ume , Hameed Irfan
Published: October 2023

This research explores the relationship between green human resource management (HR) practices and organizational agility in the context of international organizations based in Karachi, Pakistan, during the COVID-19 pandemic. Drawing upon previous research and theories, the study investigates the impact of traditional and green HR practices on organizational agility. The research underscores the crucial role of organizational support as a predictor of organizational agility during the pandemic. The study utilizes a convenience sample of international firms operating in Karachi, chosen for their potential adoption of green HR practices. Data were collected through a survey questionnaire consisting of two sets of questions, one for organizations implementing green HR practices and the other for those employing traditional HR practices. The survey items measured green training and development, green rewards and recognition, organizational support, and traditional HR counterparts. The internal consistency of the constructs was established through Cronbach’s alpha values, indicating good reliability. The results supported the hypotheses that organizations with green training and development and green rewards and recognition exhibit higher organizational agility levels than their traditional HR counterparts. However, the interaction between green HR practices and organizational support did not significantly predict organizational agility. Despite this, the study highlights the substantial impact of organizational support on organizational agility during the pandemic. These findings emphasize the need for organizations to invest in green HR practices, given their potential to enhance organizational agility. Organizations are encouraged to consider the adoption of green HR practices not only as a sustainability initiative but also as a means to enhance their ability to navigate complex and unpredictable environments.
21st century medicine and emerging biotechnological syndromes: a cross-disciplinary systematic review of novel patient presentations in the age of technology
Authors: Straw Isabel , Rees Geraint , Nachev Parashkev
Published: October 2023

Background

Biotechnological syndromes refer to the illnesses that arise at the intersection of human physiology and digital technology. Now that we experience health and illness through so much technology (e.g. wearables, telemedicine, implanted devices), the medium is redefining our expression of symptoms, the observable signs of pathology and the range of diseases that may occur. Here, we systematically review all case reports describing illnesses related to digital technology in the past ten years, in order to identify novel biotechnological syndromes, map out new causal pathways of disease, and identify gaps in care that have disadvantaged a community of patients suffering from these digital complaints.

Methods

PubMed, MEDLINE, Scopus, Cochrane Library and Web of Science were searched for case reports and case series that described patient cases involving biotechnological syndromes from 01/01/2012 to 01/02/2022. For inclusion the technology had to play a causative role in the disease process and had to be digital (as opposed to simple electronic).

Results

Our search returned 7742 articles, 1373 duplicates were removed, 671 met the criteria for full review and 372 were included in the results. Results were categorised by specialty, demonstrating that syndromes were most common in Cardiology (n = 162), Microbiology and Infectious Diseases (n = 36), and Emergency and Trauma (n = 26).

Discussion

The 372 unique patient cases demonstrated a range of severity from mild (e.g., injuries related to Pokemon Go) to moderate (e.g. pacemaker-generated rib fractures) and severe (e.g. ventilator software bugs causing cardiac arrest). Syndromes resulted from both consumer technology (e.g. gaming addictions) and medical technologies (e.g. errors in spinal stimulators). Cases occurred at both the individual level (e.g. faulty insulin pumps) and at the population level (e.g. harm from healthcare cyberattacks).

Limitations

This was a retrospective systematic review of heterogeneous reports, written in English, which may only reflect a small proportion of true prevalence rates in the population.