bluuebunny/crossref_metadata_2025 huggingface dataset:
Leading from the frontlines: community-oriented approaches for strengthening vaccine delivery and acceptance
Authors: Dhaliwal Baldeep K. , Seth Rajeev , Thankachen Betty , Qaiyum Yawar , Closser Svea , Best Tyler , Shet Anita
Published: June 2023

Background

Although immunization is one of the most successful public health interventions, vaccine hesitancy and the COVID-19 pandemic have strained health systems, contributing to global reductions in immunization coverage. Existing literature suggests that involving community members in vaccine interventions has been beneficial, but efforts to facilitate community ownership to motivate vaccine acceptance have been limited.

Methods

Our research leveraged community-based participatory research to closely involve the community from conception to implementation of an intervention to facilitate vaccine acceptance in Mewat District in Haryana, an area in India with extremely low vaccination coverage. Through the development of a community accountability board, baseline data collection on vaccination barriers and facilitators, and two human-centered design workshops, our team co-created a six-pronged intervention with community leaders and community health workers. This intervention included involving religious leaders in vaccine discussions, creating pamphlets of local vaccine champions for dissemination to parent and child caregivers, creating short videos of local leaders advocating for vaccines, implementing communication training exercises for community health workers, and implementing strategies to strengthen coordination between health workers and supervisors.

Results

Post-intervention data suggested parents and child caregivers had improvements in knowledge of the purpose of vaccines and side effects of vaccines. They noted that the involvement of religious leaders was beneficial, they were more willing to travel to vaccinate their children, and they had fewer non-logistical reasons to refuse vaccination services. Interviews with community leaders and community health workers who were involved in the creation of the intervention suggested that they experienced higher levels of ownership, they were better equipped to address community concerns, and that vaccine misinformation decreased in the post-intervention period.

Conclusion

Through this unique intervention to strengthen vaccine uptake that incorporated the needs, interests, and expertise of local community members, we developed a community-driven approach to strengthen vaccine acceptance in a population with low uptake. This comprehensive approach is essential to amplify local voices, identify local concerns and advocates, and leverage bottom-up strategies to co-design successful interventions to facilitate long-term change.
Pathophysiological basis of the cardiological benefits of SGLT-2 inhibitors: a narrative review
Authors: Panico Cristina , Bonora Benedetta , Camera Antonella , Chilelli Nino Cristiano , Prato Giuliana Da , Favacchio Giuseppe , Grancini Valeria , Resi Veronica , Rondinelli Maurizio , Zarra Emanuela , Pintaudi Basilio
Published: June 2023

In recent years, GLP-1 receptor agonists (GLP-1RA), and SGLT-2 inhibitors (SGLT-2i) have become available, which have become valuable additions to therapy for type 2 diabetes as they are associated with low risk for hypoglycemia and cardiovascular benefits. Indeed, SGLT-2i have emerged as a promising class of agents to treat heart failure (HF). By inhibiting SGLT-2, these agents lead to excretion of glucose in urine with subsequent lowering of plasma glucose, although it is becoming clear that the observed benefits in HF cannot be explained by glucose-lowering alone. In fact, multiple mechanisms have been proposed to explain the cardiovascular and renal benefits of SGLT-2i, including hemodynamic, anti-inflammatory, anti-fibrotic, antioxidant, and metabolic effects. Herein, we review the available evidence on the pathophysiology of the cardiological benefits of SGLT-2i. In diabetic heart disease, in both clinical and animal models, the effect of SGLT-2i have been shown to improve diastolic function, which is even more evident in HF with preserved ejection fraction. The probable pathogenic mechanisms likely involve damage from free radicals, apoptosis, and inflammation, and therefore fibrosis, many of which have been shown to be improved by SGLT-2i. While the effects on systolic function in models of diabetic heart disease and HF with preserved ejection fraction is limited and contrasting, it is a key element in patients with HF and reduced ejection fraction both with and without diabetes. The significant improvement in systolic function appears to lead to subsequent structural remodeling of the heart with a reduction in left ventricle volume and a consequent reduction in pulmonary pressure. While the effects on cardiac metabolism and inflammation appear to be consolidated, greater efforts are still warranted to further define the entity to which these mechanisms contribute to the cardiovascular benefits of SGLT-2i.
Alterations of gut microbiota are associated with blood pressure: a cross-sectional clinical trial in Northwestern China
Authors: Lv Jing , Wang Jihan , Yu Yan , Zhao Mengyao , Yang Wenjuan , Liu Junye , Zhao Yan , Yang Yanjie , Wang Guodong , Guo Lei , Zhao Heping
Published: June 2023

Background

The human gut microbiota (GM) is involved in the pathogenesis of hypertension (HTN), and could be affected by various factors, including sex and geography. However, available data directly linking GM to HTN based on sex differences are limited.

Methods

This study investigated the GM characteristics in HTN subjects in Northwestern China, and evaluate the associations of GM with blood pressure levels based on sex differences. A total of 87 HTN subjects and 45 controls were recruited with demographic and clinical characteristics documented. Fecal samples were collected for 16S rRNA gene sequencing and metagenomic sequencing.

Results

GM diversity was observed higher in females compared to males, and principal coordinate analysis showed an obvious segregation of females and males. Four predominant phyla of fecal GM included Firmicutes, Bacteroidetes, Actinobacteria and Proteobacteria. LEfSe analysis indicated that phylum unidentified_Bacteria was enriched in HTN females, while Leuconostocaceae, Weissella and Weissella_cibaria were enriched in control females (P < 0.05). Functionally, ROC analysis revealed that Cellular Processes (0.796, 95% CI 0.620 ~ 0.916), Human Diseases (0.773, 95% CI 0.595 ~ 0.900), Signal transduction (0.806, 95% CI 0.631 ~ 0.922) and Two-component system (0.806, 95% CI 0.631 ~ 0.922) could differentiate HTN females as effective functional classifiers, which were also positively correlated with systolic blood pressure levels.

Conclusions

This work provides evidence of fecal GM characteristics in HTN females and males in a northwestern Chinese population, further supporting the notion that GM dysbiosis may participate in the pathogenesis of HTN, and the role of sex differences should be considered.

Trial registration Chinese Clinical Trial Registry, ChiCTR1800019191. Registered 30 October 2018 – Retrospectively registered, http://www.chictr.org.cn/.
Priorities in Chronic nonbacterial osteomyelitis (CNO) – results from an international survey and roundtable discussions
Authors: Mohanna M. , Roberts E. , Whitty L. , Gritzfeld J. F. , Pain C. E. , Girschick H. J. , Preston J. , Hadjittofi M. , Anderson C. , Ferguson P. J. , Theos A. , Hedrich C. M.
Published: June 2023

Objective

Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disorder that predominantly affects children and young people. The pathophysiology and molecular mechanisms of CNO remain poorly understood, and diagnostic criteria and biomarkers are lacking. As a result, treatment is empiric and follows personal experience, case series and expert consensus plans.

Methods

A survey was designed to gain insight on clinician and patient experiences of diagnosing and treating CNO and to collate opinions on research priorities. A version containing 24 questions was circulated among international expert clinicians and clinical academics (27 contacted, 21 responses). An equivalent questionnaire containing 20 questions was shared to explore the experience and priorities of CNO patients and family members (93 responses).

Results

Responses were used to select topics for four moderated roundtable discussions at the “International Conference on CNO and autoinflammatory bone disease” (Liverpool, United Kingdom, May 25-26th, 2022). The group identified deciphering the pathophysiology of CNO to be the highest priority, followed by clinical trials, necessary outcome measures and classification criteria. Surprisingly, mental wellbeing scored behind these items.

Conclusions

Agreement exists among clinicians, academics, patients and families that deciphering the pathophysiology of CNO is of highest priority to inform clinical trials that will allow for the approval of medications for the treatment of CNO by regulatory agencies.
Canadian service providers' perspectives on reproductive coercion and abuse: a participatory action research to address their needs and support their actions
Authors: Lévesque Sylvie , Rousseau Catherine , Raynault-Rioux Laurence , Laforest Julie
Published: June 2023

Reproductive coercion and abuse (RCA) is a form of violence that affects sexual and reproductive health. Women and individuals who experienced RCA in an intimate relationship frequently consult service providers (SPs), such as health professionals or violence counselors. The objective of this article, which is the result of a participative action research project targeting RCA perpetrated by in an intimate partner, is twofold: (1) to better understand the practices as well as the barriers and facilitators encountered by SPs and (2) to develop information and awareness tools with them that meet their needs. To this end, we first held focus groups with 31 SPs. The use of thematic analysis revealed intervention strategies that focus on caring and listening, identifying signs of RCA, and creating a safe environment for disclosure. Their practices also focused on harm-reduction strategies and effective referrals. Despite the importance they gave to this issue, lack of time, inappropriate settings, and inadequate training hindered them from intervening effectively with individuals who were victims of RCA. They also indicated the need for easy-to-follow practice guidelines and patient education tools. Based on these findings and the best practices identified in the grey and scientific literature, we developed a practice guide for SPs and a booklet on RCA. The development of these guide and booklets involved a lot of back and forth to meet the needs expressed by the community and health professionals.
The utilisation of legal instruments by United Nations actors to restrict the exposure of children to unhealthy food and beverage marketing: a qualitative content analysis of UN instruments
Authors: Sing Fiona , Mackay Sally , Cinà Margherita , Swinburn Boyd
Published: June 2023

Introduction

United Nations (UN) agencies are influential global health actors that can introduce legal instruments to call on Member States to act on pressing issues. This paper examines the deployment and strength of global health law instruments used by UN actors to call on Member States to restrict the exposure of children to unhealthy food and beverage marketing.

Methods

Global health law instruments were identified from a review of four UN agencies that have a mandate over children’s exposure to marketing of unhealthy food and beverage products namely: the World Health Organization (WHO); the Food and Agriculture Organization (FAO); the United Nations General Assembly (UNGA) and the UN Office of the High Commissioner for Human Rights (OHCHR). Data on marketing restrictions were extracted and coded and descriptive qualitative content analysis was used to assess the strength of the instruments.

Results

A wide range of instruments have been used by the four agencies: seven by the WHO; two by the FAO; three by the UNGA; and eight by the UN human rights infrastructure. The UN human rights instruments used strong, consistent language and called for government regulations to be enacted in a directive manner. In contrast, the language calling for action by the WHO, FAO and UNGA was weaker, inconsistent, did not get stronger over time and varied according to the type of instrument used.

Conclusion

This study suggests that a child rights-based approach to restricting unhealthy food and beverage marketing to children would be supported by strong human rights legal instruments and would allow for more directive recommendations to Member States than is currently provided by WHO, FAO and UNGA. Strengthening the directives in the instruments to clarify Member States’ obligations using both WHO and child rights mandates would increase the utility of global health law and UN actors’ influence.
The influence of water content on the longitudinal modulus of elasticity of maize stalk pith and rind tissues
Authors: Sutherland Brandon , Steele Kirsten , Carter Joseph , Cook Douglas D.
Published: June 2023

Background

Modern computational modeling could provide the key to obtaining new insights into the mechanisms of maize stalk failure as well as suggesting new ways to improve stalk strength. However, a complete set of mechanical properties of maize tissues is required to enable computational modeling of maize stems. This study developed two compression test methods for obtaining the longitudinal modulus of elasticity of both rind and pith tissues, assessed the influence of water content on tissue properties, and investigated the relationship between rind modulus and pith modulus. These methods involved uniform 5–7 cm segments of maize stems which were scanned using a flatbed scanner then tested in compression using a universal testing machine in both intact and dissected (rind-only and pith-only) states.

Results

The modulus of elasticity of pith tissues was highest for fully turgid specimens and decreased as water was removed from the specimens. Water content was negatively correlated with the modulus of elasticity of the rind. Rind and pith tissues were found to be weakly correlated. The median ratio of rind modulus to pith modulus was found to be 17. Of the two methods investigated, the pith-only specimen preparation was found to be simple reliable while the rind-only method was found to be adversely affected by lateral bowing of the specimen.

Conclusions

Researchers can use the information in this paper to improve computational models of maize stems in three ways: (1) by incorporating realistic values of the longitudinal modulus of elasticity of pith and rind tissues; (2) by selecting pith and rind properties that match empirically observed ratios; and (3) by incorporating appropriate dependencies between these material properties and water content. From an experimental perspective, the intact/pith-only experimental method outlined in this paper is simpler than previously reported methods and provides reliable estimates of both pith and rind modulus of elasticity values. Further research using this measurement method is recommended to more clearly understand the influence of water content and turgor pressure on tissue properties.
Improved estimation of aboveground biomass of regional coniferous forests integrating UAV-LiDAR strip data, Sentinel-1 and Sentinel-2 imageries
Authors: Wang Yueting , Jia Xiang , Chai Guoqi , Lei Lingting , Zhang Xiaoli
Published: June 2023

Background

Forest aboveground biomass (AGB) is not only the basis for estimating forest carbon storage, but also an important parameter for evaluating forest carbon cycle contribution and forest ecological function. Data saturation and fewer field plots limit the accuracy of AGB estimation. In response to these questions, we constructed a point-line-polygon framework for regional coniferous forests AGB mapping using field survey data, UAV-LiDAR strip data, Sentinel-1 and Sentinel-2 imageries in this study. Under this framework, we explored the feasibility of acquiring the LiDAR sampling plots using the LiDAR sampling strategy consistent with the field survey, and analyzed the potentials of multi-scale wavelet transform (WT) textures and tree species stratification for improving AGB estimation accuracy of coniferous forests in North China.

Results

The results showed that UAV-LiDAR strip data of high density point clouds could be used as a sampling tool to achieve sample amplification. Experimental comparison results showed that the Sentinel-based AGB estimation models incorporating the multi-scale WT textures and SAR data performed better, and the model based on coniferous forests tree species significantly improved the performance of AGB estimation. Additionally, the accuracy comparison using different validation sets indicated that the proposed LiDAR sampling strategy under the point-line-polygon framework was suitable for estimating coniferous forests AGB on a large area. The highest accuracy of AGB estimation of larch, Chinese pine and all coniferous forests was 74.55%, 78.96%, and 73.42%, respectively.

Conclusions

The proposed approach can successfully alleviate the data signal saturation issue and accurately produce a large-scale wall-to-wall high-resolution AGB map by integrating optical and SAR data with a relative small number of field plots.
Changes in dairy cows’ behaviour, health, and production after transition from tied to loose housing
Authors: Pavlenko Anne , Kaart Tanel , Lidfors Lena , Arney David Richard , Aland Andres
Published: June 2023

Background

Transition of dairy cows from a tied to a loose housing system may affect their behaviour, health and production. Such housing system changes have become more frequent in Estonia but knowledge is lacking on how cows adapt to a new system. The aim of this study was to evaluate how cows’ behaviour, milk production and composition, and different aspects of their health changed after transition from tied to loose housing.

Results

A herd of 400 dairy cows was moved to a new system on the same farm, so that effects of transport were not confounding factors. Behavioural observations were made for approximately 4 months following transition. Milk production data were recorded from 12 months before to 12 months after transition. Examination for skin alterations and cleanliness, as well as body condition scoring were carried out before transition, and thereafter monthly throughout the study. Significant effects on behaviour were observed just after the transition, with increases in the behaviour indicative of poor welfare, such as vocalisation and aggression, and decreases in those indicative of a good state of welfare, such as ruminating, resting and grooming. These effects were of short duration, with most returning to a steady state after the first week. Milk production declined already before the transition but fell significantly after transition, and this fall lasted longer in older cows. Likewise, somatic cell counts were higher in all cows following transition, but older cows were affected significantly more than cows in the first lactation. The frequency of lameness and skin alterations increased on average after transition. Body condition scores fell after transition but recovered by the second month. Therefore, there were adverse effects on the behaviour, health and production of the dairy cows transferred, although, apart from older cows, of short duration.

Conclusion

The transition from tied to loose housing first had negative impacts on the welfare of the cows, although by the tenth day the behavioural indicators had returned to normal values. Impacts were more severe in higher parity cows, indicating that the change was more of a challenge for older cows.

The findings of this study suggest that animals’ behaviour and health should be more carefully observed within about 2 weeks after transition. It is quite likely that more and more farmers in Estonia and elsewhere will recognize the benefits of keeping their dairy cattle in loose housing, aimed at improving animal welfare and the value of the production chain.
Serum and follicular fluid levels of soluble receptor for advanced glycation end-products in women with and without polycystic ovary syndrome
Authors: Emami Neda , Alizadeh AliReza , Maleki-Hajiagha Arezoo , Dizavi Alireza , Vesali Samira , Moini Ashraf
Published: June 2023

Background

Advanced glycation end products (AGEs) are known to associate with the pathogenesis of several chronic diseases via interaction with their corresponding receptor (RAGE). The soluble forms of RAGE (sRAGE) are considered as anti-inflammatory agents by inhibiting the consequent adverse effects of AGE. We aimed at comparing sRAGE levels in the follicular fluid (FF) and serum of women with or without Polycystic Ovary Syndrome (PCOS) who underwent controlled ovarian stimulation for in vitro fertilisation (IVF).

Methods

A total of forty-five eligible women (26 non-PCOS (control) and 19 patients with PCOS (case)) were included the study. sRAGEs in FF and blood serum were measured using ELISA kit.

Results

No statistically significant differences were found in FF and serum sRAGE between case and control groups. Correlation analysis showed a significant and positive relationship between serum levels of sRAGE and FF sRAGE in PCOS (r = 0.639;p = 0.004), in control participants (r = 0.481;p = 0.017), and in total participants (r = 0.552;p = 0.000). Data revealed a statistically significant difference in FF sRAGE concentration among all participants by body mass index (BMI) categories (p = 0.01) and in controls (p = 0.022). Significant differences were found for all the nutrients and AGEs consumption according to Food Frequency Questionnaire in both groups (p = 0.0001). A significant reverse relationship was found between FF levels of sRAGE and AGE in PCOS (r = -0.513;p = 0.025). The concentration of sRAGE in serum and FF is the same in PCOS and control.

Conclusion

The present study revealed for the first time that there are no statistically significant differences between the concentration of serum sRAGE and FF sRAGE among Iranian women with and without PCOS. However, BMI and dietary intake of AGEs have more significant effects on sRAGE concentration in Iranian women. Future studies in developed and developing countries with larger sample sizes are required to determine the long-term consequences of chronic AGE over consumption and the optimal strategies for minimizing AGE-related pathology, specifically in low income and developing countries.
Efficacy of DigiKnowItNews: Teen, a multimedia educational website for adolescents about pediatric clinical trials: study protocol for a randomized controlled trial
Authors: Parker Alison E. , Scull Tracy M. , Kennedy Kathryn L.
Published: June 2023

Background

Pediatric research is crucial for the development of new scientific advancements, treatments, and therapies for adolescents. Yet relatively few pediatric clinical trials are conducted due to barriers to successful recruitment and retention, including knowledge and attitudes about clinical trials. Adolescents tend to experience greater autonomy to make decisions and have expressed interest in being part of the decision to participate in clinical trials. Increasing knowledge, positive attitudes, and self-efficacy related to clinical trials could positively impact the decision to participate in a pediatric clinical trial. However, there are currently few interactive, developmentally appropriate, web-based resources available to educate adolescents about clinical trials. DigiKnowItNews: Teen was created as a multimedia educational website to address the relatively low levels of enrollment in pediatric clinical trials and need for information to empower adolescents to make decisions about participating in clinical trials.

Methods

This is a parallel group randomized controlled superiority trial to test the effectiveness of DigiKnowItNews: Teen, for improving factors related to clinical trial participation among adolescent and parents. Eligible parent-adolescent (ages 12 to 17 years) pairs will be randomly assigned to one of two conditions: intervention or wait-list control. All participants will complete pre- and post-test questionnaires and participants assigned to the intervention will receive access to review the DigiKnowItNews: Teen content for 1 week. Wait-list control participants will have the option to review DigiKnowItNews: Teen after study completion. The primary outcomes are knowledge about clinical research, attitudes, and beliefs toward pediatric clinical trials, self-efficacy for making decisions related to clinical trial participation, willingness to participate in a future clinical trial, procedural fears, and parent-adolescent communication quality. Overall feedback and satisfaction related to DigiKnowItNews: Teen will also be collected.

Discussion

The trial will evaluate the effectiveness of DigiKnowIt News: Teen, an educational website about pediatric clinical trials for adolescents. If found effective in promoting factors related to future pediatric clinical trial participation, DigiKnowIt News: Teen could be used by adolescents, along with their parents, as they make the decision to participate in a clinical trial. Clinical trial researchers can also use DigiKnowIt News: Teen to aid their participant recruitment efforts.

Trial registration

ClinicalTrials.gov NCT05714943. Registered on 02/03/2023.
Left side perforated appendicitis with intestinal non-rotation: a case report
Authors: Assefa Mezgebu Alemneh , Molla Yohannis Derbew , Yasin Mensur Osman , Ali Oumer Ahmed , Desita Zerubabel Tegegne
Published: June 2023

Background

Acute appendicitis is the most common cause of acute abdominal pain, requiring emergency surgery. Symptoms and signs of acute appendicitis usually occur in the right lower quadrant. However, approximately one-third of cases have pain unexcepted location due to its various anatomical locations. Acute appendicitis is a very rare cause of left lower quadrant pain; if it occurs, situs inversus (SI) and midgut malrotation (MM) are uncommon anatomic anomalies that complicate its diagnosis and management.

Clinical presentation

Here we present a 23-year-old Ethiopian male patient who presented with epigastric and left paraumbilical abdominal pain, fever, and vomiting of a day duration. On examination at admission, the patient had left lower quadrant tenderness. Later, with the help of imaging studies, the patient was diagnosed with left-side acute perforated appendicitis with intestinal nonrotation, and he was operated on and discharged improved after 6 days of hospital stay.

Conclusion

Physicians should be aware that acute appendicitis in patients with intestinal mal-rotation may be present with left-side abdominal pain. Although it is extremely rare, acute appendicitis should always be considered in the differential diagnosis of left-side abdominal pain. An increase in awareness of this anatomical variant is essential for physicians.
Relapsed nodular lymphocyte-predominant Hodgkin lymphoma presenting as severe paraneoplastic hepatitis: a case report
Authors: Deacon Anthony J. , Goetz Naeman N. , Weber Nicholas , Clouston Andrew , Gonsalkorala Enoka , Baskerville Catherine , Leggett Barbara
Published: June 2023

Background

Hematological malignancies are an infrequent but important cause of liver dysfunction. There are several mechanisms by which this can occur, including direct malignant infiltration of the hepatic parenchyma and/or vasculature, vanishing bile duct syndrome, and paraneoplastic hepatitis. Paraneoplastic hepatitis is an extremely rare mechanism by which a hematological malignancy can cause liver dysfunction, and we present the first case, to our knowledge, of paraneoplastic hepatitis caused by nodular lymphocyte-predominant Hodgkin lymphoma in the literature.

Case presentation

A 28-year-old Caucasian male presented with 3 weeks of fatigue, epigastric pain, and jaundice. His medical history was significant for early stage nodular lymphocyte-predominant Hodgkin lymphoma in the cervical region in remission for 5 years after primary treatment with involved-field radiotherapy. Liver biochemistry was normal at the time of treatment for lymphoma and there was no known liver disease before the current presentation. On physical examination, there was scleral icterus and ecchymoses, but no evidence of hepatic encephalopathy, other stigmata of chronic liver disease, or lymphadenopathy. A computed tomography scan of his neck, chest, abdomen, and pelvis showed heterogeneous enhancement of the liver, multiple enlarged upper abdominal lymph nodes, and an enlarged spleen with multiple rounded lesions. Portal and hepatic veins were patent. Initial workup for viral, autoimmune-, toxin-, and medication-related hepatitis was negative. A transjugular liver biopsy was performed with histology showing a predominantly T-cell mediated hepatitis with very extensive multiacinar hepatic necrosis, but no evidence of lymphoma within the liver. Retroperitoneal lymph node biopsy revealed nodular lymphocyte-predominant Hodgkin lymphoma. The patient’s symptoms, bilirubin, and transaminases improved significantly after treatment with oral prednisolone and a staged introduction of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy.

Conclusions

Nodular lymphocyte-predominant Hodgkin lymphoma may cause paraneoplastic hepatitis. Physicians should be aware of the possibility of this life-threatening presentation and the importance of early liver biopsy and treatment before acute liver failure occurs. Interestingly, paraneoplastic hepatitis did not occur when nodular lymphocyte-predominant Hodgkin lymphoma was first diagnosed and confined to the cervical region, but was the presenting feature of the recurrence below the diaphragm.
Side-scan sonar underwater target segmentation using the BHP-UNet
Authors: Tang Yulin , Wang Liming , Li Houpu , Bian Shaofeng
Published: June 2023

Although target detection algorithms based on deep learning have achieved good results in the detection of side-scan sonar underwater targets, their false and missed detection rates are high for multiple densely arranged and overlapping underwater targets. To address this problem, a side-scan sonar underwater target segmentation model based on the blended hybrid dilated convolution and pyramid split attention UNet (BHP-UNet) algorithm is proposed in this paper. First, the blended hybrid dilated convolution module is adopted to improve the ability of the model to learn deep semantics and shallow features while improving the receptive field. Second, the pyramid split attention module is introduced to establish a long-term dependency between global and local information while processing multi-scale spatial features. Three sets of experimental results show that the BHP-UNet model proposed in this paper has better segmentation performance than the conventional fully convolutional network, UNet, and DeepLabv3+ models, and it is able to segment dense and overlapping targets to a certain extent. The proposed model will have significance as a guide for practical applications.
Rates and associations of relapse over 5 years of 2649 people with bipolar disorder: a retrospective UK cohort study
Authors: Hett Danielle , Morales-Muñoz Isabel , Durdurak Buse Beril , Carlish Max , Marwaha Steven
Published: June 2023

Background

Evidence regarding the rate of relapse in people with bipolar disorder (BD), particularly from the UK, is lacking. This study aimed to evaluate the rate and associations of clinician-defined relapse over 5 years in a large sample of BD patients receiving routine care from a UK mental health service.

Method

We utilised de-identified electronic health records to sample people with BD at baseline. Relapse was defined as either hospitalisation, or a referral to acute mental health crisis services, between June 2014 and June 2019. We calculated the 5-year rate of relapse and examined the sociodemographic and clinical factors that were independently associated with relapse status and the number of relapses, over the 5-year period.

Results

Of 2649 patients diagnosed with BD and receiving care from secondary mental health services, 25.5% (n = 676) experienced at least one relapse over 5 years. Of the 676 people who relapsed, 60.9% experienced one relapse, with the remainder experiencing multiple relapses. 7.2% of the baseline sample had died during the 5-year follow-up. Significant factors associated with experiencing any relapse, after adjustment for relevant covariates, were history of self-harm/suicidality (OR 2.17, CI 1.15–4.10, p = 0.02), comorbidity (OR 2.59, CI 1.35–4.97, p = 0.004) and psychotic symptoms (OR 3.66, CI  1.89–7.08, p < 0.001). Factors associated with the number of relapses over 5 years, after adjustment for covariates, were self-harm/suicidality (β = 0.69, CI 0.21–1.17, p = 0.005), history of trauma (β = 0.51, CI = 0.07–0.95, p = 0.03), psychotic symptoms (β = 1.05, CI 0.55–1.56, p < 0.001), comorbidity (β = 0.52, CI 0.07–1.03, p = 0.047) and ethnicity (β = − 0.44, CI − 0.87 to − 0.003, p = 0.048).

Conclusions

Around 1 in 4 people with BD in a large sample of people with BD receiving secondary mental health services in the UK relapsed over a 5-year period. Interventions targeting the impacts of trauma, suicidality, presence of psychotic symptoms and comorbidity could help to prevent relapse in people with BD and should be considered in relapse prevention plans.
More anterior placement of femoral tunnel position in ACL‐R is associated with postoperative meniscus tears
Authors: Hughes Jonathan D. , Gabrielli Alexandra S. , Dalton Jonathan F. , Raines Benjamin T. , Dewald Daniel , Musahl Volker , Lesniak Bryson P.
Published: June 2023

Purpose

The purpose of this study was to investigate the relationship between tunnel position in ACL reconstruction (ACL‐R) and postoperative meniscus tears.

Methods

This was a single institution, case–control study of 170 patients status‐post ACL‐R (2010–2019) separated into two matched groups (sex, age, BMI, graft type). Group 1—symptomatic, operative meniscus tears (both de novo and recurrent) after ACL‐R. Group 2—no postoperative meniscus tears. Femoral and tibial tunnel positions were measured by 2 authors via lateral knee radiographs that were used to measure two ratios (a/t and b/h). Ratio a/t was defined as distance from the tunnel center to dorsal most subchondral contour of the lateral femoral condyle (a) divided by total sagittal diameter of the lateral condyle along Blumensaat’s line (t). The ratio b/h was defined as distance between the tunnel and Blumensaat’s line (b) divided by maximum intercondylar notch height (h). Wilcoxon sign‐ranks paired test was used to compare measurements between groups (alpha set at p < 0.05).

Results

Group 1 had average follow up of 45 months and Group 2 had average follow up of 22 months. There were no significant demographic differences between Groups 1 and 2. Group 1—a/t was 32.0% (± 10.2), which was significantly more anterior than group 2, 29.3% (± 7.3; p < 0.05). There was no difference in average femoral tunnel ratio b/h or tibial tunnel placement between groups.

Conclusions

A relationship exists between more anterior/less anatomic femoral tunnel position and the presence of recurrent or de novo, operative meniscus tears after ACL‐R. Surgeons performing ACL‐R should strive for recreation of native anatomy via proper tunnel placement to maximize postoperative outcomes.

Level of evidence

Level III.
Electroacupuncture protective effects after cerebral ischemia are mediated through miR-219a inhibition
Authors: Dai Yaling , Wang Sinuo , Yang Minguang , Zhuo Peiyuan , Ding Yanyi , Li Xiaoling , Cao Yajun , Guo Xiaoqin , Lin Huawei , Tao Jing , Chen Lidian , Liu Weilin
Published: June 2023

Background

Electroacupuncture (EA) is a complementary and alternative therapy which has shown protective effects on vascular cognitive impairment (VCI). However, the underlying mechanisms are not entirely understood.

Methods

Rat models of VCI were established with cerebral ischemia using occlusion of the middle cerebral artery or bilateral common carotid artery. The brain structure and function imaging were measured through animal MRI. miRNA expression was detected by chip and qPCR. Synaptic functional plasticity was detected using electrophysiological techniques.

Results

This study demonstrated the enhancement of Regional Homogeneity (ReHo) activity of blood oxygen level-dependent (BOLD) signal in the entorhinal cortical (EC) and hippocampus (HIP) in response to EA treatment. miR-219a was selected and confirmed to be elevated in HIP and EC in VCI but decreased after EA. N-methyl-D-aspartic acid receptor1 (NMDAR1) was identified as the target gene of miR-219a. miR-219a regulated NMDAR-mediated autaptic currents, spontaneous excitatory postsynaptic currents (sEPSC), and long-term potentiation (LTP) of the EC-HIP CA1 circuit influencing synaptic plasticity. EA was able to inhibit miR-219a, enhancing synaptic plasticity of the EC-HIP CA1 circuit and increasing expression of NMDAR1 while promoting the phosphorylation of downstream calcium/calmodulin-dependent protein kinase II (CaMKII), improving overall learning and memory in VCI rat models.

Conclusion

Inhibition of miR-219a ameliorates VCI by regulating NMDAR-mediated synaptic plasticity in animal models of cerebral ischemia.
Comparison of the conventional and immersing powdered crude drugs (IPCD) methods for color and extraction of quantitative indicator ingredients in the Kampo formula decoction of daiokanzoto
Authors: Naruhashi Kazumasa , Amaike Natsumi , Shiraishi Karen , Sato Sumire , Uryuzu Chiho , Saito Yui , Tsue Narumi
Published: June 2023

Aim

The immersing powdered crude drugs (IPCD) method is a quick and simple method for preparing decoctions. Here, the conventional and IPCD methods were compared for the color and extraction of quantitative indicator ingredients in the daiokanzoto decoction solution, and the suitability of the IPCD method was assessed.

Methods

The color of decoction solutions was visually observed, and the Commission Internationale de L’éclairage (CIE) L*a*b*color parameters were measured using conventional and IPCD methods. The extracted amounts of sennoside A and glycyrrhizic acid, which are quantitative indicator ingredients of rhubarb and glycyrrhiza, respectively, were quantified.

Results

Using both methods, the decoction solution colors were strong for rhubarb alone and daiokanzoto but weak for glycyrrhiza alone. The color change of daiokanzoto was thought to be primarily caused by rhubarb alone. The L*a*b* values of the decoction solution determined by the IPCD method were comparable to those determined by the conventional method (60 min). Using the conventional method, sennoside A and glycyrrhizic acid were mostly extracted in 10 and 30 min, respectively. Using the IPCD method, both sennoside A and glycyrrhizic acid were fully extracted in 2 min. The IPCD method yielded significantly more sennoside A and glycyrrhizic acid (2 times and 1.5 times, respectively) than the conventional method (60 min).

Conclusion

The IPCD method was found to be comparable to the conventional method in terms of the color, and using IPCD method, the same or greater amounts of quantitative indicator ingredients of crude drugs in the decoction of daiokanzoto compared to the conventional method. It was suggested that there are limitations to assessing the equivalence of decoctions from decoction color. The IPCD method may be a useful method although it is prudent to use the IPCD method for Kampo formula decoction in clinical practice with a certain degree of caution.
Denosumab-associated jaw bone necrosis in cancer patients: retrospective descriptive case series study
Authors: Kang Ji-Yeon , Kim Sang-Yup , Lim Jae-Seok , Kim Jwa-Young , Jin Ga-Youn , Lee Yeon-Jung , Lee Eun-Young
Published: June 2023

Background

Denosumab (DMB) is a bone antiresorptive agent used to treat osteoporosis or metastatic cancer of the bones. However, denosumab-associated osteonecrosis of the jaw (DRONJ) has become a common complication in cancer patients. The prevalence of osteonecrosis of the jaw (ONJ) in cancer patients is estimated to be similar for both bisphosphonate-related cases (1.1 to 1.4%) and denosumab-related cases (0.8 to 2%), with the addition of adjunctive therapy with anti-angiogenic agents reportedly increasing its prevalence to 3%. (Spec Care Dentist 36(4):231–236, 2016). The aim of this study is to report on DRONJ in cancer patients treated with DMB (Xgeva®, 120mg).

Case presentation

In this study, we identified four cases of ONJ among 74 patients receiving DMB therapy for metastatic cancer. Of the four patients, three had prostate cancer and one had breast cancer. Preceding tooth extraction within 2 months of the last DMB injection was found to be a risk factor for DRONJ. Pathological examination revealed that three patients had acute and chronic inflammation, including actinomycosis colonies. Among the four patients with DRONJ referred to us, three were successfully treated without complications and had no recurrence following surgical treatment, while one did not follow up. After healing, one patient experienced a recurrence at a different site. Sequestrectomy in conjunction with antibiotic therapy and cessation of DMB use proved to be effective in managing the condition, and the ONJ site healed after an average 5-month follow-up period.

Conclusion

Conservative surgery, along with antibiotic therapy and discontinuation of DMB, was found to be effective in managing the condition. Additional studies are needed to investigate the contribution of steroids and anticancer drugs to jaw bone necrosis, the prevalence of multicenter cases, and whether there is any drug interaction with DMB.
Methicillin-resistant Staphylococcus aureus: novel treatment approach breakthroughs
Authors: Maddiboyina Balaji , Roy Harekrishna , Ramaiah M. , Sarvesh C. N. , Kosuru Sahasra Hanuman , Nakkala Ramya Krishna , Nayak Bhabani Shankar
Published: June 2023

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is a common bacterial infection that is a significant source of illness and mortality globally. The advancements in antibiotic therapies continue to be the critical aspects of treating bacterial infections, and their usage has lowered patient mortality and raised life expectancy.

Main body of the abstract

The ideal treatments for MRSA remain challenging, and the quest for new antibiotic targets and advanced drug delivery systems with safety profiles is necessary to ensure treating MRSA infections adequately in the future.

Short conclusion

This article primarily focuses on different therapeutic medications and their modes of action for general microbial infections and goes through the latest developments in novel drug delivery technologies, such as hydrogels, lipid particles, nanocarriers, and polymers for MRSA treatment.

Graphical Abstract
Medical and obstetric comorbidities and delivery outcomes in overweight and obese parturients: a retrospective analysis
Authors: Gat Roi , Hadar Eran , Orbach-Zinger Sharon , Einav Sharon
Published: June 2023

Background

Research on obesity in women of reproductive age is heterogeneous in gestational age and body mass index (BMI) classification and focused mostly on pregnancy-related rather than medical comorbidities. We studied the prevalences of pre-pregnancy BMI, chronic maternal and obstetric comorbidities, and delivery outcomes.

Methods

Retrospective analysis of real-time data collected during deliveries in a single tertiary medical center. Pre-pregnancy BMI was classified into seven groups (kg/m2): underweight (BMI < 18.5), normal weight 1 (18.5 ≤ BMI < 22.5), normal weight 2 (22.5 ≤ BMI < 25.0), overweight 1 (25.0 ≤ BMI < 27.5), overweight 2 (27.5 ≤ BMI < 30.0), obese (30.0 ≤ BMI < 35.0), and morbidly obese (BMI ≥ 35.0). Data were collected on maternal demographics, chronic medical and obstetric comorbidities, and delivery outcomes.

Results

Included were 13,726 women aged 18–50 years, with a gestational age of 240/7–416/7 weeks. Pre-pregnancy weights were 61.4% normal, 19.8% overweight, 7.6% obese, and 3.3% morbidly obese. Smoking was more prevalent among morbidly obese than among normal weight women. Obese and morbidly obese women were older and had more diabetes mellitus, hypertension, preeclampsia/eclampsia, and prior cesarean deliveries than normal weight parturients. Obese and morbidly obese women were also less likely to have a non-spontaneous conception, enter labor spontaneously (observed in the full study population and in a subgroup of term parturients), and were more likely to undergo cesarean rather than vaginal delivery. Subgroup analysis of primiparous women yielded similar results.

Conclusions

We identified a potential association between pre-pregnancy obesity and morbid obesity and higher rates of obstetric comorbidities, less natural conception and spontaneous labor, and more cesarean deliveries and adverse delivery outcomes. It remains to be seen if these findings remain after adjustment and whether they are related to obesity, treatment, or both.
TMEM132A regulates mouse hindgut morphogenesis and caudal development
Authors: Zeng Huiqing , Liu Aimin
Published: June 2023

Caudal developmental defects, including caudal regression, caudal dysgenesis and sirenomelia, are devastating conditions affecting the skeletal, nervous, digestive, reproductive and excretory systems. Defects in mesodermal migration and blood supply to the caudal region have been identified as possible causes of caudal developmental defects, but neither satisfactorily explains the structural malformations in all three germ layers. Here, we describe caudal developmental defects in transmembrane protein 132a (Tmem132a) mutant mice, including skeletal, posterior neural tube closure, genitourinary tract and hindgut defects. We show that, in Tmem132a mutant embryos, visceral endoderm fails to be excluded from the medial region of early hindgut, leading directly to the loss or malformation of cloaca-derived genitourinary and gastrointestinal structures, and indirectly to the neural tube and kidney/ureter defects. We find that TMEM132A mediates intercellular interaction, and physically interacts with planar cell polarity (PCP) regulators CELSR1 and FZD6. Genetically, Tmem132a regulates neural tube closure synergistically with another PCP regulator Vangl2. In summary, we have identified Tmem132a as a new regulator of PCP, and hindgut malformation as the underlying cause of developmental defects in multiple caudal structures.
Delayed abscission in animal cells – from development to defects
Authors: Kodba Snježana , Chaigne Agathe
Published: June 2023

Cell division involves separating the genetic material and cytoplasm of a mother cell into two daughter cells. The last step of cell division, abscission, consists of cutting the cytoplasmic bridge, a microtubule-rich membranous tube connecting the two cells, which contains the midbody, a dense proteinaceous structure. Canonically, abscission occurs 1–3 h after anaphase. However, in certain cases, abscission can be severely delayed or incomplete. Abscission delays can be caused by mitotic defects that activate the abscission ‘NoCut’ checkpoint in tumor cells, as well as when cells exert abnormally strong pulling forces on the bridge. Delayed abscission can also occur during normal organism development. Here, we compare the mechanisms triggering delayed and incomplete abscission in healthy and disease scenarios. We propose that NoCut is not a bona fide cell cycle checkpoint, but a general mechanism that can control the dynamics of abscission in multiple contexts.