bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental study on the biomechanical stability of complex acetabular fractures in the quadrilateral area: application of a dynamic anterior titanium-plate screw system
Authors: Wu Yong-De , Mei Xian-Zhong , Wu Wei-Fei , Zhang Hong-Xi , Liang Jie , Cai Xian-Hua
Published: July 2024

Background and objective

Complex acetabular fractures involving quadrilateral areas are more challenging to treat during surgery. To date, there has been no ideal internal fixation for these acetabular fractures. The purpose of this study was to evaluate the biomechanical stability of complex acetabular fractures using a dynamic anterior titanium-plate screw system of the quadrilateral area (DAPSQ) by simulating the standing and sitting positions of pelvic specimens.

Materials and methods

Eight formal in-preserved cadaveric pelvises aged 30–50 years were selected as the research objects. First, one hip of the normal pelvises was randomly used as the control model (group B) for measurement, and then one hip of the pelvises was randomly selected to make the fracture model in the 8 intact pelvises as the experimental model (group A) for measurement. In group A, acetabular both-column fractures in the quadrilateral area were established, and the fractures were fixed by DAPSQ. The biomechanical testing machine was used to load (simulated physiological load) from 400 N to 700 N at a 1 mm/min speed for 30 s in the vertical direction when the specimens were measured at random in simulated standing or sitting positions in groups. The horizontal displacement and longitudinal displacement of the acetabular fractures in the quadrilateral area were measured in both the standing and sitting simulations.

Results

As the load increased, no dislocation or internal fixation breakage occurred during the measurements. In the standing position, the horizontal displacement of the quadrilateral area fractures in group A and group B appeared to be less than 1 mm with loads ranging from 400 N to 700 N, and there was no significant difference between group A and group B (p > 0.05). The longitudinal displacement appeared to be greater than 1 mm with a load of 700 mm in group A (700 N, 2 cases), and the difference was significant between group A and group B (p < 0.05). In the sitting position, the horizontal and longitudinal displacements of the quadrilateral areas were within 0.5 mm in group A and group B, and there was no significant difference between group A and group B (p > 0.05).

Conclusion

For complex acetabular fractures in the quadrilateral area, DAPSQ fixation may provide early sitting stability, but it is inappropriate for patients to stand too early.
Let’s talk about work: pilot study of an education program on discussing work participation with cancer patients for general practitioners in training
Authors: de Wit Mariska , van Asselt Kristel M. , Mak-van der Vossen Marianne , de Boer Angela G.E.M.
Published: July 2024

Background

Cancer patients report that they lack support from healthcare providers when it comes to returning to or maintaining employment. In the education of general practitioners (GPs) in the Netherlands, there is little attention given to discussing work participation with patients. The aim of this pilot study was to evaluate a newly developed education program for GPs in training that focuses on discussing work participation with cancer patients.

Methods

Two groups of in total twenty-one GPs in training participated in the education program. GPs were educated about the importance of discussing work participation with patients, work-related problems cancer patients can experience, and advice they can give to support cancer patients regarding work issues. In this pilot study using a mixed-method design, participants evaluated the program in two self-developed questionnaires and in a focus group discussion.

Results

Seventeen participating GPs (81%) indicated that the education program was suitable for implementation in the education curriculum. Eleven participants (52%) reported that they had never discussed work participation with cancer patients before. Directly after the education program, eighteen participants (86%) reported that they planned to discuss work participation more often with their patients. Four months after the program, 67% indicated they had applied their new knowledge and skills in practice by discussing work participation and by referring cancer patients to occupational health professionals or online resources. According to the GPs in training, integrating the topic of work participation into other education for GPs in training and focusing on a broader group of patients could improve the impact of the education program.

Conclusions

According to the results of this pilot study, the newly developed education program increased the awareness of GPs in training on the importance of discussing work participation with cancer patients. Future studies should focus on whether cancer patients experience more support from their GPs for maintaining and returning to employment after their GP has participated in the training program.
Outcome evaluation of technical strategies on reduction of patient waiting time in the outpatient department at Kilimanjaro Christian Medical Centre—Northern Tanzania
Authors: Mwanswila Manasseh J. , Mollel Henry A. , Mushi Lawrencia D.
Published: July 2024

Background

The Tanzania healthcare system is beset by prolonged waiting time in its hospitals particularly in the outpatient departments (OPD). Previous studies conducted at Kilimanjaro Christian Medical Centre (KCMC) revealed that patients typically waited an average of six hours before receiving the services at the OPD making KCMC have the longest waiting time of all the Zonal and National Referral Hospitals. KCMC implemented various interventions from 2016 to 2021 to reduce the waiting time. This study evaluates the outcome of the interventions on waiting time at the OPD.

Methods

This is an analytical cross-sectional mixed method using an explanatory sequential design. The study enrolled 412 patients who completed a structured questionnaire and in-depth interviews (IDI) were conducted among 24 participants (i.e., 12 healthcare providers and 12 patients) from 3rd to 14th July, 2023. Also, a documentary review was conducted to review benchmarks with regards to waiting time. Quantitative data analysis included descriptive statistics, bivariable and multivariable. All statistical tests were conducted at 5% significance level. Thematic analysis was used to analyse qualitative data.

Results

The findings suggest that post-intervention of technical strategies, the overall median OPD waiting time significantly decreased to 3 h 30 min IQR (2.51–4.08), marking a 45% reduction from the previous six-hour wait. Substantial improvements were observed in the waiting time for registration (9 min), payment (10 min), triage (14 min for insured patients), and pharmacy (4 min). Among the implemented strategies, electronic medical records emerged as a significant predictor to reduced waiting time (AOR = 2.08, 95% CI, 1.10–3.94, p-value = 0.025). IDI findings suggested a positive shift in patients' perceptions of OPD waiting time. Problems identified that still need addressing include, ineffective implementation of block appointment and extension of clinic days was linked to issues of ownership, organizational culture, insufficient training, and ineffective follow-up. The shared use of central modern diagnostic equipment between inpatient and outpatient services at the radiology department resulted in delays.

Conclusion

The established technical strategies have been effective in reducing waiting time, although further action is needed to attain the global standard of 30 min to 2 h OPD waiting time.
Identifying the challenges of policy content related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in adolescents
Authors: Mirzaei Saeid , Mehrolhassani Mohammad Hossein , Yazdi-Feyzabadi Vahid , Jahanara Abbas , Haghdoost Ali Akbar , Oroomiei Nadia
Published: July 2024

Background

This study aims to identify policy content challenges related to high-risk sexual behaviors, stimulant drugs, and alcohol consumption in Iranian adolescents.

Methods

This qualitative study analyzed high-level and national documents pertaining to adolescent health, high-risk sexual behaviors, stimulant, and alcohol consumption in adolescents. The documents, which were published by public organizations between January 1979 and February 2023 and publicly available, were complemented by interviews with policymakers and executives. The study involved reviewing 51 papers and conducting interviews with 49 policymakers and executives at the national, provincial, and local levels who were involved in addressing adolescent behaviors related to high-risk sexual behaviors, stimulant, and alcohol consumption. The data collected was analyzed using conventional content analysis.

Results

The study’s results involved examining policy content and identifying challenges related to policy content. The analysis revealed that from the beginning of the Iranian revolution in 1979 until the late 1990s, the dominant approach in Iran was to deny the existence of high-risk behaviors among adolescents. However, in the early 2000s, the country began to adopt a new approach that acknowledged the social harms and ineffectiveness of previous strategies. As a result, a new policy framework was introduced to address high-risk behaviors among adolescents. The study’s interviews with policymakers and executives identified 12 challenges related to policy content, including parallel programs, lack of institutional mapping, lack of evidence-based policymaking, lack of integrated approach regarding training, late parent training, lack of consideration of all occurrence reasons in adolescents’ high-risk behaviors policymaking, and the existence of many abstinence policies regarding high-risk behaviors.

Conclusions

The study’s findings suggest that high-risk behaviors among adolescents in Iran are primarily a health issue, rather than a social or ideological one. Unfortunately, ideological approaches, stigma, and policymaking based on anecdotes rather than evidence have had a significant impact on this area. To improve policymaking in this domain, it is crucial to address these challenges by tackling stigma, adopting an integrated and holistic approach, and implementing evidence-based policies that consider all relevant aspects, including adolescents’ subcultures and policy audiences. Such an approach can also be useful for other countries facing similar conditions.
Costs and healthcare use of patients with chronic kidney disease in the Northern Territory, Australia
Authors: Chen Winnie , Howard Kirsten , Gorham Gillian , Abeyaratne Asanga , Zhao Yuejen , Adegboye Oyelola , Kangaharan Nadarajah , Talukder Mohammad Radwanur Rahman , Taylor Sean , Cass Alan ,   Territory Kidney Care Steering Committee
Published: July 2024

Background

The burden of chronic kidney disease (CKD) is high in the Northern Territory (NT), Australia. This study aims to describe the healthcare use and associated costs of people at risk of CKD (e.g. acute kidney injury, diabetes, hypertension, and cardiovascular disease) or living with CKD in the NT, from a healthcare funder perspective.

Methods

We included a retrospective cohort of patients at risk of, or living with CKD, on 1 January 2017. Patients on kidney replacement therapy were excluded from the study. Data from the Territory Kidney Care database, encompassing patients from public hospitals and primary health care services across the NT was used to conduct costing. Annual healthcare costs, including hospital, primary health care, medication, and investigation costs were described over a one-year follow-up period. Factors associated with high total annual healthcare costs were identified with a cost prediction model.

Results

Among 37,398 patients included in this study, 23,419 had a risk factor for CKD while 13,979 had CKD (stages 1 to 5, not on kidney replacement therapy). The overall mean (± SD) age was 45 years (± 17), and a large proportion of the study cohort were First Nations people (68%). Common comorbidities in the overall cohort included diabetes (36%), hypertension (32%), and coronary artery disease (11%). Annual healthcare cost was lowest in those at risk of CKD (AUD$7,958 per person) and highest in those with CKD stage 5 (AUD$67,117 per person). Inpatient care contributed to the majority (76%) of all healthcare costs. Predictors of increased total annual healthcare cost included more advanced stages of CKD, and the presence of comorbidities. In CKD stage 5, the additional cost per person per year was + $53,634 (95%CI 32,769 to 89,482, p < 0.001) compared to people in the at risk group without CKD.

Conclusion

The total healthcare costs in advanced stages of CKD is high, even when patients are not on dialysis. There remains a need for effective primary prevention and early intervention strategies targeting CKD and related chronic conditions.
Essential components of an effective transition from paediatric to adult neurologist care for adolescents with Duchenne muscular dystrophy; a consensus derived using the Delphi methodology in Eastern Europe, Greece and Israel
Authors: Molnar Maria Judit , Szabó Léna , Vladacenco Oana Aurelia , Cobzaru Ana Maria , Dor Talya , Dori Amir , Papadimas Georgios , Juříková Lenka , Litvinenko Ivan , Tournev Ivailo , Dixon Craig
Published: July 2024

Purpose

An increasing number of patients with Duchenne muscular dystrophy (DMD) now have access to improved standard of care and disease modifying treatments, which improve the clinical course of DMD and extend life expectancy beyond 30 years of age. A key issue for adolescent DMD patients is the transition from paediatric- to adult-oriented healthcare. Adolescents and adults with DMD have unique but highly complex healthcare needs associated with long-term steroid use, orthopaedic, respiratory, cardiac, psychological, and gastrointestinal problems meaning that a comprehensive transition process is required. A sub-optimal transition into adult care can have disruptive and deleterious consequences for a patient’s long-term care. This paper details the results of a consensus amongst clinicians on transitioning adolescent DMD patients from paediatric to adult neurologists that can act as a guide to best practice to ensure patients have continuous comprehensive care at every stage of their journey.

Methods

The consensus was derived using the Delphi methodology. Fifty-three statements were developed by a Steering Group (the authors of this paper) covering seven topics: Define the goals of transition, Preparing the patient, carers/parents and the adult centre, The transition process at the paediatric centre, The multidisciplinary transition summary – Principles, The multidisciplinary transition summary – Content, First visit in the adult centre, Evaluation of transition. The statements were shared with paediatric and adult neurologists across Central Eastern Europe (CEE) as a survey requesting their level of agreement with each statement.

Results

Data from 60 responders (54 full responses and six partial responses) were included in the data set analysis. A consensus was agreed across 100% of the statements.

Conclusions

It is hoped that the findings of this survey which sets out agreed best practice statements, and the transfer template documents developed, will be widely used and so facilitate an effective transition from paediatric to adult care for adolescents with DMD.
Clinical and genomic features of Mycobacterium avium complex: a multi-national European study
Authors: Wetzstein Nils , Diricks Margo , Anton Thomas B. , Andres Sönke , Kuhns Martin , Kohl Thomas A. , Schwarz Carsten , Lewin Astrid , Kehrmann Jan , Kahl Barbara C. , Schmidt Annika , Zimmermann Stefan , Jansson Moritz K. , Baron Sophie A. , Schulthess Bettina , Hogardt Michael , Friesen Inna , Niemann Stefan , Wichelhaus Thomas A.
Published: July 2024

Background

TheMycobacterium aviumcomplex (MAC) comprises the most frequent non-tuberculous mycobacteria (NTM) in Central Europe and currently includes twelve species.M. avium(MAV),M. intracellularesubsp.intracellulare(MINT), andM. intracellularesubsp.chimaera(MCH) are clinically most relevant. However, the population structure and genomic landscape of MAC linked with potential pathobiological differences remain little investigated.

Methods

Whole genome sequencing (WGS) was performed on a multi-national set of MAC isolates from Germany, France, and Switzerland. Phylogenetic analysis was conducted, as well as plasmids, resistance, and virulence genes predicted from WGS data. Data was set into a global context with publicly available sequences. Finally, detailed clinical characteristics were associated with genomic data in a subset of the cohort.

Results

Overall, 610 isolates from 465 patients were included. The majority could be assigned to MAV (n = 386), MCH (n = 111), and MINT (n = 77). We demonstrate clustering with less than 12 SNPs distance of isolates obtained from different patients in all major MAC species and the identification of trans-European or even trans-continental clusters when set into relation with 1307 public sequences. However, none of our MCH isolates clustered closely with the heater-cooler unit outbreak strain Zuerich-1. Known plasmids were detected in MAV (325/1076, 30.2%), MINT (62/327, 19.0%), and almost all MCH-isolates (457/463, 98.7%). Predicted resistance to aminoglycosides or macrolides was rare. Overall, there was no direct link between phylogenomic grouping and clinical manifestations, but MCH and MINT were rarely found in patients with extra-pulmonary disease (OR 0.12 95% CI 0.04–0.28,p < 0.001 and OR 0.11 95% CI 0.02–0.4,p = 0.004, respectively) and MCH was negatively associated with fulfillment of the ATS criteria when isolated from respiratory samples (OR 0.28 95% CI 0.09-0.7, p = 0.011). With 14 out of 43 patients with available serial isolates, co-infections or co-colonizations with different strains or even species of the MAC were frequent (32.6%).

Conclusions

This study demonstrates clustering and the presence of plasmids in a large proportion of MAC isolates in Europe and in a global context. Future studies need to urgently define potential ways of transmission of MAC isolates and the potential involvement of plasmids in virulence.
Precise reconstruction of the aortic valve using glutaraldehyde-treated autologous pericardium in new formula: a case report
Authors: Sabzi Feridoun , Heydari Aghigh , Asadmobini Atefeh
Published: July 2024

Background

The current study presents a novel and precise surgical technique for complete reconstruction of the aortic valve using glutaraldehyde-treated autologous pericardium in a patient with aortic valve disease and endocarditis. The technique aims to provide a more effective and reproducible method for aortic valve repair, with the goal of improving outcomes and quality of life for patients with aortic valve disease.

Case presentation

A 35-year-old Iranian male with aortic valve disease and endocarditis underwent aortic valve reconstruction surgery. Preoperative echocardiography showed a degenerative aortic valve with severe regurgitation, reduced left ventricular ejection fraction, and specific aortic root dimensions. The surgical technique involved precise measurements and calculations to design the size and shape of the new aortic valve cusps using autologous pericardium, with the goal of optimizing coaptation and function. The surgeon calculated the intercommissural distance based on the aortic annulus diameter to determine cusp size and shape. He tailored the pericardial cusps to have a height equal to 80% of the coaptation margin length. Detailed suturing techniques were used to ensure proper alignment and coaptation of the new cusps. Intraoperative evaluation of the valve function using suction and transesophageal echocardiography showed good coaptation and minimal residual regurgitation. At the 3-year follow-up, the patient had a well-functioning aortic valve with only trivial leak and was in satisfactory clinical condition.

Conclusions

Glutaraldehyde-treated autologous pericardium is a validated leaflet alternative, and the causes of its failure are late annular dilatation and other technique breakdowns. Current evidence reveals that aortic valve reconstruction with glutaraldehyde-treated autologous pericardium is associated with many advantages with the potential to improve patient outcomes and quality of life. Further clinical studies are warranted to evaluate the long-term durability and efficacy of this approach.
A study on the characteristics of the excavated pottery in Hanseong and Sabi periods of the Baekje Kingdom (South Korea): mineralogical, chemical and spectroscopic analysis
Authors: Choi Hyunkyung , Han Min Su , Moon Dong Hyeok , Kim Chul Sung , Nam Sang Won , Uhm Young Rang
Published: July 2024

The study analyzes the black color factors of black-burnished pottery excavated from the Pungnap Fortress and the Seokchon Tomb during the Hanseong period of the Baekje Kingdom. The current hypothesis surrounding the pottery’s black color factors suggests the use of magnetite, manganese oxide, and carbon. To compare the results of the black pottery, red pottery was used as the control group. To identify these black color factors, each hypothesis was investigated using several spectroscopic techniques. However, it was difficult to detect sufficient magnetite and manganese oxide on the surface of the black pottery to account for its black color. In contrast, a larger amount of carbon was located on the surface and core of the black pottery compared to the red pottery. These results indicate that the black factors can be credibly attributed to carbon rather than to magnetite or manganese oxide. The firing temperature of the black-burnished pottery was estimated from the mineral composition based on X-ray diffraction, and the firing atmosphere was deduced from the redox conditions based on the reduction index from Mössbauer spectroscopy. In addition, seven pieces of pottery excavated from Gunsu-ri Temple Site and Buyeo Ancient Tomb from the Sabi period of Baekje were investigated and compared the five pieces of pottery from the Hanseong period. Although the results were based on a limited number of potteries, various firing temperatures and redox atmosphere for pottery from the Hanseong and Sabi periods were carefully proposed.
The strategy of traditional Chinese settlement digitization: a landscape gene information chain theory-based perspective
Authors: Sa Qier , Qu Zaiming , Liu Yangyang , Shan Weilun
Published: July 2024

Traditional Chinese settlements (TCSs) embody millennia of human and cultural history, with the core culture serving as their essence. However, any damage incurred by these TCSs can result in the loss of core culture. In the era of China’s digital transformation, there has recently been a significant push toward digital reforms within TCSs. Thus, this paper introduces a traditional settlement digitalization (TSD) framework with a specific focus on enhancing the preservation of TCS landscape gene through the perspective of landscape gene information chain theory. This research uses the Nanxun traditional settlement (TS), Huzhou, Zhejiang, China, the first TS listed as a World Cultural Heritage Site in China, as a case study, extracting and identifying the area landscape gene and digital visualization status. This article identifies the landscape gene information chain of the Nanxun TS and redesigns its digital visualization and application scheme under the TSD framework. This study reveals the notion of a digital landscape gene characterized by four key attributes: identical, interactive, immersive, and intelligent. The results of this study will help guide the sustainable protection, application and planning of the Nanxun TS and promote the study of other sections of landscape gene theory. This research not only contributes to the development of landscape gene information chain theory but also provides guidance for the digital transformation of other TCSs and cultural heritage sites.
Effects of Mitoquinone (MitoQ) Supplementation on Aerobic Exercise Performance and Oxidative Damage: A Systematic Review and Meta-analysis
Authors: Gonzalo-Skok Oliver , Casuso Rafael A.
Published: July 2024

Background

Contracting skeletal muscle produces reactive oxygen species (ROS) originating from both mitochondrial and cytosolic sources. The use of non-specific antioxidants, such as vitamins C and E, during exercise has produced inconsistent results in terms of exercise performance. Consequently, the effects of the mitochondrial-targeted coenzyme Q10, named Mitoquinone (MitoQ) on exercise responses are currently under investigation.

Methods

In this study, we conducted a meta-analysis to quantitatively synthesize research assessing the impact of MitoQ on aerobic endurance performance and exercise-induced oxidative damage. PubMed, Web of Science, and SCOPUS databases were used to select articles from inception to January 16th of 2024. Inclusion criteria were MitoQ supplementation must be compared with a placebo group, showing acute exercise responses in both; for crossover designs, at least 14 d of washout was needed, and exercise training can be concomitant to MitoQ or placebo supplementation if the study meets the other inclusion criteria points. The risk of bias was evaluated through the Critical Appraisal Checklist (JBI).

Results

We identified eight studies encompassing a total sample size of 188 subjects. Our findings indicate that MitoQ supplementation effectively reduces exercise-induced oxidative damage (SMD: -1.33; 95% CI: -2.24 to -0.43). Furthermore, our findings indicate that acute and/or chronic MitoQ supplementation does not improve endurance exercise performance (SMD: -0.50; 95% CI: -1.39 to 0.40) despite reducing exercise-induced oxidative stress. Notably, our sensitivity analysis reveals that MitoQ may benefit subjects with peripheral artery disease (PAD) in improving exercise tolerance.

Conclusion

While MitoQ effectively reduces exercise-induced oxidative damage, no evidence suggests that aerobic exercise performance is enhanced by either acute or chronic MitoQ supplementation. However, acute MitoQ supplementation may improve exercise tolerance in subjects with PAD. Future research should investigate whether MitoQ supplementation concurrent with exercise training (e.g., 4–16 weeks) alters adaptations induced by exercise alone and using different doses.
Optimization of Eucalyptus essential oil extraction by applying response surface methodology in traditional distillation and its adaption to solar thermal process
Authors: Sareriya Kajal J. , Vanzara Piyush B. , Maiti Subarna
Published: July 2024

This work reports the utilization of solar thermal energy to generate Eucalyptus essential oil, reducing the dependence on conventional energy and minimizing the environmental impact. The study optimized oil extraction by traditional steam distillation using response surface methodology and applied the results to a Scheffler concentrator-driven solar steam distillation setup. The optimum factors included leaf size (0.02 m), extraction temperature (97.76 ℃), solid/solvent ratio (0.61), and extraction time (206 min), with temperature being crucial. The major oil components were 1–8 cineole (57.53–78.45%) and α-Pinene (15.27–27.83%). The outdoor experiments achieved an efficiency of 27% and produced 2 kg/h steam at an average solar insolation of 700 W/m2. Despite consistent processing temperatures favouring conventional steam distillation, the solar extraction process offers an eco-friendly alternative. In line with the sustainable development goals, this initiative is well-suited for sunny regions and small businesses targeting niche markets.
Content validation of the National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Lymphoma Symptom Index-18 (NFLymSI-18) in indolent B-cell non-Hodgkin’s lymphoma
Authors: Hurt Courtney N. , Kaiser Karen , Shaunfield Sara , Webster Kimberly A. , Keating Karen , Boyken Lara , Duffey Sara , Garcia Jessica , Cella David
Published: July 2024

Background

The NFLymSI-18 is a patient-reported outcome measure comprised of the highest priority symptoms, emotional concerns, treatment side effects, and other concerns identified by lymphoma patients and oncologists. This study assessed the content validity of the NFLymSI-18 for patients with indolent B-cell non-Hodgkin’s lymphoma (iNHL), with a focus on the Disease-Related Symptoms Physical (DRS-P) subscale.

Methods

Patients with a confirmed iNHL diagnosis who had received one or more lines of treatment were recruited during clinic visits. Patients described their symptoms, treatment side effects, and emotional concerns related to iNHL in a semi-structured interview. Qualitative data were analyzed using NVivo10.

Results

Data saturation was obtained by the 18th interview. Most participants (67%) had follicular lymphoma. 28% of participants had marginal zone lymphoma, and one participant had lymphoplasmacytoid lymphoma/Waldenström macroglobulinemia. Mean age of the 18 participants was 67 years. 56% of the sample was male. Most participants (67%) had a college or advanced degree. When asked to describe their iNHL symptoms, patients most often discussed swelling (n = 14), fatigue (n = 11), and pain (n = 8). The following symptoms were mentioned by three patients each: anxiety, appetite loss, rash, sleep disruption, trouble breathing, and malaise. Mapping of NFLymSI-18 content to these concerns showed the instrument includes all those most frequently mentioned symptoms.

Conclusions

This study supports the content validity of the NFLymSI-18, including its DRS-P Subscale, for patients with iNHL. The instrument shows strong validity for the most referenced symptoms of swelling, fatigue, and pain. The diversity of additional symptoms reported by patients is consistent with the heterogeneous symptomology of iNHL.
Reduction of myocardial lipid content assessed by H1 magnetic resonance spectroscopy in dyslipidemic patients after statins
Authors: Elmenyawy Eslam Elsayed Mohamed , Fadl Hend Gamal Abu-El , Waly Hesham Mohammed Fathy , Maaty Abdul Razek Abdul Lateef , Abdelaziz Hanaa Mahmoud Mohammad
Published: July 2024

Background

Dyslipidemia is one of the main modifiable risk factors for cardiovascular diseases, which accounts for one third of total deaths worldwide. Statin is considered the cornerstone therapy for treating dyslipidemic patients. H1 Cardiac magnetic resonance spectroscopy (MRS) is a special non-invasive, non-irradiating method for assessing myocardial lipid content in vivo in both health and disease.

Aim

To compare dyslipidemic patients and healthy individuals, and to detect the efficacy of statin on the myocardial lipid content in dyslipidemic patients to detect if there will be changes 6 months after starting statin therapy.

Methods

Laboratory lipid profile and myocardial lipid content had been measured by H1 MRS in thirty dyslipidemic patients and fifteen healthy matched age and sex individuals as a control group, then dyslipidemic patients were followed up 6 months after statin therapy at Cardiovascular Medicine and Radiology departments; Mansoura University Hospitals, Dakahlia Governorate, Egypt, during the period from January 2020 to October 2022.

Results

A total of thirty dyslipidemic patients were screened for lipid profile, myocardial lipid content by H1 MRS; 56.67% were male, with a mean age of 49 ± 9.19 years, and compared with fifteen healthy matched age and sex individuals as a control group. Laboratory lipid profile, and triglyceride lipid concentration by MRS were significantly higher in dyslipidemic group before initiating statin therapy compared to control group (p value, 0.001, 0.019 respectively). Median LDL levels were 161.10 ± 30.28 mg/dl before the start of statin therapy and were 114.27 ± 48.33 mg/dl after statin therapy (p < 0.001). There was a statistically significant reduction in triglyceride lipid concentration in dyslipidemic patients after 6 months of statin therapy: from 0.011 (0.001–0.55 (mmol/l), to 0.0025 (0.001–0.04 mmol/l) with a p value < 0.001.

Conclusions

Increased myocardial lipid content as measured by magnetic resonance spectroscopy was demonstrated in dyslipidemic patients in our study that decreased after 6 months of statin therapy.
Cyclodextrin inclusion complex and amorphous solid dispersions as formulation approaches for enhancement of curcumin’s solubility and nasal epithelial membrane permeation
Authors: Schoeman Carmen , van Niekerk Suzanne , Liebenberg Wilna , Hamman Josias
Published: July 2024

Background

Curcumin is a compound that occurs in the rhizomes of the turmeric plant (Curcuma longa) and has shown potential for the treatment of illnesses including certain neurodegenerative diseases. The bioavailability of curcumin is hindered by its extremely poor aqueous solubility.

Results

This study aimed to apply formulation strategies such as inclusion complex formation with hydroxypropyl-β-cyclodextrin (HPβCD), as well as amorphous solid dispersion (ASD) formation with poly(vinylpyrrolidone-co-vinyl acetate) (PVP VA64) and hydroxypropyl methylcellulose (HPMC) to increase curcumin’s solubility and thereby its nasal epithelial membrane permeation. The curcumin formulations were evaluated by means of DSC, TGA, FT-IR, XRPD, microscopic imaging, aqueous solubility and membrane permeation across nasal respiratory and olfactory epithelial membranes. The solubility of curcumin was substantially increased by the formulations from 8.4 µg/ml for the curcumin raw material to 79.0 µg/ml for the HPβCD inclusion complex, 256.4 µg/ml for the HPMC ASD and 314.9 µg/ml for the PVP VA64 ASD. The HPMC ASD only slightly changed the membrane permeation of curcumin, while the PVP VA64 ASD decreased the membrane permeation of curcumin. The HPβCD inclusion complex enhanced the nasal epithelial membrane permeation of curcumin statistically significantly across the olfactory epithelial tissue and extensively across the respiratory epithelial tissue.

Conclusion

Complexation of curcumin with HPβCD enhanced the solubility of curcumin and thereby also increased its permeation across excised nasal respiratory and olfactory epithelial tissue. This indicated high potential of the curcumin-HPβCD complex for nose-to-brain delivery of curcumin for treatment of neurodegenerative diseases by means of intranasal administration.

Graphical abstract
Three-dimensional artistic design method of ceramic products based on recurrent neural network technology
Authors: Wu Xueting , Song Jungyu
Published: July 2024

Three-dimensional digital technology has made breakthroughs and shown unique advantages in all walks of life. On the basis of practicality, the three-dimensional artistic design of ceramic products gradually adds some aesthetic, artistic design elements, which brings beautiful enjoyment to people’s lives and makes people’s lives colorful. This paper presents a three-dimensional artistic design method for ceramic products based on RNN (recurrent neural network) technology. With the establishment of the 3D YOLOv3 framework, the new model training is faster and more stable, the convergence speed of the loss function is faster, and the reconstructed 3D model is more accurate. After training for a certain number of times, the network gradually becomes stable, the accuracy rate is kept at 95%, and the loss function value is reduced below 0.2. The accuracy of the network model and the precision of semantic segmentation are improved. The semantic segmentation and object recognition under 3D scene reconstruction studied in this paper have certain theoretical value and high feasibility.
Ground-truth-free deep learning for 3D seismic denoising and reconstruction with channel attention mechanism
Authors: Cui Yang , Wu Juan , Bai Min , Chen Yangkang
Published: July 2024

Seismic denoising methods using supervised training normally rely on a large number of high-quality paired training data sets to obtain satisfactory results. There are two ways to generate labels for network training: one is to create synthetic data using the wave equation and the other is to use denoised data obtained through prior denoisers. However, using either training data generation methods will limit the networks’ denoising performances when faced with complex field data. Here, we develop a ground-truth-free method for 3D seismic data denoising. To improve its denoising efficiency, we exploit efficient channel attention and a convolutional block attention module to adjust the response of different channels to capture their correlation and significance using only a few parameters. Our method contains three stages: training set extension with a 3D patching scheme, training samples denoising using our unsupervised network, and an unpatching approach to reconstruct the denoised data. Numerical experiments demonstrate that our method outperforms the benchmark approaches in terms of signal-to-noise ratio improvement and useful signal preservation. Moreover, because our method is trained in an unsupervised manner, it offers greater flexibility than supervised methods when faced with different types of noise.
Prospective, Longitudinal Study of Cancer Predictors and Rates in a New York City Cohort of 598 Patients With Acromegaly
Authors: Freda Pamela U , Bruce Jeffrey N , Jin Zhezhen , Kostadinov Jane , Khandji Alexander G , Cremers Serge , Post Kalmon D
Published: July 2024

Context

Long-term growth hormone/insulin-like growth factor-1 (GH/IGF-1) excess could increase the risk of cancer in acromegaly, but individual levels of these hormones do not relate to this risk.

Objective

We newly investigated longitudinally-measured IGF-1 levels as a potential predictor of cancer in a large New York City acromegaly cohort.

Methods

We conducted a prospective, longitudinal study of 598 acromegaly (309 men, 289 women) and 292 clinically nonfunctioning pituitary adenoma (CNFPA) (140 women, 152 men) patients from the same underlying population. GH and IGF-1 levels were measured longitudinally and outcomes were observed during long-term follow-up. Cumulative exposure to IGF-1 excess was tested as a predictor of cancer. We compared cancer prevalence in acromegaly and CNFPA cohorts and incidence in each to that expected from Surveillance, Epidemiology, and End Results (SEER) data.

Results

Cancer prevalence by last follow-up was 22.6% in acromegaly and 12.7% in CNFPAs (odds ratio [OR] = 1.99 [95% CI, 1.34-2.97]) (P = .0005). Overall standardized incidence ratio for cancer was 1.78 (1.51-1.81) in the acromegaly and 1.26 (0.89-1.70) in the CNFPA cohorts. Cumulative exposure to IGF-1 excess, OR = 1.278 (1.060-1.541) (P = .01), years from acromegaly diagnosis to cancer or last follow-up, OR = 1.03 (1.004-1.057) (P = .024), and age at follow up, OR = 1.064 (1.047-1.082) (P < .001), were predictors of cancer.

Conclusion

Cancer risk is increased in acromegaly, but not in CNFPA patients. Cumulative exposure to IGF-1 excess is a predictor of cancer in acromegaly. Our data suggest that cancer risk in acromegaly relates to the degree and duration of IGF-1 excess and that full appreciation of this risk requires long-term follow up.
Clinical Course of Congenital Hypothyroidism With Gland In Situ and Necessity of L-Thyroxine Therapy After Re-evaluation
Authors: Pignata Luisa , Bagattini Brunella , Di Cosmo Caterina , Agretti Patrizia , De Marco Giuseppina , Ferrarini Eleonora , Montanelli Lucia , Tonacchera Massimo
Published: July 2024

Context

The clinical course and need for long-term L-thyroxine (LT4) therapy of congenital hypothyroidism (CH) with gland in situ (GIS) remain unclear.

Objective

To describe the clinical history of CH with GIS and evaluate the proportion of patients who can suspend therapy during follow-up.

Design and Setting

Retrospective evaluation of patients followed at referral regional center for CH of Pisa.

Patients

Seventy-seven patients with confirmed primary CH and GIS after positive neonatal screening were included. All children started LT4 upon CH confirmation on serum assay.

Interventions

At 3 years of age, 55 children underwent a clinical reevaluation after withdrawal of therapy with hormonal examinations, imaging of the thyroid gland with ultrasonography, and 123-iodine with perchlorate discharge test. Subsequent periodic controls of thyroid function were executed, and, when possible, a new attempt to stop LT4 was performed. Adequate follow-up data (at least 6 months after treatment suspension trial) were available for 49 patients.

Results

Among the 55 patients who were reassessed, 18 (32.7%) were euthyroid. Considering subsequent follow-up, 49% of patients were no longer treated and 51% were taking therapy. No differences in neonatal parameters were observed between the 2 groups; LT4 dose before the last trial off medication was higher in permanent CH (P .016).

Conclusion

Monitoring thyroid function in children with CH and GIS is necessary to evaluate the need for substitution and avoid overtreatment. Even if therapy can be suspended, patients need to be monitored because apparently normal thyroid function may decline several months after withdrawal of LT4.
The cellular basis of feeding-dependent body size plasticity in sea anemones
Authors: Garschall Kathrin , Pascual-Carreras Eudald , García-Pascual Belén , Filimonova Daria , Guse Annika , Johnston Iain G. , Steinmetz Patrick R. H.
Published: July 2024

Many animals share a lifelong capacity to adapt their growth rates and body sizes to changing environmental food supplies. However, the cellular and molecular basis underlying this plasticity remains only poorly understood. We therefore studied how the sea anemones Nematostella vectensis and Aiptasia (Exaiptasia pallida) respond to feeding and starvation. Combining quantifications of body size and cell numbers with mathematical modelling, we observed that growth and shrinkage rates in Nematostella are exponential, stereotypic and accompanied by dramatic changes in cell numbers. Notably, shrinkage rates, but not growth rates, are independent of body size. In the facultatively symbiotic Aiptasia, we show that growth and cell proliferation rates are dependent on the symbiotic state. On a cellular level, we found that >7% of all cells in Nematostella juveniles reversibly shift between S/G2/M and G1/G0 cell cycle phases when fed or starved, respectively. Furthermore, we demonstrate that polyp growth and cell proliferation are dependent on TOR signalling during feeding. Altogether, we provide a benchmark and resource for further investigating the nutritional regulation of body plasticity on multiple scales using the genetic toolkit available for Nematostella.
Investment Timing and Technological Breakthroughs
Authors: Décamps Jean-Paul , Gensbittel Fabien , Mariotti Thomas
Published: July 2024

We study the optimal investment policy of a firm facing both technological and cash-flow uncertainty. At any point in time, the firm can irreversibly invest in a stand-alone technology or wait for a technological breakthrough. Breakthroughs occur when market conditions become favorable enough, exceeding a threshold value that is ex ante unknown to the firm. The Markov state variables for the optimal investment policy are the current market conditions and their historic maximum, and the firm optimally invests in the stand-alone technology only when market conditions deteriorate enough after reaching a maximum. The path-dependent return required for investing in the stand-alone technology is always higher than if no technological breakthroughs could occur and can take arbitrarily large values following certain histories. Decreases in development costs or increases in the value of the new technology make the firm more prone to bearing downside risk and delaying investment in the stand-alone technology.

Funding: This research has benefited from financial support of the ANR [Programmes d’Investissements d’Avenir CHESS ANR-17-EURE-0010 and ANITI ANR-19-PI3A-0004] and the research foundation TSE-Partnership [Chaire Marchés des Risques et Création de Valeur, Fondation du Risque/SCOR].
ρ-Arbitrage and ρ-Consistent Pricing for Star-Shaped Risk Measures
Authors: Herdegen Martin , Khan Nazem
Published: July 2024

This paper revisits mean-risk portfolio selection in a one-period financial market, where risk is quantified by a star-shaped risk measure ρ. We make three contributions. First, we introduce the new axiom of sensitivity to large expected losses and show that it is key to ensure the existence of optimal portfolios. Second, we give primal and dual characterizations of (strong) ρ-arbitrage. Finally, we use our conditions for the absence of (strong) ρ-arbitrage to explicitly derive the (strong) ρ-consistent price interval for an external financial contract.
The Indirect Effect of Entrepreneurship on Pay Dispersion: Entry Cost Reduction, Mobility Threat, and Wage Redistribution Within Incumbent Firms
Authors: Castellaneta Francesco , Conti Raffaele , Kacperczyk Aleksandra Joanna , Mamadehussene Samir
Published: July 2024

Past research has examined the link between initiatives promoting entrepreneurship and compensation, but scholars have predominantly focused on earnings of individuals directly engaged in the founding process, such as founders, cofounders, and start-up employees. Shifting our focus to incumbent workers, we instead propose that a decline in the cost of entrepreneurship increases the variance in pay among incumbent workers who are not involved in entrepreneurial activities. We posit that, as entrepreneurship becomes a more attractive career option, due to institutional changes, the outside option value of entrepreneurship increases. The resulting increase in mobility threat will disproportionately benefit high earners or those employees who are more difficult to replace: As their bargaining power increases, incumbents will disproportionately reward these workers, especially when they are systematically more inclined to leave for entrepreneurship. We explore these arguments using a difference-in-differences methodology, based on the enactment of an entry reform that reduced the cost of entry in Portugal between 1995 and 2009. We find that an exogenous decrease in the administrative costs of establishing a new venture led to high earners capturing disproportionate rewards relative to low earners. We further show that this relationship was especially pronounced among high earners who (a) exhibited a higher ex ante propensity to transition into entrepreneurship; (b) had fewer credible outside options in paid employment; and (c) operated in industries with decentralized wage bargaining arrangements. By documenting the impact of institutional changes that promote entrepreneurship on incumbent workers’ pay, our study contributes to recent debates about the impact of entrepreneurship on individual earnings.

Funding: This work was supported by the CY Initiative, the FCT—Portuguese Foundation of Science and Technology, and the Knowledge, Technology and Organization Research Center at Skema.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.2022.16201 .