bluuebunny/crossref_metadata_2025 huggingface dataset:
A policy analysis on the inclusion of disabilities in natural disaster management in Indonesia
Authors: Pamungkas D B , Wahyunengseh R D , Haryanti R H
Published: March 2024

Climate change increases the occurrence of natural disasters. From 1909-2023, Indonesia experienced 613 natural disasters. The flood, which had 268 incidents, was the most significant natural disaster. Indonesia is known for being one of the world’s flood-prone areas. This is due to tidal water inundation, sea level rise, river overflows due to high rainfall, and land subsidence and urbanization. In facing climate change and dealing with natural disasters, no one must be left behind. Indonesia has had a policy for managing natural disasters since 1961, but Indonesia only had natural disaster management related to involving people with disabilities in 2007. This research aims to analyses the process of involving people with disabilities in managing natural disasters. The research uses qualitative methods with content analysis policy. The study finds Indonesia already has a national legal basis for involving disabilities from the planning, implementation, monitoring and evaluation stages as well as in the Disaster Risk Reduction Forum. This study concludes that there is a need for integrity between the central government and regional governments in managing natural disasters with the involvement of disabilities.
COD’s Level Reduction of Tofu Industrial Wastewater by Using Activated Coal Fly Ash as Adsorbent
Authors: Purba O G H F , Yanda R , Munandar A , Alam F C , Taher T
Published: March 2024

Tofu wastewater contained a high concentration of COD and will be dangerous if directly discharged into the environment without any pre-processing. In this research, tofu wastewater is processed using an adsorption process to determine the amount of COD reduction in tofu wastewater using coal fly ash. To maximize the adsorption process by enlarging the fly ash’s pores and removing the impurities, fly ash is activated first by using 2 M of H2SO4 100 mL. Fly ash was tested with XRD (X-Ray Diffraction) to know its crystal structure and tested with XRF (X-Ray Fluorescence) to determine the difference in the elemental composition of fly ash before and after the activation process. The research on the effect of time on the adsorption process was carried out with time variations of 15, 30, 45, 60, 75, 90, 105, and 120 minutes. The results showed that the intensity of silica in the fly ash after the activation process was more significant than before the activation process. The optimum time for fly ash to adsorb tofu wastewater was 105 minutes with eficiency of 79,71%.
Fatty Acid Profile of Pometia pinnata J.R.Forst. & G.Forst Seeds Oil as a Potentially Biodiesel Raw Material
Authors: Sholiha F U , Yuniastuti E , Nurrahma A O
Published: March 2024

Pometia pinnata J.R.Forst. & G.Forst was a tropical native to the Pacific region, it was widely found and cultivated in Indonesia and has gained attention for the yield of the seeds oil. The seed oil of Pometia pinnata was investigated for biodiesel raw material. This study explores the promising potential of Pometia pinnata seed oil as a sustainable source for biodiesel production based on the chemical composition of the fatty acid. The seeds were collected from around Central Java Province, Indonesia, and extracted by the soxhlet method. The profile of fatty acid was characterized by Gas Chromatography. The yield of Pometia pinnata seeds oil was 22.37%. Based on the GC Result, the fatty acid concentration was 48,86% of saturated fatty acid and 51,14% of unsaturated fatty acid. The main content of fatty acid was Arachidate (20:00) and Oleate (18:02). The result verified that Pometia pinnata potentially as a biodiesel raw material. These results can be the basis study for further studies about Pometia pinnata used as biodiesel.
Dynamic factors of formation of mining development strategy in the conditions of incomplete certainty of the raw material market
Authors: Lutsenko Serhii , Zhukov Serhii , Hryhoriev Yulian , Titov Danylo
Published: March 2024

The article deals with the issue of planning the development of mining operations in the context of a changing demand for iron ore products. One of the problems regarding iron ore deposit mining at the current stage of open mining development presented in this work. It includes the following: mines operate with a constant operational capacity while iron ore products price and demand significant variation is observed in mineral markets. In these conditions, there is a possibility of a significant increase in economic efficiency of mining due to the implementation of a flexible change in the main parameters of the open-pit, which is achieved by a justified correction of the development of mining operations by changing the dimensions, parameters and design of the active part of the working area in an open-pit. A technique for planning the development of mining operations in an open-pit has been developed, which differs from the known ones by the possibility of regulating the main parameters of the open-pit under conditions of a changing demand for iron ore products, and also takes into account the interrelationship of mining method parameters ensuring a basic ore stock ready for excavation in the open-pit.
Novel high-performance and cost-effective green inhibitor based on fundamental theoretical evaluations combined with electrochemical/surface examinations of Arachis hypogaea shell extract for pipeline steel corrosion in 1 M H2SO4 solution
Authors: Alao Alice Osheiza , Popoola Abimbola Patricia , Sanni Omotayo , Dada Modupeola
Published: March 2024

Traditional corrosion inhibitors have been frequently used for metal protection against strong acids. However, most of them are hazardous compounds with high costs. Therefore, due to the strict environmentally friendly regulations, green and low-cost compounds from renewable sources have gained high consideration in recent applications. In the present study, the Arachis hypogaea shell extract, commonly called groundnut, a cost-effective was selected to inhibit API X 65 pipeline steel corrosion in 1 mol·L−1 H2SO4 solution. The Arachis hypogaea shell composition was examined by FTIR analysis. The Arachis hypogaea shell on pipeline steel in H2SO4 solutions was studied via gravimetric, potentiodynamic polarization, and surface analysis (SEM and EDX). Electron donor atoms present in the Arachis hypogaea shell extract molecules is responsible for its adsorption on the surface of the metal. Experimental study shows that with increasing Arachis hypogaea shell concentrations, the inhibition tendency increased and reached 98.84% at 4 g L−1 after 24 h. Arachis hypogaea shell extract behaved as mixed-type inhibitor, and the surface coverage fits the Langmuir isotherm, signifying that the steel surface was covered by a monolayer of inhibitor molecules without intermolecular interactions. SEM analysis shows that Arachis hypogaea molecule adsorption on the metal surface reduced considerably its dissolution rate resulting in a smooth and clean surface with few damaged areas. The use of water for extraction of Arachis hypogaea shell exhibiting inhibition efficiency, non-toxic, and cost-effective than other green inhibitors, proposes the Arachis hypogaea shell as an excellent green inhibitor for API X 65 steel corrosion in 1 mol·L−1 H2SO4 solution.
Numerical investigation of CuSbS2 thin film solar cell using SCAPS-1D: enhancement of efficiency on experimental films by defect studies
Authors: Valeti Naga Jyothi , Prakash Krishna , Singha Monoj Kumar , Kumar Arvind
Published: March 2024

The study of photovoltaic solar cells has been an exciting field of research because of their environmentally friendly nature. Scientists are continuously searching for new methods to develop solar cells that are highly efficient and cost-effective. One promising option is the use of Copper Antimony Sulphide (CuSbS2) based ternary compound semiconductor in ultrathin film photovoltaic cells. This material has a high absorption coefficient, low cost, and is readily available in the earth’s crust. These characteristics make it an ideal candidate for use as a thin-film absorber layer in solar cells. In this work, FTO/CdS/In2S3/CuSbS2/Spiro-OMeTAD/Au device is proposed to improve the efficiency of experimentally designed CuSbS2-based thin film solar cells using numerical modeling. Device simulation was carried out using SCAPS-1D software, and the illumination spectrum used for this optimization was 1.5 AM. The simulated results from SCAPS-1D were compared to the experimental data. After optimizing the device parameters all the electrical parameters of the solar cell were improved. The optimized CuSbS2-based device shows power conversion efficiency (PCE) of 21.11% with short circuit current density (Jsc) of 20.96 mA cm−2, open circuit voltage (Voc) of 1.23 V, and fill factor (FF) of 81.84%. Based on the simulation results, it is possible to increase the performance of the device by varying different parameters such as the defect density of each layer, interfacial defect density, thickness, and doping concentration.
Well balanced pick-up assembly for double pulsed magnetic field apparatus
Authors: Bolzoni F , Cabassi R
Published: March 2024

The generation of high magnetic pulsed fields involves several technological challenges. State-of-the-art field peak intensities can be achieved by means of double-coil systems and, as for other configurations, a special pick-up system is required to clean the signal from spurious components and artifacts. However, the design of a well-balanced pick-up for double-coil systems is not a trivial task because of the different mutual inductance of the two field coils. In general the pick-up can be optimized for one coil only, but not for both. Here we present a new pick-up concept specifically aimed at solving this problem, based on an active compensation bridge and a special compensating coil located outside field-generating coils. Besides yielding a good balance of the signal over all pulse duration, a further advantage is an additional increase in the signal-to-noise ratio.
Theoretical study of vacuum-powered artificial muscles with inner support and flexible skin
Authors: Wang Tao , Wang Xi , Fu Guoqiang , Lu Caijiang
Published: March 2024

In the theoretical study of vacuum-powered artificial muscles, the inhomogeneous and nonlinear deformation properties of the skin have not been fully investigated, and the effect of the skin material on their performance has not been considered in the model. This work presents a theoretical analysis for the support-skin vacuum-powered artificial muscles and extends the skin to more general flexible materials, which endows the results with a strong generalization ability. The influence of various factors including structural parameters, axial force, negative pressure, and material parameter on the skin deformation are comprehensively analyzed, which is directly related to the actuation behaviors. Besides, the theoretical analysis is able to make an accurate prediction of the wrinkling behavior of the skin, including the critical boundary and wrinkling region. The experimental verification on the theoretical predicted configuration and wrinkled area of the skin have been carried out, which verifies the correctness of the results of the theoretical analysis. We believe that this work will provide an effective way for guiding the design and analyzing the actuation properties of such artificial muscles.
Generation model meets swin transformer for unsupervised low-dose CT reconstruction
Authors: Li Yu , Sun Xueqin , Wang Sukai , Qin Yingwei , Pan Jinxiao , Chen Ping
Published: March 2024

Computed tomography (CT) has evolved into an indispensable tool for clinical diagnosis. Reducing radiation dose crucially minimizes adverse effects but may introduce noise and artifacts in reconstructed images, affecting diagnostic processes for physicians. Scholars have tackled deep learning training instability by exploring diffusion models. Given the scarcity of clinical data, we propose the unsupervised image domain score generation model (UISG) for low-dose CT reconstruction. During training, normal-dose CT images are utilized as network inputs to train a score-based generative model that captures the prior distribution of CT images. In the iterative reconstruction, the initial CT image is obtained using a filtered back-projection algorithm. Subsequently, diffusion-based prior, high-frequency convolutional sparse coding prior, and data-consistency steps are employed to obtain the high-quality reconstructed image. Given the global characteristics of noise, the score network of the diffusion model utilizes a swin transformer structure to enhance the model’s ability to capture long-range dependencies. Furthermore, convolutional sparse coding is applied exclusively to the high-frequency components of the image, to prevent over-smoothing or the loss of crucial anatomical details during the denoising process. Quantitative and qualitative results indicate that UISG outperforms competing methods in terms of denoising and generalization performance.
Assessing trends in internalizing symptoms among racialized and minoritized adolescents: results from the Monitoring the Future Study 2005-2020
Authors: Kaur Navdep , Adkins-Jackson Paris B , Joseph Victoria , Campbell Mia N , Keyes Katherine M
Published: March 2024

The prevalence of depressive symptoms has rapidly accelerated among recent US adolescent birth cohorts, yet there remains little understanding of trends among racialized and minoritized groups. These groups may experience depressive symptoms due to the deleterious effects of structural racism. Using 2005-2020 Monitoring the Future survey data, we examine all racialized groups using within-group analyses to observe trends in high levels of depressive symptoms across cohorts. Generally, across racialized groups and ages, the odds of high depressive symptoms increased in recent birth cohorts. For example, among 15- to 16-year-old students racialized as American Indian or Alaska Native and Black Hispanic/Latine, the 2003-2006 birth cohort had 3.08 (95% CI, 2.00-4.76) and 6.95 (95% CI, 2.70-17.88) times’ higher odds, respectively, of high depressive symptoms as compared with the 1987-1990 birth cohorts. Moreover, in a given year, 15- to 16-year-olds generally experienced the highest depressive symptoms compared with 13- to 14-year-olds and 17- to 18-year-olds, suggesting that age effects peaked during midadolescence. Depressive symptoms increased among US adolescents by birth cohort, within all racialized and minoritized groups assessed. Public health efforts to reduce disparities may consider barriers such as structural racism that may impact the mental health of racialized/minoritized adolescents while increasing access to culturally competent mental health providers and school-based services.

This article is part of a Special Collection on Mental Health.
Transplantation of Cold-Stimulated Subcutaneous Adipose Tissue Improves Fat Retention and Recipient Metabolism
Authors: Luo Yucheng , Ma Wenhui , Cheng Shaowen , Yuan Tao , Li Jingyi , Hao Huiqin , Liu Kai , Zeng Minxi , Pan Yong
Published: March 2024

Background

Induction of beige fat for grafting is an emerging transplantation strategy. However, safety concerns associated with pharmaceutical interventions limit its wider application. Moreover, because beige fat is a special type of fat with strong metabolic functions, its effect on the metabolism of recipients after grafting has not been explored in the plastic surgery domain.

Objectives

The aim of this study was to explore whether cold-induced inguinal white adipose tissue (iWAT) transplantation has a higher retention rate and beneficial effects on recipient metabolism.

Methods

C57/BL6 mice were subjected to cold stimulation for 48 hours to induce the browning of iWAT and harvested immediately. Subsequently, each mouse received a transplant of 0.2 mL cold-induced iWAT or normal iWAT. Fat grafts and recipients' iWAT, epididymal adipose tissue, and brown adipose tissue were harvested at 8 weeks after operation. Immunofluorescence staining, real-time polymerase chain reaction, and western blot were used for histological and molecular analysis.

Results

Cold-induced iWAT grafting had a higher mean [standard error of the mean] retention rate (67.33% [1.74%] vs 55.83% [2.94%], P < .01) and more satisfactory structural integrity than normal iWAT. Histological changes identified improved adipose tissue homeostasis after cold challenge, including abundant smaller adipocytes, higher levels of adipogenesis, angiogenesis, and proliferation, but lower levels of fibrosis. More importantly, cold-induced iWAT grafting suppressed the inflammation of epididymal adipose tissue caused by conventional fat grafting, and activated the glucose metabolism and thermogenic activity of recipients' adipose tissues.

Conclusions

Cold-induced iWAT grafting is an effective nonpharmacological intervention strategy to improve the retention rate and homeostasis of grafts. Furthermore, it improves the adverse effects caused by traditional fat grafting, while also conferring metabolic benefits.
Adapted diabetes complications severity index predicts dementia risk in ageing type 2 diabetes mellitus patients
Authors: Sun Mingyang , Chen Wan-Ming , Wu Szu-Yuan , Zhang Jiaqiang
Published: March 2024

This study investigated the link between the adapted diabetes complication severity index at the time of type 2 diabetes mellitus diagnosis and diabetes-induced dementia risk in elderly patients. Elderly type 2 diabetes mellitus patients (age ≥ 60) were matched using propensity score matching. Cox regression was used to determine dementia hazard ratios; Kaplan–Meier method to assess cumulative incidence. The cohort included 256 214 elderly type 2 diabetes mellitus patients. Adapted diabetes complication severity index ≥ 1 showed higher dementia risk (adjusted hazard ratio: 1.30; 95% confidence interval: 1.27–1.34), increasing by 1.17-fold per adapted diabetes complication severity index point. Dementia risk rose progressively across adapted diabetes complication severity index scores (P < 0.0001). Higher adapted diabetes complication severity index scores at the time of type 2 diabetes mellitus diagnosis elevated dementia risk in elderly patients. Adapted diabetes complication severity index ≥ 1 is linked to increased dementia risk. Adapted diabetes complication severity index evaluation at the time of type 2 diabetes mellitus diagnosis could predict risk, aiding early interventions. Effective diabetes management is crucial for reducing dementia risk in this population.
How microsimulation translates outcome estimates to patient lifetime event occurrence in the setting of heart valve disease
Authors: Notenboom Maximiliaan L , Rhellab Reda , Etnel Jonathan R G , Huygens Simone A , Hjortnaes Jesper , Kluin Jolanda , Takkenberg Johanna J M , Veen Kevin M
Published: March 2024

Treatment decisions in healthcare often carry lifelong consequences that can be challenging to foresee. As such, tools that visualize and estimate outcome after different lifetime treatment strategies are lacking and urgently needed to support clinical decision-making in the setting of rapidly evolving healthcare systems, with increasingly numerous potential treatments. In this regard, microsimulation models may prove to be valuable additions to current risk-prediction models. Notable advantages of microsimulation encompass input from multiple data sources, the ability to move beyond time-to-first-event analysis, accounting for multiple types of events and generating projections of lifelong outcomes. This review aims to clarify the concept of microsimulation, also known as individualized state-transition models, and help clinicians better understand its potential in clinical decision-making. A practical example of a patient with heart valve disease is used to illustrate key components of microsimulation models, such as health states, transition probabilities, input parameters (e.g. evidence-based risks of events) and various aspects of mortality. Finally, this review focuses on future efforts needed in microsimulation to allow for increasing patient-tailoring of the models by extending the general structure with patient-specific prediction models and translating them to meaningful, user-friendly tools that may be used by both clinician and patient to support clinical decision-making.
A long-read draft assembly of the Chinese mantis (Mantodea: Mantidae:Tenodera sinensis) genome reveals patterns of ion channel gain and loss across Arthropoda
Authors: Goldberg Jay K , Godfrey R Keating , Barrett Meghan
Published: March 2024

Praying mantids (Mantodea: Mantidae) are iconic insects that have captivated biologists for decades, especially the species with cannibalistic copulatory behavior. This behavior has been cited as evidence that insects lack nociceptive capacities and cannot feel pain; however, this behaviorally driven hypothesis has never been rigorously tested at the genetic or functional level. To enable future studies of nociceptive capabilities in mantids, we sequenced and assembled a draft genome of the Chinese praying mantis (Tenodera sinensis) and identified multiple classes of nociceptive ion channels by comparison to orthologous gene families in Arthropoda. Our assembly—produced using PacBio HiFi reads—is fragmented (total size = 3.03 Gb; N50 = 1.8 Mb; 4,966 contigs), but is highly complete with respect to gene content (BUSCO complete = 98.7% [odb10_insecta]). The size of our assembly is substantially larger than that of most other insects, but is consistent with the size of other mantid genomes. We found that most families of nociceptive ion channels are present in the T. sinensis genome; that they are most closely related to those found in the damp-wood termite (Zootermopsis nevadensis); and that some families have expanded in T. sinensis while others have contracted relative to nearby lineages. Our findings suggest that mantids are likely to possess nociceptive capabilities and provide a foundation for future experimentation regarding ion channel functions and their consequences for insect behavior.
Prior Incarceration and Performance on Immediate and Delayed Verbal Recall Tests: Results From National Longitudinal Study of Adolescent to Adult Health—Parent Study
Authors: Testa Alexander , Jackson Dylan B , Novisky Meghan , Ganson Kyle T , Nagata Jason M , Tsai Jack
Published: March 2024

Objectives

This study aimed to investigate the cognitive functioning of formerly incarcerated older adults compared to their never-incarcerated counterparts, focusing on immediate and delayed verbal recall.

Methods

Data are from 2,003 respondents who participated in the National Longitudinal Study of Adolescent to Adult Health—Parent Study (AHPS; ages 47–82, mean age 62). AHPS participants were administered word recall memory exercises to the parent respondent from the Rey Auditory-Verbal administered Learning Test, including (a) 90-s (immediate or short-term verbal memory), (b) 60-s recall tests (delayed or long-term verbal memory), and (c) combined word recall on the 90-s and 60-s tests.

Results

Adjusting for control variables, respondents who reported prior incarceration had a lower rate of verbal recall on the combined word recall (incidence risk ratio [IRR] = 0.915, 95% confidence interval [CI] = 0.840, 0.997) and immediate word recall (IRR = 0.902, 95% CI = 0.817, 0.996). When restricting the sample to respondents over age 60, prior incarceration was associated with lower combined word recall (IRR = 0.847, 95% CI = 0.752, 0.954), immediate word recall (IRR = 0.857, 95% CI = 0.762, 0.963), and delayed word recall (IRR = 0.834, 95% CI = 0.713, 0.974).

Discussion

This study underscores the adverse impact of prior incarceration on cognitive functioning in the older adult population, emphasizing the need for targeted interventions and support for formerly incarcerated older adults. The results reinforce the importance of addressing the long-term consequences of incarceration, especially as individuals enter older adulthood.
Student and caregiver acceptability of a school-based intervention to improve sugar-sweetened beverage behaviors: a mixed methods study
Authors: Reid Annie L , Porter Kathleen J , Kirkpatrick Brittany M , Brock Donna-Jean P , Altizer Christopher J , Zoellner Jamie M
Published: March 2024

Kids SIPsmartER is a 6-month behavioral and health literacy intervention effective at reducing sugar-sweetened beverage (SSB) intake among middle school students and their caregivers in the rural Appalachian region. This exploratory mixed methods study utilized a convergent parallel design to assess participant acceptability of a school-based curriculum for students and a text messaging program for caregivers. Acceptability was assessed using surveys (873 students and 453 caregivers), five focus groups (34 students) and telephone interviews (22 caregivers). Quantitative data were analyzed descriptively, and qualitative data were content coded. On a 5-point scale, average quantitative survey acceptability ratings ranged from 2.7 to 3.3 among three student-rated questions and 4.1 to 4.2 among four caregiver-rated questions. Qualitative focus group findings suggested that students preferred curricular activities that were hands-on and involved social interaction, while caregiver interview results showed high acceptability of the text messaging program’s design, including usability, content messages and personalization. Students and caregivers reported similar program benefits: increased knowledge of SSBs and health risks, increased awareness of SSB behaviors and support to make beverage behavior changes. Results from this study can be used to understand Kids SIPsmartER’s effectiveness data, communicate the intervention’s acceptability with stakeholders and plan for future implementation studies.
Carbapenem-resistant Enterobacterales among hospitalized patients in Cape Town, South Africa: clinical and microbiological epidemiology
Authors: Tootla Hafsah Deepa , Prentice Elizabeth , Moodley Clinton , Marais Gert , Nyakutira Nyasha , Reddy Kessendri , Bamford Colleen , Niehaus Abraham , Whitelaw Andrew , Brink Adrian ,   Members (collaborators) of the Cape Town Antimicrobial Stewardship Study Alliance (CT-ASSA), Page Claudine , Schoeman Elizabeth , de Klerk Elizma , Lategan Karin , Pienaar Karlien , Henning Liezl , Du Plessis Mandy , Maseko Nomfundo , Nel Salome , Narainsamy Melenie , Vermeulen Michelle , du Toit Narissa , van Heerden Teresa , Sitharam Liza , Barendse Asa , Nagel Dane , Prince Jacqueline , Vass Letitia , Strauss Rileen , Fakier Rushana , Samuel Catherine , van Zyl Marelieze , Isaacs Leigh-Ann , Hendricks Shareefa , Dodd Amy , Daniels Reecka , Zemanay Widaad , Van Heerden Judi , Hapeela Nchimunya , Brown Parveen , Daniels Zubayr , Claassen Shantelle , Patel Fadheela , Vasuthevan Sharon , Scott Enid , Ricks Esmeralda , Curle Patricia , Wojno Justyna
Published: March 2024

Background

Carbapenem-resistant Enterobacterales (CRE) are a substantial problem in Cape Town. CRE epidemiology is largely unknown and mortality remains high.

Objectives

To describe and characterize the clinical and microbiological epidemiology of CRE within Cape Town hospitals to better inform therapy with regard to current and novel antibiotics, as well as improve antimicrobial stewardship (AMS), and infection prevention and control (IPC).

Methods

This prospective, multicentre study performed between 1 November 2020 and 30 November 2022, across three public and three private hospitals included hospitalized participants with CRE from clinical cultures. Participant demographics, clinical information and microbiology results were collected and analysed.

Results

Ninety percent of participants were from public hospitals. The age distribution ranged from 7 days to 88 years. Notable risk factors for CRE infection included recent exposure to antibiotics, medical devices and surgery. The most prevalent species was Klebsiella pneumoniae. However, a higher proportion of Serratia marcescens compared with previous reports was identified. The detected carbapenemases were blaOXA-48-like (80%) and blaNDM (11%). With the exception of amikacin (63%), tigecycline (65%), colistin (95%) and ceftazidime/avibactam (87%), susceptibility to antibiotics was low.

Conclusions

This study identified common risk factors for CRE infection and generated a description of carbapenemase enzymes, species distribution and antibiograms, enabling a better understanding of CRE epidemiology. This provides insights into transmission patterns and resistance determinants of CREs, beneficial to informing data-driven regional patient management, AMS and IPC strategies.
Unusual presentation of ‘internal hernia’ after robot-assisted radical cystectomy
Authors: Dell'Atti Lucio
Published: March 2024

Here is presented the first case of internal hernia developing from the space between ureter and muscle fascia after robot-assisted radical cystectomy with uretero-cutaneostomy diversion. An 82-year-old man underwent robot-assisted radical cystectomy with uretero-cutaneostomy diversion for high-grade urothelial carcinoma (pT2). On the Postoperative Day 7, the patient presented abdominal pain and nausea. Abdominal computed tomography showed that a part of the small intestine was protruding between the right ureter and the transverse fascia, and was strangulated, causing an obstruction of the intestine. Patient underwent an emergency laparotomy that revealed prolapse and strangulation of the small intestine through the space between the right ureter and the transversalis fascia. The ischemic intestinal tract and ureter were resected. A new right uretero-cutaneostomy diversion anastomosis with use of ureteral stent single J was created. The man was discharged 28 days after surgery, and his clinical course was uneventful through follow-up.
A rare case of bile leak due to type 2 duct of Luschka injury post open cholecystectomy: a case report
Authors: Muleta Jiksa , Belayneh Eden , Haile Kalkidan , Worku Amanuel
Published: March 2024

Bile leak is an uncommon complication post cholecystectomy. The bile may originate from the cystic duct stump and less commonly from the aberrant ducts of Luschka. Such complications may occur when anatomical variations in the biliary tree go unnoticed. This case report presents a 24-year-old otherwise healthy female who presented with abdominal pain and distension that began 3 days after she underwent open cholecystectomy for symptomatic cholelithiasis. Imaging revealed choledocholelithiasis in the distal common bile duct, and free intrabdominal fluid collection. Endoscopic retrograde cholangiopancreatography done showed contrast leak from the duct of Luschka to the gall bladder bed. The biliary tree has many anatomic variations. These variations have clinical significance for surgical treatment of patients with biliary pathology. Surgeons should be aware of such variations to decrease the risk of bile leak post cholecystectomy.
Monkey multi-organ cell atlas exposed to estrogen
Authors: Fang Wen , Qu Jiao , Zhao Wanjun , Cao Xinran , Liu Jinran , Han Quan , Chen Dijun , Lv Wen , Xie Yicheng , Sun Yang
Published: March 2024

Awareness of estrogen’s effects on health is broadening rapidly. The effects of long-term high levels of estrogen on the body involve multiple organs. Here, we used both single-cell chromatin accessibility and RNA sequencing data to analyze the potential effect of estrogen on major organs. The integrated cell map enabled in-depth dissection and comparison of molecular dynamics, cell-type compositions, and cellular heterogeneity across multiple tissues and organs under estrogen stimulation. We also inferred pseudotime cell trajectories and cell–cell communications to uncover key molecular signatures underlying their cellular processes in major organs in response to estrogen. For example, estrogen could induce the differentiation of IFIT3+ neutrophils into S100A9+ neutrophils involved in the function of endosome-to-lysosome transport and the multivesicular body sorting pathway in liver tissues. Furthermore, through integration with human genome-wide association study data, we further identified a subset of risk genes during disease development that were induced by estrogen, such as AKT1 (related to endometrial cancer), CCND1 (related to breast cancer), HSPH1 (related to colorectal cancer), and COVID-19 and asthma-related risk genes. Our work uncovers the impact of estrogen on the major organs, constitutes a useful resource, and reveals the contribution and mechanism of estrogen to related diseases.
Coronin 1-dependent cell density sensing and regulation of the peripheral T cell population size
Authors: Ndinyanka Fabrice Tohnyui , Mori Mayumi , Pieters Jean
Published: March 2024

The establishment and maintenance of peripheral T cells is important to ensure appropriate immunity. In mammals, T cells are produced in the thymus before seeding the periphery early in life, and thereafter progressive thymus involution impairs new T cell production. Yet, peripheral T cells are maintained lifelong at approximately similar cell numbers. The question thus arises: what are the mechanisms that enable the maintenance of the appropriate number of circulating T cells, ensuring that T cell numbers are neither too low nor too high? Here, we highlight recent research suggesting a key role for coronin 1, a member of the evolutionarily conserved family of coronin proteins, in both allowing T cells to reach as well as maintain their appropriate cell population size. This cell population size controlling pathway was found to be conserved in amoeba, mice and human. We propose that coronin 1 is an integral part of a cell-intrinsic pathway that couples cell density information with prosurvival signalling thereby regulating the appropriate number of peripheral T cells.
Effectiveness of methotrexate and leflunomide as corticoid-sparing drugs in patients with polymyalgia rheumatica
Authors: Vinicki Juan Pablo , Cusa Alejandra , Domingo Daniela , Velasco Zamora José Luis , Magri Sebastián , Brigante Alejandro , Schmid Maria Marcela , Ávila Paola , Zamora Natalia , Sorrentino Laura , Rodriguez Anabella M , Linarez Miguel , Pisoni Cecilia , Costi Carolina , Rodriguez Gil Gustavo , Spinetto María Andrea , Paris Vanesa Ursula , Perrotta Natalia , Maliandi María del Rosario , Rillo Oscar , Pena Claudia , Got Julio , Cavallasca Javier , Machado Escobar Maximiliano , Iturralde Carolina , Martire María Victoria , Tessel Romina , Chocobar N Saravia , Alarcon Graciela
Published: March 2024

Objectives

The need for glucocorticoid-sparing drugs (GCSD) remains an important issue and is an unmet need in the treatment of polymyalgia rheumatica (PMR). We therefore aimed to assess the effectiveness and safety of methotrexate (MTX) and of leflunomide (LEF) in daily clinical practice in PMR patients from Argentina.

Methods

A multicentre and observational study (medical records review) of PMR patients seen between 2007 and 2023, who had at least three months of follow-up after starting a GCSD, either MTX or LEF, was performed. Results are expressed as medians and interquartile ranges [25th–75th (IQR)] for continuous variables and percentages for categorical ones. The two treatment groups were compared using χ2 test for categorical variables, Mann–Whitney U test for continuous variables and the log-rank test for time-to-event data. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression. In all cases, a p-value <0.05 was considered statistically significant.

Results

One-hundred and eighty-six patients (79% female) with a median age of 72 years (IQR, 65–77 years) were included. One-hundred and forty-three patients (77%) were prescribed MTX (15, IQR 10–15) and 43 (23%) LEF (20 mg, fixed dose). Flare-ups (relapses and recurrences) occurred in 13 patients (7%) and were comparable between both groups. Persistent GCSD intake was observed in 145 patients (78%). Glucocorticoid (GC) withdrawal was achieved in 67 of these 145 patients (46%) and this occurred more frequently in the LEF group (P = 0.001). Furthermore, time until prednisone discontinuation was shorter in the LEF-treated patients (4.7 months, IQR 3–20 on LEF versus 31.8 months, IQR 10–82 on MTX, P = 0.000). Remission was found more frequently in the LEF group (P = 0.003). In the multivariate analysis, the probability of remission was higher with LEF therapy (P = 0.010) and this finding persisted in the subgroup analysis who were followed up < 40 months (OR 3.12, 95% CI = 1.30–7.47, P = 0.011).

Conclusions

This study demonstrated the clinical effectiveness of LEF and even its superiority in achieving remission when compared with MTX as GCSD in PMR patients. Further research is needed to support these findings.
Combination therapy of gabapentin and pregabalin for postherpetic neuralgia in 15 Patients
Authors: Tan Huilong , Li Yanfei , Lv Fangjun , Zeng Xianliang , Wang Shuangying
Published: March 2024

Background

Postherpetic neuralgia (PHN), a common sequela of herpes zoster, is a significant health concern, especially among the elderly. It is estimated that approximately 65% of patients above 60 years old develop PHN, and up to 75% of individuals with herpes zoster over 70 years old may develop PHN. While several drugs have been found effective, the numbers needed to treat these drugs is over six. Many patients still experience inadequate pain relief. Combination therapy is often considered when adequate pain relief is not achieved. Gabapentin is sometimes combined with pregabalin for PHN treatment and this therapy is not recommended by relevant treatment guidelines.

Methods

We conducted a retrospective analysis of medical records of PHN patients who received combination therapy with gabapentin and pregabalin at our hospital. Data collected included numeric rating scale (NRS) pain scores before and after combination therapy, as well as the duration of each therapy. Statistical analysis was performed using SPSS software.

Results

A total of 15 patients were included in this study. The mean NRS score before combination therapy was 4.40 ± 1.35, which decreased significantly to 2.20 ± 1.30 post-treatment (P = 0.001). The duration of combination therapy was comparable to that of monotherapy. One patient reported adverse reactions following the switch to combination therapy.

Conclusion

For PHN patients who do not respond adequately to monotherapy, combining gabapentin and pregabalin is a viable option. However, larger studies with randomized controlled trials are needed to further validate the findings.
Microbially conjugated bile salts found in human bile activate the bile salt receptors TGR5 and FXR
Authors: Ay Ümran , Leníček Martin , Haider Raphael S. , Classen Arno , van Eijk Hans , Koelfat Kiran V.K. , van der Kroft Gregory , Neumann Ulf. P. , Hoffmann Carsten , Bolm Carsten , Olde Damink Steven W.M. , Schaap Frank G.
Published: March 2024

Background:

Bile salts of hepatic and microbial origin mediate interorgan cross talk in the gut-liver axis. Here, we assessed whether the newly discovered class of microbial bile salt conjugates (MBSCs) activate the main host bile salt receptors (Takeda G protein-coupled receptor 5 [TGR5] and farnesoid X receptor [FXR]) and enter the human systemic and enterohepatic circulation.

Methods:

N-amidates of (chenodeoxy) cholic acid and leucine, tyrosine, and phenylalanine were synthesized. Receptor activation was studied in cell-free and cell-based assays. MBSCs were quantified in mesenteric and portal blood and bile of patients undergoing pancreatic surgery.

Results:

MBSCs were activating ligands of TGR5 as evidenced by recruitment of Gsα protein, activation of a cAMP-driven reporter, and diminution of lipopolysaccharide-induced cytokine release from macrophages. Intestine-enriched and liver-enriched FXR isoforms were both activated by MBSCs, provided that a bile salt importer was present. The affinity of MBSCs for TGR5 and FXR was not superior to host-derived bile salt conjugates. Individual MBSCs were generally not detected (ie, < 2.5 nmol/L) in human mesenteric or portal blood, but Leu-variant and Phe-variant were readily measurable in bile, where MBSCs comprised up to 213 ppm of biliary bile salts.

Conclusions:

MBSCs activate the cell surface receptor TGR5 and the transcription factor FXR and are substrates for intestinal (apical sodium-dependent bile acid transporter) and hepatic (Na+ taurocholate co-transporting protein) transporters. Their entry into the human circulation is, however, nonsubstantial. Given low systemic levels and a surplus of other equipotent bile salt species, the studied MBSCs are unlikely to have an impact on enterohepatic TGR5/FXR signaling in humans. The origin and function of biliary MBSCs remain to be determined.
Psychedelic Therapy: A Primer for Primary Care Clinicians—Lysergic Acid Diethylamide (LSD)
Authors: Beutler Bryce D. , Shinozuka Kenneth , Tabaac Burton J. , Arenas Alejandro , Cherian Kirsten , Evans Viviana D. , Fasano Chelsey , Muir Owen S.
Published: March 2024

Background:

Lysergic acid diethylamide (LSD) is a hallucinogenic agent. In the mid-20th century, it was used to augment psychoanalysis and to treat alcohol use disorder. However, LSD was banned in 1970 in part because of concerns that it could bring about or exacerbate mental illness. Its therapeutic potential remains incompletely understood.

Areas of Uncertainty:

While uncontrolled recreational use of LSD can, in rare instances, lead to long-term psychosis, adverse events in clinical trials of LSD, such as anxiety, headache, and nausea, have almost always been mild and transient. Serious adverse events, such as intense panic, suicidal ideation, and psychosis, were reported in either none or very few of the participants. However, patient selection criteria, optimal dosing strategy, and appropriate clinical follow-up guidelines remain to be established.

Therapeutic Advances:

Preliminary data suggest that LSD may be effective for the management of alcohol use disorder, anxiety, and depression. In trials of LSD for treating anxiety and depression associated with life-threatening illnesses, 77% of participants demonstrate durable relief at 1 year post-treatment. Top-line data from a large-scale phase IIb trial (n = 198) indicate that 50% of participants experience remission from generalized anxiety disorder after a single 100 μg dose of LSD. According to a meta-analysis of RCTs on LSD from the mid-20th century, single-dose regimens of LSD significantly improve alcohol use disorder (P < 0.0003) with an odds ratio (OR) of 1.96.

Limitations:

Only one large-scale clinical trial (>50 participants) has been conducted on LSD in the contemporary era of psychedelic research. Further studies with large sample sizes are needed to explore potential clinical applications.

Conclusions:

Preliminary data suggest that LSD may be one of the most potent treatments for anxiety in patients both with and without a life-threatening illness. LSD may also be beneficial for treating depression and substance use disorders.
Interventions for Pancreatitis—New Approaches, Knowledge Gaps, and Research Opportunities
Authors: Phillips Anna Evans , Hughes Steven J. , Andersen Dana K. , Bell Adam , Brand Randall , Coté Gregory A. , Cowdin Adriana , Diazgranados Nancy , Dudeja Vikas , Duggan Sinead N. , Fogel Evan , Forsmark Chris E. , Freeman A. Jay , Gittes George , Hart Phil A. , Jeon Christie , Nealon William , Neoptolemos John , Palermo Tonya M. , Pandol Stephen , Roberts Kristen M. , Rosenthal Martin , Singh Vikesh K. , Yadav Dhiraj , Whitcomb David C. , Zyromski Nicholas
Published: March 2024

There exists no cure for acute, recurrent acute or chronic pancreatitis and treatments to date have been focused on managing symptoms. A recent workshop held by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) focused on interventions that might disrupt or perhaps even reverse the natural course of this heterogenous disease, aiming to identify knowledge gaps and research opportunities that might inform future funding initiatives for NIDDK. The breadth and variety of identified active or planned clinical trials traverses the spectrum of the disease and was conceptually grouped for the workshop into behavioral, nutritional, pharmacologic and biologic, and mechanical interventions. Cognitive and other behavioral therapies are proven interventions for pain and addiction, but barriers exist to their use. Whilst a disease specific instrument quantifying pain is now validated, an equivalent is lacking for nutrition - and both face challenges in ease and frequency of administration. Multiple pharmacologic agents hold promise. Ongoing development of Patient Reported Outcome (PRO) measurements can satisfy Investigative New Drug (IND) regulatory assessments. Despite multiple randomized clinical trials demonstrating benefit, great uncertainty remains regarding patient selection, timing of intervention, and type of mechanical intervention (endoscopic versus surgery). Challenges and opportunities to establish beneficial interventions for patients were identified.
Anti-coagulants-induced intracranial hemorrhage managed with decompressive craniectomy: a case report of lesson learned
Authors: Ghimire Sagun , Shrestha Shikher , Shrestha Dinuj , maharjan Ananta , Jaiswal Bibek , chaudhary Prabin , Sherpa Sharon
Published: March 2024

Introduction and importance:

Intracerebral haemorrhage (ICH) secondary to use of anti-coagulants is one of the fearsome complications. Haemorrhage within the intracranial space due to such anti-coagulants results in expansion of the intracranial bleeding despite the reversal of anti-coagulants. Hence, timely surgical intervention can be lifesaving.

Case summary:

An elderly female who was undergoing management for her deranged coagulation parameters was found to be in a state of features suggestive of stroke. The patient was on regular anti-coagulants medication for her cardiology issues. Computed tomography (CT) scan showed intracranial haemorrhage, which underwent expansion on same day; hence decompressive craniectomy was done. During further stay in the ICU patient's Glasgow coma scale fluctuated but symptomatic improvement was noted. Anti-coagulants adjustment was made by a cardiologist and further, there was no expansion of intracranial bleeding within normal coagulation parameters.

Discussion:

Anti-coagulants are rampantly used in several cases. Despite the several complications, there is a desperate need for such medications for the betterment of the patient's condition. Pharmacological management is a major modality in the reversal of oral anti-coagulants (OAC)-induced ICH, but in rare cases in the background of OACs-induced ICH, there occurs expansion of haemorrhage. Hence there is a need for neurosurgical intervention, whether it be minimally invasive surgery or decompressive craniectomy.

Conclusion:

In the background of the low prevalence of OACs-induced ICH, there is an absence of a robust guiding treatment protocol. Furthermore, there exist minimal reported cases which underwent surgical intervention and resulted in a good prognosis.