bluuebunny/crossref_metadata_2025 huggingface dataset:
The experiences and barriers in addressing type 2 diabetes mellitus-associated erectile dysfunction: a mixed method systematic review
Authors: Hadisuyatmana Setho , Malik Gulzar , Efendi Ferry , Reisenhofer Sonia , Boyd James
Published: August 2023

Introduction

Experiences and determinants connected with type 2 diabetes mellitus-associated erectile dysfunction (T2DMED) in health appointments are not well understood and infrequently reported. This systematic review was undertaken to synthesise evidence of the experiences, facilitators, and barriers around screening ED in men with T2DM during health service consultations.

Methods

The review report was based on the guidelines provided by the Joanna Briggs Institute for conducting mixed-method systematic reviews. Eight electronic databases were searched, including Web of Science, Embase via Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO, ProQuest, PubMed, PsychInfo via Ovid, MEDLINE via Ovid, Portal Garuda. Additionally, the review manually looked through the reference lists of the studies we included. Erectile dysfunction, type 2 diabetes mellitus, screening and barriers were initially used as keywords in the search strategy. All identified primary studies written in English and Bahasa Indonesia, and published between 2001 and 2022 were meticulously screened following an agreed set of inclusion criteria.

Findings

Out of 3468 papers screened, only six were chosen for the review. These included three cross-sectional studies, two qualitative studies, and one mixed-method study. The study quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Based on the checklist criteria, the studies ranged between 5/10 to 9/10 in terms of quality. After synthesizing the findings, four main categories were identified including the willingness to discuss T2DMED, the barriers experienced and perceived, the limited understanding of T2DMED, and the support expected by men with T2DM.

Discussion

Many men kept quiet about their struggles with T2DMED, hoping to bring it up as a topic of discussion during healthcare consultations. Barriers such as embarrassment, a sense of helplessness and reluctance to seek help, financial constraints, and dismissive healthcare professionals hindered them from addressing this issue. Both the participating men and healthcare professionals lacked a comprehensive understanding of T2DMED.

Recommendations

It is important to provide education tailored to men's specific needs and improve awareness about T2DM-associated ED. Creating a more T2DMED-friendly environment could be a potential solution to increase early screening and management. Future research should investigate potential barriers that prevent HCPs from identifying and addressing T2MED since their absence in the identified studies highlights this need.

Systematic review registration

CRD42021292454.
Non-Newtonian nanofluid flow across an exponentially stretching sheet with viscous dissipation: numerical study using an SCM based on Appell–Changhee polynomials
Authors: Khader M. M. , Babatin M. M. , Megahed Ahmed M.
Published: August 2023

The objective of this article is to investigate how the properties of a non-Newtonian Williamson nanofluid flow, which occurs due to an exponential stretching sheet placed in a porous medium, are influenced by heat generation, viscous dissipation, and magnetic field. This study focuses on analyzing the heat transfer process by considering the impact of temperature on the thermal conductivity and viscosity of Williamson nanofluids. Additionally, the research significantly contributes by investigating the flow characteristics of these nanofluids when influenced by slip velocity. Using the spectral collocation method (SCM), the equations that describe the current problem are transformed into a collection of ordinary differential equations and then solved. The SCM proposed here basically depends on the properties of the Appell-type Changhee polynomials (ACPs). First, with the aid of ACPs, we give an approximate formula of the derivatives for the approximated functions. Through this procedure, the provided model is transformed into a nonlinear set of algebraic equations. Physical factors of interest, such as skin friction, the Nusselt number, and the Sherwood number, are explained using tabular expressions. Data are displayed as graphs for the nanofluid’s velocity, temperature, and concentration. The primary findings showed that increasing the Williamson, magnetic, thermal conductivity, and Brownian parameters significantly improves the thermal field. Finally, testing the suggested method with specific cases from some past literature-based publications reveal a good degree of agreement.
Competing for space? A multi-criteria scenario framework intended to model the energy–biodiversity–land nexus for regional renewable energy planning based on a German case study
Authors: Weber Jessica , Steinkamp Tim , Reichenbach Marc
Published: August 2023

Background

The need to balance renewable energy supply with biodiversity conservation has become increasingly urgent in light of current climate, energy, and biodiversity crises. However, the development of wind and solar energy often presents trade-offs such as competing for land use and potentially impacting species and habitats. To address these concerns, ‘priority zones’ for bird and bat species have been proposed as spatial designations for early species protection in the regional planning process. However, there are concerns that the areas suitable for wind and solar energy may be limited further, making it difficult to meet state- and regional-specific spatial targets for renewable energy sites.

Results

To help decision-makers deal with this challenge, a Multi-Criteria Scenario Framework has been developed and analyzed. It involves a habitat model of priority zones for species conservation and techniques from the intuitive logic scenario planning method. Through a regional case study, various planning criteria were analyzed according to scenarios, such as priority zones for species protection, settlement buffers, and forests. The framework indicates how criteria could be balanced to achieve wind energy spatial targets as well as targets for ground-mounted solar energy with the least possible impact. Results show that compared to other planning criteria, species priority zones had limited competition with spatial wind energy targets. Achieving these targets may require minimal adjustments, such as allowing wind energy in 1–3% of completely protected recreational landscapes. To reconcile land use demands in the energy transition, a balance between ‘green’ protected areas is necessary. Additionally, ground-mounted solar energy could replace some of the wind energy spatial targets while also meeting the overall solar development goals.

Conclusions

The framework provides transparency in assessing trade-offs between multiple objectives and helps quantify the ‘costs’ and ‘benefits’ in renewable energy planning. Adapting more flexible planning methods could help resolve the conflict between wind energy and species protection. Joint analysis of the areas needed for wind and solar energy and determining the optimal energy mix are gaining in importance. However, how the benefits of multi-criteria scenarios can be achieved within the confines of preoccupied and siloed organizations remains an ongoing research topic.
Development and validation a model for predicting overall survival of bladder cancer with lung metastasis: a population-based study
Authors: Liu Liang , Sun Fu-zhen , Zhang Pan-ying , Xiao Yu , Ni Hai-xin
Published: August 2023

Background

Although the number of patients with bladder cancer and lung metastasis is increasing there is no accurate model for predicting survival in these patients.

Methods

Patients enrolled in the Surveillance, Epidemiology, and End Results database between 2010 and 2015 were selected for the study. Univariate and multivariate Cox regression were used to determine independent prognostic factors, followed by development of a nomogram based on the multivariate Cox regression models. The consistency index, receiver operating characteristic curve, and calibration curve were used to validate the prognostic nomogram.

Results

506 eligible bladder cancer patients with lung metastasis were enrolled in the study and then divided randomly into training and validation sets (n = 356 vs. n = 150). Multivariate Cox regression analysis indicated that age at diagnosis, primary site, histological type, surgery of the primary site, chemotherapy, bone metastasis, and liver metastasis were prognostic factors for overall survival (OS) in patients with lung metastasis in the training set. The C-index of the nomogram OS was 0.699 and 0.747 in the training and validation sets, respectively. ROC curve estimation of the nomogram in the training and validation sets showed acceptable accuracy for classifying 1-year survival, with an area under the curve (AUC) of 0.766 and 0.717, respectively. More importantly, the calibration plot showed the nomogram had favorable predictive accuracy in both the training and validation sets.

Conclusions

The prognostic nomogram created in our study provides an individualized diagnosis, remedy, and risk evaluation for survival in patients with bladder cancer and lung metastasis. The nomogram would therefore enable clinicians to make more precise treatment decisions for patients with bladder cancer and lung metastasis.
Minimizing sperm oxidative stress using nanotechnology for breeding programs in rams
Authors: Jurado-Campos Alejandro , Soria-Meneses Pedro Javier , Arenas-Moreira María , Alonso-Moreno Carlos , Rodríguez-Robledo Virginia , Soler Ana Josefa , Garde José Julián , del Rocío Fernández-Santos María
Published: August 2023

Background

Artificial insemination (AI) is a routine breeding technology in animal reproduction. Nevertheless, the temperature-sensitive nature and short fertile lifespan of ram sperm samples hamper its use in AI. In this sense, nanotechnology is an interesting tool to improve sperm protection due to the development of nanomaterials for AI, which could be used as delivery vehicles. In this work, we explored the feasibility of vitamin E nanoemulsion (NE) for improving sperm quality during transport.

Results

With the aim of evaluating this proposal, ejaculates of 7 mature rams of Manchega breed were collected by artificial vagina and extended to 60 × 106spz/mL in Andromed®. Samples containing control and NE (12 mmol/L) with and without exogenous oxidative stress (100 µmol/L Fe2+/ascorbate) were stored at 22 and 15 ºC and motility (CASA), viability (YO-PRO/PI), acrosomal integrity (PNA-FITC/PI), mitochondrial membrane potential (Mitotracker Deep Red 633), lipoperoxidation (C11 BODIPY 581/591), intracellular reactive oxygen species (ROS) production and DNA status (SCSA®) monitored during 96 h. Our results show that NE could be used to maintain ram spermatozoa during transport at 15 and 22 ºC for up to 96 h, with no appreciable loss of kinematic and physiological characteristics of freshly collected samples.

Conclusions

The storage of ram spermatozoa in liquid form for 2–5 d with vitamin E nanoemulsions may lead more flexibility to breeders in AI programs. In view of the potential and high versatility of these nanodevices, further studies are being carried out to assess the proposed sperm preservation medium on fertility after artificial insemination.

Graphical Abstract
Lysin (K)-specific demethylase 1 inhibition enhances proteasome inhibitor response and overcomes drug resistance in multiple myeloma
Authors: Bandini Cecilia , Mereu Elisabetta , Paradzik Tina , Labrador Maria , Maccagno Monica , Cumerlato Michela , Oreglia Federico , Prever Lorenzo , Manicardi Veronica , Taiana Elisa , Ronchetti Domenica , D’Agostino Mattia , Gay Francesca , Larocca Alessandra , Besse Lenka , Merlo Giorgio Roberto , Hirsch Emilio , Ciarrocchi Alessia , Inghirami Giorgio , Neri Antonino , Piva Roberto
Published: August 2023

Background

Multiple myeloma (MM) is an incurable plasma cell malignancy, accounting for approximately 1% of all cancers. Despite recent advances in the treatment of MM, due to the introduction of proteasome inhibitors (PIs) such as bortezomib (BTZ) and carfilzomib (CFZ), relapses and disease progression remain common. Therefore, a major challenge is the development of novel therapeutic approaches to overcome drug resistance, improve patient outcomes, and broaden PIs applicability to other pathologies.

Methods

We performed genetic and drug screens to identify new synthetic lethal partners to PIs, and validated candidates in PI-sensitive and -resistant MM cells. We also tested best synthetic lethal interactions in other B-cell malignancies, such as mantle cell, Burkitt’s and diffuse large B-cell lymphomas. We evaluated the toxicity of combination treatments in normal peripheral blood mononuclear cells (PBMCs) and bone marrow stromal cells (BMSCs). We confirmed the combo treatment’ synergistic effects ex vivo in primary CD138+ cells from MM patients, and in different MM xenograft models. We exploited RNA-sequencing and Reverse-Phase Protein Arrays (RPPA) to investigate the molecular mechanisms of the synergy.

Results

We identified lysine (K)-specific demethylase 1 (LSD1) as a top candidate whose inhibition can synergize with CFZ treatment. LSD1 silencing enhanced CFZ sensitivity in both PI-resistant and -sensitive MM cells, resulting in increased tumor cell death. Several LSD1 inhibitors (SP2509, SP2577, and CC-90011) triggered synergistic cytotoxicity in combination with different PIs in MM and other B-cell neoplasms. CFZ/SP2509 treatment exhibited a favorable cytotoxicity profile toward PBMCs and BMSCs. We confirmed the clinical potential of LSD1-proteasome inhibition in primary CD138+ cells of MM patients, and in MM xenograft models, leading to the inhibition of tumor progression. DNA damage response (DDR) and proliferation machinery were the most affected pathways by CFZ/SP2509 combo treatment, responsible for the anti-tumoral effects.

Conclusions

The present study preclinically demonstrated that LSD1 inhibition could provide a valuable strategy to enhance PI sensitivity and overcome drug resistance in MM patients and that this combination might be exploited for the treatment of other B-cell malignancies, thus extending the therapeutic impact of the project.
Reimaging Earth. Architecture and the critical and speculative uses of geovisualization
Authors: Barrio Roi Salgueiro
Published: August 2023

This article addresses the debates surrounding the design uses of satellite-based geovisualizations. It asks, in particular, how geovisualizations can support new design politics towards global urbanization. The initial section of the article presents a series of theoretical critiques of geovisualization. These stress that satellite-based imagery represents a disembodied, detached form of vision that hides under a totalizing image the actual, variegated conditions and struggles happening on the ground. As a result, geovisualization is considered as an instrument that neutralizes the critical dimension of design. The article counters this critique through an analysis of two cartographic and design practices which heavily rely on satellite data. The first one is the work of Neil Brenner’s Urban Theory Lab (UTL), which uses cartography as an analytical and critical tool aimed at unpacking the sociospatial dimensions of planetary urbanization. The second case is Joyce Hsiang and Bimal Mendis’ speculative, cartographic project City of Seven Billion. My argument is that this project partially builds upon the UTL’s work, but it substitutes the latter’s analytical orientation for a projective one to investigate how architectural design can operate in the context of planetary urbanization. By analysing these two works, the article concludes that both support a design politics oriented to recognizing and then defining the questions and scales upon which architecture can intervene today.
How sociocultural factors mediate washback effect: a study of the Hong Kong Diploma of Secondary Education Examination English Language Paper 4
Authors: Wong Katagiri Nozomu
Published: August 2023

The study explores the unaddressed washback on the English-speaking test of the Hong Kong Diploma of Secondary Education Examination (HKDSE-English Language Paper 4). The HKDSE is a university entrance exam in Hong Kong which includes a group discussion speaking test known as English Language Paper 4. To identify ongoing washback effects, including sociocultural perspectives, the study analyses ongoing student washback of test-specific and non-specific preparation and how the mediating factors affect these preparations. One-hundred and ninety-nine secondary 4th to 6th grade students provided the questionnaire data in two rounds. Results from exploratory factor analysis indicate six major types of test preparation, which are categorised as two test specific, three non-specific, and one integrated type of preparation. Mediating factors comprise five categories of learner characteristics and stakeholders in and out of school. The cluster analyses identified four students’ groups intertwined with the involvement of washback and the mediating factors. A strong relationship between extrinsic factors and explicit learning and intrinsic factors and implicit learning was found. The study concludes that students’ washback is affected by mediating factors aside from the test; learning method choice by students (e.g. learning from entertainment content) has a strong relationship with specific mediating factors (e.g. interest in English).
Extraction, purification and antioxidant activity of Juglans regia shell polysaccharide
Authors: Zhou Shiyang , Huang Gangliang
Published: August 2023

In recent years, the biological activity of plant polysaccharides has attracted more and more attention. Juglans regia was one of the four-dry fruits in the world, it has very high value in nutrition and health care value was very high. To better develop the nutritional and health effects of the J. regia shell polysaccharide, J. regia shell was used as raw material to prepare polysaccharide by the water extraction and alcohol precipitation method. The molecular weight, monosaccharide components, molecular structure characteristics and antioxidant activities of its derivatives were studied. Then, a series of meaningful data information for the study of the J. regia shell polysaccharide and its derivatives were obtained. The molecular weight of the polysaccharide was 9.45 × 104 Da after the separation and purification by DEAE-52 and Sephadex G-100. The polysaccharides contained rhamnose, arabinose, galactose, glucose, xylose and galacturonic acid, and the molar ratio of each monosaccharide component was 6.7%: 16.5%: 28.3%: 11.2%: 12.5%: 24.8%. The molecular structure of J. regia shell polysaccharide contains β-glucoside bond, its structure may be → 4)-α-D-Galp-(1 → 4)-β-D-GalAp-(1 → 4)-α-D-Xylp-(1 → glycosidic bond). The study of antioxidant activity, J. regia shell polysaccharide and its derivatives showed good biological activities, especially the phosphorylated J. regia shell polysaccharide. The study of J. regia shell polysaccharide has important practical significance for improving the quality and efficiency of the J. regia industry chain.

Graphical Abstract
Moderate evidence exists for four microRNAs as potential biomarkers for tendinopathies and degenerative tendon ruptures at the upper extremity in elderly patients: conclusion of a systematic review with best‐evidence synthesis
Authors: Schmid Tristan , Wegener Florian , Hotfiel Thilo , Hoppe Matthias W.
Published: August 2023

Purpose

The aim of this systematic review was to investigate tendon‐specific microRNAs (miRNAs) as biomarkers for the detection of tendinopathies or degenerative tendon ruptures. Also, their regulatory mechanisms within the tendon pathophysiology were summarized.

Methods

A systematic literature research was performed using the PRISMA guidelines. The search was conducted in the Pubmed database. The SIGN checklist was used to assess the study quality of the included original studies. To determine the evidence and direction of the miRNA expression rates, a best‐evidence synthesis was carried out, whereby only studies with at least a borderline methodological quality were considered for validity purposes.

Results

Three thousand three hundred seventy studies were reviewed from which 22 fulfilled the inclusion criteria. Moderate evidence was found for miR‐140‐3p and miR‐425‐5p as potential biomarkers for tendinopathies as well as for miR‐25‐3p, miR‐29a‐3p, miR‐140‐3p, and miR‐425‐5p for the detection of degenerative tendon ruptures. This evidence applies to tendons at the upper extremity in elderly patients. All miRNAs were associated with inflammatory cytokines as interleukin‐6 or interleukin‐1ß and tumor necrosis factor alpha.

Conclusions

Moderate evidence exists for four miRNAs as potential biomarkers for tendinopathies and degenerative tendon ruptures at the upper extremity in elderly patients. The identified miRNAs are associated with inflammatory processes.
Application of first-generation high- and low-dose drug-coated balloons to the femoropopliteal artery disease: a sub-analysis of the POPCORN registry
Authors: Fujihara Masahiko , Takahara Mitsuyoshi , Soga Yoshimitsu , Iida Osamu , Kawasaki Daizo , Tomoi Yusuke , Tsubakimoto Yoshinori , Ogata Kenji , Karashima Eiji , Kato Taku , Kobayashi Yohei , Kaneko Nobuhito , Sasaki Shinya , Ichihashi Kei
Published: August 2023

Background

Drug-coated balloons (DCBs) have significantly changed endovascular therapy (EVT) for femoropopliteal artery (FPA) disease, in terms of the expansion of indications for EVT for symptomatic lower extremity arterial disease (LEAD). However, whether there is a difference in the performance among individual DCBs has not yet been fully discussed. The present sub-analysis of real-world data from a prospective trial of first-generation DCBs compared the clinical outcomes between high- and low-dose DCBs using propensity score matching methods. The primary endpoint was the restenosis-free and revascularization-free rates at 1 year.

Results

We compared 592 pairs matched for patient and lesion characteristics using propensity score matching among a total of 2,507 cases with first-generation DCBs (592 and 1,808 cases in the Lutonix low-dose and In.PACT Admiral high-dose DCB groups, respectively). There were no differences in patient/lesion characteristics, procedural success rates, or complications between the two groups. First-generation low-dose DCB had significantly lower patency (73.3% [95% confidence interval, 69.6%–77.3%] in the low-dose DCB group versus 86.2% [84.1%–88.3%] in the high-dose DCB group; P < 0.001) and revascularization-free (84.9% [81.9%–88.1%] versus 92.5% [90.8%–94.1%]; P < 0.001) rates. Chronic kidney disease on dialysis, cilostazol use, anticoagulant use, and severe calcification had a significant interaction effect in the association (all P < 0.05).

Conclusions

EVT to FPA with first-generation DCBs had inferior low-dose patency outcomes as compared with high-dose outcomes in the present cohort.

Level of evidence

Sub analysis of a prospective multicenter study.
Milestones in the history of neurocritical care
Authors: Kollmar Rainer , De Georgia Michael
Published: August 2023

Over the last century, significant milestones have been achieved in managing critical illness and diagnosing and treating neurological diseases. Building upon these milestones, the field of neurocritical care emerged in the 1980 and 1990 s at the convergence of critical care medicine and acute neurological treatment. This comprehensive review presents a historical account of key developments in neurocritical care in both the United States and Europe, with a special emphasis on German contributions. The scope of the review encompasses: the foundations of neurocritical care, including post-operative units in the 1920s and 30s, respiratory support during the poliomyelitis epidemics in the 40 and 50 s, cardiac and hemodynamic care in the 60 and 70 s, and stroke units in the 80 and 90 s; key innovations including cerebral angiography, computed tomography, and intracranial pressure and multi-modal monitoring; and advances in stroke, traumatic brain injury, cardiac arrest, neuromuscular disorders, meningitis and encephalitis. These advances have revolutionized the management of neurological emergencies, emphasizing interdisciplinary teamwork, evidence-based protocols, and personalized approaches to care.
Costs of implementing a multi-site facilitation intervention to increase access to medication treatment for opioid use disorder
Authors: Garcia Carla C. , Bounthavong Mark , Gordon Adam J. , Gustavson Allison M. , Kenny Marie E. , Miller Wendy , Esmaeili Aryan , Ackland Princess E. , Clothier Barbara A. , Bangerter Ann , Noorbaloochi Siamak , Harris Alex H. S. , Hagedorn Hildi J.
Published: August 2023

Background

The United States has been grappling with the opioid epidemic, which has resulted in over 75,000 opioid-related deaths between April 2020 and 2021. Evidence-based pharmaceutical interventions (buprenorphine, methadone, and naltrexone) are available to reduce opioid-related overdoses and deaths. However, adoption of these medications for opioid use disorder has been stifled due to individual- and system-level barriers. External facilitation is an evidence-based implementation intervention that has been used to increase access to medication for opioid use disorder (MOUD), but the implementation costs of external facilitation have not been assessed. We sought to measure the facility-level direct costs of implementing an external facilitation intervention for MOUD to provide decision makers with estimates of the resources needed to implement this evidence-based program.

Methods

We performed a cost analysis of the pre-implementation and implementation phases, including an itemization of external facilitation team and local site labor costs. We used labor estimates from the Bureau of Labor and Statistics, and sensitivity analyses were performed using labor estimates from the Veterans Health Administration (VHA) Financial Management System general ledger data.

Results

The average total costs for implementing an external facilitation intervention for MOUD per site was $18,847 (SD 6717) and ranged between $11,320 and $31,592. This translates to approximately $48 per patient with OUD. Sites with more encounters and participants with higher salaries in attendance had higher costs. This was driven mostly by the labor involved in planning and implementation activities. The average total cost of the pre-implementation and implementation activities were $1031 and $17,816 per site, respectively. In the sensitivity analysis, costs for VHA were higher than BLS estimates likely due to higher wages.

Conclusions

Implementing external facilitation to increase MOUD prescribing may be affordable depending on the payer’s budget constraints. Our study reported that there were variations in the time invested at each phase of implementation and the number and type of participants involved with implementing an external facilitation intervention. Participant composition played an important role in total implementation costs, and decision makers will need to identify the most efficient and optimal number of stakeholders to involve in their implementation plans.
Fabrication and functional attributes of nanotherapeutically engineered system for co-administration of adapalene and lycopene for enhanced acne management: an in vitro and in vivo investigation
Authors: Jain Amit Kumar , Mehta Parul
Published: August 2023

Background

Acne vulgaris is caused due to several different biological, environmental and specific pathological factors, resulting in secretion of unregulated amount of sebum by the sebaceous glands. Acne is thought to be a minor, self-restraint, puberty leading and hormone-induced cosmetic disorder. It significantly affects the quality of life leading to social disengagement, anxiety, depression, necessitating its therapeutic management in due course of time. Thus, despite not being fatal it has social and mental impact on individual’s life. Pathogenesis of acne is complex and multifactorial involving diverse physiological, environmental factors and significant role of propionibacterium acne. Retinoids have been used as preferred first-line therapy for treatment of acne, but they have many limitations. Adapalene has found to be acting synergistically with other drugs like benzoyl peroxide, salicylic acid, clindamycin, etc., and various other topical antioxidants.

Results

The study investigates the formulation and characterization of novel nanostructured lipid vesicles (NLVs) co-loaded with adapalene and lycopene, through topical gel. The high-pressure homogenization method was used to prepare nanostructured lipid vesicles followed by incorporation into hydrophilic gel vehicle. This novel system was scientifically tested for various evaluation parameters like size and vesicle size distribution, polydispersity index, drug entrapment efficiency and in vitro drug release characteristics, along with rheological behavior of formulation gel. Skin permeation and biodistribution characteristics through skin were also evaluated, and better localization of drug in dermis and reduced systemic penetration were the key observation in prepared formulation.

Conclusion

The simultaneous co-administration of lycopene resulted in an additive effect in therapeutic management of acne. It can be predicted that this novel NLVs-based gel along with synergistic effect of lycopene will definitely result in better therapeutic efficacy and reduced systemic adverse effects of adapalene. This combination can be explored as future alternative for acne therapy.
Understanding post-pandemic travel intention toward rural destinations by expanding the theory of planned behavior (TPB)
Authors: Azhar Mohd , Nafees Sehar , Sujood  , Hamid Sheeba
Published: August 2023

This research intends to understand post-pandemic travel intention toward rural areas by extending the theory of planned behavior (TPB). Social media use (SMU) and electronic word of mouth (eWOM) have been incorporated into the original TPB model as additional constructs to increase its predictive power. To date, no study has measured post-pandemic travel intention in the Indian context utilizing a modified model of TPB taking the studied variables; thus, this study fills this void. A sample of 305 respondents was collected on a convenience basis via an online questionnaire. The targeted population of this study were the Indian social media users who follow the web pages of travel agencies. “SPSS 20” and “AMOS 22.0” were used for the statistical analysis. The results reveal that attitude (AT), subjective norm (SN), perceived behavioral control (PBC), social media usage (SMU) and electronic word of mouth (eWOM) all have a beneficial impact on post-pandemic travel intention toward rural destinations. These factors explained approximately 53% (R2 = 0.529) of the variance in the post-pandemic travel intention toward rural destinations. A number of theoretical and managerial ramifications can be deduced from the findings of this study. The novelty of this research lies in its integration of SMU and eWOM into the original TPB framework to assess individuals’ post-pandemic travel intentions toward rural destinations.
Automastoidectomy — a case report
Authors: Seedahmed Khalid Mahmoud Sayed , Abujabal Tareq A. Y. , Akoud Fatima Ayed
Published: August 2023

Background

Automastoidectomy denotes extensive destruction of the middle ear cavity and the mastoid air cells, mimicking the appearance of a reminiscent image of the post-mastoidectomy cavity. This condition, although rare, might occur as a unique complication of chronic otitis media with cholesteatoma with subsequent destruction of the posterior wall of the external auditory canal and spontaneous partial or complete evacuation of the cholesteatoma through the canal.

Case presentation

Seventy-year-old gentleman, a retired soldier, presented to us in the ENT OPD with right ear pain for more than a year, right ear discharge for 9 months, and a decrease in the hearing of the right ear for 6 months. The condition started 18 months ago with intermittent right otalgia; Dull aching in nature. Ten months later, the patient started to experience right-sided otorrhoea which was profuse, offensive, mucopurulent, and yellowish in color. Later on, he noticed a gradually deteriorating hearing.

On examination of the right ear, there is a fleshy mass obstructing the EAC, no auricular deformity tenderness, no preauricular swelling, sinus, or deformity, and there is thinning of the skin in the right postauricular region with mild tenderness but no swelling or sinus and preserved sulcus. Otoscopic examination shows a mass obstructing the EAC found to be an everted skin tag from the posteroinferior wall of the canal. There was a widening of the canal with the destruction of the walls and the absence of the TM, the annulus tympanicum, and the ossicles with polypoidal mucosa all over the middle ear cavity.

Investigation

HRCT scan of the temporal bone shows destruction of the air cells of the right mastoid cavity with the absence of the ossicles and destruction of the posterior EAC walls.

Conclusion

Although uncommon it is considered to be a known complication of Cholesteatomatous otitis media and sometime keratosis obturates with the main feature of osteogenic destruction of the posterior wall of the EAC.
Knowledge, attitudes, practices, and compliance of rheumatic disease patients toward COVID-19 during the late pandemic
Authors: Ismail Zahraa Nour Eldine , Ibrahim Omar Nabil , Ghaly Mona Sayed , Ibrahim Maha Emad
Published: August 2023

Background

Rheumatic disease (RD) patients are liable for severe coronavirus disease 2019 (COVID-19). It is noticeable that RD patients’ practices have changed during the late COVID-19 pandemic. This study aimed to assess the knowledge, attitudes, practices, and compliance of RD patients during the late pandemic.

Results

This study included 188 patients with various RDs. The majority were female (61.7%) and were rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (40.4% and 30.9%, respectively). We found knowledge deficiencies regarding some symptoms, contact isolation, and transmission. Negative attitudes toward COVID-19 final control were detected in a large proportion (50%). Furthermore, the majority did not think they were at risk of COVID-19 due to either RD (61.7%) or their drugs (66%). Their practices were also negative; the majority stopped wearing masks (56.4%) and went to crowded places recently (83%). Moreover, most did not stop or reduce their drugs for fear of COVID-19 but for availability issues (5.3% and 9.6% vs. 37.2%). Male gender and higher education and socioeconomic levels were significantly associated with better knowledge. In addition, RDs such as reactive arthritis, steroid use, lower steroid doses, COVID-19 vaccination, high education and socioeconomic levels, and Internet use as main knowledge sources had a significant association with better attitudes. Conventional disease-modifying anti-rheumatic drugs (DMARDs) use, biologics non-use, high education, severe functional impact, and compliance before the pandemic were significantly associated with higher practice scores. Knowledge was positively correlated with attitudes and practice (P = 0.0001 and 0.003, respectively). Moreover, attitudes were negatively correlated with age (P = 0.016). In multiple linear regression analysis, education, socioeconomic status, and practice were significant positive predictors of knowledge (P = 0.002, 0.001, and 0.046, respectively). Good knowledge, COVID-19 vaccination, younger age, and lower steroid doses were significant predictors of better attitudes (P = 0.02, 0.001, 0.02, and 0.002, respectively). Furthermore, non-use of biologics and functional disability were significant predictors of good practice (P = 0.002 and 0.015, respectively).

Conclusion

Improving knowledge and educating RD patients about the importance of protective measures is essentially needed to decrease the pandemic fatigue consequences and prevent serious COVID-19 complications in those patients.
High–Temporal/High–Spatial Resolution Breast Magnetic Resonance Imaging Improves Diagnostic Accuracy Compared With Standard Breast Magnetic Resonance Imaging in Patients With High Background Parenchymal Enhancement
Authors: Eskreis-Winkler Sarah , Sung Janice S. , Dixon Linden , Monga Natasha , Jindal Ragni , Simmons Amber , Thakur Sunitha , Sevilimedu Varadan , Sutton Elizabeth , Comstock Christopher , Feigin Kimberly , Pinker Katja
Published: August 2023

New breast MRI protocol finds more cancers with fewer benign biopsies in women with high BPE
The Cholangiocarcinoma in the Young (CITY) Study: Tumor Biology, Treatment Patterns, and Survival Outcomes in Adolescent Young Adults With Cholangiocarcinoma
Authors: Pappas Leontios , Baiev Islam , Reyes Stephanie , Bocobo Andrea Grace , Jain Apurva , Spencer Kristen , Le Tri Minh , Rahma Osama E. , Maurer Jordan , Stanton Jen , Zhang Karen , De Armas Anaemy Danner , Deleon Thomas T. , Roth Marc , Peters Mary Linton B. , Zhu Andrew X. , Boyhen Kylie , VanCott Christine , Patel Tushar , Roberts Lewis R. , Lindsey Stacie , Horick Nora , Lennerz Jochen K. , Iafrate A. John , Goff Laura Williams , Mody Kabir , Borad Mitesh J. , Shroff Rachna T. , Javle Milind M. , Kelley R. Katie , Goyal Lipika
Published: August 2023

PURPOSE

Increased awareness of the distinct tumor biology for adolescents and young adults (AYAs) with cancer has led to improvement in outcomes for this population. However, in cholangiocarcinoma (CCA), a paucity of data exist on the AYA population. To our knowledge, we present the largest study to date on AYA disease biology, treatment patterns, and survival outcomes in CCA.

METHODS

A multi-institutional cohort of patients with CCA diagnosed with intrahepatic cholangiocarcinoma (ICC) or extrahepatic cholangiocarcinoma (ECC) was used for analysis. Retrospective chart review was conducted on patients who were 50 years old and younger (young; n = 124) and older than 50 years (older; n = 723).

RESULTS

Among 1,039 patients screened, 847 patients met eligibility (72% ICC, 28% ECC). Young patients had a larger median tumor size at resection compared with older patients (4.2 v 3.6 cm; P = .048), more commonly had N1 disease (65% v 43%; P = .040), and were more likely to receive adjuvant therapy (odds ratio, 4.0; 95% CI, 1.64 to 9.74). Tumors of young patients were more likely to harbor an FGFR2 fusion, BRAF mutation, or ATM mutation ( P < .05 for each). Young patients were more likely to receive palliative systemic therapy (96% v 69%; P < .001), targeted therapy (23% v 8%; P < .001), and treatment on a clinical trial (31% v 19%; P = .004). Among patients who presented with advanced disease, young patients had a higher median overall survival compared with their older counterparts (17.7 v 13.5 months; 95% CI, 12.6 to 22.6 v 11.4 to 14.8; P = .049).

CONCLUSION

Young patients with CCA had more advanced disease at resection, more commonly received both adjuvant and palliative therapies, and demonstrated improved survival compared with older patients. Given the low clinical trial enrollment and poor outcomes among some AYA cancer populations, data to the contrary in CCA are highly encouraging.
A Year at the Forefront of Hydrostat Motion
Authors: Schulz Andrew K. , Schneider Nikole , Zhang Margaret , Singal Krishma
Published: August 2023

Currently, in the field of interdisciplinary work in biology, there has been a significant push by the soft robotic community to understand the motion and maneuverability of hydrostats. This Review seeks to expand the muscular hydrostat hypothesis toward new structures, including plants, and introduce innovative techniques to the hydrostat community on new modeling, simulating, mimicking, and observing hydrostat motion methods. These methods range from ideas of kirigami, origami, and knitting for mimic creation to utilizing reinforcement learning for control of bio-inspired soft robotic systems. It is now being understood through modeling that different mechanisms can inhibit traditional hydrostat motion, such as skin, nostrils, or sheathed layered muscle walls. The impact of this Review will highlight these mechanisms, including asymmetries, and discuss the critical next steps toward understanding their motion and how species with hydrostat structures control such complex motions, highlighting work from January 2022 to December 2022.
Global SUMOylation in mouse oocytes maintains oocyte identity and regulates chromatin remodeling and transcriptional silencing at the end of folliculogenesis
Authors: Briley Shawn M. , Ahmed Avery A. , Steenwinkel Tessa E. , Jiang Peixin , Hartig Sean M. , Schindler Karen , Pangas Stephanie A.
Published: August 2023

Meiotically competent oocytes in mammals undergo cyclic development during folliculogenesis. Oocytes within ovarian follicles are transcriptionally active, producing and storing transcripts required for oocyte growth, somatic cell communication and early embryogenesis. Transcription ceases as oocytes transition from growth to maturation and does not resume until zygotic genome activation. Although SUMOylation, a post-translational modification, plays multifaceted roles in transcriptional regulation, its involvement during oocyte development remains poorly understood. In this study, we generated an oocyte-specific knockout of Ube2i, encoding the SUMO E2 enzyme UBE2I, using Zp3-cre+ to determine how loss of oocyte SUMOylation during folliculogenesis affects oocyte development. Ube2i Zp3-cre+ female knockout mice were sterile, with oocyte defects in meiotic competence, spindle architecture and chromosome alignment, and a premature arrest in metaphase I. Additionally, fully grown Ube2i Zp3-cre+ oocytes exhibited sustained transcriptional activity but downregulated maternal effect genes and prematurely activated genes and retrotransposons typically associated with zygotic genome activation. These findings demonstrate that UBE2I is required for the acquisition of key hallmarks of oocyte development during folliculogenesis, and highlight UBE2I as a previously unreported orchestrator of transcriptional regulation in mouse oocytes.
Successful Breast Conservation After Neoadjuvant Chemotherapy in Lobular Breast Cancer: The Role of Menopausal Status in Response to Treatment
Authors: Ramalingam Kirithiga , Clelland Elle , Rothschild Harriet , Mujir Firdows , Record Helena , Kaur Mandeep , Mukhtar Rita A.
Published: August 2023

Background

While neoadjuvant chemotherapy (NAC) has been shown to increase rates of breast conservation surgery (BCS) for breast cancer, response rates in invasive lobular carcinoma (ILC) appear lower than other histologic subtypes. Some data suggest higher response rates to NAC in premenopausal versus postmenopausal patients, but this has not been studied in ILC. We evaluated the rates of successful BCS after NAC in patients with ILC stratified by menopausal status.

Patients and Methods

We analyzed data from a single-institution cohort of 666 patients with stage I–III hormone receptor positive HER-2 negative ILC. We used t-tests, chi-squared tests, and multivariable logistic regression to investigate rates of NAC use, attempted BCS, and associations between NAC and successful BCS by menopausal status.

Results

In 217 premenopausal and 449 postmenopausal patients, NAC was used more often in the premenopausal group (15.2% vs. 9.8%, respectively, p = 0.041). Among those who attempted breast conservation (51.3% of pre- and 64.8% of postmenopausal cohorts), NAC was not associated with successful BCS in either group. Interestingly, for postmenopausal patients, receipt of NAC was significantly associated with increased rates of completion mastectomy in those who had positive margins at the first attempt at BCS.

Conclusion

NAC was not associated with successful BCS in either premenopausal or postmenopausal patients with ILC. Although premenopausal patients were more likely to receive NAC, these data suggest that menopausal status may not be a good predictor of response to chemotherapy. Better predictors of response and more efficacious treatment for patients with ILC are needed.
Case Report: Buprenorphine-precipitated fentanyl withdrawal treated with high-dose buprenorphine
Authors: Bormann Nicholas L. , Gout Antony , Kijewski Vicki , Lynch Alison
Published: August 2023

Background: Buprenorphine, a partial agonist of the mu-opioid receptor, is an increasingly prescribed medication for maintenance treatment of opioid use disorder. When this medication is taken in the context of active opioid use, precipitated withdrawal can occur, leading to acute onset of opioid withdrawal symptoms. Fentanyl complicates use of buprenorphine, as it slowly releases from body stores and can lead to higher risk of precipitated withdrawal.

Objectives: Describe the successful management of buprenorphine precipitated opioid withdrawal from fentanyl with high doses of buprenorphine. We seek to highlight how no adverse effects occurred in this patient and illustrate his stable transition to outpatient treatment.

Case report: We present the case of a patient with severe opioid use disorder who presented in moderately severe opioid withdrawal after taking non-prescribed buprenorphine-naloxone which precipitated opioid withdrawal from daily fentanyl use. He was treated with high doses of buprenorphine, 148 mg over the first 48 hours, averaging 63 mg per day over four days. The patient reported rapid improvement in withdrawal symptoms without noted side effects and was able to successfully taper to 16 mg twice daily by discharge.

Conclusions: This case demonstrates the safety and effectiveness of buprenorphine at high doses for treatment of precipitated withdrawal. While other options include symptomatic withdrawal management, initiating methadone or less researched options like ketamine, utilizing buprenorphine can preserve or re-establish confidence in this life-saving medication. This case also increases the previously documented upper boundary on buprenorphine dosing for withdrawal and should provide additional confidence in its use.