bluuebunny/crossref_metadata_2025 huggingface dataset:
Leveraging blockchain for energy transition in urban contexts
Authors: Montakhabi Mehdi , Madhusudan Akash , Mustafa Mustafa A , Vanhaverbeke Wim , Almirall Esteve , van der Graaf Shenja
Published: November 2023

This article explores the potential of leveraging blockchain technology to facilitate energy transition within urban settings. It explores three innovative market models—peer-to-peer, community self-consumption, and transactive energy—which hold promise for a shift in (local) electricity trading due to decentralized and digital transactional characteristics. Utilizing a scenario building framework, this research scrutinizes these market models, their corresponding trading mechanisms, and the advantages and disadvantages of implementing blockchain technology. The results provide valuable insights into investment necessities, market democratization, service quality and reliability, urban governance, civic engagement and citizenry welfare. Consequently, this study offers a novel conceptualization of market models, laying the groundwork for a systematic understanding of blockchain’s potentiality in ecosystem governance in the context of energy transition.
Bacterial pericarditis associated with a hepatic abscess in a cat
Authors: White Melissa , Miller Rachel , Locquet Laurent
Published: November 2023

Case summary

An 8-year-old male neutered domestic shorthair cat presented collapsed and was subsequently diagnosed with a pericardial effusion based on ultrasound imaging. A laboratory analysis of pericardial fluid revealed a septic pericardial effusion and further diagnostics, including abdominal ultrasound and fluid analysis, revealed a concurrent hepatic abscess. Bacterial isolation and identification from both septic foci revealed Escherichia coli. Therapeutic measures included a combination of medical and surgical intervention, the latter including a pericardiectomy, cholecystectomy, liver lobectomy and splenectomy.

Relevance and novel information

Septic pericarditis is one of the least reported causes of feline pericardial effusion. This case report describes bacterial pericarditis in a cat, suspected to be derived from a hepatic abscess via haematological spread. In this case, a favourable response was achieved with both surgical and medical management.
The Effect of Patient Gender and Undressing Method on Chest Exposure for the Treatment of a Gunshot Wound
Authors: Schwieters Katelyn R. , Drahos Bradley A. , Craig Curtis M. , Kessler William , Mabry Marshall , Norfleet Jack E. , Mazzeo Mark V. , Morris Nichole L.
Published: November 2023

Disrobing of a casualty on the battlefield is a key step in treatment to ensure injuries have been properly treated. Hesitancy to fully disrobe female patients may result in poorer treatment provided to female casualties. The goal of this study was to determine whether patient gender predicted the occurrence of complete or partial chest exposure and whether the type of undressing method predicted complete or partial exposure. Second, we sought to determine whether simulator gender, undressing method, and chest exposure predicted differences in the treatment of a gunshot wound (GSW) to the chest. Thirty-six soldiers treated GSW on male and female patient simulators. Complete chest exposures were more likely with male patients or when shears were used. For male patients, there were fewer errors, chest was exposed completely, and tearing methods were used. Results indicate opportunities to improve wound discovery and decrease GSW treatment errors, particularly for female patients.
Pivoting an Entrepreneurship Experiential Learning Module Online: Applying a Concrete Experience Framework
Authors: Monllor Javier , Michels Nicolette , Adderley Simon
Published: November 2023

Experiential learning has gained in popularity over the past 20 years in many fields and in entrepreneurship education in particular, where many educators posit that it is essential. Delivery of experiential learning activities and courses became extremely difficult and nearly impossible in some countries during the COVID-19 pandemic due to government imposed lockdowns and restrictions, forcing educational institutions to adapt and many opted to move their teaching online. How these changes impacted positively or negatively on experiential learning and students’ ability to adapt and learn has yet to be fully understood. This paper introduces a concrete experience framework and describes how it was applied to the process of pivoting an MBA experiential learning module online. It contributes by demonstrating how educators can adopt the framework in their efforts to adapt or create online courses that aim to deliver experiential learning.
Open-Science Guidance for Qualitative Research: An Empirically Validated Approach for De-Identifying Sensitive Narrative Data
Authors: Campbell Rebecca , Javorka McKenzie , Engleton Jasmine , Fishwick Kathryn , Gregory Katie , Goodman-Williams Rachael
Published: November 2023

The open-science movement seeks to make research more transparent and accessible. To that end, researchers are increasingly expected to share de-identified data with other scholars for review, reanalysis, and reuse. In psychology, open-science practices have been explored primarily within the context of quantitative data, but demands to share qualitative data are becoming more prevalent. Narrative data are far more challenging to de-identify fully, and because qualitative methods are often used in studies with marginalized, minoritized, and/or traumatized populations, data sharing may pose substantial risks for participants if their information can be later reidentified. To date, there has been little guidance in the literature on how to de-identify qualitative data. To address this gap, we developed a methodological framework for remediating sensitive narrative data. This multiphase process is modeled on common qualitative-coding strategies. The first phase includes consultations with diverse stakeholders and sources to understand reidentifiability risks and data-sharing concerns. The second phase outlines an iterative process for recognizing potentially identifiable information and constructing individualized remediation strategies through group review and consensus. The third phase includes multiple strategies for assessing the validity of the de-identification analyses (i.e., whether the remediated transcripts adequately protect participants’ privacy). We applied this framework to a set of 32 qualitative interviews with sexual-assault survivors. We provide case examples of how blurring and redaction techniques can be used to protect names, dates, locations, trauma histories, help-seeking experiences, and other information about dyadic interactions.
Study on Water Resistance of Polypropylene Based Wood-Plastic Composites Used in Building
Authors: Lin Zhang , Xiang Quan , Dongmei Xu
Published: November 2023

This research was aimed at studying the preparation of polypropylene based wood plastic composite material by twin-screw extrusion. The effects of the addition of the maleic anhydride (MAH) and wood flour on WPC properties were evaluated. WPC with 4, 5, 6, 7, 8, 9, 10 wt% of MAH contents were prepared. The mechanical properties and water resistance of WPC were studied. The result showed that with the increasing of MAH, the tensile strength of WPC increases at first and then decrease, and water absorption reduced by 39%. After immersing in water for 24 h, the tensile strength of WPC decreases but the impact strength increases, and with the increasing of MAH, the reducing extent of tensile strength increases, but the improvement extent of impact strength gradually decreases. When the MAH content exceeds 8 wt%, the impact strength of dried WPC samples (dried for 24 h) can be recovered basically. WPC with 10, 20, 30, 40 wt% of wood flour contents were prepared. The result showed that with the increasing of wood flour, the tensile strength of WPC increases at first and then decreases, the impact strength decreases, and water absorption increased by 62%. When the wood flour content exceeds 10 wt%, the impact strength of dried WPC samples can only recover partially. WPC containing different wood meal sizes was prepared. The result showed that with the decreasing of wood flour particle size, the water absorption of WPC increases obviously. The impact strength of dried WPC samples is higher than that of unsoaked WPC, when the particle size of wood flour is 60 meshes. It can be seen from the SEM photos that the distance between the wood powder fibers becomes larger after 24 h of WPC soaking in water. The finer the wood flour, the easier it is to aggregate in WPC.
Barriers to Elderly Health Care in the Occupied Palestinian Territories
Authors: El Jabari Carol , Nawajah Inad , Takruri Adel T , Hassan Sahar
Published: November 2023

This study examined different barriers to the access and utilization of primary health care services by the elderly in the occupied Palestinians territories. We collected quantitative data from a larger convenience sample of a national survey of 1299 persons in the occupied Palestinian territories (oPt) that examined the effects of Israel's colonization and its effects on health care delivery between October 2021 and February 2022. The research tool was based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questionnaire. The data was obtained from 76 elderly participants with a mean age of 68.33 years standard deviation (SD = 7.09 years). The majority (75%) reported having at least one chronic health issue and having limited access to health care. They had all finished at least six years of education. The participants claimed having health insurance, while 47.4 percent reported paying for out-of-pocket expenses and medical care was a burden. Access and affordability of health care was a problem for 70 percent of participants. Older persons and their families face access to care issues created by political, geographic, and economic barriers. Poor incomes, war-like conditions, a weak health care system, and a lack of comprehensive care delivery all impact their health.
Transcriptome analysis reveals core lncRNA-mRNA networks regulating melanization and biomineralization in Patinopecten yessoensis shell-infested by Polydora
Authors: Wang Yiying , Mao Junxia , Fan Zhiyue , Hang Yunna , Tang AnQi , Tian Ying , Wang Xubo , Hao Zhenlin , Han Bing , Ding Jun , Chang Yaqing
Published: November 2023

Background

Patinopecten yessoensis, a large and old molluscan group, has been one of the most important aquaculture shellfish in Asian countries because of its high economic value. However, the aquaculture of the species has recently been seriously affected by the frequent outbreaks of Polydora disease, causing great economic losses. Long non-coding RNAs (lncRNAs) exhibit exhibit crucial effects on diverse biological processes, but still remain poorly studied in scallops, limiting our understanding of the molecular regulatory mechanism of P. yessoensis in response to Polydora infestation.

Results

In this study, a high-throughput transcriptome analysis was conducted in the mantles of healthy and Polydora-infected P. yessoensis by RNA sequencing. A total of 19,133 lncRNAs with 2,203 known and 16,930 novel were identified. The genomic characterizations of lncRNAs showed shorter sequence and open reading frame (ORF) length, fewer number of exons and lower expression levels in comparison with mRNAs. There were separately 2280 and 1636 differentially expressed mRNAs and lncRNAs (DEGs and DELs) detected in diseased individuals. The target genes of DELs were determined by both co-location and co-expression analyses. Functional enrichment analysis revealed that DEGs involved in melanization and biomineralization were significantly upregulated; further, obviously increased melanin granules were observed in epithelial cells of the edge mantle in diseased scallops by histological and TEM study, indicating the crucial role of melanizaiton and biomineralization in P. yessoensis to resist against Polydora infestation. Moreover, many key genes, such as Tyrs, Frizzled, Wnts, calmodulins, Pifs, perlucin, laccase, shell matrix protein, mucins and chitins, were targeted by DELs. Finally, a core lncRNA-mRNA interactive network involved in melanization and biomineralization was constructed and validated by qRT-PCR.

Conclusions

This work provides valuable resources for studies of lncRNAs in scallops, and adds a new insight into the molecular regulatory mechanisms of P. yessoensis defending against Polydora infestation, which will contribute to Polydora disease control and breeding of disease-resistant varieties in molluscs.
Comprehensive identification and functional characterization of GhpPLA gene family in reproductive organ development
Authors: Wang Mingyang , Tian Dingyan , Li Tengyu , Pan Jingwen , Wang Chenlei , Wu Lanxin , Luo Kun , Mei Zhenyu , Liu Jinwei , Chen Wei , Yao Jinbo , Li Yan , Wang Fuxin , Zhu Shouhong , Zhang Yongshan
Published: November 2023

Background

Phospholipases As (PLAs) are acyl hydrolases that catalyze the release of free fatty acids in phospholipids and play multiple functions in plant growth and development. The three families of PLAs are: PLA1, PLA2 (sPLA), and patatin-related PLA (pPLA). The diverse functions that pPLAs play in the growth and development of a broad range of plants have been demonstrated by prior studies.

Methods

Genome-wide analysis of the pPLA gene family and screening of genes for expression verification and gene silencing verification were conducted. Additionally, pollen vitality testing, analysis of the pollen expression pattern, and the detection of POD, SOD, CAT, MDA, and H2O2 were performed.

Result

In this study, 294 pPLAs were identified from 13 plant species, including 46 GhpPLAs that were divided into three subfamilies (I-III). Expression patterns showed that the majority of GhpPLAs were preferentially expressed in the petal, pistil, anther, and ovule, among other reproductive organs. Particularly, GhpPLA23 and GhpPLA44, were found to be potentially important for the reproductive development of G. hirsutum. Functional validation was demonstrated by VIGS which showed that reduced expression levels of GhpPLA23 and GhpPLA44 in the silenced plants were associated with a decrease in pollen activity. Moreover, a substantial shift in ROS and ROS scavengers and a considerable increase in POD, CAT, SOD, and other physiological parameters was found out in these silenced plants. Our results provide plausibility to the hypothesis that GhpPLA23 and GhpPLA44 had a major developmental impact on cotton reproductive systems. These results also suggest that pPLAs are important for G. hirsutum’s reproductive development and suggest that they could be employed as potential genes for haploid induction.

Conclusions

The findings of the present research indicate that pPLA genes are essential for the development of floral organs and sperm cells in cotton. Consequently, this family might be important for the reproductive development of cotton and possibly for inducing the plant develop haploid progeny.
Integrated transcriptomic and proteomic analyses of two sugarcane (Saccharum officinarum Linn.) varieties differing in their lodging tolerance
Authors: Li Xiang , Li Yijie , Wei Ailin , Wang Zeping , Huang Hairong , Huang Quyan , Yang Litao , Gao Yijing , Zhu Guanghu , Liu Qihuai , Li Yangrui , Wei Shaolong , Wei Debin
Published: November 2023

Background

Lodging seriously affects sugarcane stem growth and sugar accumulation, reduces sugarcane yield and sucrose content, and impedes mechanization. However, the molecular mechanisms underlying sugarcane lodging tolerance remain unclear. In this study, comprehensive transcriptomic and proteomic analyses were performed to explore the differential genetic regulatory mechanisms between upright (GT42) and lodged (GF98-296) sugarcane varieties.

Results

The stain test showed that GT42 had more lignin and vascular bundles in the stem than GF98-296. The gene expression analysis revealed that the genes that were differentially expressed between the two varieties were mainly involved in the phenylpropanoid pathway at the growth stage. The protein expression analysis indicated that the proteins that were differentially expressed between the two varieties were related to the synthesis of secondary metabolites, the process of endocytosis, and the formation of aminoacyl-tRNA. Time-series analysis revealed variations in differential gene expression patterns between the two varieties, whereas significant protein expression trends in the two varieties were largely consistent, except for one profile. The expression of CYP84A, 4CL, and CAD from the key phenylpropanoid biosynthetic pathway was enhanced in GT42 at stage 2 but suppressed in GF98-296 at the growth stage. Furthermore, the expression of SDT1 in the nicotinate and nicotinamide metabolism was enhanced in GT42 cells but suppressed in GF98-296 cells at the growth stage.

Conclusion

Our findings provide reference data for mining lodging tolerance-related genes that are expected to facilitate the selective breeding of sugarcane varieties with excellent lodging tolerance.
Evaluation of video review tools for assessing non-technical skills in emergency department resuscitation teams: a systematic review
Authors: Alexander Emily G , Denny Fraser , Gordon Malcom WG , McKiernan Cieran , Lowe David J
Published: November 2023

Background and importance

Use of video review in medicine is established in contexts such as surgery. Although not widely used in the emergency department (ED), some centres use it to evaluate non-technical skills (NTS) to support teaching and quality improvement.

Objective

There is no consensus on assessment of NTS using video review in the ED and the purpose of this review was to identify tools used in this context.

Design, setting and participants

Studies were identified using Embase, Medline, CINAHL and Google Scholar. Inclusion criterion for the review was NTS of resuscitation teams working within the ED were assessed using video review. A systematic search method was used, and results were synthesised after search criteria was checked by two independent reviewers. Authors settled on the same 9 studies eligible for inclusion.

Outcome measures and analysis

Reliability and validity of tools identified for use in this context. Due to the heterogeneity of studies, no meta-analysis occurred.

Main results

There are 9 studies included in the review. The review was registered with PROSPERO (Ref No: CRD42022306129). Four unique tools were identified – 6 studies used T-NOTECHS, 1 used TTCA-24, 1 used CALM and 1 used the Communication tool. T-NOTECHS is validated in the literature for use in this context.

Conclusion

T-NOTECHS is the tool of choice for assessing ED teams in this context.
Cost-effectiveness of modified diagnostic strategy to safely rule-out pulmonary embolism in the emergency department: a non-inferiority cluster crossover randomized trial (MODIGLIA-NI)
Authors: Nze Ossima Arnaud , Ngaleu Siaha Bibi Fabiola , Mimouni Maroua , Mezaour Nadia , Darlington Meryl , Berard Laurence , Cachanado Marine , Simon Tabassome , Freund Yonathan , Durand-Zaleski Isabelle
Published: November 2023

Background

The aim of this trial-based economic evaluation was to assess the incremental costs and cost-effectiveness of the modified diagnostic strategy combining the YEARS rule and age-adjusted D-dimer threshold compared with the control (which used the age-adjusted D-dimer threshold only) for the diagnosis of pulmonary embolism (PE) in the Emergency Department (ED).

Methods

Economic evaluation from a healthcare system perspective alongside a non-inferiority, crossover, and cluster-randomized trial conducted in 16 EDs in France and two in Spain with three months of follow-up. The primary endpoint was the additional cost of a patient without failure of the diagnostic strategy, defined as venous thromboembolism (VTE) diagnosis at 3months after exclusion of PE during the initial ED visit. Mean differences in 3-month failure and costs were estimated using separate generalized linear-regression mixed models, adjusted for strategy type, period, and the interaction between strategy and period as fixed effects and the hospital as a random effect. The incremental cost-effectiveness ratio (ICER) was obtained by dividing the incremental costs by the incremental frequency of VTE.

Results

Of the 1,414 included patients, 1,217 (86%) were analyzed in the per-protocol analysis (648 in the intervention group and 623 in the control group). At three months, there were no statistically significant differences in total costs (€-46; 95% CI: €-93 to €0.2), and the failure rate was non inferior in the intervention group (-0.64%, one-sided 97.5% CI: -∞ to 0.21%, non-inferiority margin 1.5%) between groups. The point estimate of the incremental cost-effectiveness ratio (ICER) indicating that each undetected VTE averted in the intervention group is associated with cost savings of €7,142 in comparison with the control group. There was a 93% probability that the intervention was dominant. Similar results were found in the as randomized population.

Conclusions

Given the observed cost decrease of borderline significance, and according to the 95% confidence ellipses, the intervention strategy has a potential to lead to cost savings as a result of a reduction in the use of chest imaging and of the number of undetected VTE averted. Policy-makers should investigate how these monetary benefits can be distributed across stakeholders.

Clinicaltrials

Trial registration number ClinicalTrials.gov Identifier: NCT04032769; July 25, 2019.
Reducing fear and avoidance of memory loss improves mood and social engagement in community-based older adults: a randomized trial
Authors: Farina Francesca R , Regan John , Marquez Melissa , An Hosanna , O’Loughlin Patricia , Pavithra Pavithra , Taddeo Michelle , Knight Rachel C , Bennett Marc , Lenaert Bert , Griffith James W
Published: November 2023

Background

Alzheimer’s disease and related dementias (ADRD) are among the most feared age-related conditions. The aim of this study was to evaluate a brief psychological intervention to promote adaptive coping in older adults experiencing heightened fear of ADRD and investigate positive downstream effects on health-related secondary outcomes, including frequency of reported memory failures, psychosocial functioning, and quality of life.

Methods

Eighty-one older adults were recruited and randomized into REFRAME or active control intervention arms. Both groups received psycho-education and training in mindful monitoring of fears related to ADRD. The REFRAME group received an additional behavioral activation component intended to disrupt maladaptive avoidant coping (i.e., avoidance) strategies. Both groups completed 3-weeks of intervention exercises with accompanying questionnaires (baseline, mid- and post-intervention and 4-week follow-up).

Results

Adherence was strong (> 75%). We observed a significant reduction in ADRD-related fear and avoidance in both groups. Significant reductions were also observed for frequency of self-reported memory failures, anxiety, and depression. Depression was significantly reduced in the REFRAME group compared to the control group. Significant increases in participants’ ability to participate in social activities and well-being were also observed.

Conclusions

Findings suggest that a brief psychological intervention can mitigate ADRD-related fears and avoidant coping in older adults, and that benefits extend to broader health-related outcomes including anxiety, depression, social functioning, and well-being. Addressing ADRD-related fear has implications for healthy aging and risk reduction, as individuals may be more likely to engage in activities that are protective against ADRD but were previously avoided.

Trial registration

: https://clinicaltrials.gov/ct2/show/NCT04821960.
Human microbiota dysbiosis after SARS-CoV-2 infection have the potential to predict disease prognosis
Authors: Zhou Jie , Yang Xiping , Yang Yuecong , Wei Yiru , Lu Dongjia , Xie Yulan , Liang Hao , Cui Ping , Ye Li , Huang Jiegang
Published: November 2023

Background

The studies on SARS-CoV-2 and human microbiota have yielded inconsistent results regarding microbiota α-diversity and key microbiota. To address these issues and explore the predictive ability of human microbiota for the prognosis of SARS-CoV-2 infection, we conducted a reanalysis of existing studies.

Methods

We reviewed the existing studies on SARS-CoV-2 and human microbiota in the Pubmed and Bioproject databases (from inception through October 29, 2021) and extracted the available raw 16S rRNA sequencing data of human microbiota. Firstly, we used meta-analysis and bioinformatics methods to reanalyze the raw data and evaluate the impact of SARS-CoV-2 on human microbial α-diversity. Secondly, machine learning (ML) was employed to assess the ability of microbiota to predict the prognosis of SARS-CoV-2 infection. Finally, we aimed to identify the key microbiota associated with SARS-CoV-2 infection.

Results

A total of 20 studies related to SARS-CoV-2 and human microbiota were included, involving gut (n = 9), respiratory (n = 11), oral (n = 3), and skin (n = 1) microbiota. Meta-analysis showed that in gut studies, when limiting factors were studies ruled out the effect of antibiotics, cross-sectional and case–control studies, Chinese studies, American studies, and Illumina MiSeq sequencing studies, SARS-CoV-2 infection was associated with down-regulation of microbiota α-diversity (P < 0.05). In respiratory studies, SARS-CoV-2 infection was associated with down-regulation of α-diversity when the limiting factor was V4 sequencing region (P < 0.05). Additionally, the α-diversity of skin microbiota was down-regulated at multiple time points following SARS-CoV-2 infection (P < 0.05). However, no significant difference in oral microbiota α-diversity was observed after SARS-CoV-2 infection. ML models based on baseline respiratory (oropharynx) microbiota profiles exhibited the ability to predict outcomes (survival and death, Random Forest, AUC = 0.847, Sensitivity = 0.833, Specificity = 0.750) after SARS-CoV-2 infection. The shared differential Prevotella and Streptococcus in the gut, respiratory tract, and oral cavity was associated with the severity and recovery of SARS-CoV-2 infection.

Conclusions

SARS-CoV-2 infection was related to the down-regulation of α-diversity in the human gut and respiratory microbiota. The respiratory microbiota had the potential to predict the prognosis of individuals infected with SARS-CoV-2. Prevotella and Streptococcus might be key microbiota in SARS-CoV-2 infection.
Statistical shape analysis of maxillary palatal morphology in patients with palatally displaced canines
Authors: Sobhani Farshad , Miresmaeili Amirfarhang , Mahjub Hossein , Farhadian Maryam
Published: November 2023

Objective

Maxillary morphology has long been a subject of interest due to its possible impact on palatally and labially displaced canines. This study aims to conduct a comparison of the palate morphology between individuals with palatal and labially displaced canines and control subjects using statistical shape analysis on a coronal cross-sectional of CBCT images.

Materials and methods

Patients aged between 12 and 43 years with palatally or labially displaced canines referred to Hamadan School of Dentistry between 2014 and 2019 were recruited for this retrospective study. The sample included 29 palatally displaced canines (PDC), 20 labially displaced canines (LDC), and 20 control groups (CG). Initially, the maxillary palate coronal section was acquired and landmarked in the region between the right and the left first molar. Procrustes and principal component analyses were used to identify the primary patterns of palatal shape variation. Statistical tests were then performed to examine both shape and size differences.

Results

According to the results of Hotelling’s T2 test, there is a significant difference between the mean shape of palate in PDC and CG (P = 0.009), while the difference between the PDC-LDC and LDC-CG groups is not significant. The longest full Procrustes distance was observed between PDC and CG (distance = 0.043), and the shortest full Procrustes distance was observed between LDC and CG (distance = 0.029). The first two principal components accounted for 84.47% of the total variance. The predictive accuracy of the discriminant analysis model showed that 72.46% of cases were correctly classified into the three study groups.

Conclusions

In terms of centroid size, there was no significant difference in the sectional area between the three groups, but the difference between the mean shape of palate in the PDC and CG groups was significant. The PDC group showed more prominent mid-palatal area in the molar region.
Optimization of supraclavicular lymph node clinical target volume delineation in high-risk breast cancer: a single center experience and recommendation
Authors: Li Li , Zhang Hongyan , Wang Linwei , Xie Conghua , Yu Haijun , Zhong Yahua
Published: November 2023

Background

Prophylactic irradiation of supraclavicular lymph node drainage areas can improve the regional control rate of lymph node-positive or lymph node-negative disease but a locally-advanced stage breast cancer, and it can reduce breast cancer-related mortality. However, many controversies exist in the clinical target volume delineation of supraclavicular lymph node drainage in patients with breast cancer.

Methods

We retrospectively analyzed 42 patients with breast cancer and supraclavicular lymph node metastasis at our hospital between January 2017 and December 2021. Among these cases, 32 were locally advanced and 10 were stage IV at initial treatment. A patient with breast cancer who did not undergo dissection of the supraclavicular and infraclavicular lymph nodes at our hospital was selected as a standard patient. A contrast-enhanced computed tomography (CT) scan for positioning was used as a template image, and blood vessels, muscles, and bony landmarks were used as references for positioning. The metastatic supraclavicular lymph nodes were identified in all enrolled patients and projected into the template CT images.

Results

The metastastic pattern of supraclavicular lymph node in breast cancer was proposed: distribution along the posterolateral border of the internal jugular vein (medial supraclavicular group) and along the transverse jugular vein (lateral supraclavicular group). We theorized that the lateral and posterior borders of the clinical target volume in the supraclavicular region should include the lymph nodes in the posterior triangle of the neck (level V) in high-risk individuals. If the metastatic axillary lymph node is extensive, then the superior border of the supraclavicular region should be moved upward appropriately.

Conclusions

This study analyzed patients with breast cancer and supraclavicular lymph node metastasis at initial treatment, explored the metastastic pattern of supraclavicular lymph node, and applied anatomical knowledge to further optimize the target volume delineation of supraclavicular lymph node drainage area in high-risk breast cancer.
Methodological and reporting quality of systematic reviews on health effects of air pollutants were higher than extreme temperatures: a comparative study
Authors: Song Xuping , Luo Qiyin , Jiang Liangzhen , Ma Yan , Hu Yue , Han Yunze , Wang Rui , Tang Jing , Guo Yiting , Zhang Qitao , Ma Zhongyu , Zhang Yunqi , Guo Xinye , Fan Shumei , Deng Chengcheng , Fu Xinyu , Chen Yaolong , Yang Kehu , Ge Long , Wang Shigong
Published: November 2023

Background

An increasing number of systematic reviews (SRs) in the environmental field have been published in recent years as a result of the global concern about the health impacts of air pollution and temperature. However, no study has assessed and compared the methodological and reporting quality of SRs on the health effects of air pollutants and extreme temperatures. This study aims to assess and compare the methodological and reporting quality of SRs on the health effects of ambient air pollutants and extreme temperatures.

Methods

PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Web of Science, and Epistemonikos databases were searched. Two researchers screened the literature and extracted information independently. The methodological quality of the SRs was assessed through A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The reporting quality was assessed through Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA).

Results

We identified 405 SRs (286 for air pollution, 108 for temperature, and 11 for the synergistic effects). The methodological and reporting quality of the included SRs were suboptimal, with major deficiencies in protocol registration. The methodological quality of SRs of air pollutants was better than that of temperature, especially in terms of satisfactory explanations for any heterogeneity (69.6% v. 45.4%). The reporting quality of SRs of air pollution was better than temperature, however, adherence to the reporting of the assessment results of risk of bias in all SRs (53.5% v. 34.3%) was inadequate.

Conclusions

Methodological and reporting quality of SRs on the health effect of air pollutants were higher than those of temperatures. However, deficiencies in protocol registration and the assessment of risk of bias remain an issue for both pollutants and temperatures. In addition, developing a risk-of-bias assessment tool applicable to the temperature field may improve the quality of SRs.
Biomechanical effects of joint disc perforation on the temporomandibular joint: a 3D finite element study
Authors: Gao Wentong , Lu Jie , Gao Xiang , Zhou Jianping , Dai Hongwei , Sun Min , Xu Jie
Published: November 2023

Background

Disc perforation (DP) is a severe type of Temporomandibular Disorder (TMD). DP may induce changes in the internal stresses of the temporomandibular joint (TMJ). Herein, this study attempts to investigate the biomechanical effects of different positions and sizes of DP on the TMJ using a biomechanical approach, to explore the mechanical pathogenesis of TMD.

Methods

Eleven three-dimensional finite element (FE)models of the TMJ were constructed based on CBCT imaging files of a patient with DP on the left side. These models included the disc with anterior displacement and discs with different locations and sizes of perforations on the affected disc. FE methods were conducted on these models.

Results

Anterior displacement of the disc leads to a significant increase in the maxim von Mises stress (MVMS) in both TMJs, with the affected side exhibiting a more pronounced effect. DP occurring at the posterior band and the junction between the disc and the bilaminar region has a greater impact on the MVMS of both TMJs compared to perforations at other locations. As the size of the perforation increases, both sides of the TMJs exhibit an increase in the magnitude of MVMS.

Conclusions

Unilateral disc anterior displacement results in an increased stress on both TMJs. Unilateral DP further affects the stress on both sides of the TMJs. TMD is a progressive condition, and timely intervention is necessary in the early stages to prevent the worsening of the condition.
Breast cancer surveillance in BRCA positive Sri Lankan women: health equity for a high-risk group at a limited resource setting
Authors: Liyanage Udari Apsara , Sirisena Nirmala Dushyanthi , Deshapriya Pushpika Chathuranga , Dissanayake Vajira Harshadeva Weerabaddana
Published: November 2023

Background

BRCA1 and BRCA2 pathogenic variants account for 90% of hereditary breast malignancies, incurring a lifetime breast cancer risk of 85% and 40–45% respectively, in affected individuals. Well-resourced health care settings offer genetic counselling and genetic screening for susceptible individuals, followed by intense breast cancer surveillance programmes for those identified at high risk of breast cancer. Such high standards of care are not available in countries with limited resources. This study assessed breast cancer surveillance behaviors among a cohort of BRCA positive Sri Lankan women.

Methods

A retrospective case review of all patients diagnosed with pathogenic variants in BRCA1 and BRCA2 genes from 2015 to 2022 at the Human Genetics Unit, Faculty of Medicine, University of Colombo was carried out followed by telephone interviews of the respondents. Patients who were not contactable, deceased, undergone bilateral mastectomy and males were excluded from the interview component of the study. Standard descriptive statistics were used to analyze the data using SPSS statistics version 25.

Results

Only 25 patients were diagnosed during the study period:14/25 women responded (6/25 deceased, 3/25 non-contactable; 2/25 excluded). 71.4% (10/14) had performed breast self-examination during the preceding month; 35.7% (5/14) had a clinical breast examination (CBE), and 50% (7/14) had undergone a screening/diagnostic mammogram during the last one year. 28.5% (4/14) had undergone both mammography and CBE; 21.45% (3/14) mammogram only, 7.1% (1/14) had CBE only. 42.8%(6/14) had not undergone any surveillance(mammography, CBE or MRI). None had dual screening with mammogram and MRI. 85.71% (12/14) women expressed willingness to participate in a regular screening programme if made available.

Conclusion

Fifty percent of BRCA1/2 positive women in our study had not undergone annual imaging-based surveillance by mammography or MRI, and none had undergone annual dual screening with mammography and MRI, indicating inadequate breast cancer surveillance in this high-risk group.
Perceived knowledge, attitudes and practices regarding the medical consortium among medical staff in Sichuan, China: a cross-sectional survey
Authors: Zeng Wenqi , Tao Wenjuan , Yang Yanlin , Li Yong , Lu Bingqing , Zhao Qian , Li Zhuyue , Wang Miao , Shui Zhanglin , Wen Jin
Published: November 2023

Background

In China, fragmented and inefficient health care systems are common while quality resources are limited. To promote an organized, efficient system, the government launched a medical consortium policy to vertically integrate health care through the collaboration of different levels of medical care. Logically, medical staff’s knowledge, attitudes and practices (KAP) regarding the consortium are critical for its development. The objective of this study was to explore the KAP regarding the medical consortium among medical staff in a medical consortium in Sichuan Province, China.

Methods

A cross-sectional survey was conducted. In total, 690 medical staff members in 3 cities of Sichuan Province, China, were interviewed from November 2018 to December 2018. The questionnaire consisted of 18 items, including 4 items related to perceived knowledge, 4 items related to attitudes and 2 items related to practices, and was rated on a 5-point Likert scale (one = strongly disagree/do not know, five = strongly agree/know).

Results

The effective response sample was 640 copies of the questionnaire, and most medical staff members (92.50%) knew about the cooperation with other hospitals in the medical consortium. Medical staff scored differently on each item in the questionnaire, with the highest score being the item ‘agreeing with the ward rounds and clinical teaching and training organized by the leading hospital’ (4.54 ± 0.76), and the lowest score being the item ‘frequency in participating in ward rounds and clinical teaching organized by the leading hospital’ (2.83 ± 1.36). In addition, the effect of demographic characteristics on KAP was evaluated by stepwise multiple regression analysis, and a significant positive correlation was found between all the studied variables by Spearman’s correlation (p < 0.05).

Conclusions

This study showed that the attitudes toward and knowledge of the medical consortium significantly contribute to practices, satisfaction with the support work performed by the leading hospital and agreement of improvement after joining the medical consortium. Thus, to improve medical staff’s KAP and satisfaction, publicity and educational programs in medical consortia are necessary, and the leading hospital should attach importance to the informatization construction and demand of different medical staff members.

Clinical trial registration

There are no clinical trials in this study.
A bispecific Clec9A-PD-L1 targeted type I interferon profoundly reshapes the tumor microenvironment towards an antitumor state
Authors: Van Lint Sandra , Van Parys Alexander , Van Den Eeckhout Bram , Vandamme Niels , Plaisance Stephane , Verhee Annick , Catteeuw Dominiek , Rogge Elke , De Geest Jennifer , Vanderroost Nele , Roels Jana , Saeys Yvan , Uzé Gilles , Kley Niko , Cauwels Anje , Tavernier Jan
Published: November 2023

Despite major improvements in immunotherapeutic strategies, the immunosuppressive tumor microenvironment remains a major obstacle for the induction of efficient antitumor responses. In this study, we show that local delivery of a bispecific Clec9A-PD-L1 targeted type I interferon (AcTaferon, AFN) overcomes this hurdle by reshaping the tumor immune landscape.

Treatment with the bispecific AFN resulted in the presence of pro-immunogenic tumor-associated macrophages and neutrophils, increased motility and maturation profile of cDC1 and presence of inflammatory cDC2. Moreover, we report empowered diversity in the CD8+ T cell repertoire and induction of a shift from naive, dysfunctional CD8+ T cells towards effector, plastic cytotoxic T lymphocytes together with increased presence of NK and NKT cells as well as decreased regulatory T cell levels. These dynamic changes were associated with potent antitumor activity. Tumor clearance and immunological memory, therapeutic immunity on large established tumors and blunted tumor growth at distant sites were obtained upon co-administration of a non-curative dose of chemotherapy.

Overall, this study illuminates further application of type I interferon as a safe and efficient way to reshape the suppressive tumor microenvironment and induce potent antitumor immunity; features which are of major importance in overcoming the development of metastases and tumor cell resistance to immune attack. The strategy described here has potential for application across to a broad range of cancer types.
Overcoming BCR::ABL1 dependent and independent survival mechanisms in chronic myeloid leukaemia using a multi-kinase targeting approach
Authors: Busch Caroline , Mulholland Theresa , Zagnoni Michele , Dalby Matthew , Berry Catherine , Wheadon Helen
Published: November 2023

Background

Despite improved patient outcome using tyrosine kinase inhibitors (TKIs), chronic myeloid leukaemia (CML) patients require life-long treatment due to leukaemic stem cell (LSC) persistence. LSCs reside in the bone marrow (BM) niche, which they modify to their advantage. The BM provides oncogene-independent signals to aid LSC cell survival and quiescence. The bone-morphogenetic pathway (BMP) is one pathway identified to be highly deregulated in CML, with high levels of BMP ligands detected in the BM, accompanied by CML stem and progenitor cells overexpressing BMP type 1 receptors- activin-like kinases (ALKs), especially in TKI resistant patients. Saracatinib (SC), a SRC/ABL1 dual inhibitor, inhibits the growth of CML cells resistant to the TKI imatinib (IM). Recent studies indicate that SC is also a potent ALK inhibitor and BMP antagonist. Here we investigate the efficacy of SC in overcoming CML BCR::ABL1 dependent and independent signals mediated by the BM niche both in 2D and 3D culture.

Methods

CML cells (K562 cell line and CML CD34+ primary cells) were treated with single or combination treatments of: IM, SC and the BMP receptors inhibitor dorsomorphin (DOR), with or without BMP4 stimulation in 2D (suspension) and 3D co-culture on HS5 stroma cell line and mesenchymal stem cells in AggreWell and microfluidic devices. Flow cytometry was performed to investigate apoptosis, cell cycle progression and proliferation, alongside colony assays following treatment. Proteins changes were validated by immunoblotting and transcriptional changes by Fluidigm multiplex qPCR.

Results

By targeting the BMP pathway, using specific inhibitors against ALKs in combination with SRC and ABL TKIs, we show an increase in apoptosis, altered cell cycle regulation, fewer cell divisions, and reduced numbers of CD34+ cells. Impairment of long-term proliferation and differentiation potential after combinatorial treatment also occurred.

Conclusion

BMP signalling pathway is important for CML cell survival. Targeting SRC, ABL and ALK kinases is more effective than ABL inhibition alone, the combination efficacy importantly being demonstrated in both 2D and 3D cell cultures highlighting the need for combinatorial therapies in contrast to standard of care single agents. Our study provides justification to target multiple kinases in CML to combat LSC persistence.
Lysyl oxidase inhibits BMP9-induced osteoblastic differentiation through reducing Wnt/β-catenin via HIF-1a repression in 3T3-L1 cells
Authors: Zhang Jie , Ye FangLin , Ye AiHua , He BaiCheng
Published: November 2023

Background

Bone morphogenetic protein 9 (BMP9) is a promising growth factor in bone tissue engineering, while the detailed molecular mechanism underlying BMP9-oriented osteogenesis remains unclear. In this study, we investigated the effect of lysyl oxidase (Lox) on the BMP9 osteogenic potential via in vivo and in vitro experiments, as well as the underlying mechanism.

Methods

PCR assay, western blot analysis, histochemical staining, and immunofluorescence assay were used to quantify the osteogenic markers level, as well as the possible mechanism. The mouse ectopic osteogenesis assay was used to assess the impact of Lox on BMP9-induced bone formation.

Results

Our findings suggested that Lox was obviously upregulated by BMP9 in 3T3-L1 cells. BMP9-induced Runx2, OPN, and mineralization were all enhanced by Lox inhibition or knockdown, while Lox overexpression reduced their expression. Additionally, the BMP9-induced adipogenic makers were repressed by Lox inhibition. Inhibition of Lox resulted in an increase in c-Myc mRNA and β-catenin protein levels. However, the increase in BMP9-induced osteoblastic biomarkers caused by Lox inhibition was obviously reduced when β-catenin knockdown. BMP9 upregulated HIF-1α expression, which was further enhanced by Lox inhibition or knockdown, but reversed by Lox overexpression. Lox knockdown or HIF-1α overexpression increased BMP9-induced bone formation, although the enhancement caused by Lox knockdown was largely diminished when HIF-1α was knocked down. Lox inhibition increased β-catenin levels and decreased SOST levels, which were almost reversed by HIF-1α knockdown.

Conclusion

Lox may reduce the BMP9 osteoblastic potential by inhibiting Wnt/β-catenin signaling via repressing the expression HIF-1α partially.

Graphical abstract
Development of a clinically useful multi‐segment kinetic foot model
Authors: Zhu Songlin , Jenkyn Thomas
Published: November 2023

Background

Traditionally, gait analysis studies record the foot as a single rigid segment, leaving movements and loads within the foot undetected. In addition, very few data of multi‐segment foot kinetics have been represented in the literature due to measurement and equipment limitations. As a result, this study aims to develop a novel multi‐segment kinetic foot model that is clinically feasible and enables both kinematic and kinetic analysis of large patient groups.

Results

Outcome measurements include rotation angles of intersegmental dorsi/plantar flexion, inversion/eversion, and internal/external rotation, joint moments, joint powers and the medial longitudinal arch (MLA) height/length ratio. Repeatability of joint motions was calculated using coefficients of multiple correlation. Most joint motions measured by this foot model showed strong within‐subject reliability (R > 0.7) in healthy adults. Outcome measures were in agreement with other multi‐segment foot models found in the biomechanics literature.

Conclusions

This novel multi‐segment foot model is able to quantify intersegmental foot kinematics and kinetics and can be a useful tool for research and assessments on clinical populations.