bluuebunny/crossref_metadata_2025 huggingface dataset:
Disclosure of medical errors to patients by medical professionals: a protocol for a qualitative systematic review
Authors: Chen Guiru , Huang Rongrong , Xiong Henyu
Published: October 2024

Introduction

Although the disclosure of medical errors is an integral component of medical ethics, it remains inconsistent in practice worldwide. Despite various explanations of why healthcare professionals reveal their mistakes to patients, comprehensive comparisons and evaluations of this topic remain lacking. The objective of this review is to evaluate the experience of medical error disclosure among medical professionals who have been involved in such errors.

Methods and analysis

This work will focus on studies involving medical professionals from various countries who work in hospital settings and have obtained an understanding of and firsthand experience with medical error disclosure. This review will include qualitative studies. Studies published in databases such as PubMed, Embase, EBSCO, OVID, Web of Science, ScienceDirect, China National Knowledge Infrastructure, Wanfang Data and Cochrane Library from 1 January 2000 to 30 April 2024 will be searched as part of this research. Additionally, OpenGrey will be searched manually to obtain supplementary information. The search will be conducted starting in May 2024 and will include both Chinese-language and English-language literature. The systematic review will follow the Joanna Briggs Institute’s (JBI) methodology for systematic reviews of qualitative evidence and use the JBI System for the Unified Management, Assessment and Review of Information online program. Study authenticity will be investigated via the Qualitative Research Authenticity Evaluation Tool provided by the JBI Evidence-Based Health Care Centre, and data extraction will be performed via the Qualitative Assessment and Review Instrument data extraction tool. The results will be integrated via a pooled integration methodology and evaluated in terms of reliability via the ConQual qualitative systematic evaluation evidence grading tool.

Ethics and dissemination

Ethical approval is not required for the study because the review will be based on pre-existing data available in the literature. The results of this systematic review will be submitted to peer-reviewed journals and presented at relevant conferences.

PROSPERO registration number

CRD42024494360.
No one left to cope alone (NOLA): protocol for the development of a postdiagnostic intervention to support people newly diagnosed with dementia
Authors: Stoner Charlotte R , Durgante Helen , Birt Linda , Spector Aimee
Published: October 2024

Introduction

Receiving a diagnosis of dementia is a seminal moment in many people’s lives. It can be associated with anger and grief for both the person with dementia and their network. Despite this, there is no provision for emotional support to help people affected by dementia manage the impact of receiving that diagnosis. As such, a postdiagnostic intervention to help people process and adjust to a diagnosis of dementia is needed. This protocol describes the initial work to be undertaken as part of a Programme Development Grant. The aims are to synthesise evidence for existing interventions, understand the implementation context and establish an advisory board.

Methods and analyses

Phase 1 will consist of two systematic reviews to synthesise research evidence for existing interventions in related areas. Phase 2 will consist of two qualitative research studies. Study 1 is a UK-wide qualitative survey to understand the current lived experience of receiving a diagnosis and postdiagnostic support. Study 2 is a local qualitative study in which three groups of stakeholders will be asked about the perceived barriers and facilitators to implementing a postdiagnostic intervention in Natuional Health Services (NHS). In Phase 3, an advisory group of people living with dementia, carers and other professionals will be established to provide advice and feedback and contribute to the codevelopment of the initial intervention.

Ethics and dissemination

Health Research Authority, 15 July 2024. All data will be held in accordance with North East London NHS regulations, who act as sponsor of this development work. We will engage with policy professionals in Study 2 (Phase 2) and through this network disseminate our findings to facilitate policy change. The use of coproduction to ensure people with dementias voices are heard throughout this work will result in impact in health and well-being.
Evaluation of efficacy of oral calcium phosphate as an adjunct to standard-of-care regular phototherapy in cases of neonatal jaundice: a hospital-based double-blind, randomised, placebo-controlled trial
Authors: Ghorui Arnab , Chowdhry Bhabesh Kant , Manjhi Pramod Kumar , Kumar Pradeep , Kumar Chandra Mohan
Published: October 2024

Objective

Neonatal jaundice is the most common cause of neonatal morbidity and rehospitalisation in the first week of life, affecting approximately 60% of term and 80% of preterm neonates, with 10% requiring phototherapy to prevent bilirubin-induced neurological dysfunction. Enterohepatic circulation contributes 10%–20% of the body’s bilirubin load, and oral calcium-phosphate can inhibit this process by binding to unconjugated bilirubin and acting as a bilirubin-trapping agent in the gut. This study aimed to evaluate the efficacy of oral calcium phosphate as an adjunct to phototherapy in reducing phototherapy duration, improving bilirubin decline rate and lowering rebound hyperbilirubinaemia incidence.

Methods

This double-blind, placebo-controlled randomised controlled trial with a 1:1 allocation ratio was conducted in the neonatal intensive care unit of a tertiary care hospital in Eastern India. The investigator and the analyst were blinded to the treatment assignments. Eligible neonates with neonatal jaundice requiring phototherapy as per the ‘American Academy of Pediatrics or ‘National Institute for Health and Care Excellence’ guidelines were enrolled and randomly assigned to receive either oral calcium phosphate or placebo.

Results

The total duration of phototherapy was significantly lower in the intervention group compared with placebo (18.8±5.63 hours vs 24.3±4.50 hours; mean difference=−5.55 (95% CI −7.82 to −3.28), p<0.001). The rate of fall of bilirubin (mg/dL/hour) was also significantly higher in the intervention group (0.186±0.0137 vs 0.116±0.0088; mean difference=0.0693 (95% CI 0.0642 to 0.0745), p<0.001). The intervention group showed a trend towards a decrease in the incidence of rebound hyperbilirubinaemia, with a relative risk of 0.30 ((95% CI 0.0891 to 1.01), p=0.066).

Conclusion

The use of oral calcium phosphate results in a statistically significant reduction in phototherapy hours, an improvement in the rate of bilirubin decline and a decrease in rebound hyperbilirubinaemia incidence. This allows for shorter hospital stays and reduces the need for rehospitalisation, resulting in less mother–baby dyad separation, lower hospital resource consumption and reduced financial burden on parents.

Trial registration number

Clinical-trials-registry-India, Ref No.CTRI/2022/03/041203, dated 21 March 2022

https://ctri.nic.in/Clinicaltrials/showallp.php?mid1=57944&EncHid=&userName=Phototherapy.
Balancing benefits and risks of exercise in pregnancy: a qualitative analysis of social media discussion
Authors: Côté Emilie J M , Benton Madeleine , Gardner Rachael , Tribe Rachel
Published: October 2024

Exercise improves pregnancy outcomes, but few pregnant individuals meet physical activity guidelines. The main objective of this study was to explore the perception of exercise during pregnancy using posts and comments on Reddit, a large social media platform. Relevant user-generated posts and comments were identified on Reddit by searching systematically for a combination of keywords related to pregnancy and exercise. A dataset of 120 posts and 2892 comments was randomly selected for reflexive thematic analysis. Three themes relating to perceptions of benefits and risks to exercise in pregnancy and how they influence decision-making were generated: (1) perceived benefits of exercise: ‘We all know that exercise is good for us’; (2) perceived risks of exercise: Exercise as ‘off limits’; and (3) information seeking and decision-making: ‘I’m kinda stumped on exercise’. While the benefits of exercise during pregnancy are well recognised among Reddit users, perceived risks significantly influence their decisions to start, continue, adjust or stop exercising. Healthcare providers play a crucial role in guiding these exercise choices, emphasising the need for them to provide evidence-based advice and support pregnant individuals in achieving optimal physical activity levels. Addressing misinformation and providing supportive counselling can help pregnant individuals navigate the complexities of exercise during this critical period.
Studying Contact Replays: Investigating Mechanisms, Management and Game Exposures (SCRIMMAGE) for brain health in the Australasian National Rugby League: a protocol for a database design
Authors: Gardner Andrew J , Iverson Grant L , Bloomfield Paul , Flahive Sharron , Brown James , Edwards Suzi , Fuller Gordon W , Ghajari Mazdak , Jhala Prashant , Jones Ben , Levi Christopher R , McDonald Warren , McLeod Shreya , Owen Cameron , Page Georgia , Quarrie Kenneth L , Smith Oliver , Stanwell Peter , Tadmor Daniel , Tahu Timana , Terry Douglas P , Thomson Campbell , Tucker Ross , Fortington Lauren V
Published: October 2024

Concussions in contact sports are challenging for athletes, health professionals and sporting bodies to prevent, detect and manage. Design of interventions for primary prevention, early recognition of concussion and continuing to improve postconcussion management are essential for protecting athletes and promoting brain health. Over the last decade, there have been advancements in video technology for analysing head impact events and improvements in the clinical management of concussions. This study protocol describes how researchers, clinicians and staff from the Australasian National Rugby League (NRL) have brought these advancements together and developed a database of videos with head impact events and clinical outcomes. The intended outputs from this work will enhance the understanding of head impact events in NRL, from biomechanical and gameplay factors to concussion and return to play outcomes. Publishing this protocol increases the transparency of this large-scale effort to better identify head impacts and their relationship to concussions and player movement behaviour to contextualise these variables to generate new knowledge and support the reproducibility of these emerging findings. Between 2017 and 2023, over 5250 head contact cases were recorded in the database, from which >1700 head injury assessments were performed, and >600 concussions were diagnosed. Future studies using these data are planned to inform both primary and secondary injury prevention initiatives, such as risk analysis and prediction of game scenarios that result in concussion, as well as investigation of features and factors that help to inform the duration of recovery and return to play.
General practice trainee, supervisor and educator perspectives on the transitions in postgraduate training: a scoping review
Authors: Tran Michael , Rhee Joel , Hu Wendy , Magin Parker , Shulruf Boaz
Published: October 2024

Transitions are a period and a process, through which there is a longitudinal adaptation in response to changing circumstances in clinical practice and responsibilities. While the experience of the transition in medical student learning and in hospital-based specialty training programmes are well described and researched, the experience of the transition in community-based postgraduate general practitioner (GP) training has not been described comprehensively.

Objective

We aimed to identify, and categorise, the formative experiences of transitions in GP training and their impacts on personal and professional development.

Design

We adopted Levacet al’s scoping review methodology. Of 1543 retrieved records, 76 were selected for data extraction. Based on a combined model of the socioecological and multiple and multi-dimensional theories of transitions, data relating to the experiences of transitions were organised into contextual themes: being physical, psychosocial, organisational culture and chronological.

Eligibility criteria

Empirical studies focused on general practice trainees or training, that discussed the transitions experienced in general practice training and that were published in English were included.

Information sources

PubMed, MEDLINE and Web of Science databases were searched in January 2024 with no date limits for empirical studies on the transition experiences of GP into, and through, training.

Results

Our findings describe context-dependent formative experiences which advance, or impede, learning and development. Time is a significant modulator of the factors contributing to more negative experiences, with some initially adverse experiences becoming more positive. Identification of the inflection point that represents a shift from initially adverse to more positive experiences of transitions may help moderate expectations for learning and performance at different stages of training.

Conclusion

Challenges in training can either advance development and contribute positively to professional identity formation and clinical competency, or detract from learning and potentially contribute to burnout and attrition from training programmes. These findings will assist future research in identifying predictive factors of positive and adverse experiences of transitions and may strengthen existing and nascent GP training programmes. The findings are transferable to other community-based specialty training programmes.
TERTpromoter mutations and survival outcomes in adult-type granulosa cell tumors
Authors: Brodsky Allison L , Flores Legarreta Alejandra , Fellman Bryan M , Glassman Deanna , How Jeffrey , Vuttaradhi Veena , Sood Anil K , Ramondetta Lois Michelle , Gershenson David , Hillman Robert Tyler
Published: October 2024

Objectives

To evaluate survival outcomes among patients with adult-type granulosa cell tumors who have telomerase reverse transcriptase (TERT) promoter mutations.

Methods

This is a retrospective cohort study using the MD Anderson Rare Gynecologic Malignancy Registry. Patients with adult granulosa cell tumors who underwent molecular testing forTERTpromoter andFOXL2c.C402G mutations were included. We used descriptive statistics to compare demographic and clinical variables and estimated progression-free and overall survival with Kaplan-Meier curves. Cox proportional hazards regression and log-rank tests were employed for comparisons, with multivariable analyses adjusting for various factors.

Results

Among 70 patients, 28 (40%) hadTERT+ tumors. The median age at diagnosis was 40 years (range 12–71) forTERT− patients and 46 years (range 25–76) forTERT+ patients. At diagnosis, 22 (63%) of 35TERT− patients were stage I, 10 (29%) stage II, and 3 (9%) stage III, while in theTERT+ group, 17/23 (74%) were stage I, 3 (13%) stage II, and 3 (13%) stage II. Univariable analysis showed no difference in time from diagnosis to first recurrence (p=0.19) and from first recurrence to second recurrence (p=0.24) based on tumorTERTstatus. The median time from first to second recurrence in theTERT− group was 27.3 months (95% CI 14.1 to 40.0) and in theTERT+ group was 14.8 months (95% CI 8.1 to 21.0). There was no observed difference in overall survival between the groups (HR=0.53; 95% CI 0.19 to 1.45;p=0.21). Multivariable analysis adjusting for age at diagnosis,TERTpromoter mutation status, systemic chemotherapy, and stage demonstrated a significant difference in progression-free survival based onTERTmutation status (HR=2.89; 95% CI 1.32 to 6.36).

Conclusions

After adjustment for covariates, patients with adult granulosa cell tumors andTERT+ tumors had shorter progression-free survival after first recurrence.TERTpromoter mutations may identify a subset of patients with recurrent adult granulosa cell tumors and less favorable outcomes.
Cancer-associated foam cells hamper protective T cell immunity and favor tumor progression in human colon carcinogenesis
Authors: Daveri Elena , Vergani Barbara , Lalli Luca , Ferrero Giulio , Casiraghi Elena , Cova Agata , Zorza Marta , Huber Veronica , Gariboldi Manuela , Pasanisi Patrizia , Guarrera Simonetta , Morelli Daniele , Arienti Flavio , Vitellaro Marco , Corsetto Paola A , Rizzo Angela M , Stroscia Martina , Frati Paola , Lagano Vincenzo , Cattaneo Laura , Sabella Giovanna , Leone Biagio E , Milione Massimo , Sorrentino Luca , Rivoltini Licia
Published: October 2024

Background

Colorectal cancer (CRC) remains a significant healthcare burden worldwide, characterized by a complex interplay between obesity and chronic inflammation. While the relationship between CRC, obesity and altered lipid metabolism is not fully understood, there are evidences suggesting a link between them. In this study, we hypothesized that dysregulated lipid metabolism contributes to local accumulation of foam cells (FC) in CRC, which in turn disrupts antitumor immunosurveillance.

Methods

Tumor infiltrating FC and CD8+were quantified by digital pathology in patients affected by T2–T4 CRC with any N stage undergoing radical upfront surgery (n=65) and correlated with patients’ clinical outcomes. Multiparametric high-resolution flow cytometry analysis and bulk RNAseq of CRC tissue were conducted to evaluate the phenotype and transcriptomic program of immune cell infiltrate in relation to FC accumulation. The immunosuppressive effects of FC and mechanistic studies on FC-associated transforming growth factor-beta (TGF-β) and anti-PD-L1 inhibition were explored using an in-vitro human model of lipid-engulfed macrophages.

Results

FC (large CD68+Bodipy+macrophages) accumulated at the tumor margin in CRC samples. FChightumors exhibited reduced CD8+T cells and increased regulatory T cells (Tregs). Functional transcriptional profiling depicted an immunosuppressed milieu characterized by reduced interferon gamma, memory CD8+T cells, and activated macrophages mirrored by increased T-cell exhaustion and Treg enrichment. Furthermore, FChightumor phenotype was independent of standard clinical factors but correlated with high body mass index (BMI) and plasma saturated fatty acid levels. In CD8lowtumors, the FChighphenotype was associated with a 3-year disease-free survival rate of 8.6% compared with 28.7% of FClow(p=0.001). In-vitro studies demonstrated that FC significantly impact on CD8 proliferation in TFG-β dependent manner, while inhibition of TGF-β FC-related factors restored antitumor immunity.

Conclusions

FC exert immunosuppressive activity through a TGF-β-related pathway, resulting in a CD8-excluded microenvironment and identifying immunosuppressed tumors with worse prognosis in patients with primary CRC. FC association with patient BMI and dyslipidemia might explain the link of CRC with obesity, and offers novel therapeutic and preventive perspectives in this specific clinical setting.
Inhibition of PNCK inflames tumor microenvironment and sensitizes head and neck squamous cell carcinoma to immune checkpoint inhibitors
Authors: Ding Qin , Weng Youliang , Li Ying , Lin Wanzun , Lin Xiaosan , Lin Tingting , Yang Hanxuan , Xu Wenqian , Wang Jianmin , Ying Hongmei , Qiu Sufang
Published: October 2024

Background

The landscape of the tumor microenvironment (TME) is intricately linked to the development of head and neck squamous cell carcinoma (HNSCC) and significantly influences immunotherapy efficacy. Recent research has underscored the pivotal role of PNCK in cancer progression, yet its relationship with immunotherapy remains elusive.

Methods

We leveraged sequencing data from our cohort and public databases to evaluate PNCK expression, prognostic significance, and immune efficacy prediction. In vitro and in vivo experiments explored the role of PNCK in HNSCC progression. Animal models assessed the therapeutic effects and survival benefits of PNCK knockdown combined with immune checkpoint inhibitors (ICIs). Single-cell transcriptomics analyzed the impact of PNCK on the TME, and proteomic studies elucidated the mechanisms.

Results

PNCK exerts multifaceted critical roles in the progression of HNSCC. Lower PNCK expression is associated with improved prognosis, enhanced immune cell infiltration, and increased responsiveness to ICIs. Conversely, PNCK promotes HNSCC cell migration, invasion, proliferation, colony formation, zebrafish angiogenesis, and tumor growth in mice. Moreover, targeting PNCK enhances sensitivity to ICIs and leads to significant alterations in the T-cell and B-cell ratios within the TME. These changes are attributed to the inhibition of nuclear transcription of PNCK-phosphorylated ZEB1, which restricts cytokine release and inflames the immune microenvironment to regulate the TME.

Conclusions

Inhibition of PNCK may be a potential strategy for treating HNSCC, as it may activate the immune response and improve the TME, thereby enhancing the efficacy of immunotherapy for HNSCC patients.
Early placement of a non-invasive, pressure-regulated, fascial reapproximation device improves reduction of the fascial gap in open abdomens: a retrospective cohort study
Authors: Naveed Asad , Martin Niels D , Bawazeer Mohammed , Jastaniah Atif , Rezende-Neto Joao B
Published: October 2024

Background

Since current fascial traction methods involve invasive procedures, they are generally employed late in the management of the open abdomen (OA). This study aimed to evaluate early versus late placement of a non-invasive, pressure-regulated device for fascial reapproximation and gap reduction in OA patients.

Methods

The study included all patients who had the abdominal fascia intentionally left open after damage control operation for trauma and emergency general surgery and were managed with the device in an academic hospital between January 1, 2020, and December 31, 2023. Time of device placement in relation to the end of index laparotomy was defined as early (≤24 hours) versus late (>24 hours). Time-related mid-incisional width reduction of the fascial gap and fascial closure were assessed using descriptive and linear regression analysis.

Results

There was a significantly higher percent reduction in the fascial gap at the midpoint of the laparotomies in the early (≤24 hours) AbClo placement group compared with the late (>24 hours) AbClo placement group, respectively, median 76% versus 43%, p<0.001. Linear regression adjusting for body mass index and the number of takebacks indicated that fascial approximation was 22% higher for early placement (β=0.22; CI 0.12, 0.33, p<0.001). Primary myofascial closure rate with early (≤24 hours) application of the device was 98% versus 85% with late application.

Conclusion

Early non-invasive application of the device (≤24 hours) after the initial laparotomy resulted in greater reduction of the fascial gap and higher primary fascial closure rate compared with late placement (>24 hours). Early non-invasive intervention could prevent abdominal wall myofascial retraction in OA patients.

Level of evidence

IV.
Supporting early-career military general surgeons: an Eastern Association for the Surgery of Trauma Military Committee position paper
Authors: Horn Christopher B , Wiseman James E , Sams Valerie G , Kung Andrew C , McCartt Jason C , Armen Scott B , Riojas Christina M
Published: October 2024

Early-career surgeons must be exposed to a sufficient number of surgical cases of varying complexity in a mentored environment to allow them to solidify, sustain and build on the skills gained in training. Decreased operative volumes at military treatment facilities and assignments that do not include strong mentoring environments can place military surgeons at a disadvantage relative to their civilian counterparts during this critical time following training. The challenge of lower operative volumes in the current interwar lull has been exacerbated by the decline in beneficiary care conducted within the Military Healthcare System. These challenges must be addressed by ensuring early-career surgeons maintain exposure to a large volume of complex surgical procedures and deliberate mentoring from senior surgeons. The purpose of this position statement is to provide actionable methods to support early-career military surgeons to effectively transition from training to independent practice.
Quantum statistical mechanics of the Sachdev-Ye-Kitaev model and charged black holes
Authors: Sachdev Subir
Published: October 2024

This review is a contribution to a book dedicated to the memory of Michael E. Fisher. The first example of a quantum many body system not expected to have any quasiparticle excitations was the Wilson-Fisher conformal field theory. The absence of quasiparticles can be established in the compressible, metallic state of the Sachdev-Ye-Kitaev model of fermions with random interactions. The solvability of the latter model has enabled numerous computations of the non-quasiparticle dynamics of chaotic many-body states, such as those expected to describe quantum black holes. We review thermodynamic properties of the SYK model, and describe how they have led to an understanding of the universal structure of the low energy density of states of charged black holes without low energy supersymmetry.
Deep Learning Algorithms for Cryptocurrency Price Prediction: A Comparative Analysis
Authors: Mazinani Armin , Davoli Luca , Ferrari Gianluigi
Published: October 2024

Over the past years, cryptocurrencies have experienced a surge in popularity within the financial markets. As of today, besides being considered for investment purposes, they also serve as a widely accepted form of currency for everyday transactions. Due to the intricate characteristics of financial markets and their dependence on various factors to determine the prices of stocks and assets, the ability to predict such prices is crucial to make investment choices, especially in terms of cryptocurrencies. In this work, a comparative analysis on the suitability of Deep Learning (DL) algorithms (effective for time series forecasting) in predicting the price of three cryptocurrencies (namely Bitcoin, BTC; Ethereum, ETH; and Ripple, XRP) is assessed in terms of both short-term and long-term prediction accuracy. The results, evaluated using Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Percentage Error (MAPE), and coefficient of determination (denoted as

\(R^{2}\)

), reveal that: Transformer is generally more effective for short-term forecasts and also performs well for long-term predictions; Convolutional Neural Network-Recurrent Neural Network (CNN-RNN) demonstrates the lowest complexity in terms of number of Multiply and ACcumulate (MAC) operations; SimpleRNN has the fewest parameters and the smallest FLASH memory requirement. Overall, CNN-Gated Recurrent Unit (CNN-GRU) provides the best joint accuracy-complexity for predicting BTC and ETH prices, whereas CNN-RNN yields superior results for XRP price prediction.
Epidemiologic, Clinical and Mycological Profile of Onychomycosis in the Hospital Setting in Benin
Authors: Akpadjan Fabrice , Sissinto Savi De Tove Yolande , Tidjani Aminath Fèmie , Balola Cordule , Dotsop Laura , Degboe Bérénice , Agbessi Nadège , Koudoukpo Christiane , Adegbidi Hugues , Atadokpede Félix , Ango-Padonou Florencia do
Published: October 2024

Introduction: Onychomycosis accounts for 50% of nail disorders and remains one of the most frequent reasons for consultation in dermatology. Several factors favour the development of onychomycosis, such as age, morphological abnormalities of the nails, immunodeficiency and certain underlying pathologies. The aim was to study the epidemiological and diagnostic profile of onychomycosis in patients treated in the dermatology and venerology department of the Benin referral hospital.

Patients and Methods: This was a retrospective study conducted from 2003 to 2022, covering patients treated for onychomycosis in the Dermatology–Venerology University Clinic at the National University Hospital Center Hubert Koutoukou Maga (NUHC‐HKM) in Cotonou.

Results: During the study period, 389 new patients were seen for onychopathy, 301 of whom had a clinical suspicion of onychomycosis. Of these, 128 were confirmed by mycological examination, giving a hospital frequency of onychomycosis of 32.90% compared with onychopathy. The mean age was 44.93 ± 12.50 years; the patients were predominantly female, with a sex ratio (M/F) of 0.41. Aesthetic complaints (76.47%) were the most frequent reason for consultation, and the nail of the hand was the most common lesion location. Melanonychia was the most frequent morphological anomaly, and distolateral subungual onychomycosis was the most frequent clinical form. Yeasts (86.92%) were the most isolated group of fungi, followed, respectively, by moulds (08.44%) and dermatophytes (04.64%). Candida albicans (21.52%) was the most common species.

Conclusion: Onychomycosis is relatively uncommon in hospitals in Benin. This is underestimated because most patients with a clinical suspicion of onychomycosis do not undergo a mycological examination before being put on antifungal treatment.
Invisible Threats in Daily Life: Evaluating VOCs, Metals, and Hazards of Household Cleaning Products by Type
Authors: Kim Minjung , Yoon Chungsik , Park Jeongyeon , Lee Kiyoung , Zoh Kyung-Duk , Lim Miyoung , Lee Soyeon
Published: October 2024

Household cleaning products (HCPs) are widely used; however, their airborne emissions and hazards have not been thoroughly studied. This study is aimed at evaluating the concentrations of volatile organic compounds (VOCs) and metals present in HCPs and the hazards associated with them. A total of 23 VOCs and 19 metals from 75 HCPs (four spray types and 14 intended usage categories) were analyzed using gas chromatography–mass spectrometry and inductively coupled plasma‐mass spectrometry/optical emission spectroscopy. The largest number of VOCs (21 of 23 ingredients) were detected in spray‐type and had the highest frequency (176). d‐Limonene was found in almost all products (69 of 75) and had the highest concentration. Benzene, a carcinogen, was detected in six spray‐type products. Only three of the 23 VOCs—d‐limonene, ethyl acetate, and heptane—appeared in three, one, and one product labels, respectively. Eight of 19 metals were primarily detected in spray‐type and spray foam‐type products, with sodium, magnesium, and calcium as the main components. Nickel, another carcinogen, was detected in both spray‐type and trigger‐type products. Caution is required when using spray‐type products, especially sticker/glue/tar/oil removers containing benzene and nickel. The study discovered that the VOCs and metals varied by their spray type and lacked sufficient harmful information.
Serum Levels of Selected Cytokines and Chemokines and IgG4 in Children With Recurrent Respiratory Tract Infections
Authors: Machura Edyta , Krakowczyk Helena , Kleszyk Magdalena , Swiętochowska Elzbieta , Grzywna-Rozenek Ewa , Rusek Malgorzata , Góra Anna , Chrobak Ewelina , Pukas-Bochenek Anna , Szczepanska Maria
Published: October 2024

Background: Respiratory tract infections are a common health problem. Cytokines/chemokines play a critical role in the regulation of the immune system. Their defective production may predispose to recurrent respiratory tract infections (RRIs), and an excessive immune response may lead to chronic inflammation and cause damage to the respiratory tract. Another biomarker of respiratory infections may be immunoglobulin—IgG4. Its meaning has still been little explored. We wanted to assess the suitability of the levels of biomarkers tested: interleukin (IL)‐17A, IL‐18, IL‐23, normal T cells expressed and secreted (RANTES), and induced protein (IP)‐10, as well as immunoglobilun G4 (IgG4) to predict recurrent infections.

Methods: The study group (SG) included a total of 130 children (68 girls, 62 boys) between 3 and 17 years of age with RRI. The control group (CG) included 86 healthy children with no symptoms of inflammatory or allergic diseases (44 girls and 42 boys) of the same age. Blood samples were collected in fasting state and then serum samples were frozen and stored until biomarker assay.

Results: Serum RANTES, IL‐18, IL‐23, and IgG4 concentration were higher in all children with recurrent infections vs. those in the CG (p  < 0001). Serum levels of IL‐17A and IP‐10 were also significantly higher in the SG than in the CG, but only in the youngest children. Among the six serum markers, RANTES demonstrated the highest area under the receiver operating characteristic curve (area under curve) value (0.998, 95% confidence interval [CI]: 0.98–1.0, p < 0.001) for the diagnosis of RRIs, followed by IL‐23 (0.99, 95% CI 0.966–0,999, p < 0.001) and IL‐18 (0.957, 95% CI 0.921–0.980, p < 0.001).

Conclusions: RANTES, IL‐23, and IL‐18 could be strong predictors of respiratory infections recurrence in children.
Hemodynamic Assessment via Echocardiography During Propofol Anesthetic Induction in Healthy Dogs
Authors: Oliveira Thais Cabral de , Bispo Guilherme Andraus , Poleto Laura Beatriz de Socorro , Martinez Francisco Dantas de Maio , Souza Max Túlio Rocha de , Linhares Lais Calazans Menescal , Taffarel Marilda Onghero , Ferreira Wagner Luís , Santos e Paulo Sérgio Patto dos
Published: October 2024

Introduction: Propofol is an intravenous anesthetic administered as a bolus or continuous infusion during anesthetic induction and maintenance. Its pharmacokinetic characteristics include hepatic and extrahepatic metabolism with a rapid onset of action and short duration, which provides a smooth anesthetic induction without excitatory effects.

Objective: To evaluate whether the isolated use of propofol in anesthetic induction in dogs changes the hemodynamic variables assessed via echocardiography.

Study Design: Prospective clinical study.

Animals: Twelve healthy dogs.

Methods: The dogs were induced with propofol (dose/effect) at 3 mg/kg/minute, and echocardiographic evaluations were performed immediately before anesthetic induction (MB) and immediately after its interruption (MI), at the end of the supply of the anesthetic agent.

Results: A significant reduction was observed between the values of the following hemodynamic variables: Ejection Fraction (EF%), which varied from 70% to 65% (p = 0.011) between moments, and the Doppler Ejection Index (DEI), which ranged from 27.1 mL/beat/m2 to 22.4 mL/beat/m2 (p = 0.044). The heart rate (HR) and the other studied hemodynamic variables showed no significant differences between the evaluated moments.

Conclusion and Clinical Relevance: Propofol was a safe anesthetic‐inducing agent, maintaining stable hemodynamic indices during anesthetic induction at the used rate.
The Performance and Robustness of Power Protection Schemes for Grid‐Connected PV Systems Under Varied Smart Inverter Controllers
Authors: Alasali Feras , El-Naily Naser , Loukil Hassen , Omran Emad El Deen , Holderbaum William , Elhaffar Abdelsalam , Saidi Abdelaziz Salah
Published: October 2024

The increasing use of inverter‐based distributed generation requires a comprehensive study of its effects on fault analysis and the effectiveness of protection systems in distribution networks. This study examines the impact of different inverter control modes on multiple types of protective relay schemes. These include different overcurrent relay (OCR) schemes, both standard and nonstandard tripping characteristics, optimal coordination approaches, and different grid operation scenarios. The investigation is conducted through the utilization of grid‐connected and islanding operation modes, with fault resistance values of 0 and 5 Ω. The study is carried out on a 14‐bus CIGRE network which includes two photovoltaic (PV) farms with a capacity of 10 MVA each. The research provides several significant contributions, including the analysis of fault current contributions, examination of issues in OCR protection, investigation of the influence of fault impedance levels on OCR performance, evaluation of ideal coordination methods, and carrying out a comparative analysis utilizing optimization technique by using the water cycle optimization algorithm (WCA) and the particle swarm optimization algorithm (PSO). In addition, to guarantee the robustness of the suggested protection strategy, this work adopts a hardware‐in‐the‐loop approach. The OMICRON‐256 system is utilized to carry out real‐time testing on a SIPROTEC 7SJ62 multifunction protection relay, which validates the effectiveness of the proposed method in protecting microgrids under different PV control strategies. The total operating time for the nonstandard tripping scheme was 12.077–12.3003 s for PSO and WCA, respectively, while for the standard tripping scheme, it was 12.1226 and 12.1564 s. Moreover, these findings offer practical insights that can assist operators in effectively designing the power networks with grid‐connected PV systems by showing OCR miscoordination and no tripping events in power systems with PVs under inverters controllers.
Children with Auditory Brainstem Implants: Language Proficiency and Reading Comprehension Process
Authors: Ozkan Atak Hilal Burcu , Aslan Filiz , Sennaroglu Gonca , Sennaroglu Levent
Published: October 2024

Introduction: Auditory performance and language proficiency in young children who utilize auditory brainstem implants (ABIs) throughout the first 3 years of life are difficult to predict. ABI users have challenges as a result of delays in language proficiency and the acquisition of reading comprehension, even if ABI technology offers auditory experiences that enhance spoken language development. The aim of this study was to evaluate about the impact of language proficiency on reading comprehension skills in children with ABI. Method: In this study, 20 children with ABI were evaluated for their reading comprehension abilities and language proficiency using an Informal Reading Inventory, Test of Early Language Development-Third Edition (TELD-3), Categories of Auditory Performance-II (CAP-II), and Speech Intelligibility Rating (SIR). Three distinct aspects of reading comprehension were assessed and analyzed to provide a composite score for reading comprehension abilities. TELD-3, which measures receptive and expressive language proficiency, was presented through spoken language. Results: Studies have shown that there was a relationship between language proficiency and reading comprehension in children with ABI. In the present study, it was determined that the total scores of reading comprehension skills of the children who had poor language proficiency and enrolled in the school for the deaf were also low. The children use short, basic sentences, often repeat words and phrases, and have a restricted vocabulary. In addition, the children had difficulty reading characters and detailed paragraphs and could not remember events in a logical order. Conclusion: Children with ABI may potentially have complicated reading comprehension abilities due to lack of access to all the speech formants needed to develop spoken language. In addition, variables affecting the reading levels of children with ABI include factors such as age at implantation, duration of implant use, presence of additional disability, communication model, and access to auditory rehabilitation. The reading comprehension skills of ABI users were evaluated in this study for the first time in the literature and may constitute a starting point for the examination of variables affecting reading comprehension in this area.
ANCA-Negative Pauci-Immune Glomerulonephritis: A Review
Authors: Juanet Cristián , Hassi Isabel , Koirala Abbal
Published: October 2024

Background: Pauci-immune glomerulonephritis (PIGN) is typically secondary to antineutrophil cytoplasmic antibodies (ANCA) small-vessel vasculitis. However, some cases lack detectable circulating ANCA and are called ANCA-negative PIGN (seronegative PIGN). The reported incidence of this varies greatly. Its relationship to ANCA-associated vasculitis (AAV) is unclear. Summary: This review explores the pathophysiology of seronegative PIGN and summarizes findings from 12 studies focusing on this disease. The role of neutrophils appears to be central, with activation through cellular and humoral mechanisms. Most studies have noted less extrarenal involvement and more chronic changes in the kidney biopsy in seronegative PIGN compared to ANCA-positive cases. Studies have mostly reported using corticosteroids with cyclophosphamide for induction therapy and azathioprine for maintenance. The renal survival was noted to be lower compared to ANCA-positive PIGN. Key Messages: Whether ANCA-negative PIGN represents a distinct disease or is part of the AAV spectrum remains unclear. Prospective large-scale studies are needed to understand this disease for optimal diagnosis and management.
MUC17 is a potential new prognostic biomarker and promotes pancreatic cancer progression in obstructive jaundice
Authors: Gál Eleonóra , Menyhárt István , Veréb Zoltán , Kemény Lajos , Tiszlavicz László , Köhler Zoltán Márton , Keller-Pintér Anikó , Rakk Dávid , Szekeres András , Takács Tamás , Czakó László , Hegyi Péter , Yosef Boshra , Venglovecz Viktória
Published: October 2024

Our working group has previously shown that bile acids (BAs) accelerate carcinogenic processes in pancreatic cancer (PC) in which mucin 4 (MUC4) expression has a central role. However, the role of other mucins in PC are less clear, especially in bile-induced cancer progression. The study aim was to investigate expression of MUC17 in BAs- or human serum-treated pancreatic ductal adenocarcinoma (PDAC) cell lines and use different assays with RNA silencing/overexpression to study the role of MUC17 in cancer progression. Protein expression of MUC17 was evaluated in 55 human pancreatic samples by immunohistochemistry, and Kaplan–Meier survival analysis was used to compare survival curves. Expression of MUC17 increased in PDAC patients, especially in obstructive jaundice (OJ) and the elevated MUC17 expression associated with poorer overall survival (10.66±1.99 vs. 15.05±2.03 months; Log rank: 0.0497). Treatment of Capan-1 and AsPC-1 cells with BAs or with human serum obtained from PDAC + OJ patients enhanced the expression of MUC17, as well as the proliferative potential of the cells, whereas knockdown of MUC17 alone or in combination with MUC4 decreased BAs-induced carcinogenic processes. Our results demonstrated that MUC17 has a central role in bile-induced PC progression, and in addition to MUC4, this isoform also can be used as a novel prognostic biomarker.
Mechanisms of Electroacupuncture in Alleviating Visceral Hypersensitivity in Post-Infectious Irritable Bowel Syndrome Mice: The Role of GDNF Signaling Pathway and Gut Microbiota
Authors: Jiang Shiyuan , Pei Lixia , Chen Lu , Sun Jianhua , Song Yafang
Published: October 2024

Introduction: Post-infectious irritable bowel syndrome (PI-IBS) is a functional bowel disease that develops following an acute gastrointestinal infection. Electroacupuncture (EA) can regulate the gut microbiota and alleviate visceral hypersensitivity. Glial cell-derived neurotrophic factor (GDNF) is a potential factor in visceral hypersensitivity reactions. The aim of this study was to explore whether EA could alleviate visceral hypersensitivity in PI-IBS by regulating gut microbiota through GDNF signaling. Methods: 2,4,6-trinitrobenzene sulfonic acid was used to induce visceral hypersensitivity in PI-IBS mice. Intestinal visceral sensitivity was assessed by using the abdominal withdrawal reflex (colorectal distention). 16S ribosomal RNA sequencing profiles the gut microbiome community. Results: GDNF can exacerbate the imbalances of the gut microbiota and increase visceral hypersensitivity compared with the model group. Whereas EA treatment increases the richness and diversity of the gut microbiota, decreases differences among species and alleviates visceral sensitivity. Conclusion: EA can alleviate visceral hypersensitivity in PI-IBS by regulating the gut microbiota via GDNF signaling, providing new insights for mechanistic research on EA in PI-IBS treatment.
A Deep Learning-Based Method for Rapid 3D Whole-Heart Modeling in Congenital Heart Disease
Authors: Huang Haiping , Wu Yisheng
Published: October 2024

Introduction: This study aimed to develop a deep learning-based method for generating three-dimensional heart mesh models for patients with congenital heart disease by integrating medical imaging and clinical diagnostic information. Methods: A deep learning model was trained using CT and cardiac MRI, along with clinical data from 110 patients. The Web-based platform automatically outputs STL files for 3D printing and Unity 3D OBJ files for virtual reality (VR) applications upon uploading the medical images and diagnostic information. The models were tested on three congenital heart disease cases, with corresponding 3D-printed and VR heart models generated. Results: The 3D-printed and VR heart models received high praise from professional doctors for their anatomical accuracy and clarity. Evaluations indicated that the proposed method effectively and rapidly reconstructs complex congenital heart disease structures, proving useful for preoperative planning and diagnostic support. Conclusion: The 3D modeling approach has the potential to enhance the precision of surgical planning and diagnosis for congenital heart disease. Future studies should explore larger datasets and training models for different types of congenital heart disease to validate the model’s broad applicability.
What It Means To Be Palestinian
Authors: Matar Dina
Published: October 2024

In this essay, I argue that during moments of extreme flux and danger, such as the ongoing Israeli war against Gaza, it becomes relevant to consider how Palestinian identity is constructed and performed by a variety of actors, by Palestinians and by their supporters, as the most compelling contemporary form of a transnational anti-colonial identity emerging within and in opposition to persisting colonial structures, oppression and subjugation. It is also in these moments, I propose, that it becomes necessary to resituate, reconfigure and re-center Palestine in the imagination, not as a pre-determined bounded entity, but as an entity that is always in conversation with its imagined spatiality and temporality and with national and transnational communal anti-colonial struggles.
Gaza and the Chronology of Perpetual Return
Authors: Abou-Hodeib Toufoul
Published: October 2024

It doesn’t take much effort for a Palestinian to fall back on a narrative of recurring catastrophe, nakba, with Gaza the latest and most horrific in a long series of catastrophes. With Israel forbidding international media to enter Gaza, this newest catastrophe is mediated to us by the Gazans themselves. They try to communicate to us their suffering, but also other ways in which they want us to see them. How do we make sense of songs, smiles and small moments of hope in the middle of so much death and destruction? In their explicit defiance to being reduced to numbers, victims and refugees, Palestinians in Gaza challenge us who remain at a distance to think differently about the chronology of being Palestinian and re-inscribe it with a series of returns rather than catastrophes.