bluuebunny/crossref_metadata_2025 huggingface dataset:
Quercetin Exerts a Protective Effect on Ischemic Stroke-induced Memory Deficits in Mice
Authors: Ardianto Chrismawan , Lestari Dewi , Primadani Luthfia Hany , Puspitasari Dwi Retno , Sumartha I Nengah Budi , Nisak Khoirotin , Budiatin Aniek Setiya , Shinta Dewi Wara , Andarsari Mareta Rindang , Ifadotunnikmah Farida , Abdullah Amar Daud Iskandar , Rahmadi Mahardian , Khotib Junaidi
Published: September 2023

Objectives

Brain injury resulting from an ischemic stroke affects cognitive performance by disrupting the hippocampus. Several processes are involved in brain injury progression, including inflammation, glutamate excitotoxicity, and modulated brain peptide systems such as the melanocortin system. Reports show that quercetin exerts neuroprotective activity. This study investigates quercetin’s role in the cognitive function of ischemic stroke-induced mice and the possible mechanisms involved.

Materials and Methods

ICR mice were used. The left unilateral common carotid artery occlusion was conducted for 4 h to induce an ischemic stroke in the mice. Quercetin 50, 100, and 200 mg/kg were administered to separate groups intraperitoneally for 7 days. Cognitive function was examined using the T-maze test. The hippocampal mRNA expressions of NR2A, NR2B, melanocortin 4 receptor (MC4R), pro-opiomelanocortin precursors (POMC), and nuclear factor 2 (Nrf2) were examined using reverse transcription-polymerase chain reaction.

Results

It was found that stroke disrupted cognitive function. Quercetin administration ameliorated cognitive impairment. Quercetin attenuated the stroke-induced decrease in MC4R mRNA expression. Moreover, quercetin suppressed the stroke-induced increase in the hippocampal mRNA expression of NR2A.

Conclusion

Quercetin ameliorates cognitive deficits and normalizes impaired hippocampal melanocortin and glutamatergic signaling in ischemic stroke-induced mice.
Water as a European shared public good: The legal status of a vital resource, and its sui generis community property regime
Authors: Di Marco Antonio
Published: September 2023

Water is generally indicated as a public good that is essential for life. Within the Union water law, this emphatic qualification appears as a generic political declaration linked to the uncertain recognition of the right to water. By analysing the common private and public interests, this study argues that the restricted territorial sovereignty's theory, widely accepted for transboundary water resources, should be applied to all water resources. Water would be a shared European public good, subject to a sui generis community of property regime limiting the sovereignty of Member States over their water resources. By investigating the coherence of this community of property regime with the principle of neutrality enshrined in Article 345 TFEU, the essay suggests that the regulation of the water services would be drawn into the scope of the Treaties because of their instrumental nature in guaranteeing the exercise of fundamental rights, the social cohesion of the Union and the protection of a common public good. The idea is put forward that water services would be an emblematic case of European public services, understood as a specific development of the concept of service of general economic interest, instrumental to the implementation of the European model of society.
Preoperative Frontal and Parietal Bone Thickness Assessment to Predict Blood Loss and Transfusion During Extended Suturectomy for Isolated Sagittal Craniosynostosis
Authors: Grove Austin M. , Kirsch Hannah M. , Kurnik Nicole M. , Bristol Ruth E. , Sitzman Thomas J. , Pfeifer Cory , Singh Davinder J.
Published: September 2023

Objective

To predict the morbidity of sagittal suturectomy using preoperative computer tomographic measurement of frontal and parietal bone thickness in osteotomy sites.

Design

Retrospective analysis.

Setting

Tertiary children's hospital.

Patients

Fifty infants with nonsyndromic, isolated sagittal craniosynostosis who underwent extended sagittal suturectomy from 2015–2022.

Methods

Mean thickness of the frontal and parietal bone in regions of osteotomies were determined for each patient from preoperative CT images obtained within 30 days prior to suturectomy. The relationship between bone thickness (mm) and estimated blood loss (mL) was evaluated using Spearman's correlation and a multivariable model that adjusted for patient weight and surgery duration. The association between bone thickness and perioperative blood transfusion was evaluated using a multivariable logistic model controlling for patient weight and surgery duration.

Main Outcome Measures

Estimated blood loss, perioperative blood transfusion.

Results

Frontal and parietal bone thickness in the region of osteotomies were positively correlated with estimated blood loss (p < 0.01). After adjusting for patient weight and duration of operation, both parietal and frontal bone thickness were associated with intraoperative blood loss (R2 = 0.292, p = 0.002 and R2 = 0.216, p = 0.026). Thicker frontal and parietal bone in the line of osteotomies resulted in significantly higher odds of blood transfusion. Bone thickness in the line of parietal osteotomies was 76% accurate at identifying patients who would require blood transfusion (p = 0.004).

Conclusions

Frontal and parietal bone thickness in the line of osteotomies is associated with blood loss and perioperative blood transfusion for sagittal suturectomy operations.
Tourists’ Safety in the Risk Society: Explaining Perceptions of Safety Regarding Future Vacations
Authors: Mawby Rob , Ozascilar Mine
Published: September 2023

While the risk of crime and perceptions of safety have been regularly addressed by criminologists, this has rarely extended to asking how those considering or taking vacations perceive their security. In contrast, tourism researchers regularly focus on perceptions of safety but define this more broadly to include, inter alia, safety from health risks and natural disasters. This paper melds the two disciplines by considering which destinations US residents perceived as unsafe, focusing on risks from crime, political unrest or terrorism, and health concerns. The research used a crowdsourcing platform to collect citizens’ perceptions of safety with regard to crime, terrorism/political disorder, and health problems at the height of the COVID-19 pandemic. The findings suggest that health problems were seen as the greatest risk, but not excessively so. Mexico and China were seen as the most risky countries to visit, although US residents also considered the USA a relatively dangerous place to spend a vacation. Variations in perceptions of safety between subgroups of respondents were greatest for health problems and least for crime, suggesting that fear of crime is associated with features of everyday life that are less relevant to tourism destinations. The paper concludes by discussing the relevance of the findings for both the tourism sector and criminology.
Reinforcement learning-based aggregation for robot swarms
Authors: Sadeghi Amjadi Arash , Bilaloğlu Cem , Turgut Ali Emre , Na Seongin , Şahin Erol , Krajník Tomáš , Arvin Farshad
Published: September 2023

Aggregation, the gathering of individuals into a single group as observed in animals such as birds, bees, and amoeba, is known to provide protection against predators or resistance to adverse environmental conditions for the whole. Cue-based aggregation, where environmental cues determine the location of aggregation, is known to be challenging when the swarm density is low. Here, we propose a novel aggregation method applicable to real robots in low-density swarms. Previously, Landmark-Based Aggregation (LBA) method had used odometric dead-reckoning coupled with visual landmarks and yielded better aggregation in low-density swarms. However, the method’s performance was affected adversely by odometry drift, jeopardizing its application in real-world scenarios. In this article, a novel Reinforcement Learning-based Aggregation method, RLA, is proposed to increase aggregation robustness, thus making aggregation possible for real robots in low-density swarm settings. Systematic experiments conducted in a kinematic-based simulator and on real robots have shown that the RLA method yielded larger aggregates, is more robust to odometry noise than the LBA method, and adapts better to environmental changes while not being sensitive to parameter tuning, making it better deployable under real-world conditions.
Validation of Self-Administered Visual and Verbal Episodic Memory Tasks in Healthy Controls and a Clinical Sample
Authors: Floden Darlene P. , Hogue Olivia , Postle Abagail F. , Busch Robyn M.
Published: September 2023

This study evaluated the performance characteristics, construct validity, and reliability of two computerized, self-administered verbal and visual recognition memory tests based on the Remember-Know paradigm. Around 250 healthy control participants and 440 patients referred for neuropsychological assessment used an iPad to complete the Words and Faces recognition memory tests before or after concurrent neuropsychological testing. Performance accuracy was high but without ceiling effects. Education, but not age, was related to overall performance for both samples while the influence of gender and race differed across samples. In the clinical sample, overall performance was worse in those patients demonstrating memory impairment on clinical assessment. Words and Faces subtests demonstrated the strongest correlations with neuropsychological measures of verbal and nonverbal memory, respectively. Both showed moderate correlations with processing speed while Faces was also correlated with visuospatial skills. The memory tests showed good test–retest reliability over two testing sessions. These findings demonstrate acceptable psychometric properties in clinical and community samples and suggest that this computerized format is feasible for memory assessment in clinical contexts.
Surgical time and efficacy of illuminated chopper-assisted cataract surgery involving miosis after femtosecond laser pretreatment
Authors: Hwang Sung Ha , Eom Youngsub , Moon Hyun Seung , Nam Dong Heun
Published: September 2023

Purpose

To evaluate the efficacy of the illuminated chopper-assisted cataract surgery in terms of shortening the surgical time in eyes with miosis after femtosecond laser pretreatment.

Methods

As retrospective study, three hundred thirty-six eyes of 336 consecutive patients who underwent the femtosecond laser and illuminated chopper-assisted cataract surgery were included. Cases with pupil less than 6 mm after femtosecond laser pretreatment were included in the miosis group. Pupil diameter, surgical time, and improved efficacy (100/surgical time×pupil size) were compared between eyes with and without miosis.

Results

Of 336 eyes, 20 were included in the miosis group (6.0%). Pupil diameter was smaller in eyes with miosis than in those without miosis (5.23 ± 0.38 mm vs 7.35 ± 0.64 mm, p < 0.001); however, surgical time was not different (6.86 ± 0.73 min vs 6.60 ± 1.27 min, p = 0.071) between the two groups. Mechanical pupil dilations were not needed in any cases. As a result, improved efficacy was calculated to be higher in patients with miosis (2.83 vs 2.14, p < 0.001).

Conclusion

In terms of surgical time and improved efficacy, using the illuminated chopper simplified cataract surgery involving miosis after femtosecond laser pretreatment. The use of an illuminated chopper is expected to be a good solution for femtosecond laser-assisted cataract surgeries.
Clinical use of cryopreserved ultra-thick human amniotic membrane for anophthalmic socket contracture
Authors: AlSemari Mohammad A , AlZahrani Fatimah , Ahad Muhammad , AlHussain Hailah M , AlSulaiman Hamad , AlThagib Rawan , Strianese Diego , AlSheikh Osama
Published: September 2023

Purpose

To study the use of ultra-thick human amniotic membrane for management anophthalmic socket contracture.

Methods

A prospective study done at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Thirty-six patients (45 eyelids) were involved. Contracted socket caused by trauma, previous surgery or radiotherapy, delay in use of prosthesis, Congenital Anophthalmia/Microphthalmia, and Anophthalmia secondary to Enucleation/Evisceration were included in the study.

Results

Thirty-three patients (42 eyelids) underwent fornix reconstruction with cryopreserved ultra-thick human amniotic membrane. Mean ± SD age at surgery was (40.90 ± 17.32) years. Mean follow up was 10.5 months. Grade II fornix contracture was the most common type in 23 (54.8%) eyelids. The most common involved primary diagnosis was Anophthalmia secondary to Enucleation/Evisceration (n = 13). The incidence of pyogenic granuloma (PG) after surgery was seen in 8 eyelids (19.0%).

Conclusion

Anophthalmic contracted socket secondary to significant history of multiple PG excision (> 5 times) and secondary to enucleation/evisceration were associated with good surgical outcome. Cryopreserved ultra-thick human amniotic membrane is an ideal material for the management of anophthalmic socket contracture.
Predictors of Birth Asphyxia Among Newborns in Public Hospitals of Eastern Amhara Region, Northeastern Ethiopia, 2022
Authors: Amare Wudu Muluken , Birehanu Tarikua Afework
Published: September 2023

Background:

Ethiopia ranked fourth in the world in terms of neonatal mortality rates, with birth asphyxia accounting for the majority of neonatal deaths.

Objective:

This study aimed to determine the prevalence of birth asphyxia and associated factors among newborns delivered in government hospitals of the Eastern Amhara region, Northeastern Ethiopia, 2022.

Methods:

A hospital-based cross-sectional study was conducted in 4 government hospitals between March 10, 2022, and May 8, 2022. The subjects in the study were selected using a systematic random sampling technique. Face-to-face interviews and chart reviews were used to collect the data. The association was discovered through multivariate logistic regression analysis.

Result:

In this study, the prevalence of birth asphyxia was 13.1% (48) of the total 367 newborns. Mothers who could not read and write (AOR = 9.717; 95% CI = 3.06, 10.857); infants born with low birth weight (AOR = 2.360; 95% CI = 1.004, 5.547); primipara mothers (AOR = 5.138; 95% CI = 1.060, 26.412); mothers with less than 37 weeks of gestation (AOR = 4.261; 95% CI = 1.232, 14.746); and caesarian section delivery (AOR = 2.444; 95% CI = 1.099, 5.432) were predictors of birth asphyxia.

Conclusion:

The magnitude of birth asphyxia has managed to remain a health concern in the study setting. As a result, special attention should be paid to uneducated and primi-mothers during antenatal care visits, and prematurity and caesarian section delivery complication reduction efforts should be bolstered to prevent birth asphyxia and its complications.
Paramagnetic rim lesions lead to pronounced diffuse periplaque white matter damage in multiple sclerosis
Authors: Krajnc Nik , Schmidbauer Victor , Leinkauf Joel , Haider Lukas , Bsteh Gabriel , Kasprian Gregor , Leutmezer Fritz , Kornek Barbara , Rommer Paulus Stefan , Berger Thomas , Lassmann Hans , Dal-Bianco Assunta , Hametner Simon
Published: September 2023

Background:

Paramagnetic rim lesions (PRLs) are an imaging biomarker in multiple sclerosis (MS), associated with a more severe disease.

Objectives:

To determine quantitative magnetic resonance imaging (MRI) metrics of PRLs, lesions with diffuse susceptibility-weighted imaging (SWI)-hypointense signal (DSHLs) and SWI-isointense lesions (SILs), their surrounding periplaque area (PPA) and the normal-appearing white matter (NAWM).

Methods:

In a cross-sectional study, quantitative MRI metrics were measured in people with multiple sclerosis (pwMS) using the multi-dynamic multi-echo (MDME) sequence post-processing software “SyMRI.”

Results:

In 30 pwMS, 59 PRLs, 74 DSHLs, and 107 SILs were identified. Beside longer T1 relaxation times of PRLs compared to DSHLs and SILs (2030.5 (1519–2540) vs 1615.8 (1403.3–1953.5) vs 1199.5 (1089.6–1334.6), both p < 0.001), longer T1 relaxation times were observed in the PRL PPA compared to the SIL PPA and the NAWM but not the DSHL PPA. Patients with secondary progressive multiple sclerosis (SPMS) had longer T1 relaxation times in PRLs compared to patients with late relapsing multiple sclerosis (lRMS) (2394.5 (2030.5–3040) vs 1869.3 (1491.4–2451.3), p = 0.015) and also in the PRL PPA compared to patients with early relapsing multiple sclerosis (eRMS) (982 (927–1093.5) vs 904.3 (793.3–958.5), p = 0.013).

Conclusion:

PRLs are more destructive than SILs, leading to diffuse periplaque white matter (WM) damage. The quantitative MRI-based evaluation of the PRL PPA could be a marker for silent progression in pwMS.
Acoustic sources identified using a microphone phased array during a rocket engine test
Authors: Panda Jayanta , Crowe Evan D , Langford Lester A , Daley Earl T , Hamm Kenneth R , Sills Joel W
Published: September 2023

A new phased array of microphones, suitable for the harsh environment of a rocket launch, was built and tested during a static firing of an RS-25 engine. It uses 70 piezo-resistive, dynamic pressure sensors, optimally distributed on a 10.5-ft diameter open frame dome structure and has a 200-ft long cable bundle to carry the signals to a weather-protected cabinet containing the data systems. The test stand was imaged using an infra-red camera and a visible wavelength camera, and the beamformed noise maps were superimposed on the photographs. The first-time data from a full-scale engine test stand showed that the plume deflector at the bottom of the engine was the primary noise source. The openings of the test stand around the nozzle exit were also found to be noise sources particularly at higher frequencies. The final goal is to utilize the array during NASA’s Artemis-II launch at Kennedy Space Center.
A new street lighting control algorithm based on forecasted traffic data for electricity consumption reduction
Authors: Belloni E , Buratti C , Lunghi L , Martirano L
Published: September 2023

Buildings, urban mobility and public lighting systems are promising areas for cities to reduce energy consumption. In this work, a smart city located in a central region of Italy was investigated and a new street lighting control algorithm was developed. The method is applied to manage the public lighting system of a real case study, where efficient technologies, such as LED lamps and control systems, are already installed. Preliminary on-site measurements of traffic and lighting parameters were carried out in specific streets chosen for the case studies. The analysis was supported with lighting simulations. Based on the results, a Python-based algorithm was developed to apply switching and dimming schedules to decrease the electricity consumption of the streets. A cost/benefit study was carried out and a preliminary analysis of the environmental impact of the proposed strategy is also included. The developed algorithm could be further improved based on other boundary conditions, such as daylighting and weather data.
Surgical Explantation of Impella 5.5 With Inflow Thrombus in Patients Undergoing Durable Left Ventricular Assist Device Implantation
Authors: Salas De Armas Ismael A. , Marcano Juan , Akay Mehmet H. , Patel Manish K. , Patel Jayeshkumar , Al Rameni Dina , Kar Biswajit , Gregoric Igor D.
Published: September 2023

The Impella 5.5® (Abiomed, Danvers, MA, USA) is a microaxial flow pump that promotes left ventricular unloading and improves end-organ perfusion before durable left ventricular assist device (LVAD) implantation. Thrombus formation after Impella 5.5 insertion can occur and represents a significant challenge to device explantation. Durable LVAD implantation is typically performed without aortic cross-clamping, so a dislodged thrombus can potentially embolize and lead to catastrophic events. We describe our technique to safely explant an Impella 5.5 in patients who develop a thrombus on the inflow portion of the device before surgical LVAD implantation.
Detection of moderate to severe middle cerebral artery atherosclerotic stenosis in stroke patients: Transcranial color-coded duplex sonography versus computed tomography angiography
Authors: Toudou-Daouda Moussa , Chausson Nicolas , Smadja Didier , Alecu Cosmin
Published: September 2023

Background:

Intracranial atherosclerotic stenosis is a common cause of ischemic cerebrovascular events and is associated with a high risk of stroke recurrence. This study aimed to assess the diagnostic accuracy of transcranial color-coded duplex sonography for moderate-to-severe middle cerebral artery stenosis in stroke patients.

Methods:

A retrospective analysis was carried out, including 31 patients aged ⩾18 years hospitalized for ischemic cerebrovascular event in whom middle cerebral artery stenosis ⩾30% was identified on computed tomography angiography. Transcranial color-coded duplex sonography findings were compared to the degree of stenosis blindly identified on the computed tomography angiography used as the reference method.

Results:

Overall, 27 patients had M1 stenosis and the other 4 had M2 stenosis. To detect M2 stenosis ⩾ 50% and ⩾ 70%, stenotic to pre-stenotic ratio ⩾ 2 and ⩾ 3 had a sensitivity of 100%, respectively. To detect M1 stenosis ⩾ 70%, peak systolic velocity ⩾ 300 cm/s had a sensitivity of 53.8% and specificity of 85.7% with area under the receiver-operating characteristic curve of 0.753 (95% confidence interval: 0.568–0.938; p  = 0.026), and stenotic to pre-stenotic ratio ⩾ 3 had a sensitivity of 84.6% and a specificity of 78.6% (area under the curve = 0.854; 95% confidence interval: 0.707–1; p  = 0.002). Middle cerebral artery/anterior cerebral artery velocity ratio < 0.7 had a sensitivity of 57.1% and specificity of 90% to detect dampened pre-stenotic flow in middle cerebral artery secondary to downstream M1 stenosis ⩾ 70% (area under the curve = 0.800; 95% confidence interval: 0.584–1; p = 0.040).

This study showed that stenotic to pre-stenotic ratio ⩾ 3 was more sensitive than peak systolic velocity ⩾ 300 cm/s to screen M1 stenosis ⩾ 70%. Middle cerebral artery/anterior cerebral artery ratio < 0.7 was a good indirect sign to detect dampened pre-stenotic flow due to M1 stenosis ⩾ 70%.
Experiences and expectations of physician communication: A focus group discussion with Indian patients with type 2 diabetes mellitus
Authors: Lathia Tejal , Chittem Mahati , Chawak Shweta , Katdare Praneeta , Jayaram Shreya , Selvan Chitra
Published: September 2023

Objectives

This pilot study aimed to: (a) understand the experiences of Indian patients with type 2 diabetes mellitus and their expectations of their physicians during a medical consultation, (b) serve as a preliminary study to inform the development of a larger project exploring and improving patients’ communication experiences, and (c) assess whether the pilot study findings indicate the viability of using the Relationship: Establishment, Development, and Engagement model of communication as the conceptual framework for the larger project.

Methods

Using convenience sampling, 11 patients participated in a focus group discussion. Conventional content analysis was used.

Results

Two themes were generated: (a) A plethora of negative feelings: experiences of the physician's verbal and nonverbal communication styles, and (b) ‘I know what I want’: Expectations of communication by patients from their physician.

Conclusions

The medical encounter with the physician elicited a range of negative experiences and clear expectations from the patients with type 2 diabetes mellitus. This pilot points to the need for (a) a mixed methods approach to comprehensively examine the communication needs of patients with type 2 diabetes mellitus from their physician, (b) understand physicians’ communication practices, and (c) using these findings, culturally adapt and test the Relationship: Establishment, Development, and Engagement to improve physicians’ communication skills in India.
Benzydamine plays a role in limiting inflammatory pain induced by neuronal sensitization
Authors: Nikolaeva-Koleva Magdalena , Espinosa Ana , Vergassola Matteo , Polenzani Lorenzo , Mangano Giorgina , Ragni Lorella , Zucchi Sara , Ferrer-Montiel Antonio , Devesa Isabel
Published: September 2023

Benzydamine is an active pharmaceutical compound used in the oral care pharmaceutical preparation as NSAID. Beside from its anti-inflammatory action, benzydamine local application effectively reliefs pain showing analgesic and anaesthetic properties. Benzydamine mechanism of action has been characterized on inflammatory cell types and mediators highlighting its capacity to inhibit pro-inflammatory mediators' synthesis and release. On the other hand, the role of benzydamine as neuronal excitability modulator has not yet fully explored. Thus, we studied benzydamine’s effect over primary cultured DRG nociceptors excitability and after acute and chronic inflammatory sensitization, as a model to evaluate relative nociceptive response. Benzydamine demonstrated to effectively inhibit neuronal basal excitability reducing its firing frequency and increasing rheobase and afterhyperpolarization amplitude. Its effect was time and dose-dependent. At higher doses, benzydamine induced changes in action potential wavelength, decreasing its height and slightly increasing its duration. Moreover, the compound reduced neuronal acute and chronic inflammatory sensitization. It inhibited neuronal excitability mediated either by an inflammatory cocktail, acidic pH or high external KCl. Notably, higher potency was evidenced under inflammatory sensitized conditions. This effect could be explained either by modulation of inflammatory and/or neuronal sensitizing signalling cascades or by direct modulation of proalgesic and action potential firing initiating ion channels. Apparently, the compound inhibited Nav1.8 channel but had no effect over Kv7.2, Kv7.3, TRPV1 and TRPA1. In conclusion, the obtained results strengthen the analgesic and anti-inflammatory effect of benzydamine, highlighting its mode of action on local pain and inflammatory signalling.
Low neutrophil-to-lymphocyte ratio and pan-immune-inflammation-value predict nodal pathologic complete response in 1274 breast cancer patients treated with neoadjuvant chemotherapy: a multicenter analysis
Authors: Gasparri Maria Luisa , Albasini Sara , Truffi Marta , Favilla Karin , Tagliaferri Barbara , Piccotti Francesca , Bossi Daniela , Armatura Giulia , Calcinotto Arianna , Chiappa Corrado , Combi Francesca , Curcio Annalisa , Della Valle Angelica , Ferrari Guglielmo , Folli Secondo , Ghilli Matteo , Listorti Chiara , Mancini Stefano , Marinello Peter , Mele Simone , Pertusati Anna , Roncella Manuela , Rossi Lorenzo , Rovera Francesca , Segattini Silvia , Sgarella Adele , Tognali Daniela , Corsi Fabio
Published: September 2023

Background:

Systemic inflammatory markers draw great interest as potential blood-based prognostic factors in several oncological settings.

Objectives:

The aim of this study is to evaluate whether neutrophil-to-lymphocyte ratio (NLR) and pan-immune-inflammation value (PIV) predict nodal pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in node-positive (cN+) breast cancer (BC) patients.

Design:

Clinically, cN+ BC patients undergoing NAC followed by breast and axillary surgery were enrolled in a multicentric study from 11 Breast Units.

Methods:

Pretreatment blood counts were collected for the analysis and used to calculate NLR and PIV. Logistic regression analyses were performed to evaluate independent predictors of nodal pCR.

Results:

A total of 1274 cN+ BC patients were included. Nodal pCR was achieved in 586 (46%) patients. At multivariate analysis, low NLR [odds ratio (OR) = 0.71; 95% CI, 0.51–0.98; p = 0.04] and low PIV (OR = 0.63; 95% CI, 0.44–0.90; p = 0.01) were independently predictive of increased likelihood of nodal pCR. A sub-analysis on cN1 patients ( n = 1075) confirmed the statistical significance of these variables. PIV was significantly associated with axillary pCR in estrogen receptor (ER)−/human epidermal growth factor receptor 2 (HER2)+ (OR = 0.31; 95% CI, 0.12–0.83; p = 0.02) and ER−/HER2− (OR = 0.41; 95% CI, 0.17–0.97; p = 0.04) BC patients.

Conclusion:

This study found that low NLR and PIV levels predict axillary pCR in patients with BC undergoing NAC.

Registration:

Eudract number NCT05798806.
Role of estrogen in the regulation of central and peripheral energy homeostasis: from a menopausal perspective
Authors: Zhu Jing , Zhou Yier , Jin Bihui , Shu Jing
Published: September 2023

Estrogen plays a prominent role in regulating and coordinating energy homeostasis throughout the growth, development, reproduction, and aging of women. Estrogen receptors (ERs) are widely expressed in the brain and nearly all tissues of the body. Within the brain, central estrogen via ER regulates appetite and energy expenditure and maintains cell glucose metabolism, including glucose transport, aerobic glycolysis, and mitochondrial function. In the whole body, estrogen has shown beneficial effects on weight control, fat distribution, glucose and insulin resistance, and adipokine secretion. As demonstrated by multiple in vitro and in vivo studies, menopause-related decline of circulating estrogen may induce the disturbance of metabolic signals and a significant decrease in bioenergetics, which could trigger an increased incidence of late-onset Alzheimer’s disease, type 2 diabetes mellitus, hypertension, and cardiovascular diseases in postmenopausal women. In this article, we have systematically reviewed the role of estrogen and ERs in body composition and lipid/glucose profile variation occurring with menopause, which may provide a better insight into the efficacy of hormone therapy in maintaining energy metabolic homeostasis and hold a clue for development of novel therapeutic approaches for target tissue diseases.
A cross-sectional study on coping strategies of frontline healthcare workers amid the COVID-19 pandemic in a developing country
Authors: Akanko Isaac , Abor Patience Aseweh , Tetteh Carlos Kokuvi
Published: September 2023

Objectives:

Frontline healthcare workers encountered a heightened susceptibility to negative psychological symptoms and behavioral shifts in light of the coronavirus disease 2019 pandemic. This study determined the coping strategies adopted by frontline healthcare workers in Ghana as well as assessed any differences based on demographics, job title, and ranking in four coronavirus disease 2019-designated centers in the Greater Accra region of Ghana.

Methods:

Using a hospital-based, mixed-method approach, the study was conducted between May 2021 and September 2021. A total of 94 frontline healthcare workers were randomly sampled and given a self-administered questionnaire, while 13 healthcare workers took in-depth interviews. Data from the survey were analyzed using both IBM SPSS and IBM AMOS and the interview data were transcribed verbatim and coded using thematic analysis.

Results:

The study revealed that coronavirus disease 2019 has affected the psycho-social life of frontline healthcare workers mainly in the form of depression, anxiety, and stress. The three main coping strategies adopted by frontline healthcare workers include personal preventative measures (most dominant), seeking external expert support, and obtaining institutional support. While healthcare workers within the age group 30–39 years were found most compliant with the adoption of personal preventive measures and those below 30 years were found least compliant.

Conclusion:

This study concludes that frontline healthcare workers have been affected by a considerable level of anxiety, stress, and depression during the coronavirus disease 2019 pandemic. The study recommends a robust psychological support system at various levels of health care and an Employee Assistance Program with access to a 24-h hotline counseling service for frontline healthcare workers, continuous personal protective equipment provision, regular evidence-based updates on the management of coronavirus disease 2019 patients, and increased commitment from the government in addressing the medical needs of infected frontline healthcare workers.
Hand-Constructed CorMatrix Tubular Valve Used for Tricuspid Valve Replacement in Neonate With Congenital Tricuspid Dysplasia: Five-Year Follow-Up
Authors: Glenn Carter J. , Greenberg Jason W. , Hogue Spencer , O’Donnell Alan , Lehenbauer David G. , Moore Ryan A. , Morales David L. S.
Published: September 2023

Tricuspid valve (TV) dysplasia is a rare congenital defect that, in severe cases, can cause heart failure necessitating surgical correction. TV replacement options are limited in neonates since few commercial valves are available and the rates of failure and postoperative mortality are high. The authors report a neonate with TV dysplasia who underwent replacement with a hand-constructed tube valve using small intestinal submucosal extracellular matrix, which functioned well for >5 years.
How Does the Fear of Missing Out Moderate the Effect of Social Media Influencers on Their Followers’ Purchase Intention?
Authors: Dinh Thi Cam Tu , Wang Mengqi , Lee Yoonjae
Published: September 2023

Social media influencers, a new type of opinion leader, are considered followers’ role models and strongly affect their attitudes and behaviors. Although their power on social media platforms is an emerging phenomenon, the studies exploring the impact of influencers’ endorsement of products on their followers’ buying intentions are still limited. By employing 272 respondents exposed to influencers, this study used PROCESS models to test hypotheses. The results demonstrate that the desire to mimic influencers and the sense of materialism mediate the effect of influencers on followers’ buying intentions. In addition, fear of missing out (FOMO) plays a moderation role in these relationships by altering the impact of influencer exposure on materialism and buying intention. These findings contribute to the current literature on social media influencers, the desire to mimic, materialism, and FOMO and also yield suggestions for influencers and marketers in their strategies.
Effect of SNS Characteristics for Dining Out on Customer Satisfaction and Online Word of Mouth
Authors: Kim Choo Yeon , Cha Seong Soo
Published: September 2023

This study aims to determine how the quality characteristics of a restaurant SNS (social network service), which is rapidly growing, affect user satisfaction and how user satisfaction affects intention to visit and word of mouth. A total of 305 people responded to the survey conducted from May 9, 2021 to August 17, 2021. The validity and reliability of variables were verified. Moreover, confirmatory factor analysis and discriminant validity analysis were performed through structural equation modeling, and hypotheses were verified through path analysis. The analysis results were as follows. Among the quality characteristics of dining out SNS, reliability, playfulness, convenience, and customization were analyzed to have a statistically significant positive effect on customer satisfaction. However, interactivity does not have a significant effect. Moreover, customer satisfaction has a positive impact on the intention to visit and word-of-mouth intention, and intention to visit also has a positive effect on word-of-mouth intention. Restaurant companies should supplement their SNS marketing strategies, considering the critical factors when consumers use SNS for dining out. This study analyzed the factors that consumers value among the quality characteristics of SNS for dining out and provided meaningful implications. Although most of the previous studies investigated only the effect of the quality characteristics of dining out SNS on satisfaction and revisit intention, this study has originality because it also investigated the word of mouth of customers.
Young Adults’ Cohabitation and Dating Decisions During the COVID-19 Pandemic: A Qualitative Exploration of Romantic and Developmental Context
Authors: Jamison Tyler B. , Kanter Jeremy B.
Published: September 2023

The COVID-19 pandemic caused significant upheaval for couples and families, particularly in terms of living arrangements. Emerging adults had to make quick decisions about where and with whom to shelter in place. In this grounded theory study, we explored how 22 young adults, predominantly living in the United States, navigated relationship decisions during the pandemic. The results suggest that participants were intentional about their choices, particularly in terms of moving in together (or not). The pandemic sometimes changed the timing of cohabitation or the pace of dating relationships; however, these decisions unfolded in tandem with common developmental tasks, such as college graduation and launching a career. More broadly, our findings suggest that participants’ responses to the pandemic both reflected core aspects of emerging adulthood (e.g., instability, feeling in-between) and also challenged them (e.g., other focus, limited exploration).
Systematic Review and Meta-analysis of Clinical Outcomes After Management of Posterior Cruciate Ligament Tibial Avulsion Fractures
Authors: Gopinatth Varun , Mameri Enzo S. , Casanova Felipe J. , Khan Zeeshan A. , Jackson Garrett R. , McCormick Johnathon R. , Brophy Robert H. , Knapik Derrick M. , LaPrade Robert F. , Chahla Jorge
Published: September 2023

Background:

There is no consensus regarding the management of posterior cruciate ligament (PCL) avulsion fractures and the expected outcomes after treatment.

Purpose:

To systematically review clinical outcomes and complications after management of tibial-sided avulsion fractures of the PCL.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A literature search of Scopus, PubMed, Medline, and the Cochrane Central Register for Controlled Trials was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included were studies with evidence levels 1 to 4 that reported clinical outcomes after treatment of PCL tibial-sided avulsion fractures in humans. The quality of the included studies was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. A meta-analysis was performed for patient-reported outcome measures using random-effects modeling with 95% CIs.

Results:

A total of 58 studies published between 1999 and 2022 were identified. The mean MINORS score was 9.90 ± 4.12, indicating overall low-quality evidence with high risk of bias. The studies comprised 1440 patients (mean age, 32.59 ± 5.69 years; 75.2% males) with a mean follow-up of 26.9 ± 19.6 months (range, 5.3-126 months). Most patients were treated with open surgery (63.6%), followed by arthroscopic surgery (29.7%) and nonoperative treatment (6.7%). All patients reported significant posttreatment improvement in both subjective and objective outcomes ( P < .05 for all). Arthroscopic surgery was associated with lower postoperative posterior tibial translation compared with open surgery (range, 0.6-3.2 vs 1.7-3.1 mm), greater preoperative to postoperative improvement in Lysholm score (54.6 vs 48.8; P < .0001), higher postoperative Tegner score (6.64 ± 1.03 vs 6.14 ± 2.29; P = .0448), and a higher rate of return to sport (100% vs 89.5%; P = .009). Nonoperative management was associated with a significantly lower fracture union rate (87% vs 99.1%; P < .0001) and greater postoperative side-to-side posterior translation (4.9 ± 4.3 mm) when compared with operative management.

Conclusion:

Although nonoperative and surgical management of PCL tibial avulsion fractures resulted in high rates of fracture union and improvement in functional outcome scores and a low incidence of complications, nonoperative treatment yielded a high side-to-side posterior displacement (>4 mm) with a lower rate of fracture union compared to surgical treatment.
Systemic immuno-inflammatory index in patients with pseudoexfoliation syndrome and pseudoexfoliative glaucoma
Authors: Tukenmez Dikmen Nejla , Un Yasemin
Published: September 2023

Background:

In recent years, the role of some hematological parameters used as chronic inflammation markers in the pathogenesis of many ocular and systemic diseases has been investigated. For ocular diseases such as uveitis, keratoconus, and retinal vein occlusion, the neutrophil/lymphocyte ratio (NLR) and systemic immune-inflammatory index (SII) have been reported to be useful inflammatory biomarkers. It has also been reported that low-grade chronic inflammation plays a role in the formation of pseudoexfoliation.

Objective:

To evaluate the NLR, SII, and platelet-lymphocyte ratio (PLR) in patients with pseudoexfoliation syndrome (PEXS) and pseudoexfoliative glaucoma (PEXG).

Design:

This was a retrospective case-control study.

Methods:

This study evaluated the clinical and laboratory data of 34 patients with PEXS, 33 patients with PEXG, and 33 control patients. Detailed eye examination notes in patient files and blood count measurements were recorded.

Results:

SII values were the highest in the PEXS group, followed by the PEXG and control groups (582.01 ± 339.9, 478.14 ± 211.7, and 413.98 ± 129.5, respectively) ( p = 0.043). In paired comparisons, the SII values of the PEXS group were significantly higher than the control group ( p = 0.011). The mean NLR rate was highest in the PEXS group, followed by the PEXG and the control groups (2.46 ± 1.6, 2.17 ± 0.8, and 1.69 ± 0.4, respectively) ( p = 0.023). In paired comparisons, the mean NLR levels were higher in the PEXS and the PEXG groups than in the control group ( p = 0.03 and p = 0.01, respectively). There was no significant difference between the groups in terms of PLR. According to receiver operating characteristic curve analysis, the optimal cut-off value for estimating PEXS was found as >449.4 for SII and 1.78 for NLR ( p = 0.011 and p = 0.031, respectively).

Conclusions:

In PEXS patients, both SII and NLR were significantly higher, albeit in a small group of patients, and SII may be a helpful and supportive parameter for NLR in risk estimation in these patients. There was a statistically significant difference only in NLR in patients with PEXG when compared with the control group. However, these results need to be supported by future longitudinal and larger studies to identify any possible link between hematological inflammatory markers and pseudoexfoliation.
Identifying a Sustainable Path for RCEP: Global Overview and Comparative Analysis of Sustainable Development Provisions in Three Mega Regional Trade Agreements
Authors: Malingrey Louise , Duval Yann
Published: September 2023

This article reviews the sustainable development content of regional trade agreements (RTAs) globally, followed by a comparative analysis of sustainable development-related provisions in the Regional Comprehensive Economic Partnership (RCEP) and two other recent ‘mega’ regional trade agreements (RTAs), namely the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) and the European Union—Japan Economic Partnership Agreement (EU—Japan EPA). The analysis covers seven sustainable development-related topics: (a) sustainable development as a concept, (b) labour rights and standards, (c) environment, (d) human rights, (e) small- and medium-sized enterprises, (f) health and (g) gender. The global review of more than 440 RTA texts confirms the increasing reference to sustainable development and related areas in RTAs signed over the past decade. The comparative analysis of the three mega-RTAs in turn confirms the large gaps of RCEP in terms of sustainable development coverage. However, it also points to specific and practical ways through which RCEP could address these gaps in time to support the achievement of the 2030 Agenda for Sustainable Development—also drawing upon the interest expressed by many RCEP countries in joining CPTPP. A two-step path forward and different options for integrating sustainable development in RCEP are proposed, based on existing provisions and the differing approaches of the CPTPP and the EU-Japan EPA.

JEL Classification: F14, F19
National Central Cities: Unravelling A Chinese urban policy puzzle
Authors: Hamnett Chris , Yao Yuan , Yang Jing
Published: September 2023

This paper critically examines a recent innovation in Chinese urban policy: the designation of a new category of ‘National Central Cities’ (NCCs). These cities, of which there are currently nine, are meant to play a key role in economic modernisation and national economic development. But, despite their undoubted importance, their precise role, definition and function and their basis of designation is unclear. The paper argues first that the underlying, but implicit, theoretical rationale is growth pole theory and that the cities are meant to play a major role in the diffusion and ‘radiation’ of economic growth and other forms of development in their regional hinterlands. The paper also examines the geographical distribution of NCCs in China and looks at their ranking compared to other cities in terms of a number of different indicators such as GDP and population and asks why some cities have been chosen and not others. What is the basis of NCC designation? Finally, it speculates on the future number and distribution of NCCs, the competition for new designation and the possible benefits designation may confer.
MAVEN: compound mechanism of action analysis and visualisation using transcriptomics and compound structure data in R/Shiny
Authors: Hosseini-Gerami Layla , Hernansaiz Ballesteros Rosa , Liu Anika , Broughton Howard , Collier David Andrew , Bender Andreas
Published: September 2023

Background

Understanding the Mechanism of Action (MoA) of a compound is an often challenging but equally crucial aspect of drug discovery that can help improve both its efficacy and safety. Computational methods to aid MoA elucidation usually either aim to predict direct drug targets, or attempt to understand modulated downstream pathways or signalling proteins. Such methods usually require extensive coding experience and results are often optimised for further computational processing, making them difficult for wet-lab scientists to perform, interpret and draw hypotheses from.

Results

To address this issue, we in this work present MAVEN (Mechanism of Action Visualisation and Enrichment), an R/Shiny app which allows for GUI-based prediction of drug targets based on chemical structure, combined with causal reasoning based on causal protein–protein interactions and transcriptomic perturbation signatures. The app computes a systems-level view of the mechanism of action of the input compound. This is visualised as a sub-network linking predicted or known targets to modulated transcription factors via inferred signalling proteins. The tool includes a selection of MSigDB gene set collections to perform pathway enrichment on the resulting network, and also allows for custom gene sets to be uploaded by the researcher. MAVEN is hence a user-friendly, flexible tool for researchers without extensive bioinformatics or cheminformatics knowledge to generate interpretable hypotheses of compound Mechanism of Action.

Conclusions

MAVEN is available as a fully open-source tool at https://github.com/laylagerami/MAVEN with options to install in a Docker or Singularity container. Full documentation, including a tutorial on example data, is available at https://laylagerami.github.io/MAVEN.