bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of spontaneous breathing during an apnea test in a patient with suspected brain death using electrical impedance tomography: a case report
Authors: Chen Rongqing , Lovas András , Bakos Péter , Molnár Tamás , Hawchar Fatime , Benyó Balázs , Zhao Zhanqi , Chase J. Geoffrey , Rupitsch Stefan J. , Moeller Knut
Published: September 2024

Introduction

The apnea test (AT) is a crucial procedure in determining brain death (BD), with detection of spontaneous breathing efforts serving as a key criterion. Numerous national statutes mandate complete disconnection of the patient from the ventilator during the procedure to open the airway directly to the atmosphere. These regulations mandate visual observation as an exclusive option for detecting breathing efforts. However, reliance on visual observation alone can pose challenges in identifying subtle respiratory movements.

Case Presentation

This case report presents a 55-year-old morbidly obese male patient with suspected BD due to cerebral hemorrhage undergoing an AT. The AT was performed with continuous electrical impedance tomography (EIT) monitoring. Upon detection of spontaneous breathing movements by both visual observation and EIT, the AT was aborted, and the patient was reconnected to the ventilator. EIT indicated a shift in ventilation distribution from the ventral to the dorsal regions, indicating the presence of spontaneous breathing efforts. EIT results also suggested the patient experienced a slow but transient initial recovery phase, likely due to atelectasis induced by morbid obesity, before returning to a steady state of ventilatory support.

Conclusion

The findings suggest EIT could enhance the sensitivity and accuracy of detecting spontaneous breathing efforts, providing additional insights into the respiratory status of patients during the AT.
Workplace violence against healthcare workers in the emergency department — a 10-year retrospective single-center cohort study
Authors: Benning Leo , Teepe Gisbert W. , Kleinekort Jan , Thoma Jorun , Röttger Michael Clemens , Prunotto Andrea , Gottlieb Dominik , Klöppel Stefan , Busch Hans-Jörg , Hans Felix P.
Published: September 2024

Background

Medical staff are regularly confronted with workplace violence (WPV), which poses a threat to the safety of both staff and patients. Structured de-escalation training (DET) for Emergency Department (ED) staff has been shown to positively affect the reporting of WPV incidents and possibly reduce its impact. This study aimed to describe the development of incidence rates, causes, means, targets, locations, responses, and the time of WPV events. Additionally, it explored the effect of the staff trained in DET on the objective and subjective severity of the respective WPV events.

Methods

In a retrospective, single-center cohort study, we analyzed ten years of WPV events using the data of Staff Observation Aggression Scale-Revised (SOAS-R) score (ranging from 0 to 22) in a tertiary ED from 2014 to 2023. The events were documented by ED staff and stored in the electronic health record (EHR).

Results

Between 2014 and 2023, 160 staff members recorded 859 incidents, noting an average perceived severity of 5.78 (SD = 2.65) and SOAS-R score of 11.18 (SD = 4.21). Trends showed a non-significant rise in incident rates per 10,000 patients over time. The WPV events were most frequently reported by nursing staff, and the cause of the aggression was most often not discernible (n = 353, 54.56%). In total, n = 273 (31.78%) of the WPV events were categorized as severe, and the most frequent target of the aggressive behavior was the staff. WPV events occurred most frequently in the traumatology section and the detoxification rooms. While the majority of events could be addressed with verbal interventions, more forceful interventions were performed significantly more often for higher severity WPV events. More WPV events occurred during off-hours and were of a significantly higher objective and subjective severity. Overall, the presence of staff with completed DET led to significantly higher SOAS-R scores and higher perceived severity.

Conclusion

The findings underline the relevance of WPV events in the high-risk environment of an ED. The analyzed data suggest that DET significantly fostered the awareness of WPV. While most events can be addressed with verbal interventions, WPV remains a concern that needs to be addressed through organizational measures and further research.
Insights into epidemiological trends of severe chest injuries: an analysis of age, period, and cohort from 1990 to 2019 using the Global Burden of Disease study 2019
Authors: Chen Qingsong , Huang Guangbin , Li Tao , Zhang Qi , He Ping , Yang Jun , Li Yongming , Du Dingyuan
Published: September 2024

Background

This study assessed the global trends and burden of severe chest injury, including rib fractures, lung contusions, and heart injuries from 1990 to 2019. Herein, we predicted the burden patterns and temporal trends of severe chest injuries to provide epidemiological evidence globally and in China.

Methods

In our analysis, the age-standardized incidence rate (ASIR), prevalence rate (ASPR), and years lived with disability rate (ASYR) of severe chest injury were analyzed by gender, age, sociodemographic index, and geographical region between 1990 and 2019 using data from the Global Burden of Disease study 2019. Trends were depicted by calculating the estimated annual percentage changes (EAPCs). The impact of age, period, and cohort factors was assessed using an Age-Period-Cohort model. Autoregressive integrated moving average (ARIMA) model was employed to predict severe chest injury trends from 2020 to 2050.

Results

In 2019, the global number of severe chest injury cases reached 7.95 million, with the highest incidence rate observed in Central Europe (209.61). Afghanistan had the highest ASIRs at 277.52, while North Korea had the lowest ASIRs at 41.02. From 1990 to 2019, the Syrian Arab Republic saw significant increases in ASIR, ASPR, and ASYR, with EAPCs of 10.4%, 9.31%, and 10.3%, respectively. Burundi experienced a decrease in ASIR with an EAPC of − 6.85% (95% confidence interval [CI] − 11.11, − 2.37), while Liberia’s ASPR and ASYR declined with EAPCs of − 3.22% (95% CI − 4.73, − 1.69) and − 5.67% (95% CI − 8.00, − 3.28), respectively. Falls and road injuries remained the most common causes. The relative risk of severe chest injury by age, period, and cohort demonstrated a complex effect globally and in China. The ARIMA model forecasted a steady increase in global numbers from 2020 to 2050, while in China, it forecasted an increase in incidence, a decrease in ASIR and ASYR, and an increase in ASPR.

Conclusions

This study provides a groundbreaking analysis of global severe chest injury, shedding light on its measures and impact. These findings highlight the need for timely, specialized care and addressing regional disparities to mitigate the severe chest injury burden.
Combinatorial biosynthesis of novel aminoglycoside antibiotics via pathway engineering
Authors: Aboshanab Khaled M. , Alshahrani Mohammad Y. , Alafeefy Ahmed
Published: September 2024

With the current spread of clinically relevant multidrug-resistant (MDR) pathogens, insufficient unearthing of new anti-infectives, and the high cost required for approval of new antimicrobial agents, a strong need for getting these agents via more economic and other alternative routes has emerged. With the discovery of the biosynthetic pathways of various antibiotics pointing out the role of each gene/protein in their antibiotic-producing strains, it became apparent that the biosynthetic gene clusters can be manipulated to produce modified antibiotics. This new approach is known as the combinatorial biosynthesis of new antibiotics which can be employed for obtaining novel derivatives of these valuable antibiotics using genetically modified antibiotic-producing strains (pathway engineering). In this review and based on the available biosynthetic gene clusters of the major aminoglycoside antibiotics (AGAs), the possible alterations or modifications that could be done by co-expression of certain gene(s) previously known to be involved in unique biosynthetic steps have been discussed. In this review defined novel examples of modified AGA using this approach were described and the information provided will act as a platform of researchers to get and develop new antibiotics by the antibiotic-producing bacterial strains such as Streptomyces, Micromonospora,…etc. This way, novel antibiotics with new biological activities could be isolated and used in the treatment of infectious diseases conferring resistance to existing antibiotics.
PTN from Leydig cells activates SDC2 and modulates human spermatogonial stem cell proliferation and survival via GFRA1
Authors: Zhao Xueheng , Liu Lvjun , Huang Zenghui , Zhu Fang , Zhang Huan , Zhou Dai
Published: September 2024

Background

Spermatogonial stem cells (SSCs) are essential for the maintenance and initiation of male spermatogenesis. Despite the advances in understanding SSC biology in mouse models, the mechanisms underlying human SSC development remain elusive.

Results

Here, we analyzed the signaling pathways involved in SSC regulation by testicular somatic cells using single-cell sequencing data (GEO datasets: GSE149512 and GSE112013) and identified that Leydig cells communicate with SSCs through pleiotrophin (PTN) and its receptor syndecan-2 (SDC2). Immunofluorescence, STRING prediction, and protein immunoprecipitation assays confirmed the interaction between PTN and SDC2 in spermatogonia, but their co-localization was observed only in approximately 50% of the cells. The knockdown of SDC2 in human SSC lines impaired cell proliferation, DNA synthesis, and the expression of PLZF, a key marker for SSC self-renewal. Transcriptome analysis revealed that SDC2 knockdown downregulated the expression of GFRA1, a crucial factor for SSC proliferation and self-renewal, and inhibited the HIF-1 signaling pathway. Exogenous PTN rescued the proliferation and GFRA1 expression in SDC2 knockdown SSC lines. In addition, we found downregulation of PTN and SDC2 as well as altered localization in non-obstructive azoospermia (NOA) patients, suggesting that downregulation of PTN and SDC2 may be associated with impaired spermatogenesis.

Conclusions

Our results uncover a novel mechanism of human SSC regulation by the testicular microenvironment and suggest a potential therapeutic target for male infertility.
Analysis of moderate and severe traumatic brain injury associated with skull base fracture: a local tertiary center experience
Authors: Saad Mahmoud , Mowafy Ali A. , Naser Ahmed M. , Ismail Abdelaziz Abdalhamid , Zaher Ahmed , Serag Samer , Serag Ibrahim , Shahein Mostafa
Published: September 2024

Background

Traumatic brain injury (TBI) is a major medical and social concern in developing countries. TBI-related morbidity and mortality statistics in Egypt are lacking and do not reflect the actual magnitude of the problem.

Objectives

To overview the incidence of moderate and severe head trauma in a heavily populated developing country and document the outcome of moderate and severe TBI associated with skull base fracture (SBF).

Methodology

Data of patients admitted to our center with moderate and severe TBI associated with skull base fracture (SBF) were reviewed in the period between January 2019 and March 2023.

Results

The most common type of trauma was road traffic accidents in 54.2% of the patients; 91.2% had Single SBF (middle cranial fossa fracture was predominant 58.5%). 25.5% had an initial GCS of ≤ 8. Periorbital ecchymosis was the most common presenting sign in 36.3%. The most frequent complication (37.3%) was pneumocephalus. The presence of skull base fracture inversely affected the Glasgow outcome scale extended GOSE (P = 0.001, r = 0.674). Higher initial GCS scores were positively correlated with good GOSE (GOSE) (P = 0.001, r =− 0.222).

Conclusions

RTA represents a significant cause for moderate and severe TBI in young male population. SBF is associated with poor outcome in moderate and severe TBI. Higher initial GCS score was positively correlated with good GOSE. It is important to have an overview of different types of TBI in Egypt.
Excimer laser coronary angioplasty: a mini-narrative review of clinical outcomes
Authors: Olatunji Gbolahan , Kokori Emmanuel , Aboje John , Mohammed Saad , Asifat Olamide , Isarinade David Timilehin , Yusuf Ismaila Ajayi , Olawade David B. , Aderinto Nicholas
Published: September 2024

Background

Excimer laser coronary angioplasty (ELCA) has evolved as a pivotal element in percutaneous coronary intervention (PCI), significantly influencing procedural efficacy and safety. This mini-narrative review explores ELCA's applications, focusing on its efficacy and clinical outcomes.

Body

A search of major databases identified studies from ELCA's inception. Inclusion criteria encompassed diverse study designs exploring ELCA in coronary interventions, with rigorous data extraction ensuring accuracy and completeness. A narrative synthesis presented key findings across studies. ELCA demonstrated promising outcomes compared to traditional PCI and stent placement. Reduced reperfusion time, enhanced microcirculation, and lower postoperative major adverse cardiac events (MACE) rates highlighted its efficacy. Improved vascular and lumen dynamics, plaque modification, and successful treatment of complex lesions showcased its versatility. Quality of life enhancements positively impacted long-term recovery, particularly in acute coronary syndrome (ACS) cases. ELCA's success in challenging scenarios and its role in refining in-stent restenosis (ISR) treatment indicated broader applications. Despite limitations in some studies, ELCA presented a favorable safety profile.

Conclusion

The review underscores ELCA's dynamic role in coronary interventions, offering a promising tool for enhancing procedural outcomes. Clinical implications include improved reperfusion, adaptability in complex lesions, and potential long-term benefits for ACS patients. While integration into routine practice requires careful consideration, ELCA's positive outcomes encourage further exploration and innovation in interventional cardiology.
Single or Double Induction With 7 + 3 Containing Standard or High-Dose Daunorubicin for Newly Diagnosed AML: The Randomized DaunoDouble Trial by the Study Alliance Leukemia
Authors: Röllig Christoph , Steffen Björn , Schliemann Christoph , Mikesch Jan-Henrik , Alakel Nael , Herbst Regina , Hänel Mathias , Noppeney Richard , Hanoun Maher , Kaufmann Martin , Weinbergerova Barbora , Schäfer-Eckart Kerstin , Sauer Tim , Neubauer Andreas , Burchert Andreas , Baldus Claudia D. , Mertová Jolana , Jost Edgar , Niemann Dirk , Novák Jan , Krause Stefan W. , Scholl Sebastian , Hochhaus Andreas , Held Gerhard , Szotkowski Tomas , Rank Andreas , Schmid Christoph , Fransecky Lars , Kayser Sabine , Schaich Markus , Kramer Michael , Fiebig Frank , Haake Annett , Schetelig Johannes , Middeke Jan Moritz , Stölzel Friedrich , Platzbecker Uwe , Thiede Christian , Müller-Tidow Carsten , Berdel Wolfgang E. , Ehninger Gerhard , Mayer Jiri , Serve Hubert , Bornhäuser Martin
Published: September 2024

PURPOSE

To determine the optimal daunorubicin dose and number of 7 + 3 induction cycles in newly diagnosed AML, this randomized controlled trial compared a once daily dose of 60 mg/m
2
with 90 mg/m
2
daunorubicin in the first 7 + 3 induction and one versus two cycles of 7 + 3 induction.

PATIENTS AND METHODS

Patients age 18-65 years with newly diagnosed AML were randomly assigned to 60 versus 90 mg/m
2
daunorubicin once daily plus cytarabine. Patients with marrow blasts below 5% on day 15 after first induction were randomly assigned to receive a second induction cycle or no second induction cycle.

RESULTS

Eight hundred and sixty-four patients with a median age of 52 years were randomly assigned. After a preplanned interim analysis showing no significant difference in response between 60 and 90 mg/m
2
, all consecutive patients received 60 mg/m
2
daunorubicin once daily. The proportion of good early responders was 44% versus 48% (
P
= .983) with a composite complete remission (CRc) rate of 90% versus 89% after induction (
P
= .691); the 3-year relapse-free survival (RFS) after 60 versus 90 mg/m
2
once daily was 54% versus 50% (
P
= .561), and the 3-year overall survival (OS) was 65% versus 58% (
P
= .242). Among 389 good responders, CRc rates at the end of induction were 87% after single induction and 85% after double induction. The 3-year RFS was 51% versus 60% (hazard ratio [HR], 1.3;
P
= .091), and the 3-year OS was 76% versus 75% after single versus double induction (HR, 1.0;
P
= .937).

CONCLUSION

The use of 90 mg/m
2
daunorubicin once daily in the context of classical 7 + 3 induction does not significantly improve early response and does not lead to higher remission rates or longer survival than 60 mg/m
2
once daily. In patients with a good early response after first induction, a second induction has only a limited impact on RFS and does not result in an OS benefit.
A Process-Based Standardization of an Intraoperative Escalation Protocol in Anesthesiology
Authors: Thakrar Shilen P. , Kim Christin , Suarez-Winowiski Olga , Navarrete Sergio B. , Potter Kenneth F. , Prasanna Praveen , Graham Jamie P. , Diallo Mofya S. , Lahaye Laura , Coombs Alice A. Tolbert
Published: September 2024

Prompt recognition and management of critical events is pivotal for the provision of safe anesthetic care. This requires a well-functioning team that focuses on effective communication, timely decision-making, and escalation of potential complications. We believe that variation in bedside care leads to “near-misses,” adverse outcomes, and serious safety events (SSEs). The principles of an escalation culture have been used successfully in other highly reliable industries such as aviation, military, and manufacturing. We discuss here the introduction of a unique and compelling thought-process for developing an intraoperative escalation protocol that is specifically tailored for our institution. Inspired by a critical intraoperative event, this departmental protocol was developed based on an analysis of multispecialty literature and expert opinion to decrease the incidence of SSEs. It includes a stepwise approach and incorporates patient-specific information to guide team members who encounter dynamic clinical situations. The implementation of the protocol has facilitated continuous quality improvement through iterative education, improving communication, and enhancing decision-making. Concurrently, we have plans to incorporate technology and electronic decision support tools to enhance real-time communication, monitor performance, and foster a culture of safety.
Risk of Venous Thromboembolism After Total Knee Arthroplasty in Patients with Obstructive Sleep Apnea: Results from a National Cohort
Authors: Fowler Cosmo , Chawla Simar , Chism Lauren , Pastores Stephen M. , Auckley Dennis H
Published: September 2024

BACKGROUND:

Obstructive sleep apnea (OSA) is a prevalent condition associated with many comorbidities. However, establishing the independent impact of OSA on specific health outcomes can be challenging without access to a substantial patient cohort. This study aimed to investigate whether a diagnosis of OSA was independently associated with venous thromboembolism (VTE) after total knee arthroplasty (TKA).

METHODS:

In this retrospective cohort study, we interrogated the TriNetX Analytics Research Network, a large database comprising the billing claims and electronic health record-derived data of >117 million patients. Using Current Procedural Terminology (CPT) and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes, we identified US adult patients who underwent TKA between January 1, 2013 and January 1, 2023, with and without preexisting OSA (and ≥2 OSA occurrences overall). We then analyzed the 1-month postoperative incidence of VTE as a composite outcome of deep vein thrombosis (DVT) and pulmonary embolism (PE) incidence, as well as cerebrovascular accident (CVA), myocardial infarction (MI), and DVT and PE individually. Baseline demographic and comorbidity covariates were incorporated into a 1:1 propensity score-matched analysis to clarify the independent effect of OSA.

RESULTS:

During the 10-year study period, a total of 197,460 patients underwent TKA. Of these, 27,976 met the criteria for inclusion in the OSA cohort, while 150,830 had no documented history of OSA. In the initial analysis, OSA was significantly associated with the primary outcome (DVT/PE) as well as all secondary outcomes (CVA, MI, and individually with DVT and PE) at 1 month postsurgery. After generating propensity score matched cohorts, DVT/PE remained significantly associated with OSA, with an absolute risk difference of 0.7% (odds ratio [OR], 1.19, confidence interval [CI], 1.1–1.3, P < .001), as were the secondary outcomes of DVT (OR, 1.11, CI, 1.0–1.2, P = .030) and PE (OR, 1.41, CI, 1.2–1.6, P < .001).

CONCLUSIONS:

In this study encompassing a nationally representative sample of TKA patients, OSA was associated with increased incidence of VTE at 1 month postoperatively, an association that persisted after the generation of matched cohorts. While limitations related to the lack of patient-level data, disease severity, and therapy adherence should be acknowledged, our large sample size enabled us to factor many baseline characteristics into our analysis, reinforcing the association of these findings. Prospective work is needed on the impact of modulating factors such as anticoagulation regimen and positive airway pressure therapy on these outcomes.
Human developmental biology – a global perspective
Authors: Clark Amander T. , Goolam Mubeen , Hanna Jacob H. , Long Katie , Nicol Dianne , Petropoulos Sophie , Saitou Mitinori , Tam Patrick P. L. , Wang Hongmei
Published: September 2024

In the companion Perspective ‘Past and future of human developmental biology’ (Hopwood, 2024), historian Nick Hopwood proposes that the field of human developmental biology has gone through periods of attention and neglect. Development invited researchers from the field to respond to this idea. In this article, published to coincide with the 10th anniversary of Development's ‘From Stem Cells to Human Development’ meeting, researchers from eight countries comment on how they believe their local legal, political, regulatory, societal and technological frameworks are influencing the field's trajectory.
HbA1c and Liver Fat After 16 Weeks of Fasted versus Fed Exercise Training in Adults With Type 2 Diabetes
Authors: REES JORDAN L. , WALESIAK DEVYN , THOMPSON RICHARD , MAGER DIANA , SENIOR PETER , BOULÉ NORMAND G.
Published: September 2024

Purpose

Exercise-nutrient timing is of interest for people with type 2 diabetes (T2D) as a potential method to optimize glycemic control. However, the optimal nutritional environment for exercise is not well understood over the long term. The Fasted Exercise for Type 2 Diabetes (FED) Trial compared 16 wk of fasted versus postprandial morning exercise on glycated hemoglobin (HbA1c) and liver proton density fat fraction (PDFF).

Methods

Twenty adults with T2D were recruited and randomized to complete exercise after an overnight fast versus after their morning meal. Participants walked three mornings per week, progressing to 180 min·wk−1 over 16 wk.

Results

Groups were balanced with five males and five females each. Sixteen participants completed the trial (8 in each group, 50% female). Age, HbA1c, and PDFF were 59.8 ± 9.0 yr, 7.2 ± 0.7%, and 9.3 ± 4.1%, respectively. On average, both groups completed 98% of their walking sessions but there was no change in HbA1c (−0.2%, P = 0.588). However, one participant from each group had changes in their glucose-lowering medication during the trial, and when excluded, the fasted training group had greater improvements in HbA1c compared with the postprandial group (−0.3% vs 0.0%, P = 0.033). There was no difference in changes in liver PDFF between groups (−1.6% vs 0.3%, P = 0.221) but visceral fat and intramuscular fat decreased to a greater extent after fasted exercise.

Conclusions

Although our study had a small sample size, it suggests that exercise after an overnight fast can have high adherence and represents an option for people with T2D to improve longer-term indicators of glycemia and ectopic fat depots.
Impact of Acute Dietary and Exercise Manipulation on Next-Day RMR Measurements and DXA Body Composition Estimates
Authors: KUIKMAN MEGAN A. , SMITH ELLA , MCKAY ALANNAH K. A. , MCCORMICK RACHEL , ACKERMAN KATHRYN E. , HARRIS RACHEL , ELLIOTT-SALE KIRSTY J. , STELLINGWERFF TRENT , BURKE LOUISE M.
Published: September 2024

Purpose

The objective of this study is to investigate the effects of acute diet and exercise manipulation on resting metabolic rate (RMR) measurement variability and dual-energy x-ray absorptiometry (DXA) body composition estimates.

Methods

Ten male and 10 female endurance athletes (12 cyclists, 5 triathletes, 4 runners) of tier 2 (n = 18) to tier 3 (n = 2) caliber underwent five conditions using a Latin square counterbalance design. For 24 h, athletes consumed a diet providing excessive energy availability (EA) (75 kcal⋅kg fat-free mass (FFM)−1) without exercise (GEArest), high-EA (45 kcal⋅kg FFM−1) without (HEArest) or with exercise (HEAex), or low-EA (15 kcal⋅kg FFM−1) without (LEArest) or with exercise (LEAex). Exercise involved two bouts of cycling (morning bout: 149 ± 34 min at 55% of maximal aerobic capacity (V̇O2max); afternoon bout: 60 min at 65% of V̇O2max) that resulted in a cumulative exercise energy expenditure of 30 kcal⋅kg FFM−1. The following day, RMR and DXA measurements occurred after a 10-h fast and 12-h postexercise.

Results

There were neither sex differences in relative RMR (P = 0.158) nor effects of any of the five conditions on RMR (P = 0.358). For both male and female athletes, FFM estimates were decreased following the LEArest (−0.84 ± 0.66 kg; P = 0.001) and LEAex (−0.65 ± 0.86 kg; P = 0.016) conditions compared with the GEArest condition and following the LEArest (−0.73 ± 0.51 kg; P = 0.001) and LEAex (−0.54 ± 0.79 kg; P = 0.024) conditions compared with the HEAex condition. There was no effect of condition on fat mass estimates (P = 0.819).

Conclusions

Acute periods of diet and exercise manipulation did not create artifacts in next-day RMR measurements. However, as changes in estimates of FFM were seen, diet and exercise should be controlled in the 24-h before DXA scans.
Η εικόνα των Αράβων στην ελληνική αιγυπτιώτικη λογοτεχνία
Authors: Μούσσα Σακέρ
Published: September 2024

Η παρουσία των Αράβων δεν είναι καθόλου καινούριο στοιχείο στην ελληνική λογοτεχνία, καθώς εμφανίζεται ήδη από την αρχαία ελληνική γραμματεία , και συγκεκριμένα στους Πέρσες του Αισχύλου, ενώ υπάρχουν μελέτες που ερευνούν το αραβικό στοιχείο στο έργο ενός πολύ γνωστού μεταπολεμικού Αιγυπτιώτη συγγραφέα, του Στρατή Τσίρκα. Χαρακτηριστικά είναι τα μελετήματα του Καραμπέτσου «Stratis Tsirkas and the Arabs». Mε τίτλο «Η εικόνα των Αράβων στην ελληνική αιγυπτιώτικη λογοτεχνία» σκοπεύει στη διερεύνηση της παρουσίας του Άλλου, των Αράβων εν προκειμένω, και στον τρόπο που αυτοί αναπαριστώνται στην αιγυπτιώτικη λογοτεχνία, από τα τέλη του 19ου έως τα τέλη περίπου του 20ού αιώνα. Η συγκεκριμένη διατριβή εστιάζει την προσοχή της σε περιόδους και σε Αιγυπτιώτες λογοτέχνες που δεν έχουν διεξοδικά μελετηθεί έτσι ώστε να διερευνηθεί ευρύτερα η εικόνα του Άραβα, ως Άλλου, έτσι όπως τη μορφοποίησαν οι δημιουργοί και την προσέλαβε το ελληνικό αναγνωστικό κοινό.
Η μνήμη του υπαρκτού σοσιαλισμού στο μουσείο Σπίτι της Ευρωπαϊκής Ιστορίας
Authors: Κορρές Κώστας
Published: September 2024

-
PASS: A scoring system to evaluate persistent kidney injury in critically ill ICU adult patients
Authors: Prabhu Dattatray , Prabhu Sonali Dattatray , Mahabala Chakrapani , Prabhu Mayoor V
Published: September 2024

Background We evaluated if the course of recovery from sepsis-induced acute kidney injury (AKI) can be predicted using variables collected at admission. Methods A total of 63 patients admitted for sepsis-induced AKI in our Mangalore ICU were evaluated and baseline demographic and clinical/laboratory parameters, including serum creatinine (SCr), base excess (BE), Plethysmographic Variability Index (PVI), Caval Index, R wave variability index (RVI), mean arterial pressure (MAP) and renal resistivity index (RI) using renal doppler and need for inotropes were assessed on admission. Patients were managed as per standard protocol. After six hours of fluid resuscitation, patients were classified as volume responders or non-responders. Re-assessment was done at 24 hours and 72 hours after admission. Primary outcome was persistent AKI after 72 hours. Secondary outcome was initiation of dialysis or death within 15 days of admission. Results A total of 34 subjects recovered from AKI, of whom 32 patients were volume responders and 31 were non-responders. Response to fluid, MAP at admission and six hours, BE at admission, inotrope requirement, and PVI at admission did not correlate with recovery. Multiple logistic regression showed that SCr < 2.36 mg%, RVI > 14.45 and RI < 0.8 on admission correlated with recovery and they were evaluated further to model AKI recovery and develop PASS. PASS score = (SCr points × 5.4) + (RVI points × 4.0) + (RI points × 6.2). One point each was allotted if SCr was < 2.36, RVI was > 14.45 and RI was <0.8, and 0 otherwise. A score > 7.8 predicted recovery with a sensitivity of 79.4%, specificity of 72.4%, PPV 81.8%, NPV 76.7% and AuROC of 0.85. Conclusions The PASS score can be used to identify salvageable cases of sepsis-AKI, guiding fluid resuscitation and aiding early referral from rural to tertiary care centers for better management.
Effects of a low, medium, and high-intensity aquatic physiotherapy protocol on functional and biochemical parameters in individuals with knee osteoarthritis: protocol for a crossover randomized controlled trial
Authors: Augusto Teixeira Cesar , Haas Lisete , Frata Bruna , Fiori Bortoli Andressa , Scalco Acco Fernanda , de Castro Gustavo , Cechetti Fernanda
Published: September 2024

Background Knee osteoarthritis affects the performance of daily activities, independence, and quality of life. The etiopathogenesis of this condition considers the mechanisms of activation of metalloproteinase and reactive oxygen species production pathways. Metalloproteinases-3 (MMP-3) and Glutathione Peroxidase (GPx) may be responsible for cartilage destruction. Aquatic physiotherapy promotes a positive impact on the clinical picture of osteoarthritis, and this study presents an intervention protocol that aims to evaluate the effects of a single session of different aquatic physiotherapy modalities on the biochemical and functional behavior of patients with knee osteoarthritis. Methods This will be a crossover randomized controlled trial in which 15 individuals will be submitted to three aquatic physiotherapy modalities with a minimum 15-day wash-out period in patients over 50 years old and diagnosed with OA in at least one knee, presence of pain and at least one functional dysfunction for at least 6 months, absence of physical limitation that prevents the exercise protocol from being performed, Kellgren and Lawrence ranking between I and IV, walk independently and without auxiliary device. Variations in the concentrations of MMP-3 and GPx in peripheral blood, pain, edema, and flexibility resulting from the three aquatic physiotherapeutic interventions will be evaluated both pre- and immediate post-intervention. The reference group will be submitted to the same aquatic physiotherapy protocols, however, only the biochemical parameters and the self-perception questionnaires will be evaluated. Registration ClinicalTrials.gov (NCT05610696, 18/01/2023).
Comparison of two-dimensional Grummons’ analysis and three-dimensional asymmetry index measurement in diagnosis of dentocraniofacial asymmetry
Authors: Siswoyo Stefanus , Purbiati Maria , Krisnawati Krisnawati
Published: September 2024

Background Dentocraniofacial asymmetry is a common condition that affects many individuals. Accurate diagnosis of this condition is essential for effective treatment planning. Aim This study aimed to compare the diagnosis of dentocraniofacial asymmetry using two-dimensional and three-dimensional methods. Methods A cross-sectional, observational study was conducted at the Orthodontic Specialist Clinic of the Dental Hospital Faculty of Dentistry, University of Indonesia from March to April 2023. The study included 15 patients who had not undergone orthodontic treatment and were diagnosed with dentocraniofacial asymmetry. The study compared the results of diagnosing asymmetry in 15 different facial features, including the anterior nasal spine, upper and lower first incisors, pterygomaxillary fissure, orbita, menton, porion, upper and lower first molars, coronoid process, gonion, zygoma, latero nasale, and jugulare. Results The study found that there was no significant difference in the diagnosis of dentocraniofacial symmetry between the two- and three-dimensional methods across all 15 parameters measured. The researchers used Fisher's Exact Test to compare the proportion between dependent variables and found that the p-value was greater than 0.05, indicating that there was no significant difference in the diagnosis of dentocraniofacial symmetry between the two methods. The study also used Kappa Cohen analysis to measure the strength of agreement between the diagnosis of dentocraniofacial symmetry of the two-dimensional and three-dimensional methods on each parameter. Conclusion The findings of this study suggest that both two-dimensional and three-dimensional methods are equally effective in diagnosing dentocraniofacial asymmetry. This information may be useful for orthodontists in deciding which method to use when diagnosing dentocraniofacial asymmetry.
Leisure-Based Interventions in Adults with Schizophrenia: A Scoping Review
Authors: Nishad Amar , Mysore Nagaraj Anil Kumar , R Rao Chythra , P Keshavaram , Rajpaul Priyanka
Published: September 2024

Background Schizophrenia is a severe mental illness characterized by psychosis, apathy, social withdrawal, and cognitive impairment, which results in impaired functioning in work, school, parenting, self-care, independent living, interpersonal relationships, and leisure time. Method A systematic search was conducted using Arksey and O’Malley’s framework with studies published on leisure-based intervention from January 1990 to December 2023. Results The review included 11 articles in the study. In total two studies were pilot interventional study, one randomized controlled study, one case-control, one retrospective study, three were cross sectional, one was cross sectional longitudinal study and two were qualitative in nature. Studies used different types of leisure activities like cooking group, discussions, board games, arts and craft, painting, beading, sewing, clay work, paper craft, etc were used as an intervention. Qualitative studies found that individuals with schizophrenia spent less time in social and leisure activities and more time relaxing and doing nothing. Conclusion The study highlights the need to conduct further research on leisure-based interventions using various study designs like randomized controlled trials and mixed methods to understand its effectiveness among individuals with schizophrenia.
Gender aspects in parenthood conceptions of young Europeans. A critical reflection on the European Project B2-InF
Authors: Struyf Joke , Hens Kristien , Rozée Virginie , Vialle Manon , López-Toribio María , Carrasco José Miguel , Dimitrievska Vera , Meloska-Petrova Jana , De Bayas Sanchez Anna , Fuller Michaela , Güell Francesco
Published: September 2024

The European research project “Be Better Informed about Fertility” (B2-InF) maps what young people understand about infertility and medically assisted reproduction (MAR) and the information they want or need. One part of this project were interviews with young people in eight European countries, which were analysed on legal, sociocultural and gender aspects. In this paper we present the gender analysis results focusing on gender differences in perceptions regarding the desire to become parents, social expectations versus parenthood as a choice, family/career issues and the division of care tasks, infertility, and the meaning of parenthood. The results demonstrate clear gender differences in parenthood responsibilities and appreciations. Traditional parenthood conceptions are strong: women are held responsible for reproductive issues, male infertility is a taboo and gender differences in care roles are distinct. Nevertheless, young Europeans often do not agree with these norms. Furthermore, while many participants are seeing increased social acceptance about LGBTQ+ parenthood, prejudices and legal obstacles continue to make LGBTQ+ parenthood difficult.
Existence of solutions for the $(p,N)$-Laplacian equation with logarithmic and critical exponential nonlinearities
Authors: Jiang Jialin , Yang Yang
Published: September 2024

This paper deals with the following $(p,N)$-Laplacian equation with logarithmic and critical exponential nonlinearities. Precisely, we study the problem
\begin{equation*}
\begin{cases}
-\Delta_p u -\Delta_N u = |u|^{q-2}u \ln|u|^2 + \lambda f(u)
& \text{in }\Omega,\\
u=0
& \text{on }\partial \Omega,
\end{cases}
\end{equation*}
where $\Omega \subset \mathbb{R}^N$ is a bounded domain, $N \geq 2$, $1< p< N< q$, $\lambda > 0$ is a positive real parameter. By applying variational methods, we obtain the existence of solutions.
Reverse Faber-Krahn inequalities for Zaremba problems
Authors: Anoop Thazhe Veetil , Ghosh Mrityunjoy
Published: September 2024

Let $\Omega$ be a domain in $\mathbb{R}^n$ ($n\geq 2$) of the form
$\Omega=\Omega_{\text{out}}\setminus \overline{\Omega_{\text{in}}}$.
Set $\Omega_D$ to be either $\Omega_{\text{out}}$ or $\Omega_{\text{in}}$.
For $p\in (1,\infty)$, and $q\in [1,p]$, let $\tau_{1,q}(\Omega)$ be the first eigenvalue of
\begin{alignat*}2
-\Delta_p u &=\tau \bigg(\int_{\Omega}|u|^q dx \bigg)^{({p-q})/{q}} |u|^{q-2}u &\quad&\text{in }\Omega,\\
u &=0&\quad&\text{on } \partial\Omega_D,
\\
\frac{\partial u}{\partial \eta}&=0&\quad& \text{on } \partial \Omega\setminus \partial \Omega_D.
\end{alignat*}
Under the assumption that $\Omega_D$ is convex, we establish the following reverse Faber-Krahn inequality
$$\tau_{1,q}(\Omega)\leq \tau_{1,q}({\Omega}^\star),
$$%
where ${\Omega}^\star=B_R\setminus \overline{B_r}$ is a concentric annular region in $\mathbb{R}^n$ having the same Lebesgue measure as $\Omega$ and such that
\begin{enumerate}[(i)]
\item (when $\Omega_D=\Omega_{\text{out}}$) $W_1(\Omega_D)= \omega_n R^{n-1}$, and $(\Omega^\star)_D=B_R$,
\item (when $\Omega_D=\Omega_{\text{in}}$) $W_{n-1}(\Omega_D)=\omega_nr$, and
$(\Omega^\star)_D=B_r$.
\end{enumerate}
Here $W_{i}(\Omega_D)$ is the $i^{\text{th}}$ {\it quermassintegral}
of $\Omega_D$. We also establish Sz.-Nagy's type inequalities for parallel sets of a convex domain in $\mathbb{R}^n$ ($n\geq 3$) for our proof.
The unavoidable pressure injury/ulcer: a review of skin failure in critically ill patients
Authors: Zajac Kelsee K , Schubauer Kathryn , Simman Richard
Published: September 2024

Due to an ageing population and prolonged lifespan, pressure injury (PI) incidence is increasing. Patients with a PI typically endure longer hospital stays, which create a significant burden on healthcare resources and costs. With appropriate preventive interventions, most PIs can be avoided; however, skin failure may become inevitable in particular instances. These are classified as unavoidable PIs. Patients in a critical condition are exposed to a unique set of therapies, medications and bodily states. Oftentimes, these instances decrease tissue tolerance, which may promote PI formation. Patients who are critically ill, especially those with extended stays in the intensive care unit, are susceptible to skin failure due to: prolonged immobility; mechanical ventilation; acute respiratory distress syndrome; COVID-19; sepsis; multiorgan system dysfunction; vasopressor use; and treatment with extracorporeal membrane oxygenation. Poor perfusion leading to skin breakdown results from the compounding factors of circulatory collapse, build-up of metabolites, compromised lymphatic drainage, patient comorbidities, and ischaemia via capillary blockage in patients who are critically ill. In addition, similar physiology is present during end-of-life multisystem organ failure, which creates unavoidable skin deterioration. The aim of this review is to provide an overview of circumstances which decrease tissue tolerance and ultimately lead to PI development, despite adequate preventive measures in patients who are critically ill.
Percentage area reduction at week 4 as a prognostic indicator of complete healing in patients treated with standard of care: a post hoc analysis
Authors: Serena Thomas , Yaakov Sadia , Yaakov Raphael , King Emily , Driver Vickie R
Published: September 2024

Early indicators of healing provide valuable information on the potential benefit of treatment. In patients with hard-to-heal (chronic) diabetic foot ulcers (DFUs), timely intervention is critical. Ulcers that fail to show measurable progress within four weeks of treatment are considered recalcitrant. These ulcers increase the risk of soft tissue infection, osteomyelitis and lower extremity amputation. A prognostic indicator or surrogate marker allows for rapid evaluation of treatment efficacy and safety. An inverse correlation between a percentage area reduction (PAR) of ≤50% at week 4 and complete healing by week 12 has been previously established; however, the data were derived from a standard of care (SoC) arm of clinical trials that are over a decade old. In this post hoc analysis, data from a large multicentre prospective randomised controlled trial were reviewed to assess PAR at week 4 as a prognostic indicator in patients treated with SoC. Overall, 65.4% (17/26) of patients with PAR >50% at week 4 achieved complete closure at week 12. The receiver operating characteristic (ROC) curve for area reduction by week 4 showed strong discrimination for predicting non-healing (area under the ROC curve: 0.92; p<0.001; positive predictive value: 70.6%; negative predictive value: 87.2%). These findings are consistent with previous studies and support the use of four-week PAR as a prognostic indicator.
Catastrophic antiphospholipid syndrome: a case report and literature review
Authors: Kyoung Jun , Workman Lauren , Spurgeon-Hess Taylor , Tadrousse Kirollos S , Oostra Drew , Simman Richard
Published: September 2024

Catatrophic antiphospholipid syndrome (CAPS), a rare variant of antiphospholipid syndrome (APS), is associated with rapid multiorgan failure. While APS is associated with single medium-to-large blood vessel occlusions, CAPS is most often associated with several, concurrent vascular occlusions of small vessels, commonly of the kidneys, heart, skin and brain. We present a case of a 21-year-old female patient with a history of immune thrombocytopenia purpura and APS, who eventually developed concurrent cerebral venous sinus thrombosis, diffuse alveolar haemorrhage, renal thrombotic microangiopathy, and a necrotic, vasculitic wound on her forearm. Despite hospitalisation and treatment, her condition worsened and the patient eventually died after succumbing to suspected CAPS.
On the implementation of nonlinearities in optical neural networks: opinion
Authors: Dinc Niyazi Ulas , Oguz Ilker , Yildirim Mustafa , Moser Christophe , Psaltis Demetri
Published: September 2024

Optical neural networks are expected to be hybrid systems for the foreseeable future combining optics and electronics. The linear portion of the system, consisting of the weighted interconnections between the neurons, can be realized optically. The nonlinear activation functions and the training of the network are implemented with nonlinear optics or electronically.
Susceptibility of BS90 Biomphalaria glabrata snails to infection by SmLE Schistosoma mansoni segregates as a dominant allele in a cluster of polymorphic genes for single-pass transmembrane proteins
Authors: Blouin Michael S. , Bollmann Stephanie R. , Le Clec’h Winka , Chevalier Frédéric D. , Anderson Timothy J. C. , Tennessen Jacob A.
Published: September 2024

The trematodes that cause schistosomiasis in humans require aquatic snails as intermediate hosts. Identifying the genes in snails at which allelic variation controls resistance to infection by schistosomes could lead to novel ways to break the cycle of transmission. We therefore mapped genetic variation within the BS90 population of Biomphalaria glabrata snails that controls their resistance to infection by the SmLE population of Schistosoma mansoni. A marker in the PTC2 genomic region strongly associates with variation in resistance. The S-haplotype, which confers increased susceptibility, appears to be almost completely dominant to the R-haplotype, which confers increased resistance. This result suggests a model in which the parasite must match a molecule on the host side to successfully infect. The genomic region surrounding our marker shows high structural and sequence variability between haplotypes. It is also highly enriched for genes that code for single-pass transmembrane (TM1) genes. Several of the TM1 genes present on the S-haplotype lack orthologs on the R-haplotype, which makes them intriguing candidate genes in a model of dominant susceptibility. These results add to a growing body of work that suggests TM1 genes, especially those in this exceptionally diverse genomic region, may play an important role in snail-schistosome compatibility polymorphisms.
Cognitive correlates of math abilities in autism spectrum disorder
Authors: Tonizzi Irene , Usai M. Carmen
Published: September 2024

The purpose of the current study was to investigate the contribution of different cognitive processes to specific math abilities in students with autism spectrum disorder (ASD) and typically developing (TD) students. The study involved a group of students with ASD without intellectual disabilities (n = 26) and a group with TD students (n = 52). The two groups aged from six to 20 years old and were matched for age, sex ratio and visuospatial reasoning. To assess math abilities, four math tasks were administered: arithmetic facts, mental calculation, mathematical inferences and math problem solving. Concerning cognitive processes, participants were tested on vocabulary, verbal working memory, visuospatial working memory, response inhibition and interference control. The group with ASD showed lower scores on all specific math measures than the TD group; cognitive processes differently contributed to diverse math abilities, and vocabulary and verbal working memory were stronger associated to specific math abilities in the group with ASD than in the TD group. The current results suggest that students with ASD had lower math abilities that are generalized to different math tasks. Implications for research and clinical assessment and intervention were discussed.