bluuebunny/crossref_metadata_2025 huggingface dataset:
Cultural and co-designed principles for developing a Māori kaumātua housing village to address health and social wellbeing
Authors: Oetzel John G. , Bragg Corey , Wilson Yvonne , Reddy Rangimahora , Simpson Mary Louisa , Nock Sophie
Published: May 2024

Background

The current study is a case study of a Māori (Indigenous people of New Zealand) organisation and their developmental processes in creating a kaumātua (older people) housing village for health and social wellbeing. This study identifies how a set of established co-design and culturally-centred principles were enacted when creating and developing the village.

Method

A mixed-method concurrent design was used in creating the case with interviews (n = 4), focus groups (N = 4 with 16 total participants) and survey questionnaires (n = 56) involving kaumātua and organisation members.

Results

Survey results illustrate that suitable and affordable housing are associated with self-rated health, loneliness, and life satisfaction. The primary purpose of the housing village was to enable kaumātua to be connected to the marae (community meeting house) as part of a larger vision of developing intergenerational housing around the marae to enhance wellbeing. Further, key themes around visioning, collaborative team and funding, leadership, fit-for-purpose design, and tenancy management were grounded in cultural elements using te ao Māori (Māori worldview).

Conclusion

This case study illustrates several co-design and culturally-centred principles from a previously developed toolkit that supported the project. This case study demonstrates how one community enacted these principles to provide the ground for developing a housing project that meets the health and social wellbeing of kaumātua.
Trifocal versus Pentafocal bone transport in segmental tibial defects: a matched comparative analysis for posttraumatic osteomyelitis treatment
Authors: Hamiti Yimurang , Abudureyimu Patiman , Lyu Gang , Yusufu Aihemaitijiang , Yushan Maimaiaili
Published: May 2024

Purpose

The objective of this study was to evaluate and compare the effectiveness and clinical results of trifocal bone transport (TBT) and pentafocal bone transport (PBT) in treating distal tibial defects > 6 cm resulting from posttraumatic osteomyelitis, highlighting the potential advantages and challenges of each method.

Methods

A retrospective assessment was conducted on an overall population of 46 eligible patients with distal tibial defects > 6 cm who received treatment between January 2015 and January 2019. Propensity score analysis was used to pair 10 patients who received TBT with 10 patients who received PBT. The outcomes assessed included demographic information, external fixation time (EFT), external fixation index (EFI), bone and functional outcomes assessed using the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system, and postoperative complications evaluated using the Paley classification.

Results

The demographic and baseline data of the two groups were comparable. Following radical debridement, the average tibial defect was 7.02 ± 0.68 cm. The mean EFT was significantly shorter in the PBT group (130.9 ± 16.0 days) compared to the TBT group (297.3 ± 14.3 days). Similarly, the EFI was lower in the PBT group (20.67 ± 2.75 days/cm) than in the TBT group (35.86 ± 3.69 days/cm). Both groups exhibited satisfactory postoperative bone and functional results. Pin site infection was the most common complication and the rates were significantly different between the groups, with the PBT group demonstrating a higher incidence.

Conclusion

Both TBT and PBT effectively treat posttraumatic tibial defects greater than 6 cm, with PBT offering more efficient bone regeneration. However, PBT is associated with a higher rate of pin site infections, highlighting the importance of careful management in these complex procedures and emphasizing the need for expert surgical execution and tailored treatment approaches in orthopedic reconstructive surgery.
Bawei Chenxiang Wan ameliorates right ventricular hypertrophy in rats with high altitude heart disease by SIRT3-HIF1α-PDK/PDH signaling pathway improving fatty acid and glucose metabolism
Authors: Han Yiwei , Li Shadi , Zhang Zhiying , Ning Xin , Wu Jiajia , Zhang Xiaoying
Published: May 2024

Background

Bawei Chenxiang Wan (BCW) is among the most effective and widely used therapies for coronary heart disease and angina pectoris in Tibet. However, whether it confers protection through a right-ventricle (RV) myocardial metabolic mechanism is unknown.

Methods

Male Sprague–Dawley rats were orally administrated with BCW, which was injected concurrently with a bolus of Sugen5416, and subjected to hypoxia exposure (SuHx; 5000 m altitude) for 4 weeks. Right ventricular hypertrophy (RVH) in high-altitude heart disease (HAHD) was assessed using Fulton’s index (FI; ratio of RV to left ventricle + septum weights) and heart-weight-to-body-weight ratio (HW/BW). The effect of therapeutic administration of BCW on the RVH hemodynamics was assessed through catheterization (mean right ventricular pressure and mean pulmonary artery pressure (mRVP and mPAP, respectively)). Tissue samples were used to perform histological staining, and confirmatory analyses of mRNA and protein levels were conducted to detect alterations in the mechanisms of RVH in HAHD. The protective mechanism of BCW was further verified via cell culture.

Results

BCW considerably reduced SuHx-associated RVH, as indicated by macro morphology, HW/BW ratio, FI, mPAP, mRVP, hypertrophy markers, heart function, pathological structure, and myocardial enzymes. Moreover, BCW can alleviate the disorder of glucose and fatty acid metabolism through upregulation of carnitine palmitoyltransferase1ɑ, citrate synthase, and acetyl-CoA and downregulation of glucose transport-4, phosphofructokinase, and pyruvate, which resulted in the reduced levels of free fatty acid and lactic acid and increased aerobic oxidation. This process may be mediated via the regulation of sirtuin 3 (SIRT3)-hypoxia-inducible factor 1α (HIF1α)-pyruvate dehydrogenase kinase (PDK)/pyruvate dehydrogenase (PDH) signaling pathway. Subsequently, the inhibition of SIRT3 expression by 3-TYP (a selective inhibitor of SIRT3) can reverse substantially the anti-RVH effect of BCW in HAHD, as indicated by hypertrophy marker and serum myocardial enzyme levels.

Conclusions

BCW prevented SuHx-induced RVH in HAHD via the SIRT3-HIF1ɑ-PDK/PDH signaling pathway to alleviate the disturbance in fatty acid and glucose metabolism. Therefore, BCW can be used as an alternative drug for the treatment of RVH in HAHD.
The effects of language proficiency and awareness of time limit in animated vs. text-based situational judgment tests
Authors: Rabe Mathis , Gröne Oana R. , von Bernstorff Charlotte , Knorr Mirjana
Published: May 2024

Background

Situational Judgment Tests (SJTs) are commonly used in medical school admissions. However, it has been consistently found that native speakers tend to score higher on SJTs than non-native speakers, which can be particularly problematic in the admission context due to the potential risk of limited fairness. Besides type of SJT, awareness of time limit may play a role in subgroup differences in the context of cognitive load theory. This study examined the influence of SJT type and awareness of time limit against the background of language proficiency in a quasi high-stakes setting.

Methods

Participants (N = 875), applicants and students in healthcare-related study programs, completed an online study that involved two SJTs: one with a text-based stimulus and response format (HAM-SJT) and another with a video-animated stimulus and media-supported response format (Social Shapes Test, SST). They were randomly assigned to a test condition in which they were either informed about a time limit or not. In a multilevel model analysis, we examined the main effects and interactions of the predictors (test type, language proficiency and awareness of time limit) on test performance (overall, response percentage).

Results

There were significant main effects on overall test performance for language proficiency in favor of native speakers and for awareness of time limit in favor of being aware of the time limit. Furthermore, an interaction between language proficiency and test type was found, indicating that subgroup differences are smaller for the animated SJT than for the text-based SJT. No interaction effects on overall test performance were found that included awareness of time limit.

Conclusion

A SJT with video-animated stimuli and a media-supported response format can reduce subgroup differences in overall test performance between native and non-native speakers in a quasi high-stakes setting. Awareness of time limit is equally important for high and low performance, regardless of language proficiency or test type.
Navigating the complex dynamics of anesthesiologists’ professional identity formation in the context of their specialty training program: a phenomenographic perspective
Authors: Chin Hanna , Ingerman Åke , Block Linda , Hergès Helena Odenstedt
Published: May 2024

Background

A specialty training program is crucial for shaping future specialist doctors, imparting clinical knowledge and skills, and fostering a robust professional identity. This study investigates how anesthesiologists develop their professional identity while navigating unique challenges specific to their specialty. The formation of professional identity in anesthesiology significantly influences doctors’ well-being, teamwork, and ultimately patient care, making it a crucial aspect of anesthesiology education. Utilizing a phenomenographic approach, the research explores the learners’ personal experiences and perspectives of professional identity formation in their specialty training programs, providing valuable insights for enhancing future anesthetic educational programs.

Method

The data for this phenomenographic study were collected through semi-structured interviews with anesthesiology trainees and specialists, guided by open-ended questions. The interviews were conducted at a Swedish university hospital, and participant selection used purposive sampling, providing rich and diverse data for analysis after 15 interviews. Iterative analysis followed the seven-step phenomenographic approach. The research team, comprising qualitative research and anesthesiology education experts, ensured result validity through regular review, discussion, and reflective practices.

Results

The study reveals three fundamental dimensions: ‘Knowledge of Subject Matter,’ ‘Knowledge of Human Relations,’ and ‘Knowledge of Affect.’ These dimensions offer insights into how anesthesiologists comprehend anesthesiology as a profession, navigate interactions with colleagues and patients, and interpret emotional experiences in anesthesiology practice – all crucial elements in the formation of professional identity. The findings could be synthesized and further described by three conceptions: The Outcome-Driven Learner, the Emerging Collaborator, and the Self-Directed Caregiver.

Conclusion

The study uncovers differing learner understandings in the development of anesthesiologists’ professional identity. Varying priorities, values, and role interpretations highlight the shortcomings of a generic, one-size-fits-all educational strategy. By acknowledging and integrating these nuanced learner perspectives, as elucidated in detail in this study, the future of anesthesia education can be improved. This will necessitate a holistic approach, intertwining both natural sciences and humanities studies, focus on tacit knowledge, and flexible teaching strategies, to guarantee thorough professional development, lifelong learning, and resilience.
Learning together for better health using an evidence-based Learning Health System framework: a case study in stroke
Authors: Teede Helena , Cadilhac Dominique A. , Purvis Tara , Kilkenny Monique F. , Campbell Bruce C.V. , English Coralie , Johnson Alison , Callander Emily , Grimley Rohan S. , Levi Christopher , Middleton Sandy , Hill Kelvin , Enticott Joanne
Published: May 2024

Background

In the context of expanding digital health tools, the health system is ready for Learning Health System (LHS) models. These models, with proper governance and stakeholder engagement, enable the integration of digital infrastructure to provide feedback to all relevant parties including clinicians and consumers on performance against best practice standards, as well as fostering innovation and aligning healthcare with patient needs. The LHS literature primarily includes opinion or consensus-based frameworks and lacks validation or evidence of benefit. Our aim was to outline a rigorously codesigned, evidence-based LHS framework and present a national case study of an LHS-aligned national stroke program that has delivered clinical benefit.

Main text

Current core components of a LHS involve capturing evidence from communities and stakeholders (quadrant 1), integrating evidence from research findings (quadrant 2), leveraging evidence from data and practice (quadrant 3), and generating evidence from implementation (quadrant 4) for iterative system-level improvement. The Australian Stroke program was selected as the case study as it provides an exemplar of how an iterative LHS works in practice at a national level encompassing and integrating evidence from all four LHS quadrants. Using this case study, we demonstrate how to apply evidence-based processes to healthcare improvement and embed real-world research for optimising healthcare improvement. We emphasize the transition from research as an endpoint, to research as an enabler and a solution for impact in healthcare improvement.

Conclusions

The Australian Stroke program has nationally improved stroke care since 2007, showcasing the value of integrated LHS-aligned approaches for tangible impact on outcomes. This LHS case study is a practical example for other health conditions and settings to follow suit.
Cows with diverging haplotypes show differences in differential milk cell count, milk parameters and vaginal temperature after S. aureus challenge but not after E. coli challenge
Authors: Müller-Langhans Katharina , Oberberger Lisa , Zablotski Yury , Engelmann Susanne , Hoedemaker Martina , Kühn Christa , Schuberth Hans-Joachim , Zerbe Holm , Petzl Wolfram , Meyerholz-Wohllebe Marie Margarete
Published: May 2024

Background

In dairy cattle, mastitis causes high financial losses and impairs animal well-being. Genetic selection is used to breed cows with reduced mastitis susceptibility. Techniques such as milk cell flow cytometry may improve early mastitis diagnosis. In a highly standardized in vivo infection model, 36 half-sib cows were selected for divergent paternal Bos taurus chromosome 18 haplotypes (Q vs. q) and challenged with Escherichia coli for 24 h or Staphylococcus aureus for 96 h, after which the samples were analyzed at 12 h intervals. Vaginal temperature (VT) was recorded every three minutes. The objective of this study was to compare the differential milk cell count (DMCC), milk parameters (fat %, protein %, lactose %, pH) and VT between favorable (Q) and unfavorable (q) haplotype cows using Bayesian models to evaluate their potential as improved early indicators of differential susceptibility to mastitis.

Results

After S. aureus challenge, compared to the Q half-sibship cows, the milk of the q cows exhibited higher PMN levels according to the DMCC (24 h, p < 0.001), a higher SCC (24 h, p < 0.01 and 36 h, p < 0.05), large cells (24 h, p < 0.05) and more dead (36 h, p < 0.001) and live cells (24 h, p < 0.01). The protein % was greater in Q milk than in q milk at 0 h (p = 0.025). In the S. aureus group, Q cows had a greater protein % (60 h, p = 0.048) and fat % (84 h, p = 0.022) than q cows. Initially, the greater VT of S. aureus-challenged q cows (0 and 12–24 h, p < 0.05) reversed to a lower VT in q cows than in Q cows (48–60 h, p < 0.05).

Additionally, the following findings emphasized the validity of the model: in the S. aureus group all DMCC subpopulations (24 h-96 h, p < 0.001) and in the E. coli group nearly all DMCC subpopulations (12 h-24 h, p < 0.001) were higher in challenged quarters than in unchallenged quarters. The lactose % was lower in the milk samples of E. coli-challenged quarters than in those of S. aureus-challenged quarters (24 h, p < 0.001). Between 12 and 18 h, the VT was greater in cows challenged with E. coli than in those challenged with S. aureus (3-h interval approach, p < 0.001).

Conclusion

This in vivo infection model confirmed specific differences between Q and q cows with respect to the DMCC, milk component analysis results and VT results after S. aureus inoculation but not after E. coli challenge. However, compared with conventional milk cell analysis monitoring, e.g., the global SCC, the DMCC analysis did not provide refined phenotyping of the pathogen response.
Ficolin-A induces macrophage polarization to a novel pro-inflammatory phenotype distinct from classical M1
Authors: Zhu Li-Wen , Li Zihao , Dong Xiaohong , Wu Huadong , Cheng Yifan , Xia Shengnan , Bao Xinyu , Xu Yun , Cao Runjing
Published: May 2024

Background

Macrophages are key inflammatory immune cells that orchestrate the initiation and progression of autoimmune diseases. The characters of macrophage in diseases are determined by its phenotype in response to the local microenvironment. Ficolins have been confirmed as crucial contributors to autoimmune diseases, with Ficolin-2 being particularly elevated in patients with autoimmune diseases. However, whether Ficolin-A stimulates macrophage polarization is still poorly understood.

Methods

We investigated the transcriptomic expression profile of murine bone marrow-derived macrophages (BMDMs) stimulated with Ficolin-A using RNA-sequencing. To further confirm a distinct phenotype activated by Ficolin-A, quantitative RT-PCR and Luminex assay were performed in this study. Additionally, we assessed the activation of underlying cell signaling pathways triggered by Ficolin-A. Finally, the impact of Ficolin-A on macrophages were investigated in vivo through building Collagen-induced arthritis (CIA) and Dextran Sulfate Sodium Salt (DSS)-induced colitis mouse models with Fcna-/- mice.

Results

Ficolin-A activated macrophages into a pro-inflammatory phenotype distinct to LPS-, IFN-γ- and IFN-γ + LPS-induced phenotypes. The transcriptomic profile induced by Ficolin-A was primarily characterized by upregulation of interleukins, chemokines, iNOS, and Arginase 1, along with downregulation of CD86 and CD206, setting it apart from the M1 and M2 phenotypes. The activation effect of Ficolin-A on macrophages deteriorated the symptoms of CIA and DSS mouse models, and the deletion of Fcna significantly alleviated the severity of diseases in mice.

Conclusion

Our work used transcriptomic analysis by RNA-Seq to investigate the impact of Ficolin-A on macrophage polarization. Our findings demonstrate that Ficolin-A induces a novel pro-inflammatory phenotype distinct to the phenotypes activated by LPS, IFN-γ and IFN-γ + LPS on macrophages.
The diverse dependence of galectin-1 and -8 on multivalency for the modulation of FGFR1 endocytosis
Authors: Żukowska Dominika , Chorążewska Aleksandra , Ciura Krzysztof , Gędaj Aleksandra , Kalka Marta , Poźniak Marta , Porębska Natalia , Opaliński Łukasz
Published: May 2024

Fibroblast growth factor receptor 1 (FGFR1) is a N-glycosylated cell surface receptor tyrosine kinase, which upon recognition of specific extracellular ligands, fibroblast growth factors (FGFs), initiates an intracellular signaling. FGFR1 signaling ensures homeostasis of cells by fine-tuning essential cellular processes, like differentiation, division, motility and death. FGFR1 activity is coordinated at multiple steps and unbalanced FGFR1 signaling contributes to developmental diseases and cancers. One of the crucial control mechanisms over FGFR1 signaling is receptor endocytosis, which allows for rapid targeting of FGF-activated FGFR1 to lysosomes for degradation and the signal termination. We have recently demonstrated that N-glycans of FGFR1 are recognized by a precise set of extracellular galectins, secreted and intracellular multivalent lectins implicated in a plethora of cellular processes and altered in immune responses and cancers. Specific galectins trigger FGFR1 clustering, resulting in activation of the receptor and in initiation of intracellular signaling cascades that shape the cell physiology. Although some of galectin family members emerged recently as key players in the clathrin-independent endocytosis of specific cargoes, their impact on endocytosis of FGFR1 was largely unknown.

Here we assessed the contribution of extracellular galectins to the cellular uptake of FGFR1. We demonstrate that only galectin-1 induces internalization of FGFR1, whereas the majority of galectins predominantly inhibit endocytosis of the receptor. We focused on three representative galectins: galectin-1, -7 and -8 and we demonstrate that although all these galectins directly activate FGFR1 by the receptor crosslinking mechanism, they exert different effects on FGFR1 endocytosis. Galectin-1-mediated internalization of FGFR1 doesn’t require galectin-1 multivalency and occurs via clathrin-mediated endocytosis, resembling in this way the uptake of FGF/FGFR1 complex. In contrast galectin-7 and -8 impede FGFR1 endocytosis, causing stabilization of the receptor on the cell surface and prolonged propagation of the signals. Furthermore, using protein engineering approaches we demonstrate that it is possible to modulate or even fully reverse the endocytic potential of galectins.
Difference in early all-cause mortality among patients having hip arthroplasty a Swedish perioperative registry study 2013–2022
Authors: Magnusson J. , Karlsson J. , Sköldenberg O. , Albert J. , Frostell C. , Jakobsson J. G.
Published: May 2024

Introduction

Hip arthroplasty is a common orthopaedic procedure worldwide. There is an ongoing debate related to the fixation and anaesthesia impact on the 30-day mortality, particularly in the aging population with higher American Society of Anaesthesiology (ASA) Physical-Status.

Aim

To study the 30-day all-cause mortality in patients undergoing primary hip arthroplasty, with regards to the impact of age, ASA-class, anaesthesia techniques, indication for surgery and fixation techniques.

Materials and methods

Perioperative data for primary hip arthroplasty procedures for osteoarthritis and hip fractures registered in the Swedish Perioperative Registry (SPOR) between 2013 and June 2022 were collected. Binary logistic regressions were performed to assess the impact of age, ASA-class, anaesthetic technique, indication for surgery and fixation on odds ratio for 30-day mortality in Sweden.

Results

In total, 79,114 patients, 49,565 with osteoarthritis and 29,549 with hip fractures were included in the main study cohort. Mortality was significantly higher among hip fracture patients compared with osteoarthritis, cumulative 8.2% versus 0.1% at 30-days respectively (p < 0.001). Age above 80 years (OR3.7), ASA 3–5 (OR3.3) and surgery for hip fracture (OR 21.5) were associated with significantly higher odds ratio, while hybrid fixation was associated with a significantly lower odds ratio (OR0.4) of 30-day mortality. In the same model, for the subgroups of osteoarthritis and hip fracture, only age (OR 3.7) and ASA-class (OR 3.3) had significant impact, increasing the odds ratio for 30-day mortality. Hemi arthroplasty was commonly used among the hip fracture patients 20.453 (69.2%), and associated with a significantly higher odds ratio for all-cause 30-day mortality as compared to total hip arthroplasty when adjusting for age and ASA-class and fixation 2.3 (95%CI 1.9–2.3, p < 0.001).

Conclusions

All-cause 30-day mortality associated with arthroplasty differed significantly between the two cohorts, hip fracture, and osteoarthritis (8.2% and 0.1% respectively) and mortality expectedly increased with age and higher ASA-class. Anaesthetic method and cement-fixation did not impact the odds ratio for all-cause 30-day mortality after adjustment for age and ASA-class.
Novel frontiers in urogenital cancers: from molecular bases to preclinical models to tailor personalized treatments in ovarian and prostate cancer patients
Authors: De Lazzari Giada , Opattova Alena , Arena Sabrina
Published: May 2024

Over the last few decades, the incidence of urogenital cancers has exhibited diverse trends influenced by screening programs and geographical variations. Among women, there has been a consistent or even increased occurrence of endometrial and ovarian cancers; conversely, prostate cancer remains one of the most diagnosed malignancies, with a rise in reported cases, partly due to enhanced and improved screening efforts.

Simultaneously, the landscape of cancer therapeutics has undergone a remarkable evolution, encompassing the introduction of targeted therapies and significant advancements in traditional chemotherapy. Modern targeted treatments aim to selectively address the molecular aberrations driving cancer, minimizing adverse effects on normal cells. However, traditional chemotherapy retains its crucial role, offering a broad-spectrum approach that, despite its wider range of side effects, remains indispensable in the treatment of various cancers, often working synergistically with targeted therapies to enhance overall efficacy.

For urogenital cancers, especially ovarian and prostate cancers, DNA damage response inhibitors, such as PARP inhibitors, have emerged as promising therapeutic avenues. In BRCA-mutated ovarian cancer, PARP inhibitors like olaparib and niraparib have demonstrated efficacy, leading to their approval for specific indications. Similarly, patients with DNA damage response mutations have shown sensitivity to these agents in prostate cancer, heralding a new frontier in disease management. Furthermore, the progression of ovarian and prostate cancer is intricately linked to hormonal regulation. Ovarian cancer development has also been associated with prolonged exposure to estrogen, while testosterone and its metabolite dihydrotestosterone, can fuel the growth of prostate cancer cells. Thus, understanding the interplay between hormones, DNA damage and repair mechanisms can hold promise for exploring novel targeted therapies for ovarian and prostate tumors.

In addition, it is of primary importance the use of preclinical models that mirror as close as possible the biological and genetic features of patients’ tumors in order to effectively translate novel therapeutic findings “from the bench to the bedside”.

In summary, the complex landscape of urogenital cancers underscores the need for innovative approaches. Targeted therapy tailored to DNA repair mechanisms and hormone regulation might offer promising avenues for improving the management and outcomes for patients affected by ovarian and prostate cancers.
Health-Related Quality of Life in severely injured patients in Finland: an observational cohort study of 325 patients with 1-year follow-up
Authors: Riuttanen Antti , Brand Vilma , Jokihaara Jarkko , Huttunen Tuomas T. , Mattila Ville M.
Published: May 2024

Background

Major trauma has a significant effect on Health-Related Quality of Life (HR-QoL). It is unclear, however, which factors most affect HR-QoL. This study aims to evaluate HR-QoL after severe injury in Finland and determine how different injury patterns and patient-related factors, such as level of education and socioeconomic group, are associated with HR-QoL. We also assess how well different injury scoring systems associate with HR-QoL.

Methods

We retrospectively analyzed 325 severely injured trauma patients (aged ≥ 18 years, New Injury Severity Score, (NISS) ≥ 16, and alive at 1 year after injury) treated in the Intensive Care Unit (ICU) or High Dependence Unit (HDU) of Tampere University Hospital (TAUH) from 2013 through 2016. HR-QoL was assessed with the EQ-5D-3L questionnaire completed during ICU stay and 1 year after injury. HR-QOL index values and reported problems were further compared with Finnish population norms.

Results

The severity of the injury (measured by ISS and NISS) had no significant association with the decrease in HR-QoL. Length of ICU stay had a weak negative correlation with post-injury HR-QoL and a weak positive correlation with the change in HR-QoL. The largest mean decrease in HR-QoL occurred in patients with spinal cord injury (Spine AIS ≥ 4) (-0.338 (SD 0.136)), spine injury in general (Spine AIS ≥ 2 (-0.201 (SD 0.279)), and a lower level of education (-0.157 (SD 0.231)). Patient’s age, sex, or socioeconomic status did not seem to associate with smaller or greater changes in HR-QoL.

Conclusions

After serious injury, many patients have permanent disabilities which reduce HR-QoL. Injury scoring systems intended for assessing the risk for death did not seem to associate with HR-QoL and are not, therefore, a meaningful way to predict the future HR-QoL of a severely injured patient. Recovery from the injury seems to be weaker in poorer educated patients and patients with spinal cord injury, and these patients may benefit from targeted additional measures. Although there were significant differences in baseline HR-QoL levels between different socioeconomic groups, recovery from injury appears to be similar, which is likely due to equal access to high-quality trauma care.
Early adiposity rebound: predictors and outcomes
Authors: Pomi Alessandra Li , Pepe Giorgia , Aversa Tommaso , Corica Domenico , Valenzise Mariella , Messina Maria Francesca , Morabito Letteria Anna , Stagi Stefano , Wasniewska Malgorzata
Published: May 2024

Adiposity rebound (AR) refers to the second rise of the body mass index (BMI) curve that usually occurs between six and eight years of age. AR timing has a significant impact on patients’ health: early AR (EAR), usually before the age of five, is considered to be the earliest indicator of obesity and its related health conditions later in life. Many studies have evaluated factors that can be predictors of EAR, and identified low birth weight and gestational weight gain as novel predictors of EAR, highlighting the role of the intrauterine environment in the kinetics of adiposity. Furthermore, children with breastfeeding longer than 4 months have been found to be less likely to have an EAR, whereas children born to advanced-age mothers, high maternal BMI had a higher risk of having an EAR. Some differences were found in the timing of AR in boys and girls, with girls being more likely to have EAR. The aim of this review is to answer the following three questions: 1) Which are the prenatal and perinatal factors associated with increased risk of EAR? Is gender one of these? 2) Which are the outcomes of EAR in childhood and in adulthood? 3) Which measures can be taken in order to prevent premature AR?
Comparing effectiveness of physiotherapy versus drug management on fatigue, physical functioning, and episodic disability for myalgic encephalomyelitis in post-COVID-19 condition: a study protocol of randomized control trial
Authors: Sarker Altaf Hossain , Hossain K.M. Amran , Kabir Md. Feroz , Jahan Sharmila , Hossain Md. Zahid , Hossain Tofajjal , Jahid Iqbal Kabir
Published: May 2024

Background

Physiotherapy interventions effectively improved fatigue and physical functioning in non-COVID patients with myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). There is a research gap on the effectiveness of physiotherapy interventions versus drug management on ME/CFS in post-COVID-19 conditions (PCC).

Methods

We planned a three-arm prospective randomized control trial on 135 PCC cases with ME/CFS who are diagnosed between 20 November 2023 and 20 May 2024 from a population-based cohort. The study aims to determine the effectiveness of physiotherapy interventions as adapted physical activity and therapeutic exercise (APTE) provided in institution-based care versus telemedicine compared with drug management (DM). Participants will be assigned to three groups with the concealed location process and block randomization with an enrollment ratio of 1:1:1. The post-treatment evaluation will be employed after 2 months of interventions, and follow-up will be taken after 6 months post-intervention. The Chalder fatigue scale will measure the primary outcome of fatigue. SF-36 and the disability-adjusted life years (DALYs) will measure the secondary outcome of physical functioning and episodic disability.

Discussion

This study will address the research gap to determine the appropriate approach of physiotherapy or drug management for ME/CFS in PCC cases. The future direction of the study will contribute to developing evidence-based practice in post-COVID-19 condition rehabilitation.

Trial registration

The trial is registered prospectively from a primary Clinical Trial Registry side of WHO CTRI/2024/01/061987. Registered on 29 January 2024.
Dual-color FISH analyses of xenogeneic human fibroblast sheets transplanted to repair lung pleural defects in an immunocompromised rat model
Authors: Kanzaki Masato , Takagi Ryo , Mitsuboshi Shota , Shidei Hiroaki , Isaka Tamami , Yamato Masayuki
Published: May 2024

Background

Pulmonary air leaks (PALs) due to visceral pleura injury during surgery is frequently observed after pulmonary resections and the complication is difficult to avoid in thoracic surgery. The development of postoperative PALs is the most common cause of prolonged hospitalization. Previously, we reported that PALs sealants using autologous dermal fibroblast sheets (DFSs) harvested from temperature-responsive culture dishes successfully closed intraoperative PALs during lung resection.

Objective

In this study, we investigated the fate of human DFSs xenogenetically transplanted onto lung surfaces to seal PALs of immunocompromised rat. Dual-color FISH analyses of human fibroblast was employed to detect transplantation human cells on the lung surface.

Results

One month after transplantation, FISH analyses revealed that transplanted human fibroblasts still composed a sheet-structure, and histology also showed that beneath the sheet’s angiogenesis migrating into the sheets was observed from the recipient tissues. FISH analyses revealed that even at 3 months after transplantation, the transplanted human fibroblasts still remained in the sheet. Dual-color FISH analyses of the transplanted human fibroblasts were sparsely present as a result of the cells reaching the end of their lifespan, the cells producing extracellular matrix, and remained inside the cell sheet and did not invade the lungs of the host.

Conclusions

DFS-transplanted human fibroblasts showed that they are retained within cell sheets and do not invade the lungs of the host.
New error bounds for Newton’s formula associated with tempered fractional integrals
Authors: Hezenci Fatih , Budak Hüseyin
Published: May 2024

In this paper, we first construct an integral identity associated with tempered fractional operators. By using this identity, we have found the error bounds for Simpson’s second formula, namely Newton–Cotes quadrature formula for differentiable convex functions in the framework of tempered fractional integrals and classical calculus. Furthermore, it is also shown that the newly established inequalities are the extension of comparable inequalities inside the literature.
Factors and management techniques in odontogenic keratocysts: a systematic review
Authors: Dioguardi Mario , Quarta Cristian , Sovereto Diego , Caloro Giorgia Apollonia , Ballini Andrea , Aiuto Riccardo , Martella Angelo , Lo Muzio Lorenzo , Di Cosola Michele
Published: May 2024

Objectives

Odontogenic keratocysts exhibit frequent recurrence, distinctive histopathological traits, a tendency towards aggressive clinical behavior, and a potential linkage to the nevoid basal cell carcinoma syndrome. The aim of this systematic review is to compile insights concerning the control of this condition and assess the effectiveness of various treatment approaches in reducing the likelihood of recurrence.

Materials and methods

The following systematic review adhered to the PRISMA guidelines. The systematic revision was registered on PROSPERO and  structured around the questions related to the population, intervention, control, outcome and study design (PICOS).

Results

After conducting a search on the PubMed database, we initially identified 944 records. After using end-note software to remove duplicate entries, results totally with 462 distinct records. A thorough review of the titles and abstracts of these articles led to the selection of 50 papers for in-depth examination. Ultimately, following the application of our eligibility criteria, we incorporated 11 articles into our primary outcome analysis.

Conclusion

Among the studies examined, the most common location for these lesions was found to be in the area of the mandibular ramus and the posterior region of the mandible. In cases where the exact location wasn’t specified, the mandible emerged as the predominant site. When we considered the characteristics of these lesions in studies that mentioned locularity, most were described as unilocular in two studies, while in two other studies, the prevalence of multilocular lesions was observed. Risk factors associated with keratocyst recurrence include younger patient age, the presence of multilocular lesions, larger lesion size, and a longer anteroposterior dimension. Certain treatment methods have demonstrated a lack of relapses. These include the use of 5-fluorouracil, marsupialization, enucleation with peripheral ostectomy or resection, enucleation and curettage, as well as resection without creating continuity defects. However, it is important to note that further research is essential. Prospective studies and randomized trials are needed to collect more comprehensive evidence regarding the effectiveness of various treatment approaches and follow-up protocols for managing odontogenic keratocysts.

Clinical relevance

Odontogenic keratocysts still enter into differential diagnoses with other lesions that affect the jaw bones such as ameloblastama and other tumor forms, furthermore it is not free from recurrence, therefore the therapeutic approach to the lesion aimed at its elimination can influence both the possible recurrence and complications, knowledge of the surgical methods that offer the most predictable and clinically relevant result for the management of follow-up and recurrences.
An alternative approach to ontology-based curriculum development in higher education
Authors: Piriyapongpipat Pattamaporn , Goldin Sally , Ditcharoen Nadh
Published: May 2024

Global trends in higher education emphasize the development of curricula that offer greater responsiveness to learners. Creating flexible and responsive curricula will require additional support systems for curriculum management. The first step toward sustainably developing this kind of system is to represent essential curricular information in a way that allows sharing common components across various work processes within the educational environment. The current research implements a new approach for representing curriculum components, by systematically analyzing external source data to extract the basic knowledge, skills and dependencies which then become objects into an ontology. The resulting ontology should act as a computationally-accessible model of the curriculum with sufficient information and usable quality. This paper describes a trial implementation of our approach using actual curriculum documents. Results from performance metrics and expert evaluation validate the proposed strategy and suggest that the approach is feasible for real-world practice.
Integrating incentive spirometry and progressive muscle training in managing respiratory compromise in Guillain–Barré syndrome
Authors: Bappah Babangida Shehu , Womboh Idoo , Ewah Patrick Ayi , Umar Lawan , Mohammed Jibril
Published: May 2024

Background

Guillain–Barré syndrome (GBS) is one of the most common causes of acute neuromuscular paralysis in developed and developing countries. It is a complex autoimmune disorder characterized by progressive skeletal muscle weakness, potentially involving respiratory muscles. The purpose of this case report was to explore the importance of combined use of incentive spirometry and progressive muscle training as essential therapies in a 20-year-old male diagnosed with GBS.

Case presentation

This is a case report of a 20-year-old Nigerian male university student who was brought to the trauma center on a wheelchair with weakness of both upper and lower limbs which was said to be progressive, and a diagnosis of GBS was made by the attending physician. On examination, he was discovered to have quadriparesis with mild respiratory muscle involvement. He deteriorated with cardiopulmonary compromise and was transferred into intensive care unit. He was managed with supplementary oxygen therapy until there was significant improvement and he was weaned off oxygen therapy and then needed further evaluation and management. The patient was placed on immunoglobulin in conjunction with incentive spirometry, progressive strengthening exercise and exercise training which proved to be effective as he regained all the lost function within a few weeks of symptoms.

Results

This intervention delves into the synergistic potential of fortifying respiratory muscles and improving respiratory function alongside overall muscle strength which resulted in the patient regaining all the lost function within a few weeks.

Conclusions

The combined use of incentive spirometry and progressive muscle training in addition to immunoglobulin was effective in modulating GBS related impairments. We recommend the use of a multifaceted strategy in the management of patients with GBS and other similar health conditions.
Robot-assisted treatment of secondary epilepsy caused by parasitic infection: a case report
Authors: Luo Juan , Chen Xin , Yu Sixun , Shu Haifeng
Published: May 2024

Background

Cerebral sparganosis represents the most severe manifestation of sparganosis, with a relatively low global incidence. For cases of secondary epileptic seizures caused by sparganosis infection in the functional areas of the brain, what advanced neurosurgical techniques should be employed to precisely identify and excise the epileptic lesions in the deep functional areas of the brain, aiming to achieve maximal removal while minimising the risk of neurological deficits? This remains a current challenge for epilepsy surgeons.

Case presentation

A 24-year-old Chinese male was admitted to our hospital, presenting with a history of left limb twitching persisting for over a year. His main clinical symptoms presented twitching and numbness of his left limb without loss of consciousness. Under the premise of inappropriate anti-seizure treatment, recurrent epilepsy attacked persist. The patient's diagnosis was considered as “space-occupying lesions in the several lobes of brain, secondary epilepsy” after comprehensive assessment and discussion. And experts considered that the patient's space-occupying lesions in the right frontal and parietal lobes were highly suspected to be infected by parasites. This report delved into the application of neurosurgery robot-assisted frameless stereotaxic technology and intraoperative stereotactic electroencephalography (SEEG) monitoring technology to accurately locate and optimize removal of parasite-related epileptic lesions situated in functional areas of the brain. As a result, the patient had achieved seizure freedom, leaving no symptoms of neurological deficit.

Conclusions

With the highly integrated development of imaging technology, mechanical technology, computer control technology, and artificial intelligence, surgical robots are poised to play a larger role across various neurosurgical specialties in the future. Considering benefits for patients and the promising application of this technology, its utilization holds significant value.
Study on the distribution of average wind speeds at a mountainous bridge site for structural durability design
Authors: Cheng Cheng , Luo Beilong , Jiang Yan , Liu Jian
Published: May 2024

Conventional wind speed distribution methods (e.g., Rayleigh distribution and Weibull distribution) may not adequately capture complex characteristics of wind fields in mountainous areas. To address this problem, this study proposes a semi-parametric mix method for modeling the distribution of average wind speeds based on the combination of nonparametric Kernel Density Estimation (KDE) and Generalized Pareto Distribution (GPD). In the proposed method, KDE focuses on capturing the distribution in the main part of average wind speeds, while GPD aims at performing the distribution in terms of those in the extreme part. The segment point (i.e., the threshold) between KDE and GPD distributions is determined based on the combination of conditional mean excesses criterion and empirical rule. Meanwhile, the selection of modeling parameters should ensure that the mix distribution model is continuous and differentiable at the identified threshold point. Then, the commonly-used conditional probability model is further introduced to describe the wind direction distribution. Finally, a case study based on the measured 10-min average wind speeds at a mountainous bridge site is employed to demonstrate the effectiveness of the proposed method. The results indicate that: (1) the distribution of omnidirectional average wind speeds in the mountainous bridge site exhibits an obviously single-peak characteristic, while those considering wind directionality present a certain bimodal characteristic; (2) the proposed method can effectively describe wind speed distributions with different statistical characteristics, and the fitting accuracy outperforms the frequently-employed Weibull distribution model.
Experimental characteristic evaluation of micro hole EDM drilling of Ni51.58Ti48.34 alloy with copper electrode and response optimization using GRG assisted with GA
Authors: Sahoo Amiya Kumar , Mishra Dhananjay R.
Published: May 2024

Nitinol, a biocompatible material, is gradually becoming famous for its superelasticity, shape memory and corrosion resistance behaviours. However, the lower machinability due to the strain-hardening effect and lower thermal conductivity is contrary to its adventitious properties. Therefore, EDM is a preferable machining process for materials like Nitinol. EDM, thermal processing, raises the concern of processing Nitinol with minimal variation of its well-known properties and economical machining process. Therefore, this article deals with multi-objective optimization through GRG-assisted GA of µ-EDM drilling of Ni51.58Ti48.34 alloy using a copper electrode and distilled water. It was found that discharge current and servo voltage significantly influence the responses. The GA, with the assistance of GRG, optimized the multiple responses (viz. MRR, TWR and DoT) and yielded a discharge current of 12 A, gap voltage of 40 V, discharge time of 2 µs, charging time of 9 µs and flushing pressure of 50 kg/cm2. The confirmatory experiment yielded MRR of 0.0036 g/min, TWR of 0.0038 g/min and DoT of 0.0089 radians. There were variations of the predicted and experimentally validated responses by − 2.78, 26.32 and 35.96% for MRR, TWR and DoT, respectively.