bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocean Heat Convergence and North Atlantic Multidecadal Heat Content Variability
Authors: Moat B. I. , Sinha B. , Berry David I. , Drijfhout S. S. , Fraser N. , Hermanson L. , Jones D. C. , Josey S. A. , King B. , Macintosh C. , Megann A. , Oltmanns M. , Sanders R. , Williams S.
Published: May 2024

We construct an upper ocean (0–1000 m) North Atlantic heat budget (26°–67°N) for the period 1950–2020 using multiple observational datasets and an eddy-permitting global ocean model. On multidecadal time scales, ocean heat transport convergence controls ocean heat content (OHC) tendency in most regions of the North Atlantic with little role for diffusive processes. In the subpolar North Atlantic (45°–67°N), heat transport convergence is explained by geostrophic currents, whereas ageostrophic currents make a significant contribution in the subtropics (26°–45°N). The geostrophic contribution in all regions is dominated by anomalous advection across the time-mean temperature gradient although other processes make a significant contribution, particularly in the subtropics. The time scale and spatial distribution of the anomalous geostrophic currents are consistent with a simple model of basin-scale thermal Rossby waves propagating westward/northwestward in the subpolar gyre, and multidecadal variations in regional OHC are explained by geostrophic currents periodically coming into alignment with the mean temperature gradient as the Rossby wave passes through. The global ocean model simulation shows that multidecadal variations in the Atlantic meridional overturning circulation are synchronized with the ocean heat transport convergence consistent with modulation of the west–east pressure gradient by the propagating Rossby wave.

Significance Statement

The purpose of the work is to understand why the North Atlantic Ocean warms up and cools down on time scales of about 40 years. The key finding is that the temperature fluctuations are caused by an oceanic wave pushing the ocean surface up and down and causing ocean currents to change direction, pushing heat into and out of different parts of the ocean, and drawing down or emitting heat to the atmosphere. The findings matter because the warm and cool periods affect the climate of the countries surrounding the North Atlantic. Climate models need to account for this oceanic wave process to correctly predict how it will change in the future and affect the large-scale climate in a warming world.
Awareness of medical cannabis regulations among UK police officers – a cross-sectional study
Authors: Erridge Simon , Wang Claire , Troup Lucy , Sodergren Mikael H
Published: May 2024

Cannabis-based products for medicinal use were rescheduled in the UK in November 2018. The primary outcomes of this cross-sectional survey were to assess awareness of legislation governing these products among UK police officers and whether they had received appropriate training. 200 police officers completed the survey, and 57 (28.5%) respondents did not know these products were legal on prescription in the UK. 177 (88.5%) police officers believed they would benefit from more training on them and how to identify legal medical cannabis patients. Education on the legalities of cannabis-based products for medicinal use and why they are prescribed is necessary to improve knowledge among police officers.
The Effects of Motionless Interventions Based on Visual-Auditory Instructions With Sonification on Learning a Rhythmic Motor Skill
Authors: Ghambari Shiva , Arsham Saeed , Ramezanzade Hesam
Published: May 2024

Our aim in this study was to investigate the effects of motionless interventions, based on visual-auditory integration with a sonification technique, on the learning a complex rhythmic motor skill. We recruited 22 male participants with high physical fitness and provided them four acquisition sessions in which to practice hurdle running, based on a visual-auditory instructional pattern. Next, we divided participants into three groups: visual-auditory, auditory, and control. In six sessions of motionless interventions, with no physical practice, participants in the visual-auditory group received a visual-auditory pattern similar to their experience during the acquisition period. The auditory group only listened to the sound of sonified movements of an expert hurdler, and the control group received no instructional interventions. Finally, participants in all three groups underwent post-intervention and transfer tests to determine their errors in the spatial and relative timing of their leading leg’s knee angular displacement. Both visual-auditory and auditory groups had significantly less spatial error than the control group. However, there were no significant group differences in relative timing in any test phase. These results indicate that the use of the sonification technique in the form of visual-auditory instruction adapted to the athletes’ needs benefitted perception-sensory capacities to improve motor skill learning.
Successful treatment of a rare giant accessory cavitated uterine mass: a case report
Authors: Deng Fenglian , Liu Ke , Huang Yanzhuo , Chen Qiuling , Wang Lijuan , Xiao Xinqi , Zhang Lu
Published: May 2024

An accessory cavitated uterine mass (ACUM) is a very rare obstructive genital malformation characterized by pelvic pain and severe dysmenorrhea. It is easily mistaken for other obstructive genital malformations in women, such as cystic uterine adenomyosis or cystic degeneration of uterine fibroids. This case report describes a 30-year-old patient with a huge uterine cornual mass. Successful resection was performed by surgical excision, and the lesion was diagnosed as an ACUM. Given the rarity of a giant ACUM, this report also includes a brief review of the relevant literature.
Multi-functional Inconel 625 micro-machining and process optimization using ANFIS
Authors: Thakur Surendra Singh , Pradhan Sharad K , Sharma Aditi , Sonia Pankaj , Sehgal Shankar , Ramu Gandikota
Published: May 2024

The primary objective of this study is to develop an adaptive neuro-fuzzy inference-based system (ANFIS) that assesses the ideal parameters and impact of the micro-electro-discharge machining (Micro-EDM) technique on surface roughness (SR). In this work multi-functional Inconel alloy specimens were machined using micro-elector-discharge machining (Micro-EDM) with zinc-coated copper electrodes in a graphite nano abrasive submersion medium. An ANFIS and Taguchi design of experiments (DOE) was employed to evaluate the Micro-EDM method. The study utilized Taguchi's L9 mixed orthogonal arrays (OA) to consider three process variables, namely open voltage (V), capacitance (C), and powder concentration (CP). ANOVA analysis was conducted to identify important process variables and evaluate their influence on surface properties. The experimental results showed that all approaches were effective in representing the process. Based on the results of the response surface methodology (RSM) and ANFIS predictions, the correlation coefficients (R2) of the experimental roughness were 0.995649 and the root mean square error (RMSE) value was 1.01226e-06, respectively. The results obtained indicate a strong alignment between the predicted and experimental values, effectively fulfilling the proposed objective. These findings hold significant potential for practical applications in the Micro-EDM industry, particularly in the machining of Inconel alloy.
Effect of open crack on axial compressor performance
Authors: Wang Zhongyi , Song Tianchu , Wang Yanhua , Li Zheng , Chu Shuguang
Published: May 2024

To investigate the effects and mechanisms of rotor open crack on axial compressor performance, a steady 3D single-passage numerical simulation is used on NASA Stage 35. The results show that the crack leakage flow can affect the compressor performance, and the crack at the middle span has the most serious effect. At 100% rotating speed, there is a 1.2% decrease in peak total pressure ratio and a 0.36% decrease in peak efficiency. Besides, the stability margin is reduced by 26.9% relatively. The effect of crack is not only limited to the span range near it, and the main phenomena of cracks at different spans are various, concentrating in the aspects of vortex structure and stator passage flow. From peak efficiency to near stall condition, the effect of crack leakage flow is gradually strengthened, which leads to the flow blockage and reduces the working flow range of compressor. With the decrement of rotating speed, the reduction of stability margin increases gradually, but the influence span range of crack at low-speed narrows.
Nerolidol Alleviates Oxidative Stress and Inflammation in Diabetic Retinopathy Mediated by High Glucose through Ameliorating Nrf2/HO-1 Pathway
Authors: Li Changhong , Shi Buchao , Li Dong , Li Hui
Published: May 2024

Background

Diabetic retinopathy (DR) is the foremost microvascular problem that causes drastic visual impairment in diabetes patients. Hyperglycemia-triggered reaction cascade of inflammation and oxidative stress constitute the DR pathogenesis. The existing treatment options are not completely satisfactory.

Materials and Methods

We investigated the cell viability by 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay, inflammatory mediators, lactate dehydrogenase (LDH), superoxide dismutase, glutathione, and malonaldehyde (MDA) levels by ELISA and qRT-PCR assay, protein expression of Nrf2 and heme oxygenase-1 (HO-1) by western blotting assay were analyzed.

Results

According to our research, nerolidol (NRD) increases the proliferation and antioxidant activity of human retinal endothelial cells (HRECs) by inducing Nrf2/HO-1 signaling, while attenuating MDA, an oxidative stress marker, LDH, and inflammatory mediators. These outcomes suggest that a substantial reaction of inflammation and oxidative stress injury happened in DR, which might be correlated to the instigation of the signaling Nrf2/HO-1.

Conclusion

NRD effectively suppresses oxidative stress and inflammation in HG-induced HRECs. The primary mechanism of NRD on DR may be linked to the activation of the Nrf2/HO-1 pathway and may give a useful medicine for DR treatment.
Effects of mobile music listening: Patterns of changes in focus of attention, environmental perception, and self-experience
Authors: Kuch Mia , Wöllner Clemens
Published: May 2024

In this study, we examined how mobile music listening can change one’s perception of the environment. Using a mixed-methods approach, we subjected the written statements of 112 individuals to content analysis and association rule mining to identify categorical relationships. Findings revealed two distinct qualities of perception that are related to relevant factors: (1) Altered attentional focus is predominantly characterized by an intentional shift of attention, usually to exclude the external world from perception. Here, we found associations with situational context and affect regulation. (2) Altered perception and experience of the self are characterized by the inclusion and modification of the environment, or by an altered sense of oneself. They are related to musical attributes, affect regulation, situational context, and behavioral change. We also found an association between the two qualities of perception. Based on the patterns identified, we were able to determine temporal relationships between the effects of mobile music listening. For example, participants often reported that they consciously used music to improve or enhance their mood. On the one hand, they achieve this by focusing their attention on the music and thus blocking out the outside world. On the other hand, mood enhancement through music may lead to a more positive experience of the environment and behavioral consequences. We summarize our findings in a model showing patterns of changes in perception with regard to antecedents and consequences. This model exemplifies the plurality of mobile listening strategies and their psychological effects, advancing our understanding of the multifaceted nature of mobile music listening.
Using Artificial Intelligence to Improve the Accuracy of a Wrist-Worn, Noninvasive Glucose Monitor: A Pilot Study
Authors: Qureshi Muhammad Rafaqat Ali , Bain Stephen Charles , Luzio Stephen , Handy Consuelo , Fowles Daniel J. , Love Bradley , Wareham Kathie , Barlow Lucy , Dunseath Gareth J. , Crane Joel , Masso Isamar Carrillo , Ryan Julia A. M. , Chaudhry Mohamed Sabih
Published: May 2024

Background:

Self-monitoring of glucose is important to the successful management of diabetes; however, existing monitoring methods require a degree of invasive measurement which can be unpleasant for users. This study investigates the accuracy of a noninvasive glucose monitoring system that analyses spectral variations in microwave signals.

Methods:

An open-label, pilot design study was conducted with four cohorts (N = 5/cohort). In each session, a dial-resonating sensor (DRS) attached to the wrist automatically collected data every 60 seconds, with a novel artificial intelligence (AI) model converting signal resonance output to a glucose prediction. Plasma glucose was measured in venous blood samples every 5 minutes for Cohorts 1 to 3 and every 10 minutes for Cohort 4. Accuracy was evaluated by calculating the mean absolute relative difference (MARD) between the DRS and plasma glucose values.

Results:

Accurate plasma glucose predictions were obtained across all four cohorts using a random sampling procedure applied to the full four-cohort data set, with an average MARD of 10.3%. A statistical analysis demonstrates the quality of these predictions, with a surveillance error grid (SEG) plot indicating no data pairs falling into the high-risk zones.

Conclusions:

These findings show that MARD values approaching accuracies comparable to current commercial alternatives can be obtained from a multiparticipant pilot study with the application of AI. Microwave biosensors and AI models show promise for improving the accuracy and convenience of glucose monitoring systems for people with diabetes.
Prevalence of cervical intraepithelial lesions and associated factors among women attending a cervical cancer clinic in Western Uganda; results based on Pap smear cytology
Authors: Ssedyabane Frank , Niyonzima Nixon , Nambi Najjuma Josephine , Birungi Abraham , Atwine Raymond , Tusubira Deusdedit , Randall Thomas C , Castro Cesar M , Lee Hakho , Ngonzi Joseph
Published: May 2024

Introduction:

There are high incidence and mortality rates of cervical cancer among females in East Africa. This is exacerbated by limited up-to-date data on premalignant lesions and associated factors in this setting. In this study, we determined the prevalence of cervical intraepithelial lesions and associated factors among women attending the Mbarara Regional Referral Hospital cervical cancer clinic in Southwestern Uganda.

Methods:

In this cross-sectional study, 364 participants were recruited from among women attending the Mbarara Regional Referral Hospital cervical cancer clinic from 1 April to 30 June 2023. On consent, the study nurse collected demographic data and Pap smears, which were microscopically examined and reported by a laboratory scientist and a pathologist following the Bethesda grading system (2014). Statistical analyses were done in STATA version 17, using proportions, Chi-square, bivariate, and multivariate logistic regression analysis to determine associated factors at ⩽0.05 significance level.

Results:

The mean age of participants was 41.9 years. A third of all study participants (37.6%, 132/351) were contraceptive users, mostly hormonal contraceptives (87.1%, 115/132). Almost 88% (307/351) had an unknown Human Papilloma Virus status. The prevalence of cervical intraepithelial lesions among our study participants was 6.6% (23/351), of which 73.9% (17/23) were low-grade squamous intraepithelial lesions. More than half (9/17, 52.9%) of low-grade squamous intraepithelial lesions were active hormonal contraceptive users. Use of hormonal contraceptives (OR: 3.032, p: 0.0253), use of intrauterine devices (OR: 6.284, p: 0.039), and any family history of cervical cancer (OR: 4.144, p: 0.049) were significantly associated with cervical intraepithelial lesions.

Conclusion:

The prevalence of cervical intraepithelial lesions was 6.6%, lower than global estimates. Use of hormonal and intrauterine device contraceptives, as well as family history of cervical cancer, were significantly associated with cervical intraepithelial lesions among our study population. Prospective studies are recommended to further understand associations between different types of intrauterine devices and hormonal contraceptives, and cervical lesions.
Recommendations of Clinical Practice Guidelines for the treatment of urinary incontinence in women: A methodological survey
Authors: Moura Mariana Del Grossi , Sorrilha Flávia Blaseck , Magnusson Gabriela , Barberato-Filho Silvio , Lopes Luciane Cruz , Pereira Glasiela Isabele Camargo , Bergamaschi Cristiane de Cássia
Published: May 2024

Objective:

This study described and analysed key recommendations from Clinical Practice Guidelines (CPGs) concerning urinary incontinence (UI) treatment in women.

Materials and methods:

We carried out searches in the following databases: MEDLINE, EMBASE, Web of Science, Virtual Health Library, among others. The reviewers, in duplicate and independently, selected the documents and extracted the data. The quality assessment of the guidelines was carried out, in triplicate, using the Appraisal of Guidelines REsearch and Evaluation (AGREE II) instrument.

Results:

Six CPGs were selected for analysis. Pelvic Floor Muscle Training (PFMT) is the primary treatment for UI, with adjunctive therapies (biofeedback, vaginal cones, dynamic lumbopelvic stabilisation, and electrical stimulation) recommended alongside PFMT. Discrepancies among CPG were noted in recommendations for drug treatments and invasive procedures, suggesting the need for individualised approaches. When conservative non-pharmacological treatments failed, drugs are recommended. Mid-urethral slings were endorsed, with alternatives like colposuspension or autologous rectus fascial slings considered when mid-urethral slings were unsuitable. Botulinum toxin type A was suggested for urge UI patients unresponsive to conservative therapy.

Conclusion:

UI treatment must prioritise the conservative non-pharmacological therapies and progressing to invasive options, as necessary. These evidence-based findings aim to guide patients, healthcare professionals, and policy managers in effectively managing UI.

Level of evidence:

Not applicable
Subjective Indicators of Overtraining and Their Relationship to Sport Fitness: A 1-year Observation of Elite Athletes
Authors: Jelínek Martin , Květon Petr , Burešová Iva
Published: May 2024

This study explores the relationships among indicators of overtraining in adolescent athletes. The research employed widely-accepted tools for subjective overtraining indicator detection, as identified through a systematic review. Two groups of athletes were observed, comprising 13 athletes with bi-weekly assessments and 66 athletes with assessments every 3 months over a one-year period. The study analyzed relationships between variables using repeated measures correlations. A correlation matrix was subjected to principal component analysis. Three fundamental groups of indicators, reflecting negative emotionality (accompanied by sleep problems), self-concept characteristics, and core symptoms of overtraining syndrome captured through subjective sport fitness and vigor. This research emphasizes the intrinsic link between emotional and physical aspects in the lives of elite athletes, shedding light on the complex interplay of overtraining indicators in the context of adolescent developmental period.
Safety and clinical outcomes of endovascular therapy versus medical management in late presentation of large ischemic stroke
Authors: Mujanovic Adnan , Strbian Daniel , Demeestere Jelle , Marto João Pedro , Puetz Volker , Nogueira Raul G , Abdalkader Mohamad , Nagel Simon , Raymond Jean , Ribo Marc , Michel Patrik , Yoshimura Shinichi , Zaidat Osama O , Winzer Simon , Ortega-Gutierrez Santiago , Sheth Sunil A , Siegler James E , Dusart Anne , Haussen Diogo C , Henon Hilde , Serrallach Bettina L , Mohammaden Mahmoud H , Möhlenbruch Markus A , Olive-Gadea Marta , Puri Ajit S , Sakai Nobuyuki , Klein Piers , Tomppo Liisa , Caparros Francois , Ramos João Nuno , Jumaa Mouhammad , Zaidi Syed , Dobrocky Tomas , Martinez-Majander Nicolas , Nannoni Stefania , Bellante Flavio , Rodriguez-Calienes Aaron , Salazar-Marioni Sergio , Virtanen Pekka , Kaiser Daniel PO , Ventura Rita , Jesser Jessica , Castonguay Alicia C , Qureshi Muhammad M , Masoud Hesham E , Galecio-Castillo Milagros , Requena Manuel , Lauha Riikka , Hu Wei , Lin Eugene , Miao Zhongrong , Roy Daniel , Yamagami Hiroshi , Seiffge David J , Strambo Davide , Ringleb Peter A , Lemmens Robin , Fischer Urs , Nguyen Thanh N , Kaesmacher Johannes
Published: May 2024

Introduction:

The benefit of endovascular therapy (EVT) among stroke patients with large ischemic core (ASPECTS 0–5) in the extended time window outside of trial settings remains unclear. We analyzed the effect of EVT among these stroke patients in real-world settings.

Patients and methods:

The CT for Late Endovascular Reperfusion (CLEAR) study recruited patients from 66 centers in 10 countries between 01/2014 and 05/2022. The extended time-window was defined as 6–24 h from last-seen-well to treatment. The primary outcome was shift of the 3-month modified Rankin scale (mRS) score. Safety outcomes included symptomatic intracranial hemorrhage (sICH) and mortality. Outcomes were analyzed with ordinal and logistic regressions.

Results:

Among 5098 screened patients, 2451 were included in the analysis (median age 73, 55% women). Of patients with ASPECTS 0–5 ( n = 310), receiving EVT ( n = 209/310) was associated with lower 3-month mRS when compared to medical management (median 4 IQR 3–6 vs 6 IQR 4–6; aOR 0.4, 95% CI 0.2–0.7). Patients undergoing EVT had higher sICH (11.2% vs 4.0%; aOR 4.1, 95% CI 1.2–18.8) and lower mortality (31.6% vs 58.4%, aOR 0.4; 95% CI 0.2–0.9) compared to medically managed patients. The relative benefit of EVT was comparable between patients with ASPECTS 0 and 5 and 6–10 in the extended time window (interaction aOR 0.9; 95% CI 0.5–1.7).

Conclusion:

In the extended time window, patients with ASPECTS 0–5 may have preserved relative treatment benefit of EVT compared to patients with ASPECTS 6–10. These findings are in line with recent trials showing benefit of EVT among real-world patients with large ischemic core in the extended time window.

Trial registration number:

clinicaltrials.gov; Unique identifier: NCT04096248
Electronic-Screening, Brief Intervention and Referral to Treatment (e-SBIRT) for Addictive Disorders: Systematic Review and Meta-Analysis
Authors: Jones Matthew , Seel Christopher J. , Dymond Simon
Published: May 2024

Background:

Addictive disorders are significant global public health burdens. Treatment uptake with these disorders is low and outcomes can be mixed. Electronic screening, brief intervention, and referral to treatment (e-SBIRT) programs have potential to improve uptake and treatment outcomes. To date, however, no prior review of the literature has been conducted to gauge the effectiveness of e-SBIRT for addictive disorders.

Methods:

We conducted a systematic review and meta-analysis of the literature concerning e-SBIRT for addictive disorders by surveying the MEDLINE, PubMed, Web of Science, Scopus, Embase, and PsycInfo databases on January 17, 2023.

Results:

Ten articles were included at analysis reporting evaluation of e-SBIRT interventions for substance use disorders including alcohol use in a variety of settings. No articles were identified regarding treatment for behavioral addictions such as disordered/harmful gambling. Meta-analysis found e-SBIRT to be effective at reducing drinking frequency in the short term only. e-SBIRT was not found to be advantageous over control conditions for abstinence or other treatment outcomes. We identified and described common components of e-SBIRT programs and assessed the quality of available evidence, which was generally poor.

Conclusion:

The present findings suggest that research regarding e-SBIRT is concentrated exclusively on higher-risk substance use. There is a lack of consensus regarding the effectiveness of e-SBIRT for addictive disorders. Although common features exist, e-SBIRT designs are variable, which complicates identification of the most effective components. Overall, the quality of outcome evidence is low, and furthermore, high-quality experimental treatment evaluation research is needed.
Using historical data to access the surface subsidence in the vegetable belt of the Three Lakes Region, Switzerland
Authors: Roeoesli Claudia , Egli Markus
Published: May 2024

Abstrac﻿t

The ‘Grosses Moos’ in the Three Lakes Region (Berner Seeland) was formed by the Wallis glacier resulting in a peat bog-dominated landscape. During the last two centuries this area was drained by a complex channel system to enable highly fertile agricultural activity. As such, the region is the vegetable belt of Switzerland. However, as the peat has degraded due to overexploitation, the situation for agriculture production has become critical. Consequently, measures are needed to prevent soil degradation and water accumulation. The extent of surface changes for the last ~ 100 years is, however, not precisely known and is assumed to have varied spatially. To understand the historical evolution of this area, we used a unique map from 1920 to compare the surface height with the newest digital terrain models (DTM) in order to estimate surface subsidence, and thus soil degradation, for the last 100 years. More than 44,000 single measurement points drawn on the historical map were digitized to derive the DTM that served as a basis for further analysis. The in-depth investigation of the observation methods and the accuracy assessment allows us to conclude that differences in the DTMs of up to 2.4 m (i.e., averaged rate of 2.4 cm yr−1) can be attributed to large-scale soil subsidence and that degradation was heterogeneously distributed over the investigated area. The data provide the basis for further soil restoration efforts in the area.
Ferroptosis is a protective factor for the prognosis of cancer patients: a systematic review and meta-analysis
Authors: Li Shen , Tao Kai , Yun Hong , Yang Jiaqing , Meng Yuanling , Zhang Fan , Ma Xuelei
Published: May 2024

Background

Cancer is a leading global cause of death. Conventional cancer treatments like surgery, radiation, and chemotherapy have associated side effects. Ferroptosis, a nonapoptotic and iron-dependent cell death, has been identified and differs from other cell death types. Research has shown that ferroptosis can promote and inhibit tumor growth, which may have prognostic value. Given the unclear role of ferroptosis in cancer biology, this meta-analysis aims to investigate its impact on cancer prognosis.

Methods

This systematic review and meta-analysis conducted searches on PubMed, Embase, and the Cochrane Library databases. Eight retrospective studies were included to compare the impact of ferroptosis inhibition and promotion on cancer patient prognosis. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Studies lacking clear descriptions of hazard ratios (HR) and 95% confidence intervals for OS and PFS were excluded. Random-effects meta-analysis and meta-regression were performed on the included study data to assess prognosis differences between the experimental and control groups. Meta-analysis results included HR and 95% confidence intervals.

This study has been registered with PROSPERO, CRD 42023463720 on September 27, 2023.

Results

A total of 2,446 articles were screened, resulting in the inclusion of 5 articles with 938 eligible subjects. Eight studies were included in the meta-analysis after bias exclusion. The meta-analysis, after bias exclusion, demonstrated that promoting ferroptosis could increase cancer patients’ overall survival (HR 0.31, 95% CI 0.21–0.44) and progression-free survival (HR 0.26, 95% CI 0.16–0.44) compared to ferroptosis inhibition. The results showed moderate heterogeneity, suggesting that biological activities promoting cancer cell ferroptosis are beneficial for cancer patient’s prognosis.

Conclusions

This systematic review and meta-analysis demonstrated that the promotion of ferroptosis yields substantial benefits for cancer prognosis. These findings underscore the untapped potential of ferroptosis as an innovative anti-tumor therapeutic strategy, capable of addressing challenges related to drug resistance, limited therapeutic efficacy, and unfavorable prognosis in cancer treatment.

Registration

CRD42023463720.
Discontinuation of HIV oral pre-exposure prophylaxis: findings from programmatic surveillance within two general population HIV programs in Nigeria
Authors: Anyasi Helen , Idemudia Augustine , Badru Titilope , Onyegbule Stanley , Isang Etiemana , Sanwo Olusola , Pandey Satish Raj , Chiegil Robert , Bateganya Moses , Schwartz Katie , Njuguna Njambi , Persaud Navindra , Plotkin Marya , Iyortim Isa , Khamofu Hadiza
Published: May 2024

Background

As oral PrEP scales up in Nigeria, information about uptake, use pattern and client preference in a real-world, implementation setting is invaluable to guide refining service provision and incorporation of oral PrEP and other prevention measures into routine health services. To add to this body of knowledge, our study examines factors associated with discontinuation of PrEP among HIV negative individuals across two large scale programs in Nigeria.

Methods

Using program implementation data from two large-scale HIV projects in Akwa Ibom and Cross River states in Nigeria between January 2020 and July 2021, we used logistic regression to explore factors associated with early discontinuation (i.e., stopping PrEP within one month of starting) among HIV-negative individuals who initiated PrEP in the programs.

Results

Of a total of 26,325 clients; 22,034 (84%) discontinued PrEP within the first month. The odds of PrEP discontinuation were higher among clients who enrolled in community-based distribution sites (aOR 2.72; 95% C.I: 2.50–2.96) compared to those who enrolled in program-supported facilities and never married (aOR 1.76; 95% C.I: 1.61–1.92) compared to married clients. Clients who initiated PrEP because of high-risk sexual behaviour (aOR 1.15, 95% C.I 1.03–1.30) or inconsistent use or non-use of condoms (aOR 1.96, 95% C.I 1.60–2.41) had greater odds of discontinuing PrEPthan those who initiated PrEP because they were in a serodifferent relationship.

Conclusion

The behavioural and demographic factors associated with early discontinuation of PrEP suggest that risk stratification of pre-initiation and follow up counselling may be helpful in raising continuation rates. On the service delivery side, strategies to strengthen follow-up services provided by community-based distribution sites need to be introduced. Overall, the low continuation rate calls for a review of programmatic approaches in provision of PrEP services in Nigeria.
Association of longitudinal trajectories of fasting plasma glucose with all-cause and cardiovascular mortality among a Chinese older population: a retrospective cohort study
Authors: Chen Xuejiao , Ding Jiacheng , Shi Zhan , Bai Kaizhi , Shi Songhe , Tian Qingfeng
Published: May 2024

The association between fasting plasma glucose (FPG), an important indicator of overall glycemic status, and the risk of cardiovascular mortality has been well investigated. The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. This study aimed to identify long-term FPG trajectories and investigate the association between trajectory groups and cardiovascular and all-cause mortality. A latent class growth mixture modeling (LCGMM) was used to identify FPG trajectories. Cox proportional hazard models were used to estimate associations between FPG trajectories and the risk of all-cause and cardiovascular mortality. A U-shaped relationship between FPG and all-cause and cardiovascular mortality was observed in the restricted cubic spline regression models. Two FPG longitudinal trajectories of low-level (mean FPG = 5.12mmol/L) and high-level (mean FPG = 6.74mmol/L) were identified by LCGMM. After being adjusted for potential confounders, compared with the low-level category, the hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.23(1.16–1.30) and 1.25(1.16–1.35), respectively, for the high-level group. Long-term FPG trajectories are significantly associated with and potentially impact the risk of all-cause and cardiovascular mortality.
From Slow Shifts to Fast Flips: Unraveling problem-based learning group function dynamics
Authors: Mellon Matthew , Dunn Nicholas , Azim Arden , Chan Teresa M. , Sibbald Matthew
Published: May 2024

Purpose

Problem-Based Learning (PBL) relies on self-directed learning in small groups in the presence of a tutor. While the effectiveness of PBL is often attributed to the dynamics of group function, change in group function over time and factors influencing group function development are less understood. This study aims to explore the development of PBL group function over time to better understand the factors that give rise to high-functioning groups.

Method

We examined time-function graphs of group function and conducted semi-structured focus group discussions in 2023 with medical students enrolled in a PBL curriculum. Students reflected on their experiences in four different PBL groups, creating time-function graphs to characterize development of group function over 8–12-week periods. We analyzed graphs and transcripts in a staged approach using qualitative description and direct content analysis, sensitized by two frameworks: Tuckman’s Stages of Group Development and the Dimensions of PBL Group Function.

Results

Three archetypes of PBL group function development were identified: Slow Shifters, Fast Flippers, and Coasters. (1) Slow Shifters were characterized by a complex and extended pattern of growth consistent with Tuckman’s model, typically occurring amongst inexperienced groups, or groups faced with a novel task. (2) Fast Flippers were characterized by abrupt state changes in group function arising from internal or external disruptions. (3) Coasters were characterized by plateaus, where maintenance of group function was a frequently cited challenge. Abrupt changes and plateaus occurred more among mature groups and groups with significant PBL experience.

Conclusions

PBL group function varies over time in 3 different patterns. Classic Tuckman’s stages are apparent among inexperienced groups, or groups facing novel tasks, whereas experienced groups often face abrupt change or plateaus. PBL educators and students should consider the need for novelty and disruption in more experienced groups to incite growth.
Metabolomics reveals metabolites associated with hair follicle cycle in cashmere goats
Authors: Ma Shengchao , Cao Wenzhi , Ma Xiaolin , Ye Xiaofang , Qin Chongkai , Li Bin , Liu Wenna , Lu Qingwei , Wu Cuiling , Fu Xuefeng
Published: May 2024

Background

The hair follicle is a skin accessory organ that regulates hair development, and its activity varies on a regular basis. However, the significance of metabolites in the hair follicle cycle has long been unknown.

Results

Targeted metabolomics was used in this investigation to reveal the expression patterns of 1903 metabolites in cashmere goat skin during anagen to telogen. A statistical analysis was used to investigate the potential associations between metabolites and the hair follicle cycle. The findings revealed clear changes in the expression patterns of metabolites at various phases and in various feeding models. The majority of metabolites (primarily amino acids, nucleotides, their metabolites, and lipids) showed downregulated expression from anagen (An) to telogen (Tn), which was associated with gene expression, protein synthesis and transport, and cell structure, which reflected, to some extent, that the cells associated with hair follicle development are active in An and apoptotic in An–Tn. It is worth mentioning that the expression of vitamin D3 and 3,3’,5-triiodo-L-thyronine decreased and then increased, which may be related to the shorter and longer duration of outdoor light, which may stimulate the hair follicle to transition from An to catagen (Cn). In the comparison of different hair follicle development stages (An, Cn, and Tn) or feeding modes (grazing and barn feeding), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that common differentially expressed metabolites (DEMs) (2’-deoxyadenosine, L-valine, 2’-deoxyuridine, riboflavin, cytidine, deoxyguanosine, L-tryptophan, and guanosine-5’-monophosphate) were enriched in ABC transporters. This finding suggested that this pathway may be involved in the hair follicle cycle. Among these DEMs, riboflavin is absorbed from food, and the expression of riboflavin and sugars (D-glucose and glycogen) in skin tissue under grazing was greater and lower than that during barn feeding, respectively, suggesting that eating patterns may also alter the hair follicle cycle.

Conclusions

The expression patterns of metabolites such as sugars, lipids, amino acids, and nucleotides in skin tissue affect hair follicle growth, in which 2’-deoxyadenosine, L-valine, 2’-deoxyuridine, riboflavin, cytidine, deoxyguanosine, L-tryptophan, and guanosine-5’-monophosphate may regulate the hair follicle cycle by participating in ABC transporters. Feeding practices may regulate hair follicle cycles by influencing the amount of hormones and vitamins expressed in the skin of cashmere goats.
A study on vertebral refracture and scoliosis after percutaneous kyphoplasty in patients with osteoporotic vertebral compression fractures
Authors: Qi Zhichao , Zhao Shengli , Li Haonan , Wen Zhenxing , Chen Bailing
Published: May 2024

Purpose

To analyze the association between scoliosis and vertebral refracture after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures (OVCFs).

Methods

A retrospective study was conducted on 269 patients meeting the criteria from January 2014 to October 2022. All patients underwent PKP with complete data and were followed-up for > 12 months. First, it was verified that scoliosis was a risk factor in 269 patients. Second, patients with scoliosis were grouped based on the Cobb angle to evaluate the impact of the post-operative angle. The cox proportional hazards regression analysis and survival analysis were used to calculate the hazard ratio and recurrence time.

Results

A total of 56 patients had scoliosis, 18 of whom experienced refractures after PKP. The risk factors for vertebral refractures included a T-score < − 3.0 and presence of scoliosis (both p < 0.001). The results indicated that the vertebral fractured arc (T10 − L4) was highly influential in scoliosis and vertebral fractures. When scoliotic and initially fractured vertebrae were situated within T10 − L4, the risk factors for vertebral refracture included a postoperative Cobb angle of ≥ 20° (p = 0.002) and an increased angle (p = 0.001). The mean recurrence times were 17.2 (10.7 − 23.7) months and 17.6 (7.9 − 27.3) months, respectively.

Conclusion

Osteoporosis combined with scoliosis significantly increases the risk of vertebral refractures after PKP in patients with OVCFs. A postoperative Cobb angle of ≥ 20° and an increased angle are significant risk factors for vertebral refractures when scoliotic and initially fractured vertebrae are situated within T10 − L4.
Genetic markers associated with the widespread insecticide resistance in malaria vector Anopheles funestus populations across Tanzania
Authors: Odero Joel O. , Nambunga Ismail H. , Masalu John P. , Mkandawile Gustav , Bwanary Hamis , Hape Emmanuel E. , Njalambaha Rukiyah M. , Tungu Patrick , Ngowo Halfan S. , Kaindoa Emmanuel W. , Mapua Salum A. , Kahamba Najat F. , Nelli Luca , Wondji Charles , Koekemoer Lizette L. , Weetman David , Ferguson Heather M. , Baldini Francesco , Okumu Fredros O.
Published: May 2024

Background

Anopheles funestus is a leading vector of malaria in most parts of East and Southern Africa, yet its ecology and responses to vector control remain poorly understood compared with other vectors such as Anopheles gambiae and Anopheles arabiensis. This study presents the first large-scale survey of the genetic and phenotypic expression of insecticide resistance in An. funestus populations in Tanzania.

Methods

We performed insecticide susceptibility bioassays on An. funestus mosquitoes in nine regions with moderate-to-high malaria prevalence in Tanzania, followed by genotyping for resistance-associated mutations (CYP6P9a, CYP6P9b, L119F-GSTe2) and structural variants (SV4.3 kb, SV6.5 kb). Generalized linear models were used to assess relationships between genetic markers and phenotypic resistance. An interactive R Shiny tool was created to visualize the data and support evidence-based interventions.

Results

Pyrethroid resistance was universal but reversible by piperonyl-butoxide (PBO). However, carbamate resistance was observed in only five of the nine districts, and dichloro-diphenyl-trichloroethane (DDT) resistance was found only in the Kilombero valley, south-eastern Tanzania. Conversely, there was universal susceptibility to the organophosphate pirimiphos-methyl in all sites. Genetic markers of resistance had distinct geographical patterns, with CYP6P9a-R and CYP6P9b-R alleles, and the SV6.5 kb structural variant absent or undetectable in the north-west but prevalent in all other sites, while SV4.3 kb was prevalent in the north-western and western regions but absent elsewhere. Emergent L119F-GSTe2, associated with deltamethrin resistance, was detected in heterozygous form in districts bordering Mozambique, Malawi and the Democratic Republic of Congo. The resistance landscape was most complex in western Tanzania, in Tanganyika district, where all five genetic markers were detected. There was a notable south-to-north spread of resistance genes, especially CYP6P9a-R, though this appears to be interrupted, possibly by the Rift Valley.

Conclusions

This study underscores the need to expand resistance monitoring to include An. funestus alongside other vector species, and to screen for both the genetic and phenotypic signatures of resistance. The findings can be visualized online via an interactive user interface and could inform data-driven decision-making for resistance management and vector control. Since this was the first large-scale survey of resistance in Tanzania’s An. funestus, we recommend regular updates with greater geographical and temporal coverage.

Graphical Abstract
Amino acids production using pineapple plant stem by optimised one-step fermentation
Authors: Chu Pei-Hsia , Jenol Mohd Azwan , Phang Lai-Yee , Ibrahim Mohamad Faizal , Purkan Purkan , Hadi Sofijan , Abd-Aziz Suraini
Published: May 2024

Background

The surge in global pineapple production has led to an excess of waste, demanding a sustainable approach for bioconversion. Despite its substantial volume, pineapple plant stems remain largely neglected, often discarded as on-farm waste. These stems, composed of intricate structures, necessitate a multi-step process for effective bioconversion. A promising alternative involves a single-step approach using microorganisms to combine hydrolysis and fermentation processes, yielding significant amino acid production from pineapple plant stems. This is aligned with Sustainable Development Goals 13 in reducing carbon dioxide and greenhouse gas emissions from traditional waste disposal methods.

Results

The utilisation of Bacillus subtilis ATCC 6051 for amino acid production demonstrated success, yielding 1.28 mg/mL of total free amino acids with a remarkable 67.13 mg/g yield. This represents a 13% increase in concentration and a 12% boost in yield compared to commercial starch. The study underscores the pivotal role of medium composition, highlighting the significance of pineapple plant stems as a substrate and other key components to enhance amino acid production.

Conclusion

Notably, the study achieved a substantial improvement in total amino acids production, reaching 9.57 mg/mL with a yield of 423.97 mg/g—an impressive 6.32-fold increment. This emphasises the enhanced potential of pineapple plant stems as a valuable resource for amino acid production, shedding light on the importance of optimising medium composition for maximum yield.

Graphical Abstract
Case volume and specialization in critically ill emergency patients: a nationwide cohort study in Japanese ICUs
Authors: Fujinaga Jun , Otake Takanao , Umeda Takehide , Fukuoka Toshio
Published: May 2024

Background

Previous studies have explored the association between the number of cases and patient outcomes for critical illnesses such as sepsis and trauma, as well as various surgeries, with the expectation that a higher number of cases would have a more favorable effect on patient outcomes. The aim of this study was to elucidate the association among intensive care unit (ICU) case volume, specialization, and patient outcomes in critically ill emergency patients and to determine how ICU case volumes and specializations impact the outcomes of these patients in Japanese ICUs.

Methods

Utilizing data from the Japanese Intensive Care PAtient Database (JIPAD) from April 2015 to March 2021, this retrospective cohort study was conducted in 80 ICUs across Japan and included 72,214 emergency patients aged ≥ 16 years. The primary outcome measure was in-hospital mortality, and the secondary outcomes encompassed ICU mortality, 28-day mortality, ventilator-free days, and the lengths of ICU and hospital stays. Bayesian hierarchical generalized linear mixed models were used to adjust for patient- and ICU-level variables.

Results

This study revealed a significant association between a higher ICU case volume and decreased in-hospital mortality. In particular, ICUs with a higher percentage (> 75%) of emergency patients showed more pronounced effects, with the odds ratios for in-hospital mortality in the higher case volume quartiles (Q2, Q3, and Q4) being 0.92 (95% credible interval [CI]: 0.88–0.96), 0.70 (95% CI: 0.67–0.73), and 0.78 (95% CI: 0.73–0.83), respectively, compared with the lowest quartile (Q1). Similar trends were observed for various secondary outcomes.

Conclusions

Higher ICU case volumes were significantly associated with lower in-hospital mortality rates in Japanese ICUs predominantly treating critically ill emergency patients. These findings emphasize the importance of ICU specialization and highlight the potential benefits of centralized care for critically ill emergency patients. These findings are potential insights for improving health care policy in Japan and may be valuable in emergency care settings in other countries with similar healthcare systems, after careful consideration of contextual differences.