bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the impact of distance and disadvantage on lung cancer care and outcomes: a study protocol
Authors: McInnerney Daisy , Quaife Samantha L. , Cooke Samuel , Mitchinson Lucy , Pogson Zara , Ricketts William , Januszewski Adam , Lerner Anna , Skinner Dawn , Civello Sarah , Kane Ros , Harding-Bell Ava , Calman Lynn , Selby Peter , Peake Michael D. , Nelson David
Published: August 2024

Background

Lung cancer is the third most common cancer in the UK and the leading cause of cancer mortality globally. NHS England guidance for optimum lung cancer care recommends management and treatment by a specialist team, with experts concentrated in one place, providing access to specialised diagnostic and treatment facilities. However, the complex and rapidly evolving diagnostic and treatment pathways for lung cancer, together with workforce limitations, make achieving this challenging. This place-based, behavioural science-informed qualitative study aims to explore how person-related characteristics interact with a person’s location relative to specialist services to impact their engagement with the optimal lung pathway, and to compare and contrast experiences in rural, coastal, and urban communities. This study also aims to generate translatable evidence to inform the evidence-based design of a patient engagement intervention to improve lung cancer patients’ and informal carers’ participation in and experience of the lung cancer care pathway.

Methods

A qualitative cross-sectional interview study with people diagnosed with lung cancer < 6 months before recruitment (in receipt of surgery, radical radiotherapy, or living with advanced disease) and their informal carers. Participants will be recruited purposively from Barts Health NHS Trust and United Lincolnshire Hospitals NHS Trusts to ensure a diverse sample across urban and rural settings. Semi-structured interviews will explore factors affecting individuals’ capability, opportunity, and motivation to engage with their recommended diagnostic and treatment pathway. A framework approach, informed by the COM-B model, will be used to thematically analyse facilitators and barriers to patient engagement.

Discussion

The study aligns with the current policy priority to ensure that people with cancer, no matter where they live, can access the best quality treatments and care. The evidence generated will be used to ensure that lung cancer services are developed to meet the needs of rural, coastal, and urban communities. The findings will inform the development of an intervention to support patient engagement with their recommended lung cancer pathway.

Protocol registration

The study received NHS Research Ethics Committee (Ref: 23/SC/0255) and NHS Health Research Authority (IRAS ID 328531) approval on 04/08/2023. The study was prospectively registered on Open Science Framework (16/10/2023;https://osf.io/njq48).
Maintenance intravenous fluid therapy in infants with sepsis and hyponatremia: a clinical trial
Authors: Milani Hani , Tajalli Saleheh , Behrouzi Kamran , Homan Nakisa , Zamaniashtiani Fateme , Vafaee Ali , Vahedi Zahra , Khalesi Nasrin
Published: August 2024

Background

This study aimed to compare the effect of two methods of maintenance intravenous fluid therapy on hyponatremia in hospitalized infants with sepsis.

Methods

In a double-blinded randomized clinical trial, 60 term infants with sepsis were enrolled. Blood samples were taken to determine sodium, potassium, Creatinine, and BUN levels before the initiation of treatment. Urine samples were taken to assess specific gravity and urinary output. Infants in the intervention group received half saline in 10% dextrose and infants in the control group were assigned to receive the conventional solution as maintenance. The above indicators were re-evaluated 24 and 48 h after the initiation of treatment. Two groups were compared concerning the incidence of hyponatremia, and other criteria such as urinary output and urinary specific gravity, blood urea nitrogen (BUN), and creatinine levels.

Results

Hyponatremia was more common in the control group. Sodium levels were significantly higher in half saline recipients 24 h (137.83 ± 2.86 vs. 134.37 ± 1.91 mmol/L), and 48 h (138.10 ± 2.41 vs. 133.66 ± 1.98 mmol/L) after treatment (P < 0.001). Although BUN in the intervention group was significantly higher in comparison to the control group, the difference in urinary output, urine specific gravity, potassium, and Creatinine levels were not significant in the two groups.

Conclusions

The use of a half-saline solution as maintenance fluid reduces the risk of hyponatremia after 48 h when compared to 0.18%NaCl.

Trial registration

This has been registered at Iranian Registry of Clinical Trials (Retrospectively registered, Registration date: 2017-10-12, identifier: IRCT2017053034223N1, https://irct.behdasht.gov.ir/trial/26204).
Evaluation of probiotics’ efficiency on cariogenic bacteria: randomized controlled clinical study
Authors: Sakaryalı Uyar Didem , Üsküdar Güçlü Aylin , Çelik Ekin , Memiş Özgül Betül , Altay Koçak Aylin , Başustaoğlu Ahmet Celal
Published: August 2024

Background

Probiotics are live beneficial bacteria to human health and their efficiency on oral health is still being investigated. The purpose of this study was to evaluate the level of Streptococcus mutans and Lactobacillus species with and without the use of probiotics for six-months after the treatment of all dental caries under general anesthesia.

Methods

Fifty-eight pediatric patients without any systemic diseases, whose dental treatments were completed under general anesthesia (GA), were included in the study. The patients were recruited in two-groups; Group A: Patients started using probiotics after GA and Group B: Patients did not use probiotics after GA. Saliva samples were taken from all patients on the day before GA (T0), at one-month (T1), three-month (T2) and six-month (T3) follow-up after GA. The counts of cariogenic bacteria were determined by the analysis of saliva samples using real-time polymerase chain reaction. Statistical significance level was accepted as p < 0.05.

Results

There was statistically significant difference between Group A and B for T0, T1, T2 and T3 regarding S. mutans (p = 0.001, p = 0.04, p = 0.04, p = 0.03; p < 0.05). However, there was no statistically significant difference between groups regarding Lactobacillus species (p ≥ 0.05).

Conclusions

Probiotic use and treatment of all caries significantly reduced the level of S. mutans but not Lactobacillus species. Furthermore, S. mutans decreased after cessation of probiotics, but it was not statistically significant.

Trial registration

Study was registered as “Effects of Probiotics on Streptococcus mutans and Lactobacillus species” with the registration number of NCT05859646 (16/05/2023) at https://www.clinicaltrials.gov Protocol Registration and Results System.
The CAREPAL-8: a short screening tool for multidimensional family caregiver burden in palliative care
Authors: Ullrich Anneke , Bergelt Corinna , Marx Gabriella , Daubmann Anne , Benze Gesine , Heine Julia , Dickel Lisa-Marie , Wowretzko Feline , Zhang Youyou , Bokemeyer Carsten , Nauck Friedemann , Oechsle Karin
Published: August 2024

Background

Family caregivers of terminally ill and dying people do not only experience varying levels but also different dimensions of caregiver-related strain and burden. The aim of the study was to develop a short multidimensional screening tool for the detection of burden in family caregivers in palliative care.

Methods

Family caregivers of cancer patients newly admitted to specialist inpatient palliative care (N = 232) completed questionnaires on psychological burden, quality of life, social support and need fulfillment. A latent class mixture model was used to identify discrete classes of family caregivers related to their multidimensional caregiver burden. Multinomial logistic regression analyses were performed to identify the most predictive items from a set of established questionnaires.

Results

Four latent classes of family caregivers were identified: Currently stable caregivers (37%), Caregivers with unmet needs (20%), Psychologically burdened caregivers (30%), and High-risk caregivers (13%). Each of these classes describes a different risk profile of multidimensional family caregiver burden, although family caregivers exhibit high levels of distress across all classes. From a set of 48 items, we identified eight items that predicted the class membership best. These items represent the items of the novel multidimensional screening tool: The 8-item Screening Tool for Family Caregiver Burden in Palliative Care (CAREPAL-8). Except for social support, the items maintained fidelity to the conceptualization of multidimensional caregiver burden used in this study. A preliminary classification system was developed, which has yet to be validated.

Conclusions

This study represents the first step in the establishment of a practical, self-administered screening tool that might help healthcare providers to tailor caregiver care according to their burden in daily practice. Brevity of the 8-item tool might facilitate its use in routine clinical care.
A randomized controlled trial of acupuncture and receptive music therapy for sleep disorders in the elderly—ELAMUS: study protocol
Authors: Klocke C. , Rhein K. , Cramer H. , Kröger B. , Wetzel A-J. , Vagedes J. , Mauch H. , Beißner F. , Joos S. , Valentini J.
Published: August 2024

Background

Globally, the demographic shift towards an aging population leads to significant challenges in healthcare systems, specifically due to an increasing incidence of multimorbidity resulting in polypharmacy among the elderly. Simultaneously, sleep disorders are a common complaint for elderly people. A treatment with pharmacological therapies often leads to side effects causing a high potential for dependency. Within this context, there is a high need to explore non-pharmacological therapeutic approaches. The purpose of this study is to evaluate the effectiveness of acupuncture and music therapy, both individually and combined as a multimodal therapy, in the treatment of sleep disorders in individuals aged 70 years and older.

Methods

We conduct a confirmatory randomized controlled trial using a two-factorial study design. A total of n = 100 elderly people receive evidence-based standard care information for age-related sleep disorders. Beyond that, patients are randomly assigned into four groups of n = 25 each to receive acupuncture, receptive music therapy with a monochord, multimodal therapy with both acupuncture and music therapy, or no further therapy. The study’s primary outcome measurement is the improvement in sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) (global score), at the end of intervention. Additionally, depression scores (Geriatric Depression Scale), health-related quality of life (Short-Form-Health Survey-12), neurovegetative activity measured via heart rate variability, and safety data are collected as secondary outcomes. Using a mixed-methods approach, a qualitative process evaluation will be conducted to complement the quantitative data.

Discussion

The study is ongoing and the last patient in is expected to be enrolled in April 2024. The results can provide valuable insights into the effectiveness of non-pharmacological interventions for sleep disorders among the elderly, contributing to a more personalized and holistic approach in geriatric healthcare.

Trial registration

German Clinical Trials Register (DRKS00031886).
IGF-I and GH Genes polymorphism and their association with milk yields, composition and reproductive performance in Holstein–Friesian dairy cattle
Authors: Saleh Ahmed A. , Hassan Tarek G. M. , EL-Hedainy Dalia K. A. , El-Barbary Adel S. A. , Sharaby Mahmoud A. , Hafez Elsayed E. , Rashad Amr M. A.
Published: August 2024

Background

The insulin-like growth factor (IGF-I) and growth hormone (GH) genes have been identified as major regulators of milk yield and composition, and reproductive performance in cattle. Genetic variations/polymorphism in these genes have been found to influence milk production, yield and quality. This investigation aimed to explore the association between IGF-I and GH polymorphisms and milk yield and composition, and reproductive performance in a herd consisting of 1000 Holstein–Friesian (HF) dairy cattle from El-Alamia farm. The experimental animals were 76 ± 7.25 months in age, with an average live weight of 750 ± 50.49 kg, and raised under the same conditions of feeding and weather. The studied animals were divided into three categories; high producers (n = 280), medium producers (n = 318) and low producers (n = 402).

Results

The digestion of 249 bp for IGF-I-SnaBI using the Restriction-fragment-length-polymorphism (RFLP) technique yielded two alleles; T (0.59) and C (0.41) and three genotypes; TT (0.52), TC (0.39) and CC (0.09) and this agrees with the results of DNA/gene sequencing technique. The sequencing analysis of the IGF-I gene revealed polymorphism in position 472 (C > T). Nucleotide sequencing of the amplified fragment of the IGF-I gene of different genotypes was done and submitted to the NCBI GenBank with Accession no. MH156812.1 and MH156811.1. While the digestion of 432 bp for GH-AluI using the RFLP technique yielded two alleles; A (0.81) and G (0.19) and two genotypes; AA (0.77) and AG (0.23) and this agrees with the results of DNA/gene sequencing technique. The sequencing analysis of the GH gene revealed polymorphism in the position 1758 C > G and in turn led to changes in amino acid sequence as Alanine for (A) compared to Glycine for (G). Nucleotide sequencing of the amplified fragment of the GH gene was done and submitted to the NCBI GenBank with Accession no. MH156810.1. The results of this study demonstrate the effects of variants of the GH-IGF-I somatotrophic axis on milk production and composition traits in commercial HF cattle. The greatest values of milk yield and reproductive performance were observed on IGF-I-SnaBI-TC and GH-AluI-AG genotypes. While the greatest % fat and % protein values were observed on IGF-I-SnaBI-CC and GH-AluI-AA genotyped individuals.

Conclusion

The genetic variation of the studied genes can be utilized in selecting animals with superior milk yield, composition and reproductive performance in Holstein–Friesian Dairy Cattle under subtropical conditions.
Single-cell tumor heterogeneity landscape of hepatocellular carcinoma: unraveling the pro-metastatic subtype and its interaction loop with fibroblasts
Authors: Guo De-Zhen , Zhang Xin , Zhang Sen-Quan , Zhang Shi-Yu , Zhang Xiang-Yu , Yan Jia-Yan , Dong San-Yuan , Zhu Kai , Yang Xin-Rong , Fan Jia , Zhou Jian , Huang Ao
Published: August 2024

Background

Tumor heterogeneity presents a formidable challenge in understanding the mechanisms driving tumor progression and metastasis. The heterogeneity of hepatocellular carcinoma (HCC) in cellular level is not clear.

Methods

Integration analysis of single-cell RNA sequencing data and spatial transcriptomics data was performed. Multiple methods were applied to investigate the subtype of HCC tumor cells. The functional characteristics, translation factors, clinical implications and microenvironment associations of different subtypes of tumor cells were analyzed. The interaction of subtype and fibroblasts were analyzed.

Results

We established a heterogeneity landscape of HCC malignant cells by integrated 52 single-cell RNA sequencing data and 5 spatial transcriptomics data. We identified three subtypes in tumor cells, including ARG1+ metabolism subtype (Metab-subtype), TOP2A+ proliferation phenotype (Prol-phenotype), and S100A6+ pro-metastatic subtype (EMT-subtype). Enrichment analysis found that the three subtypes harbored different features, that is metabolism, proliferating, and epithelial-mesenchymal transition. Trajectory analysis revealed that both Metab-subtype and EMT-subtype originated from the Prol-phenotype. Translation factor analysis found that EMT-subtype showed exclusive activation of SMAD3 and TGF-β signaling pathway. HCC dominated by EMT-subtype cells harbored an unfavorable prognosis and a deserted microenvironment. We uncovered a positive loop between tumor cells and fibroblasts mediated by SPP1-CD44 and CCN2/TGF-β-TGFBR1 interaction pairs. Inhibiting CCN2 disrupted the loop, mitigated the transformation to EMT-subtype, and suppressed metastasis.

Conclusion

By establishing a heterogeneity landscape of malignant cells, we identified a three-subtype classification in HCC. Among them, S100A6+ tumor cells play a crucial role in metastasis. Targeting the feedback loop between tumor cells and fibroblasts is a promising anti-metastatic strategy.
Manipulating host secreted protein gene expression: an indirect approach by HPV11/16 E6/E7 to suppress PBMC cytokine secretion
Authors: Zhong Mei-zhen , Xu Mei-nian , Zheng Si-qi , Cheng Shu-qiong , Zeng Kang , Huang Xiao-wen
Published: August 2024

Human papillomavirus (HPV) 11/16 E6/E7 proteins have been recognized to be pivotal in viral pathogenesis. This study sought to uncover the potential mechanisms of how HPV11/16 E6/E7-transfected keratinocytes inhibit cytokine secretion in peripheral blood mononuclear cells (PBMC). Upon co-culturing HPV11/16 E6/E7-transfected keratinocytes with PBMC in a non-contact manner, we observed a marked decrease in various cytokines secreted by PBMC. To determine if this suppression was mediated by specific common secreted factors, we conducted transcriptomic sequencing on these transfected cells. This analysis identified 53 common differentially secreted genes in all four HPV-transfected cells. Bioinformatics analysis demonstrated these genes were predominantly involved in immune regulation. Results from quantitative PCR (qPCR) and an extensive literature review suggested the downregulation of 12 genes (ACE2, BMP3, BPIFB1, CLU, CST6, CTF1, HMGB2, MMP12, PDGFA, RNASE7, SULF2, TGM2), and upregulation of 7 genes (CCL17, CCL22, FBLN1, PLAU, S100A7, S100A8, S100A9), may be crucial in modulating tumor immunity and combating pathogenic infections, with genes S100A8 and S100A9, and IL-17 signaling pathway being particularly noteworthy. Thus, HPV11/16 E6/E7 proteins may inhibit cytokine secretion of immune cells by altering the expression of host-secreted genes. Further exploration of these genes may yield new insights into the complex dynamics of HPV infection.
Demographic characteristics, diagnostic challenges, treatment patterns, and caregiver burden of mitochondrial diseases: a retrospective cross-sectional study
Authors: Zhao Xutong , Yu Meng , Zhang Wei , Hou Yue , Yuan Yun , Wang Zhaoxia
Published: August 2024

Background

This study aimed to explore the demographic characteristics, diagnostic challenges, treatment patterns, and caregiver burden of mitochondrial diseases.

Methods

This retrospective cross-sectional study enrolled patients diagnosed with mitochondrial diseases from the Department of Neurology at Peking University First Hospital between January 2010 and December 2021. A questionnaire covering demographic characteristics, diagnostic dilemma, treatment, economic aspects, and caregiver stress was administered, and disability was assessed using the modified Rankin Scale (mRS).

Results

A total of 183 patients (mean age: 16 (IQR: 12–25), 49.72% males) were enrolled, including 124 pediatric patients and 59 adult patients. MELAS (106. 57.92%) and Leigh syndrome (37, 20.22%) were predominant among the mitochondrial disease subtypes. Among them, 132 (72.13%) patients were initially misdiagnosed with other diseases, 58 (31.69%) patients visited 2 hospitals before confirmed as mitochondrial disease, and 39 (21.31%) patients visited 3 hospitals before confirmed as mitochondrial disease. Metabolic modifiers were the most common type of drugs used, including several dietary supplements such as L-carnitine (117, 63.93%), Coenzyme Q10 (102, 55.74%), idebenone (82, 44.81%), and vitamins (99, 54.10%) for proper mitochondrial function. Mothers are the primary caregivers for both children (36.29%) and adults (38.98%). The mRS score ranged from 0 to 5, 92.35% of the patients had different degrees of disability due to mitochondrial disease. The average monthly treatment cost was 3000 RMB for children and 3100 RMB for adults.

Conclusions

This study provided valuable insights into the characteristics and challenges of mitochondrial diseases, which underscores the need for improved awareness, diagnostic efficiency, and comprehensive support for patients and caregivers.
Intraplantar aminoglutethimide, a P450scc inhibitor, reduced the induction of mechanical allodynia in a rat model of thrombus-induced ischemic pain
Authors: Kwon Soon-Gu , Choi Hoon-Seong , Yoon Seo-Yeon , Roh Dae-Hyun , Lee Jang-Hern
Published: August 2024

Neuroactive steroids (NASs) directly affect neuronal excitability. Despite their role in the nervous system is intimately linked to pain control, knowledge is currently limited. This study investigates the peripheral involvement of NASs in chronic ischemic pain by targeting the cytochrome P450 side-chain cleavage enzyme (P450scc). Using a rat model of hind limb thrombus-induced ischemic pain (TIIP), we observed an increase in P450scc expression in the ischemic hind paw skin. Inhibiting P450scc with intraplantar aminoglutethimide (AMG) administration from post-operative day 0 to 3 significantly reduced the development of mechanical allodynia. However, AMG administration from post-operative day 3 to 6 did not affect established mechanical allodynia. In addition, we explored the role of the peripheral sigma-1 receptor (Sig-1R) by co-administering PRE-084 (PRE), a Sig-1R agonist, with AMG. PRE reversed the analgesic effects of AMG during the induction phase. These findings indicate that inhibiting steroidogenesis with AMG alleviates peripheral ischemic pain during the induction phase via Sig-1Rs.
Efficacy of tranexamic acid versus placebo in reducing blood loss during burn excisional surgery: a multi-center, double-blind, parallel, randomized placebo-controlled clinical trial (TRANEX)
Authors: Gigengack R. K. , Slob J. , Vries A. Meij-de , Bosma E. , Loer S. A. , Koopman J. S. H. A. , van der Vlies C. H.
Published: August 2024

Background

Despite an increase in knowledge, blood loss during burn excisional surgery remains a major challenge and is an independent predictor of mortality. During burn surgery, limited measures are available to control the bleeding. Increased fibrinolysis could be one of the contributing factors of blood loss during burn excisional surgery. Tranexamic acid inhibits the fibrinolytic response, and a small body of evidence shows positive effects of tranexamic acid on the volume of blood loss.

Methods

The main objectives of this study are twofold, (1) to investigate whether tranexamic acid reduces blood loss and (2) to investigate the changes in coagulation after burn trauma and during burn excisional surgery. This study is a multicenter double-blind randomized clinical trial in patients scheduled for burn excisional surgery within the Dutch burn centers. All adult patients scheduled for burn surgery with an expected blood loss of ≥ 250 are eligible for inclusion in this study. The study is powered on a blood loss reduction of 25% in the intervention group. In total, 95 subjects will be included. The intervention group will receive 1500 mg tranexamic acid versus placebo in the other group. Primary endpoint is reduction of blood loss. Secondary endpoints include occurrence of fibrinolysis during surgery, graft take of the split skin graft, and differences in coagulation and blood clot formation.

Discussion

This protocol of a randomized controlled trial aims to investigate the efficacy of tranexamic acid in reducing blood loss during burn excisional surgery. Furthermore, this study aims to clarify the coagulation status after burn trauma and during the surgical process.

Trial registration

EudraCT: 2020-005405-10; ClinicalTrial.gov: NCT05507983 (retrospectively registered in August 2022, inclusion started in December 2021).
Anticoccidial activity of a botanical natural product based on eucalyptus, apigenin and eugenol against Eimeria tenella in broiler chickens
Authors: Geng Tiantian , Ruan Xiaodie , Xie Ying , Shen Bang , Fang Rui , Zhao Junlong , Zhou Yanqin
Published: August 2024

Background

Chicken coccidiosis is an intracellular parasitic disease that presents major challenges to the development of the commercial poultry industry. Perennial drug selective pressure has led to the multi-drug resistance of chicken coccidia, which makes the prevention and control of chicken coccidiosis extremely difficult. In recent years, natural plant products have attracted the attention of researchers due to their inherent advantages, such as the absence of veterinary drug residues. The development of these natural products provides a new direction for the prevention and treatment of chicken coccidiosis.

Methods

The anticoccidial effect of a natural plant product combination formulation (eucalyptus oil + apigenin + eugenol essential oil) was tested against Eimeria tenella in broilers. To search for the optimal concentration of the combination formulation, we screened 120 broilers in a chicken cage trial in which 100 broilers were infected with 5 × 104 sporulated Eimeria tenella oocysts; broilers receiving a decoquinate solution was set up as a chemical control. The optimal anticoccidial concentration was determined by calculating the anticoccidial index (ACI), and the suitable concentration was used as the recommended dose for a series of safety dose assessment tests, such as feed conversion ratio (FCR), hematological indices and serum biochemical indices, as well as liver and kidney sections, at onefold (low dose), threefold (medium dose) and sixfold (high dose) the recommended dose (RD).

Results

The results showed that this combination formulation of three plant natural products had a better anticoccidial effect than formulations containing two plant natural products or a single one, with an ACI of 169.3. The dose gradient anticoccidial test revealed that the high-dose formulation group had a better anticoccidial effect (ACI = 169.2) than the medium- and low-dose groups. The safety evaluation test showed that concentrations of the formulation at one-, three- and sixfold the RD were non-toxic to Arbor Acres broilers, indicating the high safety of the combination formulation.

Conclusions

The combination formulation showed not only a moderate anticoccidial effect but also had a high safety profile for broilers. The results of this study indicate a new alternative for the prevention and control of coccidiosis in broilers.

Graphical Abstract
Age-related differences in the loss and recovery of serial sarcomere number following disuse atrophy in rats
Authors: Hinks Avery , Power Geoffrey A.
Published: August 2024

Background

Older adults exhibit a slower recovery of muscle mass following disuse atrophy than young adults. At a smaller scale, muscle fibre cross-sectional area (i.e., sarcomeres in parallel) exhibits this same pattern. Less is known, however, about age-related differences in the recovery of muscle fibre length, driven by increases in serial sarcomere number (SSN), following disuse. The purpose of this study was to investigate age-related differences in SSN adaptations and muscle mechanical function during and following muscle immobilization. We hypothesized that older adult rats would experience a similar magnitude of SSN loss during immobilization, however, take longer to recover SSN than young following cast removal, which would limit the recovery of muscle mechanical function.

Methods

We casted the plantar flexors of young (8 months) and old (32 months) male rats in a shortened position for 2 weeks, and assessed recovery during 4 weeks of voluntary ambulation. Following sacrifice, legs were fixed in formalin for measurement of soleus SSN and physiological cross-sectional area (PCSA) with the un-casted soleus acting as a control. Ultrasonographic measurements of pennation angle (PA) and muscle thickness (MT) were conducted weekly. In-vivo active and passive torque-angle relationships were constructed pre-cast, post-cast, and following 4 weeks of recovery.

Results

From pre- to post-cast, young and older adult rats experienced similar decreases in SSN (–20%, P < 0.001), muscle wet weight (–25%, P < 0.001), MT (–30%), PA (–15%, P < 0.001), and maximum isometric torque (–40%, P < 0.001), but there was a greater increase in passive torque in older (+ 180%, P < 0.001) compared to young adult rats (+ 68%, P = 0.006). Following cast removal, young exhibited quicker recovery of SSN and MT than old, but SSN recovered sooner than PA and MT in both young and old. PCSA nearly recovered and active torque fully recovered in young adult rats, whereas in older adult rats these remained unrecovered at ∼ 75%.

Conclusions

This study showed that older adult rats retain a better ability to recover longitudinal compared to parallel muscle morphology following cast removal, making SSN a highly adaptable target for improving muscle function in elderly populations early on during rehabilitation.
Prion protein gene (PRNP) variation in German and Danish cervids
Authors: Ernst Sonja , Piestrzyńska-Kajtoch Agata , Gethmann Jörn , Natonek-Wiśniewska Małgorzata , Sadeghi Balal , Polak Miroslaw P. , Keller Markus , Gavier-Widén Dolores , Moazami-Goudarzi Katayoun , Houston Fiona , Groschup Martin H. , Fast Christine
Published: August 2024

The structure of cellular prion proteins encoded by the prion protein gene (PRNP) impacts susceptibility to transmissible spongiform encephalopathies, including chronic wasting disease (CWD) in deer. The recent emergence of CWD in Northern European reindeer (Rangifer tarandus), moose (Alces alces alces) and red deer (Cervus elaphus), in parallel with the outbreak in North America, gives reason to investigate PRNP variation in European deer, to implement risk assessments and adjust CWD management for deer populations under threat. We here report PRNP-sequence data from 911 samples of German red, roe (Capreolus capreolus), sika (Cervus nippon) and fallow deer (Dama dama) as well as additional data from 26 Danish red deer close to the German border and four zoo species not native to Germany. No PRNP sequence variation was observed in roe and fallow deer, as previously described for populations across Europe. In contrast, a broad PRNP variation was detected in red deer, with non-synonymous polymorphisms at codons 98, 226 and 247 as well as synonymous mutations at codons 21, 78, 136 and 185. Moreover, a novel 24 bp deletion within the octapeptide repeat was detected. In summary, 14 genotypes were seen in red deer with significant differences in their geographical distribution and frequencies, including geographical clustering of certain genotypes, suggesting “PRNP-linages” in this species. Based on data from North American CWD and the genotyping results of the European CWD cases, we would predict that large proportions of wild cervids in Europe might be susceptible to CWD once introduced to naive populations.
SARS-CoV-2 variants divergently infect and damage cardiomyocytes in vitro and in vivo
Authors: Mok Bobo Wing-Yee , Kwok Maxwell , Li Hung Sing , Ling Lowell , Lai Angel , Yan Bin , Law Cherie Tsz-Yiu , Yeung Chui Him , Zhang Anna Jinxia , Tam Rachel Chun-Yee , Kukic Anja , Cremin Conor J. , Zhang Yajie , Long Teng , Kang Zhisen , Luo Ruibang , Leung Kam Tong , Li Albert M. , Lui Grace , Tsui Stephen Kwok-Wing , Chan Jasper Fuk-Woo , To Kelvin Kai-Wang , Chan Paul K. S. , Yan Bryan P. , Chen Honglin , Poon Ellen Ngar-Yun
Published: August 2024

Background

COVID-19 can cause cardiac complications and the latter are associated with poor prognosis and increased mortality. SARS-CoV-2 variants differ in their infectivity and pathogenicity, but how they affect cardiomyocytes (CMs) is unclear.

Methods

The effects of SARS-CoV-2 variants were investigated using human induced pluripotent stem cell-derived (hiPSC-) CMs in vitro and Golden Syrian hamsters in vivo.

Results

Different variants exhibited distinct tropism, mechanism of viral entry and pathology in the heart. Omicron BA.2 most efficiently infected and injured CMs in vitro and in vivo,and induced expression changes consistent with increased cardiac dysfunction, compared to other variants tested. Bioinformatics and upstream regulator analyses identified transcription factors and network predicted to control the unique transcriptome of Omicron BA.2 infected CMs. Increased infectivity of Omicron BA.2 is attributed to its ability to infect via endocytosis, independently of TMPRSS2, which is absent in CMs.

Conclusions

In this study, we reveal previously unknown differences in how different SARS-CoV-2 variants affect CMs. Omicron BA.2, which is generally thought to cause mild disease, can damage CMs in vitro and in vivo. Our study highlights the need for further investigations to define the pathogenesis of cardiac complications arising from different SARS-CoV-2 variants.
Justice concerns in large-scale renewable energy projects: a case study echoing the importance of procedural justice in wind energy development in Kenya
Authors: Ndi Frankline A.
Published: August 2024

Background

Large-scale renewable energy projects are increasingly being rolled out across rural Kenya, with the government playing a frontline role in attracting energy investors through various state-led and state-centric policies and investment incentives such as feed-in-tariffs and power purchase agreements. While these policies are commendable, and are indeed attracting many private investors, existing studies document how social and environmental justice concerns are often overlooked—sometimes causing local contestations against energy projects. However, to date, there has been less attention given to cases where procedural justice elements (e.g., access to information, access to meaningful participation, access to justice, and respect for local culture) led to a successful land negotiation for energy development without outright conflict. Using a case study in Kenya, this article aims to bridge this gap by showing how a fair application of various elements of procedural justice in land consultation has facilitated the establishment of the Kipeto wind farm. This qualitative research is based on semi-structured interviews that took place from February to March 2023, with a follow-up visit in December the same year, supplemented with review of secondary data sources.

Results

The results indicate that for energy projects to be accommodated in and by communities, access to land must be properly negotiated, particularly with the actual landowners whose livelihoods are most likely to be implicated by the project. Second, local people’s perception of what they regard as a ‘just’ or ‘fair’ process of land consultation constitutes the basis for their acquiescence and compliance.

Conclusion

Ensuring a ‘just’ procedure in land consultation with the actual landowners is a key strategy to avoid conflicts. Land investors, governments, and policy-makers who interface and negotiate with communities must ensure the provision of procedural justice, particularly in contexts where local livelihood is tied to land and where land is individually owned. Although the findings suggest a positive case of wind energy development in Kenya, the project is barely 4 years old; things may change overtime if agreed conditions are not met as specified in the MoU. Therefore, additional follow-up research is needed to ascertain the extent to which both KEL and landowners live up to their promises.
Spatiotemporal changes and driving factors of ecosystem services between karst and non-karst World Heritage sites in Southwest China
Authors: Chen Yue , Rong Li , Xiong Kangning , Feng Mingjun , Cheng Cai
Published: August 2024

Understanding the spatiotemporal variation and drivers of ecosystem services is fundamental to optimal management and sustainable development of World Heritage (WH) sites. Although WH sites face multiple natural and anthropogenic threats, our understanding of their ecosystem services is still limited, especially for karst WH sites. In this study, we assessed habitat quality (HQ), carbon storage (CS), soil retention (SR), water conservation (WC), and the combined ecosystem service (CES) of karst and non-karst WH sites in Southwest China from 2000 to 2020 using the InVEST model. We also assessed trade-offs/synergies among ecosystem services using the spatial overlay method, and identified driving factors of variation in ecosystem services using geographical detector and structural equation models. The results showed that ecosystem services of the WH sites exhibited high spatiotemporal variation. In particular, there were higher values in the property zone than in the buffer zone, and an increasing trend in SR but a decreasing trend in HQ and CES over time. Compared to non-karst sites, karst WH sites had significantly lower values of HQ, CS, SR, and CES, but higher spatial heterogeneity in CS, WC, and CES. Weak trade-offs among ecosystem services dominated the WH sites, with the proportion of weak synergies increasing over time. Compared to non-karst sites, karst WH sites had a significantly lower proportion of strong synergies and a significantly higher proportion of weak synergies. The provision of ecosystem services was primarily influenced by natural factors (e.g., landscape division index and normalized difference vegetation index), followed by anthropogenic factors (e.g., distance from road and population density). Overall, these findings may have important implications for decision-making aimed at protecting the outstanding universal value, authenticity, and integrity of WH with different attributes.
Dosimetric implications of kidney anatomical volume changes in 177Lu-DOTATATE therapy
Authors: Khan Jehangir , Rydèn Tobias , Van Essen Martijn , Svensson Johanna , Grudzinski Joseph , Bernhardt Peter
Published: August 2024

Introduction

This study aims to evaluate the use of CT-based whole kidney parenchyma (WKP) segmentation in 177Lu-DOTATATE dosimetry. Specifically, it investigates whether WKP volumes change during treatment and evaluates the accuracy of applying a single delineated WKP volume for dosimetry. Furthermore, it aims to determine the cause of WKP volume changes—whether caused by radiation or amino acid infusion—by comparing them with spleen volume changes as a marker for radiation-induced alterations.

Methods

SPECT/CT images of 18 patients were acquired over the abdomen approximately 4 h (h) (D0), 24 h (D1), 48 h (D2) and 168 h (D7) post-administration of 177Lu-DOTATATE. CT guided WKP volumes were measured before (baseline) and during treatment. Kidney activity concentrations at each time point were derived from CT-segmented WKP overlaid on SPECT scans. The accuracy of using WKP segmentation from a single CT for all time points was assessed against the gold standard of segmenting each WKP individually. Time-integrated activity calculations were based on a tri-exponential curve fit of the kidney activity concentration over time. Kidney absorbed doses were estimated under the assumption of local energy deposition. Additionally, the impact of various partial volume correction methods on dosimetry was evaluated.

Results

Whole-kidney parenchyma (WKP) volumes, ranging from 31 to 243 mL, showed a gradual increase from baseline (mean ± SD = 130.6 ± 46.1 mL) at the initial time points D0 (138.5 ± 44.7 mL) and D1 (139.4 ± 41.6 mL), followed by a slight decrease at D2 (132.8 ± 44.5 mL) and a further decrease at D7 (129.2 ± 42.7 mL). The volume increase at D0 and D1 was statistically significant. Spleen volume did not change during treatment, suggesting that amino acid infusion rather than irradiation effects caused WKP volume changes. Bland-Altman analysis revealed WKP volume biases of 8.77% (D0 vs. BL), 10.77% (D1 vs. BL), 1.10% (D2 vs. BL), and 1.10% (D7 vs. BL), with corresponding uncertainties of 24.4%, 23.6%, 25.4%, and 25.4%, respectively. When WKP segmentation from a single CT is applied across all SPECTs, these WKP volume changes could overestimate the activity concentration and mean absorbed doses up to 4.3% and 2.5%, respectively. The absorbed dose uncertainties using a recovery coefficient (RC) of 0.85 for single-time-point WKP delineation increase the absorbed dose uncertainty by 4% compared to the use of patient-specific RCs and time specific segmentation of WKP volumes.

Conclusions

Kidney volume exhibited significant variation form D0 to D7, affecting the precision of dosimetry calculation, primarily due to errors in whole-kidney parenchyma (WKP) delineation. Notably, using WKP segmentation from a single CT scan applied to sequential SPECT images introduce further uncertainty and may lead to an overestimation of the absorbed dose. The fluctuations in kidney volume are most likely attributable to amino acid infusion.
Automatic reorientation to generate short-axis myocardial PET images
Authors: Yang Yuling , Wang Fanghu , Han Xu , Xu Hui , Zhang Yangmei , Xu Weiping , Wang Shuxia , Lu Lijun
Published: August 2024

Background

Accurately redirecting reconstructed Positron emission tomography (PET) images into short-axis (SA) images shows great significance for subsequent clinical diagnosis. We developed a system for automatic redirection and quantitative analysis of myocardial PET images.

Methods

A total of 128 patients were enrolled for 18 F-FDG PET/CT myocardial metabolic images (MMIs), including 3 image classifications: without defects, with defects, and excess uptake. The automatic reorientation system includes five modules: regional division, myocardial segmentation, ellipsoid fitting, image rotation and quantitative analysis. First, the left ventricular geometry-based canny edge detection (LVG-CED) was developed and compared with the other 5 common region segmentation algorithms, the optimized partitioning was determined based on partition success rate. Then, 9 myocardial segmentation methods and 4 ellipsoid fitting methods were combined to derive 36 cross combinations for diagnostic performance in terms of Pearson correlation coefficient (PCC), Kendall correlation coefficient (KCC), Spearman correlation coefficient (SCC), and determination coefficient. Finally, the deflection angles were computed by ellipsoid fitting and the SA images were derived by affine transformation. Furthermore, the polar maps were used for quantitative analysis of SA images, and the redirection effects of 3 different image classifications were analyzed using correlation coefficients.

Results

On the dataset, LVG-CED outperformed other methods in the regional division module with a 100% success rate. In 36 cross combinations, PSO-FCM and LLS-SVD performed the best in terms of correlation coefficient. The linear results indicate that our algorithm (LVG-CED, PSO-FCM, and LLS-SVD) has good consistency with the reference manual method. In quantitative analysis, the similarities between our method and the reference manual method were higher than 96% at 17 segments. Moreover, our method demonstrated excellent performance in all 3 image classifications.

Conclusion

Our algorithm system could realize accurate automatic reorientation and quantitative analysis of PET MMIs, which is also effective for images suffering from interference.
Retraction Note: Federated recognition mechanism based on enhanced temporal-spatial learning using mobile edge sensors for firefighters
Authors: Jamil Harun , Ali Khan Murad , Kim Do-Hyeun
Published: August 2024

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s42408-023-00203-5.
Application of image recognition-based tracker-less augmented reality navigation system in a series of sawbone trials
Authors: Chui Elvis Chun-Sing , Mak Kyle Ka-Kwan , Ng Randy Hin-Ting , Fung Ericsson Chun-Hai , Mak Harold Hei-Ka , Chan Mei-Shuen , Zhao Wei , Su Xiuyun , Zhang Jin , Xu Jianglong , Sang Hongxun , Pei Guoxian , Ong Michael Tim-Yun , Cheung Wing-Hoi , Law Sheung-Wai , Wong Ronald Man Yeung , Yung Patrick Shu-Hang
Published: August 2024

Background

This study introduced an Augmented Reality (AR) navigation system to address limitations in conventional high tibial osteotomy (HTO). The objective was to enhance precision and efficiency in HTO procedures, overcoming challenges such as inconsistent postoperative alignment and potential neurovascular damage.

Methods

The AR-MR (Mixed Reality) navigation system, comprising HoloLens, Unity Engine, and Vuforia software, was employed for pre-clinical trials using tibial sawbone models. CT images generated 3D anatomical models, projected via HoloLens, allowing surgeons to interact through intuitive hand gestures. The critical procedure of target tracking, essential for aligning virtual and real objects, was facilitated by Vuforia’s feature detection algorithm.

Results

In trials, the AR-MR system demonstrated significant reductions in both preoperative planning and intraoperative times compared to conventional navigation and metal 3D-printed surgical guides. The AR system, while exhibiting lower accuracy, exhibited efficiency, making it a promising option for HTO procedures. The preoperative planning time for the AR system was notably shorter (4 min) compared to conventional navigation (30.5 min) and metal guides (75.5 min). Intraoperative time for AR lasted 8.5 min, considerably faster than that of conventional navigation (31.5 min) and metal guides (10.5 min).

Conclusions

The AR navigation system presents a transformative approach to HTO, offering a trade-off between accuracy and efficiency. Ongoing improvements, such as the incorporation of two-stage registration and pointing devices, could further enhance precision. While the system may be less accurate, its efficiency renders it a potential breakthrough in orthopedic surgery, particularly for reducing unnecessary harm and streamlining surgical procedures.
Sixteen-year outcomes of patients undergoing minimally invasive direct coronary artery bypass surgery: a single-center experience
Authors: Akintoye Oluwanifemi , Divya Aabha , Farid Shakil , Nashef Samer , De Silva Ravi
Published: August 2024

Background

Minimally invasive direct coronary artery bypass (MIDCAB) grafting is a safe technique for revascularization of the left anterior descending artery. The objective of this study was to evaluate the long-term outcomes of patients who underwent MIDCAB surgery in our institution. This was a retrospective, observational outcome study of retrospectively collected data. Data was collected using community, electronic, and paper medical records as well as telephone follow-up conversations with patients who underwent MIDCAB between December 1996 and June 2021. The primary outcome measure was mortality. Secondary outcomes included revascularization, myocardial infarction, and wound infection. Survival analysis was performed using the Kaplan–Meier method.

Results

A total of 215 patients were identified in the study period undergoing MIDCAB at our center. The median age was 77 years, and the cohort consisted of 180 (83.3%) of male patients. The median follow-up period was 16 years (12.1–17.7). At follow-up, freedom from repeat left anterior descending revascularization and from other vessels, revascularization was 96.7% and 89.1% respectively. Survival rates were 99.5%, 81.0%, and 45.2% survival at 1 year, 10 years, and 25 years respectively. Univariate analysis showed age (p < 0.01, Hazard ratio 1.08 confidence interval 1.05–1.11) and left ventricular function (p < 0.01, hazard ratio 2.40, confidence interval 1.66–3.45) as factors associated with mortality.

Conclusions

Our single-center experience of MIDCAB demonstrated excellent long-term freedom from revascularization and other complications. Although limited by the retrospective nature, the study shows MIDCAB to be a safe procedure for definitive revascularization of the left anterior descending coronary artery.