bluuebunny/crossref_metadata_2025 huggingface dataset:
Stressors, emotions, and social support systems among respiratory nurses during the Omicron outbreak in China: a qualitative study
Authors: Yu Wenzhen , Zhang Ying , Xianyu Yunyan , Cheng Dan
Published: March 2024

Background

Respiratory nurses faced tremendous challenges when the Omicron variant spread rapidly in China from late 2022 to early 2023. An in-depth understanding of respiratory nurses’ experiences during challenging times can help to develop better management and support strategies. The present study was conducted to explore and describe the work experiences of nurses working in the Department of Pulmonary and Critical Care Medicine (PCCM) during the Omicron outbreak in China.

Methods

This study utilized a descriptive phenomenological method. Between January 9 and 22, 2023, semistructured and individual in-depth interviews were conducted with 11 respiratory nurses at a tertiary hospital in Wuhan, Hubei Province. A purposive sampling method was used to select the participants, and the sample size was determined based on data saturation. The data analysis was carried out using Colaizzi’s method.

Results

Three themes with ten subthemes emerged: (a) multiple stressors (intense workload due to high variability in COVID patients; worry about not having enough ability and energy to care for critically ill patients; fighting for anxious clients, colleagues, and selves); (b) mixed emotions (feelings of loss and responsibility; feelings of frustration and achievement; feelings of nervousness and security); and (c) a perceived social support system (team cohesion; family support; head nurse leadership; and the impact of social media).

Conclusion

Nursing managers should be attentive to frontline nurses’ needs and occupational stress during novel coronavirus disease 2019 (COVID-19) outbreaks. Management should strengthen psychological and social support systems, optimize nursing leadership styles, and proactively consider the application of artificial intelligence (AI) technologies and products in clinical care to improve the ability of nurses to effectively respond to future public health crises.
GPX8+ cancer-associated fibroblast, as a cancer-promoting factor in lung adenocarcinoma, is related to the immunosuppressive microenvironment
Authors: Bai Ying , Han Tao , Dong Yunjia , Liang Chao , Gao Lu , Liu Yafeng , Zhou Jiawei , Guo Jianqiang , Ge Deyong , Wu Jing , Hu Dong
Published: March 2024

Background

Cancer-associated fibroblasts (CAFs) play a crucial role in the tumor microenvironment of lung adenocarcinoma (LUAD) and are often associated with poorer clinical outcomes. This study aimed to screen for CAF-specific genes that could serve as promising therapeutic targets for LUAD.

Methods

We established a single-cell transcriptional profile of LUAD, focusing on genetic changes in fibroblasts. Next, we identified key genes associated with fibroblasts through weighted gene co-expression network analysis (WGCNA) and univariate Cox analysis. Then, we evaluated the relationship between glutathione peroxidase 8 (GPX8) and clinical features in multiple independent LUAD cohorts. Furthermore, we analyzed immune infiltration to shed light on the relationship between GPX8 immune microenvironment remodeling. For clinical treatment, we used the tumor immune dysfunction and exclusion (TIDE) algorithm to assess the immunotherapy prediction efficiency of GPX8. After that, we screened potential therapeutic drugs for LUAD by the connectivity map (cMAP). Finally, we conducted a cell trajectory analysis of GPX8+ CAFs to show their unique function.

Results

Fibroblasts were found to be enriched in tumor tissues. Then we identified GPX8 as a key gene associated with CAFs through comprehensive bioinformatics analysis. Further analysis across multiple LUAD cohorts demonstrated the relationship between GPX8 and poor prognosis. Additionally, we found that GPX8 played a role in inducing the formation of an immunosuppressive microenvironment. The TIDE method indicated that patients with low GPX8 expression were more likely to be responsive to immunotherapy. Using the cMAP, we identified beta-CCP as a potential drug-related to GPX8. Finally, cell trajectory analysis provided insights into the dynamic process of GPX8+ CAFs formation.

Conclusions

This study elucidates the association between GPX8+ CAFs and poor prognosis, as well as the induction of immunosuppressive formation in LUAD. These findings suggest that targeting GPX8+ CAFs could potentially serve as a therapeutic strategy for the treatment of LUAD.
Mutagenetic analysis of the biosynthetic pathway of tetramate bripiodionen bearing 3-(2H-pyran-2-ylidene)pyrrolidine-2,4-dione skeleton
Authors: Zang Haixia , Cheng Yijia , Li Mengjia , Zhou Lin , Hong Li-Li , Deng Hai , Lin Hou-Wen , Zhou Yongjun
Published: March 2024

Background

Natural tetramates are a family of hybrid polyketides bearing tetramic acid (pyrrolidine-2,4-dione) moiety exhibiting a broad range of bioactivities. Biosynthesis of tetramates in microorganisms is normally directed by hybrid polyketide synthase (PKS) and nonribosomal peptide synthetase (NRPS) machineries, which form the tetramic acid ring by recruiting trans- or cis-acting thioesterase-like Dieckmann cyclase in bacteria. There are a group of tetramates with unique skeleton of 3-(2H-pyran-2-ylidene)pyrrolidine-2,4-dione, which remain to be investigated for their biosynthetic logics.

Results

Herein, the tetramate type compounds bripiodionen (BPD) and its new analog, featuring the rare skeleton of 3-(2H-pyran-2-ylidene)pyrrolidine-2,4-dione, were discovered from the sponge symbiotic bacterial Streptomyces reniochalinae LHW50302. Gene deletion and mutant complementation revealed the production of BPDs being correlated with a PKS-NRPS biosynthetic gene cluster (BGC), in which a Dieckmann cyclase gene bpdE was identified by sit-directed mutations. According to bioinformatic analysis, the tetramic acid moiety of BPDs should be formed on an atypical NRPS module constituted by two discrete proteins, including the C (condensation)-A (adenylation)-T (thiolation) domains of BpdC and the A-T domains of BpdD. Further site-directed mutagenetic analysis confirmed the natural silence of the A domain in BpdC and the functional necessities of the two T domains, therefore suggesting that an unusual aminoacyl transthiolation should occur between the T domains of two NRPS subunits. Additionally, characterization of a LuxR type regulator gene led to seven- to eight-fold increasement of BPDs production. The study presents the first biosynthesis case of the natural molecule with 3-(2H-pyran-2-ylidene)pyrrolidine-2,4-dione skeleton. Genomic mining using BpdD as probe reveals that the aminoacyl transthiolation between separate NRPS subunits should occur in a certain population of NRPSs in nature.
Genetic confounding in the association of early motor development with childhood and adolescent exercise behavior
Authors: Zi Yahua , Bartels Meike , Dolan Conor , de Geus Eco J.C.
Published: March 2024

Introduction

Early motor development has been found to be a predictor of exercise behavior in children and adolescents, but whether this reflects a causal effect or confounding by genetic or shared environmental factors remains to be established.

Methods

For 20,911 complete twin pairs from the Netherlands Twin Register a motor development score was obtained from maternal reports on the timing of five motor milestones. During a 12-year follow-up, subsamples of the mothers reported on the twins’ ability to perform seven gross motor skills ability (N = 17,189 pairs), and weekly minutes of total metabolic equivalents of task (MET) spent on sports and exercise activities at age 7 (N = 3632 pairs), age 10 (N = 3735 pairs), age 12 (N = 7043 pairs), and age 14 (N = 3990 pairs). Multivariate phenotypic and genetic regression analyses were used to establish the predictive strength of the two motor development traits for future exercise behavior, the contribution of genetic and shared environmental factors to the variance in all traits, and the contribution of familial confounding to the phenotypic prediction.

Results

Significant heritability (h2) and shared environmental (c2) effects were found for early motor development in boys and girls (h2 = 43-65%; c2 = 16-48%). For exercise behavior, genetic influences increased with age (boys: h2age7 = 22% to h2age14 = 51%; girls: h2age7 = 3% to h2age14 = 18%) paired to a parallel decrease in the influence of the shared environment (boys: c2age7 = 68% to c2age14 = 19%; girls: c2age7 = 80% to c2age14 = 48%). Early motor development explained 4.3% (p < 0.001) of the variance in future exercise behavior in boys but only 1.9% (p < 0.001) in girls. If the effect in boys was due to a causal effect of motor development on exercise behavior, all of the factors influencing motor development would, through the causal chain, also influence future exercise behavior. Instead, only the genetic parts of the regression of exercise behavior on motor development were significant. Shared and unique environmental parts of the regression were largely non-significant, which is at odds with the causal hypothesis.

Conclusion

No support was found for a direct causal effect in the association between rapid early motor development on future exercise behavior. In boys, early motor development appears to be an expression of the same genetic factors that underlie the heritability of childhood and early adolescent exercise behavior.
Efficacy and safety of switching to dolutegravir/lamivudine in virologically suppressed people with HIV-1 aged ≥ 50 years: week 48 pooled results from the TANGO and SALSA studies
Authors: Walmsley Sharon , Smith Don E. , Górgolas Miguel , Cahn Pedro E. , Lutz Thomas , Lacombe Karine , Kumar Princy N. , Wynne Brian , Grove Richard , Bontempo Gilda , Moodley Riya , Okoli Chinyere , Kisare Michelle , Jones Bryn , Clark Andrew , Ait-Khaled Mounir
Published: March 2024

Background

As the population of people with HIV ages, concerns over managing age-related comorbidities, polypharmacy, immune recovery, and drug-drug interactions while maintaining viral suppression have arisen. We present pooled TANGO and SALSA efficacy and safety results dichotomized by age (< 50 and ≥ 50 years).

Methods

Week 48 data from the open-label phase 3 TANGO and SALSA trials evaluating switch to once-daily dolutegravir/lamivudine (DTG/3TC) fixed-dose combination vs continuing current antiretroviral regimen (CAR) were pooled. Proportions of participants with HIV-1 RNA ≥ 50 and < 50 copies/mL (Snapshot, intention-to-treat exposed) and safety were analyzed by age category. Adjusted mean change from baseline in CD4 + cell count was assessed using mixed-models repeated-measures analysis.

Results

Of 1234 participants, 80% of whom were male, 29% were aged ≥ 50 years. Among those aged ≥ 50 years, 1/177 (< 1%) DTG/3TC participant and 3/187 (2%) CAR participants had HIV-1 RNA ≥ 50 copies/mL at 48 weeks; proportions with HIV-1 RNA < 50 copies/mL were high in both treatment groups (≥ 92%), consistent with overall efficacy and similar to observations in participants aged < 50 years (≥ 93%). Regardless of age category, CD4 + cell count increased or was maintained from baseline with DTG/3TC. Change from baseline in CD4 + /CD8 + ratio was similar across age groups and between treatment groups. One CAR participant aged < 50 years had confirmed virologic withdrawal, but no resistance was detected. In the DTG/3TC group, incidence of adverse events (AEs) was similar across age groups. Proportions of AEs leading to withdrawal were low and comparable between age groups. Although drug-related AEs were generally low, across age groups, drug-related AEs were more frequent in participants who switched to DTG/3TC compared with those who continued CAR. While few serious AEs were observed in both treatment groups, more were reported in participants aged ≥ 50 years vs < 50 years.

Conclusions

Among individuals with HIV-1, switching to DTG/3TC maintained high rates of virologic suppression and demonstrated a favorable safety profile, including in those aged ≥ 50 years despite higher prevalence of concomitant medication use and comorbidities.

Trial registration number: TANGO, NCT03446573 (February 27, 2018); SALSA, NCT04021290 (July 16, 2019).
How can the Sendai framework be implemented for disaster risk reduction and sustainable development? A qualitative study in Iran
Authors: Nekoei-Moghadam Mahmood , Moradi Seyed Mobin , Tavan Asghar
Published: March 2024

Background

The Sendai Framework is the United Nations’ most significant approach to reducing the risk of disasters from 2015 to 2030. This framework designed for all communities. However, communities should create operational and remedial strategies based on their unique circumstances. Considering the gaps in the implementation of Sendai framework strategies in Iran, as a developing country, the present study was designed.

Method

This study was conducted by using a qualitative direct content analysis method to find out the expert’s opinions on the implementation of the Sendai framework in Iran from 2021 to 2023. 35 experts in the focus group discussion and 9 experts in the interview were the participants of the study.

Results

Study findings were merged and reported as one main theme entitled Executive actions for implementing the Sendai Framework, four categories, and 37 codes. Eleven codes for the strategy of understanding disaster risk, 11 codes for the strategy of strengthening disaster risk governance to manage disaster risk, eight codes for the strategy of Investing in disaster risk reduction for resilience, and finally, seven codes for the strategy of enhancing disaster preparedness for effective response and to “Build Back Better” in recovery, rehabilitation, and reconstruction were identified as implementation solutions.

Conclusion

The Sendai Framework has not provided any detailed implementation solutions because the countries’ economic, social, level of development, etc., are different. The study’s findings can be used as a guide for other developing countries.
Cardiovascular disease in Alpha 1 antitrypsin deficiency: an observational study assessing the role of neutrophil proteinase activity and the suitability of validated screening tools
Authors: Sapey E. , Crowley L. E. , Edgar R. G. , Griffiths D. , Samanta S. , Crisford H. , Bolton C. E. , Hurst J. R. , Stockley R. A.
Published: March 2024

Background

Alpha 1 Antitrypsin Deficiency (AATD) is a rare, inherited lung disease which shares features with Chronic Obstructive Pulmonary Disease (COPD) but has a greater burden of proteinase related tissue damage. These proteinases are associated with cardiovascular disease (CVD) in the general population. It is unclear whether patients with AATD have a greater risk of CVD compared to usual COPD, how best to screen for this, and whether neutrophil proteinases are implicated in AATD-associated CVD. This study had three aims. To compare CVD risk in never-augmented AATD patients to non-AATD COPD and healthy controls (HC). To assess relationships between CVD risk and lung physiology. To determine if neutrophil proteinase activity was associated with CVD risk in AATD. Cardiovascular risk was assessed by QRISK2® score and aortic stiffness measurements using carotid-femoral (aortic) pulse wave velocity (aPWV). Medical history, computed tomography scans and post-bronchodilator lung function parameters were reviewed. Systemic proteinase 3 activity was measured. Patients were followed for 4 years, to assess CVD development.

Results

228 patients with AATD, 50 with non-AATD COPD and 51 healthy controls were recruited. In all COPD and HC participants, QRISK2® and aPWV gave concordant results (with both measures either high or in the normal range). This was not the case in AATD. Once aPWV was adjusted for age and smoking history, aPWV was highest and QRISK2® lowest in AATD patients compared to the COPD or HC participants. Higher aPWV was associated with impairments in lung physiology, the presence of emphysema on CT scan and proteinase 3 activity following adjustment for age, smoking status and traditional CVD risk factors (using QRISK2® scores) in AATD. There were no such relationships with QRISK2® in AATD. AATD patients with confirmed CVD at four-year follow up had a higher aPWV but not QRISK2® at baseline assessment.

Conclusion

aPWV measured CVD risk is elevated in AATD. This risk is not captured by QRISK2®. There is a relationship between aPWV, lung disease and proteinase-3 activity. Proteinase-driven breakdown of elastin fibres in large arteries and lungs is a putative mechanism and forms a potential therapeutic target for CVD in AATD.
BIRC5 expression by race, age and clinical factors in breast cancer patients
Authors: Hamilton Alina M. , Walens Andrea , Van Alsten Sarah C. , Olsson Linnea T. , Nsonwu-Farley Joseph , Gao Xiaohua , Kirk Erin L. , Perou Charles M. , Carey Lisa A. , Troester Melissa A. , Abdou Yara
Published: March 2024

Purpose

Survivin/BIRC5 is a proliferation marker that is associated with poor prognosis in breast cancer and an attractive therapeutic target. However, BIRC5 has not been well studied among racially diverse populations where aggressive breast cancers are prevalent.

Experimental design

We studied BIRC5 expression in association with clinical and demographic variables and as a predictor of recurrence in 2174 participants in the Carolina Breast Cancer Study (CBCS), a population-based study that oversampled Black (n = 1113) and younger (< 50 years; n = 1137) participants with breast cancer. For comparison, similar analyses were conducted in The Cancer Genome Atlas [TCGA N = 1094, Black (n = 183), younger (n = 295)]. BIRC5 was evaluated as a continuous and categorical variable (highest quartile vs. lower three quartiles).

Results

Univariate, continuous BIRC5 expression was higher in breast tumors from Black women relative to non-Black women in both estrogen receptor (ER)-positive and ER-negative tumors and in analyses stratified by stage (i.e., within Stage I, Stage II, and Stage III/IV tumors). Within CBCS and TCGA, BIRC5-high was associated with young age (< 50 years) and Black race, as well as hormone receptor-negative tumors, non-Luminal A PAM50 subtypes, advanced stage, and larger tumors (> 2 cm). Relative to BIRC5-low, BIRC5-high tumors were associated with poor 5-year recurrence-free survival (RFS) among ER-positive tumors, both in unadjusted models [HR (95% CI): 2.7 (1.6, 4.6)] and after adjustment for age and stage [Adjusted HR (95% CI): 1.87 (1.07, 3.25)]. However, this relationship was not observed among ER-negative tumors [Crude HR (95% CI): 0.7 (0.39, 1.2); Adjusted HR (95% CI): 0.67 (0.37, 1.2)].

Conclusion

Black and younger women with breast cancer have a higher burden of BIRC5-high tumors than older and non-Black women. Emerging anti-survivin treatment strategies may be an important future direction for equitable breast cancer outcomes.
Expression- and splicing-based multi-tissue transcriptome-wide association studies identified multiple genes for breast cancer by estrogen-receptor status
Authors: McClellan Julian C. , Li James L. , Gao Guimin , Huo Dezheng
Published: March 2024

Background

Although several transcriptome-wide association studies (TWASs) have been performed to identify genes associated with overall breast cancer (BC) risk, only a few TWAS have explored the differences in estrogen receptor-positive (ER+) and estrogen receptor-negative (ER-) breast cancer. Additionally, these studies were based on gene expression prediction models trained primarily in breast tissue, and they did not account for alternative splicing of genes.

Methods

In this study, we utilized two approaches to perform multi-tissue TWASs of breast cancer by ER subtype: (1) an expression-based TWAS that combined TWAS signals for each gene across multiple tissues and (2) a splicing-based TWAS that combined TWAS signals of all excised introns for each gene across tissues. To perform this TWAS, we utilized summary statistics for ER + BC from the Breast Cancer Association Consortium (BCAC) and for ER- BC from a meta-analysis of BCAC and the Consortium of Investigators of Modifiers of BRCA1 and BRCA2 (CIMBA).

Results

In total, we identified 230 genes in 86 loci that were associated with ER + BC and 66 genes in 29 loci that were associated with ER- BC at a Bonferroni threshold of significance. Of these genes, 2 genes associated with ER + BC at the 1q21.1 locus were located at least 1 Mb from published GWAS hits. For several well-studied tumor suppressor genes such as TP53 and CHEK2 which have historically been thought to impact BC risk through rare, penetrant mutations, we discovered that common variants, which modulate gene expression, may additionally contribute to ER + or ER- etiology.

Conclusions

Our study comprehensively examined how differences in common variation contribute to molecular differences between ER + and ER- BC and introduces a novel, splicing-based framework that can be used in future TWAS studies.
Investigating the use of finerenone in children with chronic kidney disease and proteinuria: design of the FIONA and open-label extension studies
Authors: Schaefer Franz , Montini Giovanni , Kang Hee Gyung , Walle Johan Vande , Zaritsky Joshua , Schreuder Michiel F. , Litwin Mieczyslaw , Scalise Andrea , Scott Helen , Potts James , Iveli Pablo , Breitenstein Stefanie , Warady Bradley A.
Published: March 2024

Introduction

Proteinuria is a modifiable risk factor for chronic kidney disease (CKD) progression in children. Finerenone, a selective, non-steroidal, mineralocorticoid receptor antagonist (MRA) has been approved to treat adults with CKD associated with type 2 diabetes mellitus (T2DM) following results from the phase III clinical trials FIDELIO-DKD (NCT02540993) and FIGARO-DKD (NCT02545049). In a pre-specified pooled analysis of both studies (N = 13,026), finerenone was shown to have an acceptable safety profile and was efficacious in decreasing the risk of adverse kidney and cardiovascular outcomes and of proteinuria.

Objective

FIONA and the associated open-label extension (OLE) study aim to demonstrate that combining finerenone with an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) is safe, well-tolerated, and effective in sustainably reducing urinary protein excretion in children with CKD and proteinuria.

Design

FIONA (NCT05196035; Eudra-CT: 2021–002071-19) is a randomized (2:1), double-blind, placebo-controlled, multicenter, phase III study of 6 months’ duration in approximately 219 pediatric patients. Patients must have a clinical diagnosis of CKD (an eGFR ≥ 30 mL/min/1.73 m2 if ≥ 1 to < 18 years or a serum creatinine level ≤ 0.40 mg/dL for infants 6 months to < 1 year) with significant proteinuria despite ACEi or ARB usage. The primary objective is to demonstrate that finerenone, added to an ACEi or ARB, is superior to placebo in reducing urinary protein excretion. FIONA OLE (NCT05457283; Eudra-CT: 2021–002905-89) is a single-arm, open-label study, enrolling participants who have completed FIONA. The primary objective of FIONA OLE is to provide long-term safety data.

FIONA has two primary endpoints: urinary protein-to-creatinine ratio (UPCR) reduction of ≥ 30% from baseline to day 180 and percent change in UPCR from baseline to day 180. A sample size of 198 participants (aged 2 to < 18 years) in FIONA will provide at least 80% power to reject the null hypothesis of either of the two primary endpoints.

Conclusion

FIONA is evaluating the use of finerenone in children with CKD and proteinuria. Should safety, tolerability, and efficacy be demonstrated, finerenone could become a useful additional therapeutic agent in managing proteinuria and improving kidney outcomes in children with CKD.

Trial registration

ClinicalTrials.gov NCT05196035. Registered on 19 January 2022.
Fleas of wild carnivores in Romania: diversity, distribution, and host-associations
Authors: Deak Georgiana , Ionică Angela Monica , Péter Áron , Sándor Attila David , Matei Ioana Adriana , D’Amico Gianluca , Liénard Emmanuel , Gherman Călin Mircea , Mihalca Andrei Daniel , Bouhsira Emilie
Published: March 2024

Background

Fleas are important hematophagous insects, infesting mammals and birds with a worldwide distribution. Fleas of medical importance have been reported from various carnivores worldwide, such as felids, canids, or mustelids. Romania hosts a wide carnivore diversity, but very little is known about flea species that parasitize these animals in Romania. This study aimed to provide a better understanding of the fleas’ diversity and their distribution in a relatively large and diverse number of wild carnivore hosts from Romania.

Methods

From 2013 to 2021, 282 carcasses of wild carnivores from different locations in Romania were collected and examined for the presence of ectoparasites. All collected fleas were morphologically identified using specific keys and descriptions. An analysis of the co-occurrence networks was performed.

Results

A total of 11 flea species were identified: Pulex irritans (41.09%), Paraceras melis (20.11%), Ctenocephalides felis (7.33%), Ctenocephalides canis (7.83%), Monopsyllus sciurorum (11.11%), Chaetopsylla trichosa (21.96%), Chaetopsylla homoea (5.5%), Chaetopsylla tuberculaticeps (100%), Chaetopsylla rothschildi (13.33%), Chaetopsylla sp. (14.34%), Chaetopsylla globiceps (5.12%), Echidnophaga gallinacea (10%). The statistical analyses showed a significant difference between the infestation of Martes foina with females being more frequently infected than males (66% versus 33%). Paraceras melis infesting Meles meles had a significantly higher prevalence in female badgers than in males (× 2 = 7.7977, P < 0.01) and higher intensities of infestations in males than in females (t = 1.871, P < 0.05).

Conclusions

This is the first large-scale study investigating the distribution and diversity of flea species infesting wild carnivores in Romania. Three flea species were identified for the first time in Romania (E. gallinacea, C. homoea, and C. tuberculaticeps).

Graphical Abstract
Parenteral nutrition: a life–saving intervention for 4 months in short bowel syndrome—a case report and review of the literature
Authors: Švagždys Saulius , Smolskaitė Ieva , Vindžigalskytė Rūta
Published: March 2024

Background

Short bowel syndrome (SBS) in adults is defined as having less than 180 to 200 cm of remaining small bowel. Many literature sources do not provide precise epidemiological data, and challenges in estimating the prevalence of SBS include its multifactorial etiology and varying definitions. The most common pathologies leading to SBS include Crohn disease, mesenteric ischemia, radiation enteritis, post-surgical adhesions, and post-operative complications.

Case presentation

This article presents a clinical case of a 76-year-old Lithuanian patient who underwent parenteral nutrition for four months due to SBS. Before the following diagnosis, the patient had undergone two surgeries. During the hospitalization, life-threatening conditions such as stercoral peritonitis, septic shock, and acute respiratory failure, were observed and treated. As a result of SBS, hypoproteinemia and hypoalbuminemia developed, leading to the prescription of full parenteral nutrition. After correcting the malnutrition, a third surgery was performed, resulting in the discontinuation of parenteral nutrition and the resumption of a regular diet.

Conclusions

Parenteral nutrition is the sole effective method for preserving the lives of patients with a short segment of the intestine. While on parenteral nutrition, patients can be prepared for reconstructive surgery.
Approximation by modified $(p,q)$-gamma-type operators
Authors: Braha Naim Latif
Published: March 2024

The main object of this paper is to construct a new class of modified $(p,q)$
(
p
,
q
)
-Gamma-type operators. For this new class of operators, in section one, the general moments are find; in section two, the Korovkin-type theorem and some direct results are proved by considering the modulus of continuity and modulus of smoothness and their behavior in Lipschitz-type spaces. In section three, some results in the weighted spaces are given, and in the end, some shape-preserving properties are proven.
Modified inertial viscosity extrapolation method for solving quasi-monotone variational inequality and fixed point problems in real Hilbert spaces
Authors: Abuchu Jacob A. , Ofem Austine E. , Işık Hüseyin , Ugwunnadi Godwin C. , Narain Ojen K.
Published: March 2024

In this paper, we introduce and study a viscous-type extrapolation algorithm for finding a solution of the variational inequality problem and a fixed point constraint of quasi-nonexpansive mappings under the scope of real Hilbert spaces when the underlying cost operator is quasi-monotone. The method involves inertial viscosity approximation and a constructed self-adjustable step size condition that depends solely on the information of the previous step. We establish a strong convergence result of the proposed method under certain mild conditions on the algorithm parameters. Finally, to demonstrate the gain of our method, some numerical examples are presented in comparison with some related methods in literature.
The power of museums with ethnographic collections: two cases in Brazil
Authors: Russi Adriana
Published: March 2024

“The Power of Museums” was the General Conference on the central theme of the International Council of Museums (ICOM) in 2022 (Prague). This article aims to discuss the ability of ethnographic collections to combat prejudice and promote freedom, cultural diversity, religious diversity, and democracy, among other aspects of human rights. Here, we propose a theoretical reflection on the power of museums, considering the context of the decolonization of ethnographic collections in Brazil. To illustrate the discussion, we briefly present two recent cases in the country that refer to the appreciation of indigenous, religious, and cultural diversity. The first is related to a photographic collection of indigenous peoples that is part of the Museu Paranaense (MUPA) collection in Curitiba (southern Brazil). The second case involves collections from a group of people who descend from enslaved people and members of Terreiros de Umbanda and Candomblé in the city of Rio de Janeiro (southeastern region), which is now preserved at the Museu da Republica. For this purpose, we present a brief context on the historical development of Brazil, its contemporary museum universe, and Associação Brasileira de Antropologia’s initiative to map ethnographic collections in Brazil. Both cases reveal experiences of decolonizing ethnographic collections with the direct involvement of the associated communities. These cases demonstrate how it is possible to deconstruct collections shaped within colonialist and prejudiced perspectives by presenting new narratives that appreciate cultures that were previously.
Neuroimaging studies of cannabidiol and potential neurobiological mechanisms relevant for alcohol use disorders: a systematic review
Authors: Hurzeler Tristan , Watt Joshua , Logge Warren , Towers Ellen , Suraev Anastasia , Lintzeris Nicholas , Haber Paul , Morley Kirsten C.
Published: March 2024

The underlying neurobiological mechanisms of cannabidiol’s (CBD) management of alcohol use disorder (AUD) remains elusive.

Aim We conducted a systematic review of neuroimaging literature investigating the effects of CBD on the brain in healthy participants. We then theorise the potential neurobiological mechanisms by which CBD may ameliorate various symptoms of AUD.

Methods This review was conducted according to the PRISMA guidelines. Terms relating to CBD and neuroimaging were used to search original clinical research published in peer-reviewed journals.

Results Of 767 studies identified by our search strategy, 16 studies satisfied our eligibility criteria. The results suggest that CBD modulates γ-Aminobutyric acid and glutamate signaling in the basal ganglia and dorso-medial prefrontal cortex. Furthermore, CBD regulates activity in regions associated with mesocorticolimbic reward pathways; salience, limbic and fronto-striatal networks which are implicated in reward anticipation; emotion regulation; salience processing; and executive functioning.

Conclusion CBD appears to modulate neurotransmitter systems and functional connections in brain regions implicated in AUD, suggesting CBD may be used to manage AUD symptomatology.
Influence of plastic shape on interim fragmentation of compostable materials during composting
Authors: Pfohl Patrizia , Rueckel Markus , Meyer Lars , Battagliarin Glauco , Künkel Andreas , Hüffer Thorsten , Zumstein Michael , Hofmann Thilo , Wohlleben Wendel
Published: March 2024

Common experience with rotting wooden buildings demonstrates that fragmentation is a necessary natural process during biodegradation. In analogy, the loss of structural integrity of biodegradable plastics during biodegradation produces interim microplastic fragments. It is currently not known which parameters govern fragmentation kinetics: chemical structure, physical shape, and composite layers, or composting conditions may all be relevant. Here we investigated the influence of physical shape on the fragmentation of a polyester blend during laboratory tests simulating industrial composting. Methods previously validated on micronized granules as model shape were applied to shapes that better represent consumer products, such as micronized thin films and shredded plastic-coated paper cups. The peak interim number of detected fragments, which are between 3 and 2000 µm, ranked highest for micronized films, lower for micronized plastic granules, and even lower for coated paper cups. The layered structure of polyester on cellulose may thus have stabilized the biodegrading polyester compound against fragmentation. For thin films, fragment counts dissipated with halftime of 2.5 days, and less than 10–8% of the initially added polyester mass was detected in fragments between 3 and 25 µm at the last sampling time point. The physical shape and multilayer structure of the polymer-containing product were found to be decisive for fragmentation kinetics, indicating that tests on micronized polymer granules might not be representative of the release mechanism of fragments from consumer products containing plastic coatings.
Serologic Detection of Hepatocellular Carcinoma: Application of Machine Learning and Implications for Diagnostic Models
Authors: Johnson Philip J. , Bhatti Ehsan , Toyoda Hidenori , He Shan
Published: March 2024

PURPOSE

The gender, age, lens culinaris agglutinin-reactive fraction of alphafetoprotein, alphafetoprotein, des-gamma-carboxyprothrombin (GALAD) score is a biomarker-based statistical model for the serologic diagnosis of hepatocellular carcinoma (HCC) that has been developed and validated using the case-control approach with a view to early detection. Performance has, however, been suboptimal in the first prospective studies which better reflect the real-world situation. In this article, we report the application of machine learning to a large, prospectively accrued, HCC surveillance data set.

PATIENTS AND METHODS

Models were built on a cohort of 3,473 patients with chronic liver disease within a rigorous surveillance program between 1998 and 2014, during which 459 patients with HCC were detected. Two random forest (RF) models were trained. The first RF model uses the same variables as the original GALAD model (GALAD-RF); the second is based on routinely available clinical and laboratory features (RF-practical). For comparison, we evaluated a logistic regression GALAD model trained on this longitudinal prospective data set (termed GALAD-Ogaki).

RESULTS

Models were evaluated using a repetitive cross-validation approach with the metrics averaged over 100 independent runs. As judged by area under the receiver operator curve (AUROC) and F1 score, the GALAD RF model significantly outperformed the original GALAD model. The RF-practical model also outperformed the original GALAD model in terms of both AUROC and F1 score, and both models outperformed the individual biomarkers. An online web application that implemented the GALAD-RF and RF-practical models is presented.

CONCLUSION

RF-based models improve on the diagnostic performance of the original GALAD model in the setting of a standard HCC surveillance program. Further prospective validation studies are warranted using these models and could be expanded to offer prediction of risk of HCC development over defined periods of time.
“God Save Me from a Civilized Indian”: Labor Union Schools and Contending Visions for Indigenous Education in Ecuador, 1936–1963
Authors: Rosas Marlen
Published: March 2024

From the 1930s to the 1960s, Indigenous activists in Ecuador unsettled the prevailing paradigm of acculturation, practicing literacies that advanced their capacities for political mobilization around labor and land rights. Leaders on the haciendas of Cayambe allied with the Communist Party of Ecuador to organize their locally grounded politics against an urban-based indigenista movement. Both movements highlighted the need for Indigenous emancipation from the confines of the feudalistic labor system but diverged in their visions of Indigenous agency. Labor activists recognized that landowners relied on education for social control, so they made autonomous schooling a central hallmark of their struggle. Previous scholarship, focused on 1980s state directives for intercultural bilingual education, has not explored the orientation of Cayambe's early schools toward labor rights pedagogy. Analyzing textbooks, periodicals, and oral histories, I argue that Cayambe's teachers pursued notions of national inclusion that fused citizenship rights with socialist ideals and practices of Indigenous autonomy.
Hypofractionated Stereotactic Radiosurgery in the Management of Brain Metastases
Authors: Lehrer Eric J. , Breen William G. , Singh Raj , Palmer Joshua D. , Brown Paul D. , Trifiletti Daniel M. , Sheehan Jason P.
Published: March 2024

Stereotactic radiosurgery (SRS) is an important weapon in the management of brain metastases. Single-fraction SRS is associated with local control rates ranging from approximately 70% to 100%, which are largely dependent on lesion and postoperative cavity size. The rates of local control and improved neurocognitive outcomes compared with conventional whole-brain radiation therapy have led to increased adoption of SRS in these settings. However, when treating larger targets and/or targets located in eloquent locations, the risk of normal tissue toxicity and adverse radiation effects within healthy brain tissue becomes significantly higher. Thus, hypofractionated SRS has become a widely adopted approach, which allows for the delivery of ablative doses of radiation while also minimizing the risk of toxicity. This approach has been studied in multiple retrospective reports in both the postoperative and intact settings. While there are no reported randomized data to date, there are trials underway evaluating this paradigm. In this article, we review the role of hypofractionated SRS in the management of brain metastases and emerging data that will serve to validate this treatment approach. Pertinent articles and references were obtained from a comprehensive search of PubMed/MEDLINE and clinicaltrials.gov.
Optimizing Recurrent Glioblastoma Salvage Treatment: A Multicenter Study Integrating Genetic Biomarkers From the Korean Radiation Oncology Group (21-02)
Authors: Kim Dowook , Lee Joo Ho , Kim Nalee , Lim Do Hoon , Song Jin Ho , Suh Chang-Ok , Wee Chan Woo , Kim In Ah
Published: March 2024

BACKGROUND AND OBJECTIVES:

Few studies have used real-world patient data to compare overall treatment patterns and survival outcomes for recurrent glioblastoma (rGBM). This study aimed to evaluate postprogression survival (PPS) according to the treatment strategy for rGBM by incorporating biomarker analysis.

METHODS:

We assessed 468 adult patients with rGBM who underwent standard temozolomide-based chemoradiation. The impact of predictors on PPS was evaluated in patients with isocitrate dehydrogenase wild-type rGBM (n = 439) using survival probability analysis. We identified patients who would benefit from reirradiation (re-RT) during the first progression.

RESULTS:

Median PPS was 3.4, 13.8, 6.6, and 10.0 months in the best supportive care (n = 82), surgery (with/without adjuvant therapy, n = 112), chemotherapy alone (n = 170), and re-RT (with/without chemotherapy, n = 75) groups, respectively. After propensity score matching analysis of the cohort, both the surgery and re-RT groups had a significantly better PPS than the chemotherapy-only group; however, no significant difference was observed in PPS between the surgery and re-RT groups. In the surgery subgroup, surgery with chemotherapy (P = .024) and surgery with radio(chemo)therapy (P = .039) showed significantly improved PPS compared with surgery alone. In the no-surgery subgroup, radio(chemo)therapy showed significantly improved PPS compared with chemotherapy alone (P = .047). Homozygous deletion of cyclin-dependent kinase inhibitor 2A/B, along with other clinical factors (performance score and progression-free interval), was significantly associated with the re-RT survival benefit.

CONCLUSION:

Surgery combined with radio(chemo)therapy resulted in the best survival outcomes for rGBM. re-RT should also be considered for patients with rGBM at first recurrence. Furthermore, this study identified a specific genetic biomarker and clinical factors that may enhance the survival benefit of re-RT.
Η χρήση οπτικών μέσων και πολυμέσων στην υποβοήθηση ατόμων με χαμηλή όραση
Authors: Οικονομίδης Κωνσταντίνος
Published: March 2024

Στόχος της διδακτορικής διατριβής με θέμα: «Η χρήση οπτικών μέσων και πολυμέσων στην υποβοήθηση ατόμων με χαμηλή όραση», που υλοποιήθηκε στην Ιατρική Σχολή του Α.Π.Θ., ήταν αφενός να διερευνηθούν η αποδοχή και η συμμόρφωση στη χρήση βοηθημάτων χαμηλής όρασης, μετά από παροχή ενός εξατομικευμένου πρωτοκόλλου εκπαίδευσης, που αποσκοπούσε στην αξιοποίηση της υπολειπόμενης όρασης και στην υποβοήθηση των καθημερινών δραστηριοτήτων και αφετέρου να διερευνηθούν παράμετροι που πιθανώς επιδρούν στην αποδοχή και χρήση των βοηθημάτων χαμηλής όρασης. Πραγματοποιήθηκε μια διερευνητική μελέτη που συμπεριέλαβε ασθενείς με χαμηλή όραση, προερχόμενων από το Εργαστήριο Πειραματικής Οφθαλμολογίας του Α.Π.Θ. Καταγράφηκαν τα δημογραφικά στοιχεία των ασθενών και αξιολογήθηκαν τόσο οι σχετιζόμενες με την όραση καθημερινές οπτικές απαιτήσεις τους όσο και η σχετιζόμενη με την όραση ποιότητα ζωής, με τη χορήγηση του ερωτηματολογίου ΝΕΙ VFQ-25. Οι συμμετέχοντες εκπαιδεύτηκαν στη χρήση ενός ευρέος φάσματος βοηθημάτων χαμηλής όρασης πριν από τη χορήγησή τους. Η συμμόρφωση με τη χρήση των βοηθημάτων χαμηλής όρασης εκτιμήθηκε 1 χρόνο μετά την αρχική χορήγηση με τη χρήση ενός σύντομου ερωτηματολογίου με ερωτήσεις τύπου Likert Scale, το οποίο χορηγήθηκε τηλεφωνικά. Το δείγμα περιλάμβανε 100 ενήλικους ασθενείς, εκ των οποίων το 68% ήταν ηλικίας άνω των 65 ετών και οι 50 ήταν άνδρες. Η κύρια αιτία της χαμηλής όρασης (57,0%) ήταν η Ηλικιακή Εκφύλιση της Ωχράς Κηλίδας και η μέση βαθμολογία στο VFQ-25 ήταν 49,2 (SD=17,8). Από τους ασθενείς του δείγματος 74 ασθενείς χρησιμοποίησαν βοηθήματα χαμηλής όρασης και το 75,6% αυτών των ασθενών προτίμησε ένα οπτικό βοήθημα. Η συντριπτική πλειονότητα (98,7%) αυτών των ασθενών δήλωσε ότι χρησιμοποιούσε το βοήθημα 1 χρόνο μετά την αρχική εξέταση και το 62,1% αυτών ανέφερε ότι χρησιμοποιούσε το βοήθημα συχνά έως πολύ συχνά. Είναι σημαντικό ότι το 76% αυτών των ασθενών δήλωσε ότι η ποιότητα ζωής τους επηρεάστηκε θετικά από τη χρήση του βοηθήματος και το 97,3% θα συνιστούσε τη χρήση των βοηθημάτων χαμηλής όρασης σε άλλο άτομο με το ίδιο πρόβλημα. Η παροχή κατάλληλης εκπαίδευσης πριν από τη χορήγηση των βοηθημάτων, φαίνεται να έχει μεγάλη σημασία για τη βελτίωση του ποσοστού συμμόρφωσης με τη χρήση των βοηθημάτων χαμηλής όρασης. Τα αποτελέσματα της παρούσας διατριβής θα μπορούσαν να χρησιμοποιηθούν για την ανάπτυξη κατάλληλων στρατηγικών για τη βελτίωση της συμμόρφωσης με τη χρήση βοηθημάτων χαμηλής όρασης.
Pontic Greek cuisine
Authors: Κεραμάρης Αχιλλεύς
Published: March 2024

Η Ποντιακή Κουζίνα (ΠΚ) υψώνεται ως ένα μοναδικό μνημείο γεύσεων, μαρτυρώντας την πλούσια ιστορία και τον αστείρευτο πολιτισμό του ποντιακού Ελληνισμού. Σφυρηλατημένη μέσα από αιώνες εμπειρίας και προσαρμογής, η ΠΚ ξεχωρίζει για την ιδιότυπη ταυτότητά της, η οποία διαμορφώθηκε από το περιβάλλον του Πόντου, την αλληλεπίδραση με σύνοικους λαούς και την αστείρευτη δημιουργικότητα του ποντιακού Ελληνισμού. Παρότι η ΠΚ διαθέτει μια πλούσια ιστορία και ιδιαίτερη ταυτότητα, παραμένει σε μεγάλο βαθμό άγνωστη στο ευρύτερο ελληνικό κοινό. Σε αυτό το πλαίσιο, η παρούσα διδακτορική εργασία σκοπεύει στην ανάδειξη και αξιοποίηση της ΠΚ, αποκαλύπτοντας τα μοναδικά της χαρακτηριστικά και την αξία της.H πολυπλοκότητα του θέματος και η ανάγκη για ολιστική θεώρηση, οδήγησαν στην επιλογή μεικτής μεθοδολογίας. Εφαρμόσθηκε η μέθοδος της συγκλίνουσας παράλληλης σχεδίασης, συλλέγοντας ταυτόχρονα ποσοτικά και ποιοτικά δεδομένα. Η έρευνα εστίασε στα χαρακτηριστικά της ΠΚ, όπως οι τεχνικές παραγωγής και η διατροφική αξία ενός εμβληματικού παραδοσιακού προϊόντος της, του «Φούρνικου» (Καβουρδισμένο καλαμποκάλευρο). Επιπλέον, εστίασε στο συμβολισμό ενός δημοφιλούς πιάτου της, της «Τανωμένον Σορβά» (ΤΣ) (γιαουρτόσουπα). Μέσω της ανάλυσης διάφορων πηγών, όπως λαογραφικά έργα και βιβλία μαγειρικής, αναδείχθηκαν τα χαρακτηριστικότερα εδέσματα της ΠΚ, υπογραμμίζοντας την αξία αυτών των πηγών. Πέρα από αυτό, στην παρούσα διατριβή διερευνήθηκαν οι διατροφικές συνήθειες των Ποντίων κατοίκων της Δυτικής Μακεδονίας, με εστίαση στα παραδοσιακά εδέσματα της ΠΚ. Κατά την ανάλυση του «Φούρνικου», διαπιστώθηκε ότι το αλεύρι διαθέτει ισχυρές αντιοξειδωτικές ιδιότητες (TPC, 156.00±3.00 mg GAE/100 g), καθώς και υψηλή περιεκτικότητα σε πρωτεΐνες (10.86±0.36 g/100 g) και βασικά μέταλλα. Επιπλέον, κρίθηκε ιδανικό για την παρασκευή χυλών, όπως ο παραδοσιακός ποντιακός χυλός «Χαβίτζ’». Αυτά τα χαρακτηριστικά το καθιστούν ένα τρόφιμο με δυνητικά ευεργετική επίδραση στην υγεία και ιδανικό για διάφορες χρήσεις στη βιομηχανία τροφίμων, συμπεριλαμβανομένων των αρτοσκευασμάτων, των δημητριακών πρωινού και των ζυμαρικών χωρίς γλουτένη. Η ΤΣ, πέρα από τη γευστική της αξία, φέρει πλούσια ιστορική κληρονομιά, συμβάλλοντας στην ανάδειξη της ποντιακής γαστρονομικής ταυτότητας. Η παρασκευή και η από κοινού κατανάλωση της εν λόγω σούπας, ενισχύει την αίσθηση του «ανήκειν» και ζωντανεύει μνήμες. Επιπροσθέτως, τονίστηκε η σημασία των βιβλίων μαγειρικής ως μέσων διαφύλαξης και μετάδοσης της ποντιακής γαστρονομικής παράδοσης στις νεότερες γενιές. Παρότι οι παραδόσεις αυτές αποτελούν σημαντικό κομμάτι της πολιτισμικής ταυτότητας των Ποντίων της Δυτικής Μακεδονίας, παρατηρήθηκε μείωση της προτίμησης προς τα παραδοσιακά τρόφιμα στις νεότερες γενιές. Η εν λόγω διατριβή δύναται να συμβάλλει στη διατήρηση της Ποντιακής Κουζίνας ως πολιτισμικού φαινομένου και στην ενημέρωση για την υψηλή διατροφική της αξία. Επιπλέον, προτείνονται ενέργειες για τη διαφύλαξη του πολιτισμικού πλούτου της ΠΚ και την ανάδειξη της αξίας της γαστρονομικής παράδοσης του ποντιακού Ελληνισμού.