bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival of the Fittest? A Call for Hospitality to Incorporate Ecology Into Business Practice and Education
Authors: Legrand Willy , Kuokkanen Henri , Marucco Francesca , Hazenberg Saakje , Fischer Frauke
Published: June 2023

Biodiversity and the science that addresses its conservation, loss, and recovery, including conservation biology and restoration ecology, are high on the contemporary global agenda. While the hospitality industry has taken major steps toward net carbon zero and even net positive business, we argue that it has another significant advance to make. The United Nations has dedicated 2021–2030 as the decade of ecosystem restoration, and along with it, several other organizations offer guidance on how businesses should approach the natural environment. Considering the role of hospitality as a consumer of nature, we call for the industry to implement these principles in practice through nature-based solutions and restorative and regenerative hospitality. To strengthen this transformation, we urge hospitality management education to include the basic concepts of ecology, biodiversity, and environmental science, along with their application, in curricula. By doing this, education can advance from presenting sustainability actions as a necessity into illustrating and justifying their need on a planetary scale. The change will facilitate the next step the hospitality industry must take in transforming its relationship with the natural environment.
Prevalence of intra-osseous veins and venous lakes in the posterior skull base on 3T MRI
Authors: Benson John C , Hamilton-Cave Matt , Carr Carrie M , Lane John I
Published: June 2023

Background

Intra-osseous vessels are normal anatomic structures in the calvarium and skull base. On imaging, these structures—particularly venous lakes—can mimic pathologic abnormalities. This study sought to assess the prevalence of veins and lakes in the skull base on MRI.

Materials and Methods

A retrospective review was completed of consecutive patients that underwent contrast-enhanced MRI imaging of the internal auditory canals. The clivus, jugular tubercles, and basio-occiput were assessed for the presence of both intra-osseous veins (serpentine and/or branching vessels) and venous lakes (well-circumscribed round or oval enhancing structures). Vessels in the adjacent synchondroses major foramina were excluded. Three board-certified neuroradiologists performed independent blinded reviews, with discrepancies agreed upon by consensus.

Results

96 patients were included in this cohort (58.3% female). Mean age was 58.4 years (range = 19–85). At least one intra-osseous vessel was identified in 71 (74.0%) patients. 67 (70.0%) had at least one skull base vein, and 14 (14.6%) had at least one venous lake. Both vessel subtypes were observed in 8.3% of patients. Vessels were more commonly observed in women, though this did not reach statistical threshold ( p = 0.56). Age was not associated with the presence of vessels (0.59) or vessel location ( p values ranged from 0.44–0.84).

Conclusions

Intra-osseous skull base veins and venous lakes are relatively common findings on MRI. Both vascular structures should be considered normal anatomy, and care should be taken to not confuse these for pathologic entities.
Patient-perceived benefits and risks of off-label use of SGLT2 inhibitors and GLP-1 receptor agonists in type 1 diabetes: a structured qualitative assessment
Authors: Edwards Khary , Uruska Aleksandra , Duda-Sobczak Anna , Zozulinska-Ziolkiewicz Dorota , Lingvay Ildiko
Published: June 2023

Background:

Patients with type 1 diabetes mellitus (T1DM) may have suboptimal glucose control and are interested in the use of adjuvant therapies.

Objectives:

To determine, from the patients’ perspective, the reasons for initiation of glucagon-like peptide 1 receptor agonist (GLP-1RA) and/or sodium glucose cotransporter 2 inhibitor (SGLT2i) in treating T1DM; perceived benefits/side effects, reasons for discontinuation, and willingness to reinitiate therapy.

Design:

Retrospective chart review with structured telephone interviews.

Methods:

We identified patients with T1DM treated with a GLP-1RA and/or SGLT2i for >3 months at University of Texas Southwestern Medical Center (Dallas, TX, USA) and Poznan University (Poznan, Poland). We conducted structured telephone interviews regarding their experiences.

Results:

We interviewed 68 participants treated with GLP-1RA and 82 with SGLT2i. Treatment was initiated for improving glycemic control (as reported by 61.8% versus 81.7% of GLP-1RA and SGLT2i users, respectively), weight loss/appetite suppression (51.4% versus 23.2%) and to reduce insulin requirement (13.2% versus 11%). Most participants (86.8% of GLP-1RA and 89.0% of SGLT2i users) reported ⩾1 benefit attributed to therapy. Reported benefits were improved glycemic control (reported by 58.8% versus 82.9% of GLP-1RA and SGLT2i users, respectively), weight loss/appetite suppression (63.2% versus 30.5%), and reduced insulin requirement (27.9% versus 34.1%). More GLP-1RA users reported side effects versus SGLT2i users (63.2% versus 36.6%); 22.6% discontinued GLP-1RA due to side effects versus 11.0% SGLT2i users. Diabetic ketoacidosis (DKA) was reported by 4.9% of SGLT2i users, but none in GLP-1RA users. Of those who discontinued medication, 60.7% of GLP-1RA versus 56.0% of SGLT2i prior users were willing to reinitiate treatment.

Conclusions:

Patients with T1DM report initiating adjuvant treatment with GLP-1RA and/or SGLT2i to improve glycemic control and lose weight; most patients reported perceived benefits from these therapies. Side effects (including DKA) are reported more commonly in real life than in clinical trials. Given patient interest in these medications, further studies should evaluate the long-term risk–benefits ratio in larger cohorts.
Episcleritis; and posterior uveitis misdiagnosed as orbital cellulitis in a child patient with Behçet’s disease
Authors: Jari Mohsen , Nasiri Shidrokh , Ghandehari Mohammadreza
Published: June 2023

Behçet’s disease is a chronic multisystem vasculitis that presented with several manifestations. Episcleritis is a benign inflammation of the episcleral tissue and is rarely reported in Behçet’s disease. We reported an 11-year-old girl who was admitted due to pain and swelling around the left eye with initial diagnosis of preseptal cellulitis. The patient had a history of recurrent oral aphthous ulcers and genital ulcers. Episcleritis and posterior uveitis were reported in ophthalmic examination and ultrasonography. Pathergy skin test and human leukocyte antigens (HLA) B5 and HLA-B51 were positive, consistent with the diagnosis of Behcet’s disease. This case report emphasizes that various pathological causes may cause episcleritis and uveitis in children, one of which is rheumatic diseases, that should always be considered.
Finding benefits in a cardiac event: Direct links with positive affect and healthy dietary behaviors during cardiac rehabilitation
Authors: Primgaard Anahi R , Bennett Kymberley K , Wilson Elizabeth J , Harry Kadie M , Eways Kalon R , Smith Marcia A , Bergland Dennis S , Smith Andrew J
Published: June 2023

Benefit finding (BF) may be a coping strategy that positively influences outcomes after a stressful event, but previous studies provide an inconsistent pattern of results across several different patient populations. This study aimed to reconcile these inconsistencies by testing whether positive affect related to a cardiac event (PA) mediates the relationship between BF and healthy dietary behaviors, and whether this mediating relationship is stronger for participants high in disease severity. Participants were patients with cardiovascular disease in a cardiac rehabilitation program. Results supported partial mediation, but the interaction was not as predicted: participants low in disease severity showed a stronger relationship between BF and PA than their counterparts high in disease severity. Additionally, the PA/healthy dietary behaviors relationship was negative. Health providers may encourage patients in CR to engage in BF, but also to make thoughtful food decisions when in a positive mood, especially for patients low in disease severity.
The position of vanadium in the crystal structure of zoisite, variety tanzanite: Structural refinement, optical absorption spectroscopy and bond-valence calculations
Authors: Bačík Peter , Wildner Manfred , Cempírek Jan , Škoda Radek , Cibula Peter , Vaculovič Tomáš
Published: June 2023

Vanadium is the dominant trace element and chromophore in tanzanite, the most valued gemmological variety of zoisite. The structure of zoisite–tanzanite was obtained by structural refinement to assess the vanadium location in the zoisite structure. However, the small V content in tanzanite evidenced by electron microprobe and laser ablation inductively coupled plasma mass spectrometry limits the exact determination of the V position in the zoisite structure. Structural refinement revealed that the average bond length of the less distorted M1,2O6 octahedron is below 1.90 Å, and M3O6 has slightly longer bonds with an average of ca. 1.96 Å. The M1,2 site is slightly overbonded with a bond-valence sum (BVS) of 3.03 vu, whereas M3 is slightly underbonded (BVS = 2.78 vu). Optical absorption spectra revealed that most V is trivalent, but a small portion is probably in a four-valent state. Therefore, crystal field Superposition Model and Bond-Valence Model calculations were applied based on several necessary assumptions: (1) V occupies octahedral sites; and (2) it can occur in two oxidation states, V3+ or V4+. Crystal field Superposition Model calculations from the optical spectra indicated that V3+ prefers occupying the M1,2 site; the preference of V4+ from the present data was impossible to determine. Bond-Valence Model calculations revealed no unambiguous preference for V3+, although simple bond-length calculation suggests the preference of the M3 site. However, it is quite straightforward that the M1,2 site is better suitable for V4+. If the possible octahedral distortion is considered, the M1,2O6 octahedron is subject to a smaller change in distortion if occupied by V3+ than the M3O6 octahedron. Consequently, considering the results of both the crystal field Superposition Model and Bond-Valence Model calculations, we assume that both V3+ and V4+ prefer the M1,2 site.
Antiviral CD8+T-cell immune responses are impaired by cigarette smoke and in COPD
Authors: Chen Jie , Wang Xinyuan , Schmalen Adrian , Haines Sophia , Wolff Martin , Ma Huan , Zhang Huabin , Stoleriu Mircea Gabriel , Nowak Johannes , Nakayama Misako , Bueno Marta , Brands Judith , Mora Ana L. , Lee Janet S. , Krauss-Etschmann Susanne , Dmitrieva Anna , Frankenberger Marion , Hofer Thomas P. , Noessner Elfriede , Moosmann Andreas , Behr Jürgen , Milger Katrin , Deeg Cornelia A. , Staab-Weijnitz Claudia A. , Hauck Stefanie M. , Adler Heiko , Goldmann Torsten , Gaede Karoline I. , Behrends Jochen , Kammerl Ilona E. , Meiners Silke
Published: June 2023

Background

Virus infections drive COPD exacerbations and progression. Antiviral immunity centres on the activation of virus-specific CD8+T-cells by viral epitopes presented on major histocompatibility complex (MHC) class I molecules of infected cells. These epitopes are generated by the immunoproteasome, a specialised intracellular protein degradation machine, which is induced by antiviral cytokines in infected cells.

Methods

We analysed the effects of cigarette smoke on cytokine- and virus-mediated induction of the immunoproteasomein vitro,ex vivoandin vivousing RNA and Western blot analyses. CD8+T-cell activation was determined in co-culture assays with cigarette smoke-exposed influenza A virus (IAV)-infected cells. Mass-spectrometry-based analysis of MHC class I-bound peptides uncovered the effects of cigarette smoke on inflammatory antigen presentation in lung cells. IAV-specific CD8+T-cell numbers were determined in patients’ peripheral blood using tetramer technology.

Results

Cigarette smoke impaired the induction of the immunoproteasome by cytokine signalling and viral infection in lung cellsin vitro,ex vivoandin vivo. In addition, cigarette smoke altered the peptide repertoire of antigens presented on MHC class I molecules under inflammatory conditions. Importantly, MHC class I-mediated activation of IAV-specific CD8+T-cells was dampened by cigarette smoke. COPD patients exhibited reduced numbers of circulating IAV-specific CD8+T-cells compared to healthy controls and asthmatics.

Conclusion

Our data indicate that cigarette smoke interferes with MHC class I antigen generation and presentation and thereby contributes to impaired activation of CD8+T-cells upon virus infection. This adds important mechanistic insight on how cigarette smoke mediates increased susceptibility of smokers and COPD patients to viral infections.
Looking ahead in early-phase trial design to improve the drug development process: examples in oncology
Authors: Vanderbeek Alyssa M. , Redd Robert A. , Ventz Steffen , Trippa Lorenzo
Published: June 2023

Background

Clinical trial design must consider the specific resource constraints and overall goals of the drug development process (DDP); for example, in designing a phase I trial to evaluate the safety of a drug and recommend a dose for a subsequent phase II trial. Here, we focus on design considerations that involve the sequence of clinical trials, from early phase I to late phase III, that constitute the DDP.

Methods

We discuss how stylized simulation models of clinical trials in an oncology DDP can quantify important relationships between early-phase trial designs and their consequences for the remaining phases of development. Simulations for three illustrative settings are presented, using stylized models of the DDP that mimic trial designs and decisions, such as the potential discontinuation of the DDP.

Results

We describe: (1) the relationship between a phase II single-arm trial sample size and the likelihood of a positive result in a subsequent phase III confirmatory trial; (2) the impact of a phase I dose-finding design on the likelihood that the DDP will produce evidence of a safe and effective therapy; and (3) the impact of a phase II enrichment trial design on the operating characteristics of a subsequent phase III confirmatory trial.

Conclusions

Stylized models of the DDP can support key decisions, such as the sample size, in the design of early-phase trials. Simulation models can be used to estimate performance metrics of the DDP under realistic scenarios; for example, the duration and the total number of patients enrolled. These estimates complement the evaluation of the operating characteristics of early-phase trial design, such as power or accuracy in selecting safe and effective dose levels.
Significant improvement of psychotic symptoms in treatment-resistant schizophrenia with clozapine in an adolescent with SHINE syndrome: a case report
Authors: Yang Maxine , Rubin Arielle , Wondimu Rebecca , Grebe Theresa , Ritfeld Gaby
Published: June 2023

This report highlights a rare single-gene cause of early-onset, treatment-resistant schizophrenia, and its unique responsiveness to clozapine therapy. This case describes a pediatric female who was diagnosed with early-onset schizophrenia and catatonia in her early adolescence, and was later found to have DLG4-related synaptopathy, also known as SHINE syndrome. SHINE syndrome is a rare neurodevelopmental disorder caused by dysfunction of the postsynaptic density protein-95 (PSD-95), encoded by the DLG4 gene. After failing three antipsychotic drug treatments, the patient was started on clozapine, which resulted in significant improvements in positive and negative symptoms. This case illustrates the impact of clozapine in treatment-resistant early-onset psychosis and exemplifies practical implications for genetic testing in early-onset schizophrenia.
Determination of individual factors associated with hallux valgus using SVM-RFE
Authors: Nakao Hidetoshi , Imaoka Masakazu , Hida Mitsumasa , Imai Ryota , Nakamura Misa , Matsumoto Kazuyuki , Kita Kenji
Published: June 2023

Introduction

This cross-sectional study aimed to determine the factors related to hallux valgus (HV) and their importance using support vector machine-recursive feature elimination (SVM-RFE).

Methods

A total of 864 participants aged ≥ 18 years were enrolled. The Manchester scale was used to determine the presence of HV (summed scores for both feet ≥ 4). The questionnaire included items such as age, sex, height, weight, and foot measurements. These internal factors were analyzed to determine if they are related to HV using SVM-RFE.

Results

The results of tenfold cross-validation using SVM-RFE revealed that the numbers of feature selections were 10, 10, and 9 for age, sex, and body weight, respectively, and these factors were shown to be related to HV. HV was found to be more common in women than in men (women, 24.9%; men, 7.6%), but the sex difference was not significant in older people.

Conclusion

Age and sex were found to be important factors associated with HV identified via feature selection using SVM-RFE.
Enhanced recovery after surgery in primary liver cancer patients undergoing hepatectomy: experience from a large tertiary hospital in China
Authors: Huang Huan , Zhou Ping , Li Jia , Luo Hongping , Yu Liping
Published: June 2023

Objective

Enhanced recovery after surgery (ERAS) has significant effects in gastrointestinal surgery, urology, and orthopedic department, but the application of ERAS in liver cancer patients undergoing hepatectomy is less reported. This study aims to identify the effectiveness and safety of ERAS in liver cancer patients undergoing hepatectomy.

Methods

Patients who performed ERAS and no-ERAS after hepatectomy due to liver cancer from 2019 to 2022 were prospectively and retrospectively collected, respectively. Preoperative baseline data, surgical characteristics, and postoperative outcomes of patients in ERAS and non-ERAS groups were compared and analyzed. Logistic regression analysis was conducted to identify the risk factors of complications occurrence and prolonged hospital stay.

Results

In total, 318 patients were included in the study, 150 and 168 individuals in the ERAS group and non-ERAS group, respectively. The preoperative baseline and surgical characteristics between the ERAS and non-ERAS groups were comparable and not statistically different. Postoperative visual analogue scale pain score, the median day of gastrointestinal function recovery postoperative, complications rate, and postoperative hospitalization days were lower in the ERAS group than in the non-ERAS group. In addition, multivariate logistic regression analysis found that the implementation of the ERAS was an independent protective factor for prolonged hospitalization stay and complications occurrence. The rate of rehospitalization after discharge (< 30 days) in the ERAS group was lower than that in the non-ERAS group, but there was no statistical difference between the two groups.

Conclusions

The application of ERAS in hepatectomy for patients with liver cancer is safe and effective. It can accelerate gastrointestinal function recovery postoperative, shorten the length of hospital stay, and reduce postoperative pain and complications.
Salivary level of microRNA-146a and microRNA-155 biomarkers in patients with oral lichen planus versus oral squamous cell carcinoma
Authors: Mehdipour Masoumeh , Shahidi Minoo , Anbari Fahimeh , Mirzaei Homa , Jafari Soudeh , Kholghi Azam , Lotfi Ehsan , Manifar Soheila , Mashhadiabbas Fatemeh
Published: June 2023

Background

Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa, which has potential for malignant transformation. MicroRNAs play an important role in immunopathogenesis of OLP, and may be used for prediction of its malignant transformation. This study aimed to assess the salivary level of microRNA-146a and microRNA-155 biomarkers in patients with OLP and oral squamous cell carcinoma (OSCC).

Methods

In this case-control study, unstimulated saliva samples were collected from 60 patients, including 15 patients with dysplastic OLP, 15 OLP patients without dysplasia, 15 patients with OSCC, and 15 healthy controls according to the Navazesh technique. After RNA extraction, the expression of microRNA-146a and microRNA-155 was quantified by real-time quantitative polymerase chain reaction (RT-qPCR). The data were analyzed by the Kruskal-Wallis and Dunn-Bonferroni tests.

Results

The difference in expression of microRNA-146a and microRNA-155 among the four groups was significant (P < 0.05). Pairwise comparisons of the groups showed significantly higher expression of microRNA-146a in OLP (P = 0.004) and dysplastic OLP (P = 0.046) patients compared with the control group. Up-regulation of this biomarker in OSCC patients was not significant compared with the control group (P = 0.076). Up-regulation of micro-RNA-155 was only significant in OLP group, compared with the control group (P = 0.009). No other significant differences were found (P > 0.05).

Conclusion

Considering the altered expression of MicroRNA-146a and microRNA-155 in dysplastic OLP and OSCC, their altered expression may serve as an alarming sign of malignancy. However, further investigations are still required.
Experiences of patient education among people affected by cardiovascular disease: a qualitative study based on Andragogy model
Authors: Niksadat Negin , Ghaffari Mohtasham , Ramezankhani Ali , Rakhshanderou Sakineh , Farahani Ali Vasheghani , Negarandeh Reza
Published: June 2023

Background

Patient education is a key component of patient care, positively affecting health promotion and self-care ability. In this regard, an extensive body of research supports the use of the andragogy model in patient education. The study aimed to explore the experiences of people with cardiovascular disease in patient education.

Methods

This qualitative study involved 30 adult patients with cardiovascular disease who were hospitalized or had a history of hospitalization. They were purposively recruited with maximum variation from two large hospitals in Tehran, Iran. Data were gathered by conducting semi-structured interviews. Data collection was done by conducting semi-structured interviews. Then, the data were analyzed using directed content analysis and a preliminary framework based on six constructs of the andragogy model.

Results

Data analysis resulted in the development of 850 primary codes, which were reduced to 660 during data reduction. These codes were grouped into nineteen subcategories under the six primary constructs of the andragogy model, i.e., need-to-know, self-concept, prior experience, readiness for learning, orientation to learning, and motivation for learning. The most common problems in patient education were associated with self-concept, previous experience, and readiness for learning components.

Conclusion

This study provides valuable information about the problems of patient education for adults with cardiovascular disease. Correction of the issues identified can improve care quality and patient outcomes.
Women’s experiences of dealing with fertility and side effects in contraceptive decision making: a qualitative study based on women’s blog posts
Authors: Johansson Lydia , Vesström Julia , Alehagen Siw , Kilander Helena
Published: June 2023

Background

Worldwide, there is limited knowledge regarding women’s views of future fertility in relation to contraceptive use. Few studies include material where women share their experiences at peer-written public domain websites, in spite of a larger portion of women discontinuing use of contraceptives. The objective of this study was to explore women’s experiences of contraceptive methods based on data gathered from individual blog posts.

Methods

Explorative qualitative study including 123 individual blog posts as the data source analysed with inductive thematic analysis.

Results

Two themes were identified. Theme 1, ‘Seeking control over reproduction and optimise fertility’ including the sub-themes; Having the possibility to decide if, and when, to become pregnant, The value of effective contraceptive methods and the impact of women’s sexuality, A wish to understand the body’s normal fertility function and Limited knowledge—sharing information about the menstrual cycle during counselling and Theme 2, ‘Making the complex decision on their own’ including the sub- themes; Limited or subpar guidance in counselling and need for information from social media, Relational and environmental factors influencing contraceptive decision making and Considering beneficial effects and fears of adverse health effects when using hormonal contraceptive methods.

Conclusions

During counselling, women desired an extended dialogue regarding effectiveness, health effects of different methods and an increased understanding of their menstrual cycle. Insufficient understanding of contraceptive methods can lead to use of methods not providing the expected level of protection. Hormonal contraceptives, especially Long-acting reversible contraception (LARC) were believed to inhibit fertility long after ending treatment.
Proton beam therapy in multimodal treatment for locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinus
Authors: Saito Takashi , Nakayama Masahiro , Ohnishi Kayoko , Tanaka Shuho , Nakamura Masatoshi , Murakami Motohiro , Matsumoto Shin , Baba Keiichiro , Fujii Keitaro , Mizumoto Masashi , Tabuchi Keiji , Sakurai Hideyuki
Published: June 2023

Background

To evaluate proton beam therapy (PBT) in multimodal treatment for locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinus (NPSCC).

Methods

The cases in this study included T3 and T4 NPSCC without distant metastases that were treated at our center using PBT between July 2003 and December 2020. These cases were classified into 3 groups based on resectability and treatment strategy: surgery followed by postoperative PBT (group A); those indicated to be resectable, but the patient refused surgery and received radical PBT (group B); and those declared unresectable based on the extent of the tumor and treated with radical PBT (group C).

Results

The study included 37 cases, with 10, 9 and 18 in groups A, B and C, respectively. The median follow-up period in surviving patients was 4.4 years (range 1.0-12.3 years). The 4-year overall survival (OS), progression-free survival (PFS), and local control (LC) rates were 58%, 43% and 58% for all patients; 90%, 70% and 80% in group A, 89%, 78% and 89% in group B; and 24%, 11% and 24% in group C. There were significant differences in OS (p = 0.0028) and PFS (p = 0.009) between groups A and C; and in OS (p = 0.0027), PFS (p = 0.0045) and LC (p = 0.0075) between groups B and C.

Conclusions

PBT gave favorable outcomes in multimodal treatment for resectable locally advanced NPSCC, including surgery followed by postoperative PBT and radical PBT with concurrent chemotherapy. The prognosis for unresectable NPSCC was extremely poor, and reconsideration of treatment strategies, such as more active use of induction chemotherapy, may improve outcomes.
Circumferential approach via dynamic position in OLIF combined with freehand screw pedicle fixation for lumbar tuberculosis requiring multilevel instrumentation: a 3-year retrospective study
Authors: He Jinyue , Luo Fei , Fang Qing , Xiang Yu , Xu Jianzhong , Zhang Zehua
Published: June 2023

Purpose

To advance a modified oblique lumbar interbody fusion (M-OLIF) achieving anterior debridement and posterior freehand instrumentation simultaneously in circumferential approach via dynamic position and compare with traditional combined anterior–posterior surgery (CAPS) in clinical and radiological evaluation.

Patients and methods

Innovative freehand instrumentation in floating position was described. Consecutive patients having undergone surgeries for lumbar tuberculosis from 2017 January to 2019 December had been retrospectively reviewed. Patients with follow-ups for at least 36 months were included and divided into M-OLIF or CAPS group according to surgical methods applied. Outcomes included operation time, estimated blood loss, complication profile for safety evaluation; Vascular Analogue Scale (VAS) and Oswestry Disability Index (ODI) for efficacy evaluation; C-reactive protein and Erythrocyte Sedimentation Rate for tuberculosis activity and recurrence evaluation; X-ray and CT scan for radiological evaluation.

Results

Totally 56 patients had been enrolled in the study (26 for M-OLIF and 30 for CAPS). Compared with CAPS group, M-OLIF group illustrated significantly decreased estimated blood loss, operation time, hospital stay, and less postoperative morbidities. Meanwhile, M-OLIF group showed earlier improvement in VAS in 3 days and ODI in the first month postoperatively, without obvious discrepancy in further follow-ups. The overall screw accuracy in M-OLIF and CAPS group was 93.8% and 92.3% respectively, without significant difference in perforation distribution.

Conclusion

M-OLIF was efficient for lumbar tuberculosis requiring multilevel fixation, with reduced operation time and iatrogenic trauma, earlier clinical improvement compared with traditional combined surgery.
Repurposing Amphotericin B: anti-microbial, molecular docking and molecular dynamics simulation studies suggest inhibition potential of Amphotericin B against MRSA
Authors: Farid Neha , Bux Khair , Ali Kashif , Bashir Asma , Tahir Rahima
Published: June 2023

Amphotericin B (AMPH) is an anti-fungal drug and this study, for the first time as best of our knowledge, reports the repurposing of the Amphotericin B. The drug was found to show significant antibacterial potential revealed by antimicrobial screening, molecular docking, and mode of action analysis targeting Penicillin Binding Protein 2a (PBP 2a protein) which is target of β-lactam drugs and is involved in cell wall synthesis. Mode of action analysis showed the drug to have hydrophobic and hydrophilic interactions with both C-terminal, trans-peptidase and non-penicillin binding domain of the protein. Additionally, to evaluate the impact of ligand binding on the protein's conformational dynamics, molecular dynamics (MD) simulations were used. Comparative Dynamical flexibility (RMSF) and Dynamics Cross Correlation (DCCM) followed by MD simulations revealed the complex formation significantly effecting structural dynamics of the enzyme significantly in the non-penicillin binding domain (327–668) and slightly in trans peptidase domain. Radius of gyration assessment further showed ligand binding also decreasing over all compactness of protein. Secondary structure analysis indicated the complex formation changing the conformational integrity in non-penicillin binding domain. Hydrogen bond analysis and MMPBSA, free energy of calculations followed by MD simulations, also complemented the antimicrobial and molecular docking revelations suggesting Amphotericin B to have substantial antibacterial potential.
No impact of helminth coinfection in patients with smear positive tuberculosis on immunoglobulin levels using a novel method measuring Mycobacterium tuberculosis-specific antibodies
Authors: Pushpamithran Giggil , Skoglund Camilla , Olsson Fanny , Méndez-Aranda Melissa , Schön Thomas , Segelmark Mårten , Stendahl Olle , Gilman Robert H. , Blomgran Robert
Published: June 2023

Helminth/tuberculosis (TB)-coinfection can reduce cell-mediated immunity against Mycobacterium tuberculosis (Mtb) and increase disease severity, although the effects are highly helminth species dependent. Mtb have long been ranked as the number one single infectious agent claiming the most lives. The only licensed vaccine for TB (BCG) offers highly variable protection against TB, and almost no protection against transmission of Mtb. In recent few years the identification of naturally occurring antibodies in humans that are protective during Mtb infection has reignited the interest in adaptive humoral immunity against TB and its possible implementation in novel TB vaccine design. The effects of helminth/TB coinfection on the humoral response against Mtb during active pulmonary TB are however still unclear, and specifically the effect by globally prevalent helminth species such as Ascaris lumbricoides, Strongyloides stercoralis, Ancylostoma duodenale, Trichuris trichiura. Plasma samples from smear positive TB patients were used to measure both total and Mtb-specific antibody responses in a Peruvian endemic setting where these helminths are dominating. Mtb-specific antibodies were detected by a novel approach coating ELISA-plates with a Mtb cell-membrane fraction (CDC1551) that contains a broad range of Mtb surface proteins. Compared to controls without helminths or TB, helminth/TB coinfected patients had high levels of Mtb-specific IgG (including an IgG1 and IgG2 subclass response) and IgM, which were similarly increased in TB patients without helminth infection. These data, indicate that helminth/TB coinfected have a sustained humoral response against Mtb at the level of active TB only. More studies on the species-specific impact of helminths on the adaptive humoral response against Mtb using a larger sample size, and in relation to TB disease severity, are needed.
Economical revenue maximization in mobile edge caching and blockchain enabled space-air-ground integrated networks
Authors: Du Jianbo , Lv Jiaju , Lu Guangyue
Published: June 2023

In this paper, we study an edge caching and blockchain enabled space-air-ground integrated networking (SAGIN) network, where a low-earth-orbit (LEO) satellite serves as the content provider, and multiple edge caching enabled unmanned aerial vehicles (UAVs) will cache some contents to provide user equipments (UEs) with satisfactory content access services together with the satellite. Moreover, there’s a blockchain system that is deployed on UAVs, to provide the network with trust mechanism without requiring a centralized authority. From the standpoint of the operator, we intend to maximize the long-term averaged economical revenue by providing UEs with satisfactory and secure content access services. To achieve this purpose, we will jointly optimize the content placement of each UAV, content replacement when each UAV is full, the access control of each UE, and the blockchain deployment strategy about each UAV. the concept of queues in Lyapunov optimization is utilized to represent the backlog of edge equipment, ensuring the stability of virtual queues on UAVs and satellites, while satisfying the caching capacity constraints for content caching and blockchain deployment. Due to the tight coupling of optimization in each time slot and the variables within each time slot, our problem, which involves stochastic optimization and binary integer programming, is challenging to solve. To address this issue, we initially employ Lyapunov optimization theory to transform and decouple the problem into individual time-slot optimization problems. Subsequently, we utilize an effective heuristic algorithm called the fireworks algorithm to solve these individual optimization problems. However, the original fireworks algorithm cannot be directly applied to our problem due to its binary characteristics and inter-coupling constraints. Therefore, we have redesigned the explosion and mutation operations to adapt them to our specific problem. Simulation results demonstrate that our proposed algorithm outperforms other baseline algorithms.
Normal thyroid stimulating hormone is associated with all-cause mortality in patients with acute myocardial infarction after percutaneous coronary intervention
Authors: Ni Wei-cheng , Kong Shu-ting , Lin Ken , Huang Yu-heng , Li Jun-feng , Shi San-ling , Lu Yu-cheng , Cheng Ling , Chen Chang-xi , Zhou Hao
Published: June 2023

Background

Circulating thyroid-stimulating hormone (TSH) levels within the normal reference range can affect the cardiovascular system. The present study investigated the prognostic value of normal TSH levels in patients presenting with acute myocardial infarction (AMI) following percutaneous coronary intervention (PCI).

Methods

Between January 2013 and July 2019, 1240 patients with AMI and normal thyroid function were enrolled and classified according to TSH tertile. The trial endpoint was all-cause mortality. The integrated discrimination index (IDI) and the net reclassification index (NRI) were used to assess the combined predictive values of the TSH levels and the Global Registry of Acute Coronary Events (GRACE) scores.

Results

After a median 44.25-month follow-up, 195 individuals died. Even after covariate adjustment by multivariate Cox regression (HR: 1.56; 95% CI 1.08–2.25; P = 0.017), the patients in the third TSH tertile were at the highest risk of all-cause mortality. A subgroup analysis revealed significant interactions between the TSH levels and the GRACE scores (high risk vs. low/medium risk) (P = 0.019). The addition of the TSH levels to the GRACE scores substantially improved the prediction of all-cause mortality, especially for high-risk patients (NRI = 0.239; IDI = 0.044; C-statistic value range 0.649–0.691; all significant).

Conclusions

The third TSH tertile is associated with a higher incidence of all-cause mortality than the first TSH tertile in high-risk patients presenting with AMI after PCI.
Examining correlates of aggression and mediating effect of psychological distress between exposure to media violence and aggression in lebanese adults
Authors: Chabbouh Alfred , Hallit Souheil , Farah Nour , Youssef Christina , Hankache Abdo , Fekih-Romdhane Feten , Bitar Zeinab , Obeid Sahar
Published: June 2023

Background

Violent media is the most consumed type of media in Lebanon. Many studies have linked exposure to media violence to increased aggression and psychological distress. As Lebanon is going through socio-political turmoil, we aimed to [1] explore the correlates of aggression (i.e., sociodemographic factors, BMI, loneliness, social competence, and psychological distress) in a sample of Lebanese adults from the general population, and [2] to examine the mediating effect of psychological distress in the association between exposure to media violence and aggression in this sample.

Methodology

Adults were recruited through online convenience sampling. We employed scales to assess content-based media exposure (C-ME), aggression (BPAQ-SF), psychological distress (DASS-8), loneliness (JGLS), and perceived social competence (PSCS).

Results

Exposure to media violence was associated with all four aggression subtypes (verbal, physical, hostility, and anger). Psychological distress partially mediated all these associations; higher exposure to media violence was significantly associated with more psychological distress, which was significantly associated with higher levels of all types of aggression. Moreover, higher exposure to media violence was significantly associated with higher levels of all types of aggression.

Conclusion

In the sociopolitical context of Lebanon, violent media could be considered a public hazard. Psychological distress likely potentiates the association between exposure to violent media and aggression. Future research should focus on determining what components of psychological distress underpin this mediation.
The contribution of DNA methylation to the (dys)function of oligodendroglia in neurodegeneration
Authors: Fodder Katherine , de Silva Rohan , Warner Thomas T. , Bettencourt Conceição
Published: June 2023

Neurodegenerative diseases encompass a heterogeneous group of conditions characterised by the progressive degeneration of the structure and function of the central or peripheral nervous systems. The pathogenic mechanisms underlying these diseases are not fully understood. However, a central feature consists of regional aggregation of proteins in the brain, such as the accumulation of β-amyloid plaques in Alzheimer’s disease (AD), inclusions of hyperphosphorylated microtubule-binding tau in AD and other tauopathies, or inclusions containing α-synuclein in Parkinson’s disease (PD), dementia with Lewy bodies (DLB) and multiple system atrophy (MSA). Various pathogenic mechanisms are thought to contribute to disease, and an increasing number of studies implicate dysfunction of oligodendrocytes (the myelin producing cells of the central nervous system) and myelin loss. Aberrant DNA methylation, the most widely studied epigenetic modification, has been associated with many neurodegenerative diseases, including AD, PD, DLB and MSA, and recent findings highlight aberrant DNA methylation in oligodendrocyte/myelin-related genes. Here we briefly review the evidence showing that changes to oligodendrocytes and myelin are key in neurodegeneration, and explore the relevance of DNA methylation in oligodendrocyte (dys)function. As DNA methylation is reversible, elucidating its involvement in pathogenic mechanisms of neurodegenerative diseases and in dysfunction of specific cell-types such as oligodendrocytes may bring opportunities for therapeutic interventions for these diseases.
Nano-fluorescent quantum dots as substrates for determination of ribavirin in pharmaceuticals and human plasma as well as monitoring of its kinetic interaction with salmon sperm DNA
Authors: Abdel Hakiem Ahmed Faried , Boushra John M. , Noureldeen Deena A. M. , Lashien Adel S. , Attia Tamer Z.
Published: June 2023

Ribavirin (RIB) was successfully determined by fluorescence spectroscopy upon its quenching to environment friendly phosphorus and nitrogen co-doped carbon quantum dots (PNQDs). Different analytical parameters affecting the fluorescence spectra have been optimized and validated in accordance to the ICH guidelines. The proposed method has provided an efficient tracing of the interaction between RIB molecules and the synthesized QDs in an acidic medium (off-mode). The RIB molecules have shown excellent sensitivity by quenching of the emission band at 401 nm upon excitation at 245 nm throughout a linear range of 0.06–10.00 µg/mL with detection and quantitation limits down to 14.00 and 40.00 ng/mL, respectively. The quenching mode was proven to be static in raw samples and samples extracted of spiked plasma for quenching rate constants of 1.30 × 1012 L M−1 S−1 and 1.73 × 1012 L M−1 S−1, respectively. The proposed method has been successfully applied for determination of RIB in the commercial capsules and spiked human plasma samples with good recovery percentages in between 102.00 and 103.00%. Interestingly, these carbon dots have been utilized as nano-fluorescent platforms for assessment of the binding interaction kinetics between the RIB molecules and salmon sperm DNA (ssDNA). This has been implemented through peeling off the RIB molecules from surface of the PNQDs upon successive addition of the ssDNA and hence fluorescence restoration (turning on). Consequently, this provides  a successful monitoring of its antimicrobial potency. It was evidenced a strong binding interaction with a binding constant of 2.38 × 104 mol−1/L. Significantly, this could open doors for an extended application for on-site monitoring of RIB as well as its interactions with biomolecules and microorganisms.
Robotic‐assisted total knee arthroplasty is not associated with increased risk of postoperative deep vein thrombosis
Authors: Itou Junya , Kuwashima Umito , Itoh Masafumi , Okazaki Ken
Published: June 2023

Purpose

Prolongation of operation time due to registration and pin insertion has been reported with robotic‐assisted total knee arthroplasty (RATKA), and there has been concern about an increase in the postoperative incidence of deep vein thrombosis (DVT). In this study, we compared the incidence of DVT after RATKA with that after conventional manual TKA (mTKA).

Methods

This consecutive retrospective series included 141 knees that underwent primary TKA using the Journey II system. The CORI robot was used. There were 60 RATKAs and 81 mTKAs. Doppler ultrasound was performed in all patients on postoperative day 7 to determine whether DVT was present.

Results

The operation time was longer in the RATKA cohort (99.5 min vs 78.0 min, p < 0.001). The overall incidence of DTV was 43.9% (62/141 knees), all of which were asymptomatic. There was no significant difference in incidence of DVT between RATKA and mTKA (50.0% vs 39.5%, p = 0.23). Use of the robot did not affect the incidence of DVT following TKA (odds ratio 1.02, 95% confidence interval 0.40–2.60; p = 0.96).

Conclusion

The incidence of DVT was not significantly different between RA‐TKA and mTKA. Multiple logistic regression indicated that RATKA is not associated with increased risk of postoperative DVT.

Level of evidence

IV.
A randomised controlled feasibility trial of an early years language development intervention: results of the ‘outcomes of Talking Together evaluation and results’ (oTTer) project
Authors: Nielsen Dea , d’Apice Katrina , Cheung Rachael W. , Bryant Maria , Heald Rebecca , Storr Chloe , Tracey Louise , Rashid Rukhsana , Dickerson Josie , Bowyer-Crane Claudine
Published: June 2023

Background

Early language difficulties are associated with poor school readiness and can impact lifelong attainment. The quality of the early home language environment is linked to language outcomes. However, few home-based language interventions have sufficient evidence of effectiveness in improving preschool children’s language abilities. This study reports the first stage in the evaluation of a theory-based programme, Talking Together (developed and delivered by BHT Early Education and Training) given over 6 weeks to families in the home setting. We aimed to test the feasibility and acceptability of delivering Talking Together in the Better Start Bradford community prior to a definitive trial, using a two-armed randomised controlled feasibility study.

Methods

Families from a single site within the Better Start Bradford reach area were randomly allocated (1:1) to the Talking Together intervention or a wait list control group. Child language and parent-level outcome measures were administered before randomisation (baseline), pre-intervention (pre-test), 2 months post-intervention start (post-test), and 6 months post-intervention start (follow-up). Routine monitoring data from families and practitioners were also collected for eligibility, consent, protocol adherence, and attrition rates. Descriptive statistics on the feasibility and reliability of potential outcome measures were analysed alongside qualitative feedback on trial design acceptability. Pre-defined progression-to-trial criteria using a traffic light system were assessed using routine monitoring data.

Results

Two-hundred and twenty-two families were assessed for eligibility; of these, 164 were eligible. A total of 102 families consented and were randomised (intervention: 52, waitlist control: 50); 68% of families completed outcome measures at 6-month follow-up. Recruitment (eligibility and consent) reached ‘green’ progression criteria; however, adherence reached ‘amber’ and attrition reached ‘red’ criteria. Child- and parent-level data were successfully measured, and the Oxford-CDI was identified as a suitable primary outcome measure for a definitive trial. Qualitative data not only indicated that the procedures were largely acceptable to practitioners and families but also identified areas for improvement in adherence and attrition rates.

Conclusions

Referral rates indicate that Talking Together is a much-needed service and was positively received by the community. A full trial is feasible with adaptations to improve adherence and reduce attrition.

Trial registration

ISRCTN registry ISRCTN13251954. Retrospectively registered 21 February 2019