bluuebunny/crossref_metadata_2025 huggingface dataset:
Light-weighted quasi-zero stiffness device based on connected inclined beams on a flexible support
Authors: Zhang Zhongwen , Xu Zhao-Dong
Published: November 2024

QZS isolators are particularly useful for low frequency excitations that are difficult to isolate for traditional isolation techniques. These isolators can be designed based on bistable structure which is very simple and of low weight. However, an external rigid restraint in transverse direction is often required for this kind of isolator which severely limits its application. This paper investigates a light-weighted QZS device that shows the QZS regardless of flexibility of the support. The device is based on inclined beams connected axially in series. Mechanism of the structure to generate the quasi-zero stiffness is discussed. A numerical model is developed for predicting its behavior. A series of tests were conducted to validate behavior of the structure and the numerical model, and a thorough numerical parametric study was performed. Based on the results, QZS isolators were designed and tested which is shown to have light weight and a good loading capacity.
Exploring dynamics, stability, and bifurcation in a coupled damped oscillator with piezoelectric energy harvester
Authors: Amer TS , Abdelhfeez SA , Elbaz Rewan F , Abohamer MK
Published: November 2024

In this work, we analyze and investigate the mathematical modeling of a dynamical system connected to a piezoelectric device. Piezoelectric transducers are established as highly effective energy harvesting (EH) devices, often employed in real-world mechanical systems. The structure of the dynamical model contains a damped Duffing oscillator acting as the major component, which is connected to an unstretched pendulum and simultaneously to the piezoelectric harvester. To derive the governing equations of motion (EOM), Lagrange’s equations are applied based on the system’s generalized coordinates, in which they are analytically solved using the multiple scales (MS) perturbation method up to the second approximation. Moreover, the solutions achieved are compared with numerical ones to increase transparency and demonstrate the accuracy of the approximate solutions. In addition, comprehensive graphical representations have been produced to investigate the nonlinear stability of the modulation equations. Phase portraits, bifurcation diagrams, and Lyapunov spectra are displayed to depict various system behaviors, alongside Poincaré maps for deeper understanding. The various stability ranges are also explored and discussed. In conclusion, mechanical vibrations are transformed into electricity by the piezoelectric transducer connected to the dynamic model, which has widespread applications and includes crystal oscillators, medical ultrasound, gas igniters, and displacement transducers.
Comparative analysis of direct search methods for material design optimization
Authors: Coropețchi I.C. , Constantinescu D.M. , Vasile A. , Sorohan Șt. , Apostol D.A.
Published: November 2024

This paper contributes to the field of optimization for periodic composite material design by systematically evaluating the performance of four direct search algorithms: greedy, simulated annealing (SA), genetic algorithms (GA), and particle swarm optimization (PSO). The central goal is to determine the optimal arrangement of two material domains inside a representative volume element (RVE) while respecting the constraint that half volume of the domains is composed of a specific material, with the effective shear modulus as the objective function. The main contribution of this work is the detailed comparison of these algorithms in terms of success rates and computational efficiency, providing critical insights into their suitability for different problem scales. For a small-scale problem (16 cells), PSO achieves a 100% success rate, while SA demonstrates over 90% success but at a higher computational cost. The greedy algorithm, despite its simplicity, achieves a 72% success rate with the lowest computational effort, requiring an average of 256 objective function evaluations. GA, however, exhibits the lowest success rate at 52% and requires the highest average number of evaluations (5003.2). Furthermore, the paper extends the analysis to a more complex problem (36 cells), where the adaptability and efficiency of the algorithms are tested. This investigation highlights the trade-offs between algorithmic complexity, success rate, and computational cost, offering practical guidelines for selecting suitable optimization methods based on problem size and characteristics.
Examining gamification affordances for intrinsic needs of satisfaction in tourist engagement activities on digital platforms in Hong Kong
Authors: Chan Wun-Han
Published: November 2024

The effectiveness of gamification elements has been widely examined in different aspects over the past decade. However, recent research showed that not all gamification elements can effectively engage users or consumers in different domains including video games and online shopping activities. To examine these inconsistent results, affordance theory was expanded to propose a new affordance design model in the gamification context. This study included a questionnaire survey of 303 Hong Kong residents, aged 18- 60 years old. SmartPLS4.0 structural equation modelling (PLS-SEM) was employed. The findings indicated that the proposed gamification affordances were largely significant for consumers’ psychological satisfaction needs, except for hedonic-based features. The results also demonstrated that gamification serves as a rewarding tool for consumers to foster social connections and achieve self-fulfillment. This highlights the utilitarian value within the relationship between consumers and activities in tourism. The objective of this research was to identify which gamification affordances most effectively fulfilled consumers’ psychological need of satisfaction by incorporating self-determination theory. This study contributed using a new affordance model to understand consumer actions in the knowledge construction of gamification effectiveness, especially in the tourist markets and its impact on consumers’ psychological satisfaction needs. The effectiveness of gamification of reward-based affordances present that the this research provide valuable insights that can be used by marketers to develop effective online marketing strategies specifically for online tourism activities in Hong Kong.
Re(cover)ing Revelations: Formulating Black Ancestral Text Analysis in Education Research
Authors: Teague Latoya M. , Nagbe Mariama N.
Published: November 2024

Traditional research on Blackness in education often renders Black people nonhuman (Wynter, 1994). In this article, we formulate Black ancestral text analysis, a qualitative research method in which Black thinkers excavate the ancestral knowledges offered in intellectual texts. Our method rejects the white gaze of counting and condemning Black people in education research by reflecting on Black interiority and analyzing the texts that Black intellectuals produce. This article offers a set of research protocol questions to guide an analysis of how Black thinkers re(cover) un/seen, embodied, and alternative knowledges from multigenre historical and literary texts. Through this qualitative approach, we gather information about the texts, including knowledge about the story, the storyteller/storytelling, and the storage (the archival collection). Further, through deep meditation, we come to understand ancestral knowledge, or alternative forms of knowledge when reflecting on the un/seen and the silences in texts. Black ancestral text analysis emerged from a curiosity to explore alternative forms of knowledge and recovery in education research. We present an example of this ancestral knowledge excavation process using Wynter’s critique of the inner eye, school curriculum, student activism outlined in news articles, and Alvin Ailey’s (1960) “Revelations.” We conclude with a discussion of the communal obligations and ethical commitments of abstracting alternative knowledges within Black education research.
Improved ant colony optimization algorithm based on islands type for mobile robot path planning
Authors: Li Qian , Li Qipeng , Cui Baoling
Published: November 2024

According to the characteristics of ant colony optimization (ACO) algorithm in mobile robot path planning, such as local optimal solution, slow convergence speed, low search efficiency, and propensity to produce numerous deadlock ants, an improved ACO algorithm based on island type (insular ACO (INACO)) is introduced. In this algorithm, firstly, several islands are established between the starting and the ending position of environment, serving as intermediate nodes for the paths searched by the ants. This greatly reduces the number of deadlock ants. Additionally, rectangular areas are initialized with non-uniform pheromone levels between adjacent islands, while other areas are set to a constant minimum pheromone value. This prevents blind searches during the initial stages of path planning. Furthermore, an adaptive volatilization coefficient is introduced into the global pheromone update rules to balance the convergence and global search ability. Finally, optimal parameter combinations of INACO are determined by simulation. INACO algorithm is simulated in various grid maps and compared with other improved ACO algorithms. Results demonstrate its superior global optimal search capability and rapid convergence speed. The average iterative times is 2.7 in a 20 × 20 grid environment and 4.7 in a 30 × 30 grid environment. Notably, INACO produces very few lost ants, with mean values of 50.1 and 95.2 in 20 × 20 and 30 × 30 grid environments, respectively.
Distinct components of Stroop interference and facilitation: The role of phonology and response modality
Authors: Qiu Yicheng , van Heuven Walter JB
Published: November 2024

Multi-stage accounts of Stroop effects suggest that Stroop effects result from different conflict and facilitation components. Consistent with these accounts, Augustinova et al. reported evidence for task, semantic, and response components in Stroop effects. They also investigated how vocal and manual responses impacted the magnitude of each of the conflict and facilitation components. However, the role of phonological components in Stroop effects was not investigated in their study. The impact of phonology on Stroop effects has been observed in several studies. However, these studies did not investigate the role of different conflict/facilitation components in Stroop effects. To investigate the impact of phonological components as well as task, semantic, and response components on Stroop effects, a vocal and manual Stroop task was for the first time conducted with Chinese speakers using a design similar to that of Augustinova et al. The data revealed only in the vocal Stroop task phonological conflict and facilitation, whereas semantic and response conflicts were found with vocal and manual responses. Implications of the findings for response modality effects and the measures of facilitation/conflict components are discussed.
The impact of health maintenance organizations on improving cardiac surgery outcomes
Authors: Skidmore Kimberly L. , Flattmann Farrah E. , Cagle Hayden , Shekoohi Sahar , Kaye Alan D.
Published: November 2024

Background and objectives:

California is one of a few states with mandatory reporting of mortality after coronary artery bypass graft (CABG) surgery. The Affordable Care Act restructured Medicaid, preferentially penalizing patients experiencing poverty because payments to hospitals for isolated surgical events overshadow payments to primary care clinicians. We propose outcomes are superior when hospital networks organize surgical episodes within the context of primary care inside that same network.

Design and methods:

We listed factors impacting outcomes after CABG. CABG surgery outcome depends upon the integration of issues beginning years preoperatively and extending for decades. Therefore, we studied one health maintenance organization (HMO) from 2009 to 2020 compared to surrounding individual hospitals. We divided 58 hospitals in Northern California in 2009 according to income and population. To focus on changes introduced because of COVID-19, we compared a public database for the subset in 2009 for any relationship between poverty in a zip code and low volumes of CABG in that area to overall mortality in 2020. First, we defined low-income zip codes as those with a higher rate of poverty than the state average or with a lower per capita average income, per Census Bureau. Second, low volume was defined as a population under 165,000 because a hospital adjacent to a larger community can easily transfer care, sharing surgeons and processes. Third, we defined low volume as fewer than 180 CABG per year.

Results:

Our qualitative evidence synthesis reveals that informal communication and hospital HMO policies improve CABG outcomes. In our small pilot data, Chi-square analysis showed higher crude mortality rates in 1507 CABG in 17 low-income low-volume hospitals versus 8163 CABG in the other 41 Northern California hospitals (2.72% vs 1.69%, p = 0.0064). Low-income low-volume hospitals had a relative mortality risk of 1.61 (95% CI: 1.14–2.27). These hospitals had a mean mortality rate of 3.79%, readmission 11.12%, and stroke 1.84%. A patient undergoing CABG in a low-income low-volume hospital has a 61% higher chance of dying. The number needed to treat analysis shows that one life can potentially be saved for every 97 patients referred to another institution.

Conclusion:

We describe features of an HMO that contribute to up to fourfold lower mortality rates.
The Contestation of National Adaptation Policies in Indonesia
Authors: Apresian Stanislaus Risadi
Published: November 2024

Indonesia actively supports the United Nations Framework Convention on Climate Change to achieve the Global Goal on Adaptation by setting ambitious climate change adaptation pledges in its Nationally Determined Contributions. This paper explores the implementation of those adaptation commitments within a polycentric governance structure in Indonesia. There is a debate about whether polycentric institutions help or hinder the effectiveness of adaptation outcomes. The question remains, why is the implementation of climate change adaptation policies in Indonesia ineffective? This paper argues that the contestation between the National Development Planning Agency and the Ministry of Environment and Forestry, as two dominant ministries in adaptation, has beset the polycentric structure of adaptation governance in Indonesia and resulted in ineffective adaptation policy implementation. Moreover, the polycentric adaptation governance is ineffective because Indonesia is still facing problems in coordination, collaboration, policy learning, leadership, resource distribution, and dispersion of power.
Major Sesquiterpenoids in Psychotria laui Leaf Essential oil Exhibit Anti-Inflammatory and Cytotoxic Properties
Authors: Tran Tien Dong , Le Anh Tuan , Le Thang Quoc , Pham Ty Viet
Published: November 2024

Objective: This study aims to investigate the chemical constituents and biological properties of the essential oil derived from Psychotria laui, a plant recognized for its medicinal applications, particularly in traditional Vietnamese medicine, where it is utilized for the treatment of digestive and inflammatory disorders. Methods: Fresh leaves of Psychotria laui were gathered in Quangtri, Vietnam, and subjected to hydro-distillation using a Clevenger-type apparatus to obtain the essential oil. The chemical composition of the essential oil was analyzed by gas chromatography-mass spectrometry (GC-MS). The antioxidant potential was measured using the DPPH (2,2-Diphenyl-1-picrylhydrazyl) assay, while the inhibition of nitric oxide production was tested in lipopolysaccharide-stimulated RAW264.7 cells. Cytotoxicity against the SK-LU-1 cell line (human lung adenocarcinoma) was evaluated using the sulforhodamine B (SRB) assay. Results: The essential oil from Psychotria laui contained 78 distinct constituents. The major compounds identified were spathulenol (10.4%), thujopsan-2- α-ol (9.5%), 7- epi- α-eudesmol (6.5%), 14-hydroxy-9- epi-( E)-caryophyllene (4.4%), epi- α-cadinol (3.9%), α-muurolol (3.8%), 1- epi-cubenol (3.5%), and δ-cadinene (3.2%). The essential oil showed no antioxidant activity, with an IC50 (half-maximal inhibitory concentration) value greater than 500 µg/mL, in contrast to the positive control, L-ascorbic acid, which had an IC50 of 7.78 ± 0.39 µg/mL in the DPPH assay. However, its anti-inflammatory activity was evident by its ability to inhibit nitric oxide production, with an IC50 of 19.48 ± 1.53 µg/mL in lipopolysaccharide-stimulated RAW264.7 macrophages. Moreover, the essential oil exhibited potent cytotoxicity against the SK-LU-1 cancer cell line, with an IC50 of 8.49 ± 0.73 µg/mL in the SRB assay. Conclusion: The essential oil from Psychotria laui leaves contains numerous bioactive compounds and exhibits significant anti-inflammatory and cytotoxic properties, although it lacks antioxidant activity.
Congenital hiatal hernia with vermis hypoplasia, dysmorphic features and negative genetic study: A case report
Authors: Mujahed Ramzi H , Shaheen Manal M , Abusafa Ikram M , Shahin Amenah G , Bouzieh Ethar A , Baniodeh Bushra S , Asaad Hamda L
Published: November 2024

Congenital hiatal hernia is a rare congenital defect and often occurs at a sporadic basis, but familial cases have also been reported. Here, we report on a 3-year-old male patient of Middle-Eastern descent, diagnosed at 5 months of age patient presenting with a congenital hiatal hernia, vermis hypoplasia manifested by axial hypotonia and horizontal nystagmus, preauricular tag, and dysmorphic features with negative genetic mutations, not fitting any reported association or syndrome, suggesting the potential existence of a novel disease entity and highlighting the necessity for further exploration into rare genetic conditions for comprehensive patient care and syndrome characterization.
Aligning practitioner's perception: Empowering MAST framework for evaluating telemedicine services
Authors: Parvez Ayesha , Saleem Javeria , Bhatti Muhammad Ajmal , Hasan Arshad , Mahmood Asif , Ali Zulfiqar , Tauqeer Tauseef
Published: November 2024

Objective

Telemedicine is a digital substitute for in-person healthcare service delivery systems that has gained popularity amid the global COVID-19 pandemic. The objective of this study was to evaluate telemedicine compatibility from the perspective of healthcare practitioners to enhance the effectiveness and spectrum of the Model for Assessment of Telemedicine.

Method

Primary and Secondary Healthcare and King Edward Medical University extended their respective telemedicine services in 2020 where 24,516 patients were benefited from the telemedicine services provided by 1273 doctors from different specializations. A cross-sectional survey via online questionnaire was conducted among purposively sampled 248 healthcare practitioners designated at telemedicine portals in the public sector; further analysed by descriptive analysis and Monte Carlo Feature Selection.

Results

Healthcare practitioner perception was analysed explicitly and found significant in addition to the existing domains under multidisciplinary assessment in the Model for Assessment of Telemedicine model. The variables of subdomains integration with healthcare system, patient facilitation, technology ease, capacity building, ethical integrity, outcome assessment and communication gap under proposed healthcare practitioner perception domain were found interdependent. The variables of patient satisfaction, resource preservation, healthcare practitioner satisfaction, digital connectivity, user-friendliness, and patient safety were found to be of higher importance (RI values). However, the compatibility of telemedicine with the healthcare system was also influenced by interdependencies (RI plot) and multifaceted interactions of variables derived from the healthcare practitioner perception.

Conclusion

The variables of healthcare practitioner perception were exhibiting various weightages of importance and interdependencies in determining the compatibility of telemedicine within the healthcare system and recommended to be considered in the Model for Assessment of Telemedicine framework.
Middle-class Populism: Political Inequalities and Populist Appeal in India
Authors: Chhibber Pradeep
Published: November 2024

Populist appeals resonate in contemporary India because of political inequalities. These inequalities persist because political parties are stuck in a reciprocity trap that favours local elites, who provide the party with financial support and resources. This reciprocity trap not only perpetuates political inequalities but also leads to the systematic marginalization of the poor by political parties who remain less receptive to populist appeals by a political leader. This article shows that the middle class, not the poor, were more receptive to populist messages in the 2024 elections. Even though Modi remained immensely popular, the middle classes found Rahul Gandhi’s populist message more compelling. The analysis is based on the pre-and post-election surveys from 2024 and other NES surveys.
Communication Apprehension in the Workplace: The Role of Position and Facilitation Skills
Authors: Kaneko Atsuko
Published: November 2024

Communication apprehension (CA) is widely recognized as a significant inhibitor of communication and performance, making its management crucial. This study explored the connections between gender, managerial status, communication frequency, and discussion skills in explaining CA in the Japanese working population ( N = 300). Our findings suggest that facilitation skills explain CA better than personal attributes or communication frequency and that the gender difference in CA was only observed in nonmanagers. We discuss the implications of our findings for research and education.
Aesthetic Literacies in Digital Learning Ecologies: Tracing Aesthetic Tools and Functions in a Youth Literary Salon
Authors: Storm Scott
Published: November 2024

Concerned with disinformation, fake news, and a posttruth era, literacy research on digital learning ecologies has focused on content of the texts that youth encounter but less explicitly on aesthetics—issues of form or the way a text is written. Drawing on critical sociocultural theories, this article examines youth aesthetic meaning-making with non-neutral digital texts. The data analyzed are part of a multiyear multimethod study of the aesthetic literacy practices of queer youth of color and allies. Data were collected during an online summer literary salon where youth discussed textual content alongside issues of aesthetic forms. Findings illustrate that youth drew on a broad range of aesthetic tools to achieve (1) a poetic function concerned with how aesthetic forms elicit figurative, connotative, and storied meanings; (2) a catalytic function concerned with how aesthetic forms persuade, manipulate, or encourage particular actions; and (3) an ideological function concerned with how aesthetic forms inscribe or contest social inequalities. These tools and functions, complicate previous understandings of disinformation, fake news, and critical reasoning in literacies research. This study suggests a critical sociocultural approach to aesthetics as territory for further scholarship across many areas of literacy research.
Participatory science and course-based undergraduate research experience to improve research-informed teaching of evolution and palaeontology
Authors: Lautenschlager Stephan
Published: November 2024

This study introduces a participatory science-inspired approach to teaching and curriculum design, involving undergraduate students directly in active research. Using a case study on dinosaur eye size, integrated into a first-year undergraduate course in Geology and Palaeontology at a UK university, this study presents the advantages and disadvantages of this approach for both teachers and learners. As part of the study, 22 undergraduate students were involved in data collection, analysis, and the subsequent publication processes, emphasizing active student participation in research. A subsequent survey demonstrated high student engagement and perceived relevance of this participatory science-style teaching approach. Results indicate that students found the approach appealing, engaging, and beneficial for understanding scientific concepts and methods. The case study shows that a participatory science approach through a course-based research experience can enhance student engagement and learning by providing meaningful, hands-on research experiences. This approach allowed students to apply theoretical knowledge in a realistic context, fostering their understanding of evolutionary theory through active data collection and analysis. However, care should be taken concerning data accuracy and ethical aspects, such as exploitation of labour and the recognition of knowledge creators and participants. Despite these challenges, the benefits of integrating such approaches into higher education curricula can be substantial, offering a valuable model for teaching evolutionary theory and related topics.
Adaption of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care of children
Authors: Packendorff Niclas , Magnusson Carl , Axelsson Christer , Hagiwara Magnus Andersson
Published: November 2024

Background

The emergency medical service (EMS) addresses all chief complaints across all ages in various contexts. Children in EMS present a particular challenge due to their unique anatomical and physical properties, which require specific training that EMS clinicians often report lacking. This combination exposes children to incidents threatening patient safety. The most common method to highlight incidents is the incident reporting system. Studies have shown underreporting of such incidents, highlighting the need for multiple methods to measure and enhance patient safety in EMS for children. Thus, the aim of this study was to modify and adapt the current Ambulance TT for road-based EMS (ATT) to a pediatric version (pATT) with a guide containing definitions of triggers.

Methods

The adaption of the ambulance trigger tool to a version suitable for children followed a stepwise manner, including (1) a review of previous literature to pinpoint areas of risk regarding patient safety among children in EMS. (2) Three sessions of expert panel discussions via video meetings were held to evaluate each trigger of the ATT in terms of clinical relevance, comprehensibility, language and areas of risk regarding patient safety among children in EMS. (3) Clinical use of the pATT along with Retrospective Record Review (RRR). (4) Calculation of Item-level validity index and positive predictive value (PPV) for each trigger. (5) calculate inter-rater reliability between two independent record reviewers.

Results

The literature search revealed 422 respective 561 articles in Cinahl and Medline where headlines and abstracts were read to identify areas posing risks to patient safety in EMS for children. During the structured discussions, one trigger was added to the existing 19 derived from the ATT, and the trigger definitions were modified to suit children. The three most common triggers identified in the 900 randomly selected records were deviation from treatment guidelines (63.9%), incomplete documentation (48.3%), and the patient is non conveyed after EMS assessment (41.1%). The positive triggers were categorized into near miss (54.6%), no harm incident (5.8%), and harmful incident (0.4%). Inter-rater reliability testing showed excellent agreement.

Conclusion

This study demonstrates the adaptation of an existing trigger tool (ATT) to one suitable for children. It also shows that the trigger tool, along with retrospective record review, is a feasible method to evaluate patient safety in EMS, thus complementing existing methods.
Burden of Parkinson’s disease in Central Asia from 1990 to 2021: findings from the Global Burden of Disease study
Authors: Akhmedullin Ruslan , Supiyev Adil , Kaiyrzhanov Rauan , Issanov Alpamys , Gaipov Abduzhappar , Sarria-Santamera Antonio , Tautanova Raushan , Crape Byron
Published: November 2024

Background

Central Asia is known to face various ecological challenges that constitutes major risk factors for Parkinson’s disease (PD). This study examines the burden of PD in Central Asia, a region where data on neurological disorders is notably sparse.

Methods

Building on the latest Global Burden of Disease Study (GBD 2021), this study investigates the Years of Life Lost (YLLs), Years Lived with Disability (YLDs), and Disability-Adjusted Life Years (DALYs) associated with PD in Central Asia and its countries from 1990 to 2021. The authors calculated average annual percent change (AAPC) to analyze trends, and compared individual country estimates to global figures. Additionally, incorporating data from the World Bank, both Bayesian hierarchical and non-hierarchical frequentist regression models were employed to assess their impact on DALYs.

Results

The DALYs varied across the study period, primarily driven by YLLs. While YLLs showed a uniform trend, YLDs were mostly incremental. Kazakhstan had the highest estimates across all metrics and was the only country aligned with global patterns. Age- and sex-specific estimates revealed substantial variations, with notably high figures found in male subjects from Tajikistan. The YLLs, YLDs, and DALYs for Kazakhstan, Uzbekistan, and Turkmenistan saw a significant increase in AAPCs. In contrast, Kyrgyzstan and Tajikistan saw declines, likely attributable to civic conflict and inter-country differences in population structure. Further comparison of DALY trends revealed significant deviations for all countries from the global pattern.

Conclusion

This study showed an overall increase in PD burden from 1990 to 2021. These findings underscore the need for targeted strategies to reduce PD burden, with a particular focus on Kazakhstan. Integrating historical information is crucial for discussing the plausible mechanisms in studies sourced from the GBD.
Homozygous splice-site variant in ENPP1 underlies generalized arterial calcification of infancy
Authors: Noor Ul Ayan Hafiza , Nitschke Yvonne , Mughal Abdul Razzaq , Thiele Holger , Malik Naveed Altaf , Hussain Ijaz , Haider Syed Muhammad Ijlal , Rutsch Frank , Erdmann Jeanette , Tariq Muhammad , Aherrahrou Zouhair , Ahmad Ilyas
Published: November 2024

ENPP1 (ectonucleotide pyrophosphatase/phosphodiesterase 1) plays a critical role by converting extracellular ATP to AMP, generating extracellular PPi, a potential inhibitor of calcification. Pathogenic variants in the ENPP1 cause generalized arterial calcification of infancy (GACI [OMIM 208000]). GACI, is an ultra-rare disease characterized by early-onset calcification of large and medium-sized arteries, leading to severe cardiovascular complications such as heart failure, pulmonary stenosis (PS), hypertension, and more. In this study, we report a novel homozygous splice-site pathogenic variant in ENPP1 (NM_006208, c.2230 + 5G > A; p.Asp701Asnfs*2) residing in C-terminal nuclease-like domain (NLD) of ENPP1 protein in a Pakistani family diagnosed with severe valvular PS and mild right ventricular hypertrophy (RVH). cDNA assays confirmed the skipping of exon 21, and the splice product underwent nonsense-mediated decay. Functional studies on fibroblasts from the patient demonstrated increased calcification and decreased enzymatic activity of ENPP1, recapitulating the hallmarks of GACI. By combining genetic analysis with the in vitro study, we substantiate that ENPP1:c.2230 + 5G > A variant is pathogenic, underscoring its role in the development of GACI.
Policy impact of the Imperial College COVID-19 Response Team: global perspective and United Kingdom case study
Authors: van Elsland Sabine L. , O’Hare Ryan M. , McCabe Ruth , Laydon Daniel J. , Ferguson Neil M. , Cori Anne , Christen Paula
Published: November 2024

Background

Mathematical models and advanced analytics play an important role in policy decision making and mobilizing action. The Imperial College Coronavirus Disease 2019 (COVID-19) Response Team (ICCRT) provided continuous, timely and robust epidemiological analyses to inform the policy responses of governments and public health agencies around the world. This study aims to quantify the policy impact of ICCRT outputs, and understand which evidence was considered policy-relevant during the COVID-19 pandemic.

Methods

We collated all outputs published by the ICCRT between 01-01-2020 and 24-02-2022 and conducted inductive thematic analysis. A systematic search of the Overton database identified policy document references, as an indicator of policy impact.

Results

We identified 620 outputs including preprints (16%), reports (29%), journal articles (37%) and news items (18%). More than half (56%) of all reports and preprints were subsequently peer-reviewed and published as a journal article after 202 days on average. Reports and preprints were crucial during the COVID-19 pandemic to the timely distribution of important research findings. One-fifth of ICCRT outputs (21%) were available to or considered by United Kingdom government meetings. Policy documents from 41 countries in 26 different languages referenced 43% of ICCRT outputs, with a mean time between publication and reference in the policy document of 256 days. We analysed a total of 1746 policy document references. Two-thirds (61%) of journal articles, 39% of preprints, 31% of reports and 16% of news items were referenced in one or more policy documents (these 217 outputs had a mean of 8 policy document references per output). The most frequent themes of the evidence produced by the ICCRT reflected the evidence-need for policy decision making, and evolved accordingly from the pre-vaccination phase [severity, healthcare demand and capacity, and non-pharmaceutical interventions (NPIs)] to the vaccination phase of the epidemic (variants and genomics).

Conclusion

The work produced by the ICCRT affected global and domestic policy during the COVID-19 pandemic. The focus of evidence produced by the ICCRT corresponded with changing policy needs over time. The policy impact from ICCRT news items highlights the effectiveness of this unique communication strategy in addition to traditional research outputs, ensuring research informs policy decisions more effectively.
Navigating SARS-CoV-2-related immunopathology in Crohn’s disease: from molecular mechanisms to therapeutic challenges
Authors: Chen Chang-Cyuan , Lin Yu-An , Liu Kuan-Ting , Huang Chun-Yao , Shih Chun-Ming , Lee Yuan-Ti , Pan Jun-Liang , Lee Ai-Wei
Published: November 2024

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) not only posed major health and economic burdens to international societies but also threatens patients with comorbidities and underlying autoimmune disorders, including Crohn’s disease (CD) patients. As the vaccinated population is gradually relieved from the stress of the latest omicron variant of SARS-CoV-2 due to competent immune responses, the anxiety of CD patients, especially those on immunosuppressive treatment, has not subsided. Whether the use of immunosuppressants for remission of CD outweighs the potential risk of severe coronavirus disease 2019 (COVID-19) has long been discussed. Thus, for the best benefit of CD patients, our primary goal in this study was to navigate the clinical management of CD during the COVID pandemic. Herein, we summarized COVID-19 outcomes of CD patients treated with immunosuppressive agents from multiple cohort studies and also investigated possible mechanisms of how SARS-CoV-2 impacts the host immunity with special consideration of CD patients. We first looked into the SARS-CoV-2-related immunopathology, including lymphocytopenia, T-cell exhaustion, cytokine storms, and their possible molecular interactions, and then focused on mechanistic actions of gastrointestinal systems, including interruption of tryptophan absorption, development of dysbiosis, and consequent local and systemic inflammation. Given challenges in managing CD, we summarized up-to-date clinical and molecular evidence to help physicians adjust therapeutic strategies to achieve the best clinical outcomes for CD patients.
Validity and reliability of the osteoporotic fracture treatment score (OF score) and outcomes across various treatments in osteoporosis vertebral compression fracture patients
Authors: Mekariya Korawish , Santipas Borriwat , Khamnurak Harit , Sirichativapee Wilasinee , Korwutthikulrangsri Ekkapoj , Ruangchainikom Monchai , Sutipornpalangkul Werasak
Published: November 2024

Background

Osteoporotic vertebral compression fractures (OVF) are prevalent and substantially impact healthcare systems and patients’ quality of life. The osteoporotic fracture treatment score (OF score), developed by the German Society of Orthopedics and Trauma (DGOU), guides surgical decisions, but its reliability and validity are underexplored. This study assessed the OF score’s inter- and intraobserver reliability, validated its treatment recommendations, and investigated intermediate outcomes of different DGOU-recommended surgical strategies for OVF.

Methods

A retrospective cohort study was conducted. Inter- and intraobserver reliability of the OF score and its subcomponents were analyzed using clinical and radiographic data. Validity was assessed by comparing the OF score’s recommended treatments with actual treatments received. Outcomes at the final follow-up were back pain visual analog scale, Oswestry Disability Index, EQ-VAS, EQ-5D-5 L, adjacent fracture incidence, local kyphotic angle, and reoperation rates. Patients with at least 1-year follow-up were included.

Results

A total of 157 patients (84.7% female; mean age 74.2 ± 10.5 years) were evaluated. The most frequent osteoporotic fracture (OF) types were OF4 (49.0%) and OF3 (40.8%). The OF score demonstrated good interobserver reliability (ICC = 0.77, 95% CI: 0.65–0.86) and intraobserver reliability (ICC = 0.83, 95% CI: 0.72–0.90). Kappa values for subcomponents ranged from 0.57 to 0.89. Excluding patients with indeterminate recommendations (OF score = 6), 82.9% received treatments concordant with OF score recommendations. Receiver operating characteristic curve analysis showed an area under the curve of 0.77 (95% CI: 0.67–0.86); an OF score cutoff > 6.5 predicted actual treatment with 87.9% sensitivity and 61.0% specificity. All surgical treatments showed comparable improvements in clinical outcomes. However, patients treated with stand-alone cement augmentation (CA) had less local kyphotic angle correction (P = 0.004) and greater postoperative kyphotic progression (P < 0.001) than those undergoing short-segment (SS-PI) or long-segment instrumentation (LS-PI). No significant differences in adjacent fractures or complications were observed.

Conclusions

The OF score is a reliable and valid system with good discriminative ability for surgical decision-making in OVF patients. CA, SS-PI, and LS-PI are viable options with comparable functional outcomes. However, in OF3 or OF4 fractures, caution is advised due to lesser kyphosis correction and greater kyphotic progression with CA compared to SS-PI or LS-PI, as recommended by the DGOU.
Clinical characteristics and prognosis of steroid-resistant nephrotic syndrome in children: a multi-center retrospective study
Authors: Li Sheng , He Chao , Sun Yu , Chen Jie , Liu Yunguang , Huang Zengpo , Huang Weifang , Meng Yongqiu , Liu Wenjing , Lei Xianqiang , Zhao Rihong , Lin Zihui , Huang Chunlin , Lei Fengying , Qin Yuanhan
Published: November 2024

Background

This study investigated the factors influencing the prognosis of children with steroid-resistant nephrotic syndrome (SRNS) in patients from the Guangxi region.

Methods

We retrospectively analyzed clinical and pathological data of 279 patients with SRNS from six tertiary hospitals in Guangxi. Clinical data were compared between initial (I-SRNS) and secondary (S-SRNS) steroid resistance subgroups and Cox regression analysis was used to determine risk factors for chronic kidney disease (CKD) and CKD stage 5 (CKD5) in patients with SRNS.

Results

The median age of onset was 54 months. Thirty-three patients had extra-kidney manifestations. Fifty-two, 24, 57, 33, and 41 patients had hypertension, acute kidney injury, vitamin D deficiency, high intraocular pressure, and dwarfism, respectively. One hundred eighty-two and 92 patients had I-SRNS and S-SRNS, respectively. There were significant differences in sex, ethnicity, family history, incidence of hematuria, clinical classification, efficacy of immune agents, and prognosis between groups (P < 0.05). Among the 279 cases of SRNS, 239 had normal kidney function, 37 developed CKD, and 16 had CKD5. An increase in serum creatinine level (HR = 1.003) was significantly associated with CKD in children with SRNS, and effective immunosuppressant therapy decreased the CKD risk (HR = 0.168). Patients with increased serum creatinine levels (HR = 1.003) and acute kidney injury (HR = 4.829) were more likely to progress to CKD5.

Conclusions

Children with S-SRNS showed a higher response to immunosuppressants than those with I-SRNS. Effective immunosuppressant therapy was found to protect against CKD, whereas increased acute kidney injury was an independent risk factor for CKD5.
Detection and molecular characterization of carbapenem-resistant gram-negative bacterial isolates
Authors: Mustafa Aliaa A. , Abushady Hala , Roshdy Reda , Elateek Sawsan Y. , El Essawy Ayman K.
Published: November 2024

Antimicrobial-resistant bacteria (ARB) are responsible for increased mortality and morbidity. Therefore, this study focuses on evaluating traditional and molecular diagnostic tools of carbapenem-resistant gram-negative bacteria (CRGNB). In order to achieve this, 94 samples, from different patients’ specimens, and surrounding environment, were collected from intensive care units (ICUs) at Ain Shams University Specialized Hospital and the National Cancer Institute, Cairo, Egypt. The swabs were cultured on appropriate media, including Chromogenic medium (HiCrome KPC Agar Base “HIMEDI AM1831”), and MacConkey-10 µg imipenem disc resulting in 136 isolates with different culture characteristics. Next, the selected isolates were subjected to VITEK 2 machine and 16SrRNA (16 S ribosomal RNA) sequencing. The sensitivity of HiCROME KPC agar for CRGNB detection was 99.3% and 94.7%, in reference to the MacConkey-disc and VITEK-2 methods, respectively. The HiCrome KPC agar assumptions for bacterial identification were not as consistent as those of VITEK 2 (with only 47.4% agreement) and 16SrRNA gene sequencing analysis. The approaches discussed in this study facilitate providing rapid diagnosis and treatment of CRGNB, which helps increase survival rates. HiCrome KPC agar is considered a relatively accurate and easy method that can be used in any laboratory. In addition, the selected strains were deposited in the gene bank with the accession numbers OR553657, OR553658, and OR553659. It is noteworthy that Genus Acinetobacter is the major CRGNB isolated from the patients and environmental surfaces in the hospitals. This highlights the importance of proper environmental and terminal cleaning procedures in healthcare facilities and applying control measures to ensure infection prevention.
New strategies for lung cancer diagnosis and treatment: applications and advances in nanotechnology
Authors: Feng Jiaqi , Zhang Pengpeng , Wang Dingli , Li Yuting , Tan Jiaxiong
Published: November 2024

Lung cancer leads in causing cancer-related mortality worldwide, continually posing a significant threat to human health. Current imaging diagnostic techniques, while offering non-invasive detection, suffer from issues such as insufficient sensitivity and the risks associated with radiation exposure. Pathological diagnosis, the gold standard for confirmation, also faces challenges like invasiveness and high costs. In treatment, surgery, radiotherapy, and chemotherapy are the main modalities, each encountering challenges related to precision, environmental adaptability, and side effects. Nanotechnology’s advancement provides new solutions for the diagnosis and treatment of lung cancer, promising to enhance diagnostic accuracy and reduce side effects during treatment. This article introduces the main types of nanomaterials used in the field of lung cancer, offering a comprehensive overview of current research on the application of nanotechnology in early screening, diagnosis, treatment, and monitoring of lung cancer, and summarizing ongoing clinical research findings.
The Role of Delta-Opioid Receptor in Mediating the Cardioprotective Effects of Morphine Preconditioning via the JAK2/STAT3 Pathway in a Failing Heart
Authors: Pan Xinxin , Guo Chengxiao , Wang Baoli , Cao Biyun , Wu Juan , Chen Xinyu , He Shufang , Zhang Ye , Jin Shiyun
Published: November 2024

BACKGROUND:

Failing heart is more likely to suffer from myocardial ischemia/reperfusion (I/R) injury. This poses a great challenge for anesthesiologists in managing patients with heart failure during major surgery. Evidence from animal studies suggests that the delta-opioid receptor (DOR) contributes to alleviating acute myocardial injuries. However, little is known regarding the cardioprotective effects of cardiac DOR in patients with chronic heart failure. This study aimed to examine DOR expression in failing hearts and explore how DOR regulates the Janus kinase signal transducer and activator of the transcription-3 (JAK/STAT3) pathway to mediate morphine-induced cardio protection in heart failure.

METHODS:

We measured the DOR protein levels in human and rat heart tissues with chronic heart failure. To investigate the cardioprotective role of DOR, we administered the DOR-specific antagonist, naltrindole (NTD), and JAK2 inhibitor, AG490, before morphine preconditioning (MPC) in an isolated perfusion model of myocardial I/R injury in postinfarcted failing rat heart. We examined the infarct size, cardiac enzymes, cardiac function, cardiomyocyte apoptosis, apoptosis-related proteins, and STAT3 phosphorylation in the heart.

RESULTS:

The protein levels of DOR were significantly elevated in the myocardial tissues of humans and rats with chronic heart failure, by 1.4-fold (mean difference 0.41; 95% confidence interval [CI], 0.04–0.78; P = .032) and 2.3-fold (mean difference 1.26; 95% CI, 0.25–2.28; P = .009), respectively, compared to control tissues. Disease severity positively correlated with DOR expression (human: R2 = 0.316, P = .004; rat: R2 = 0.871, P = .021). Blocking DOR substantially reversed the cardioprotective effects of MPC in postinfarcted rat hearts, increasing the mean (standard deviation) percentage of infarct size from 15.0 (3.9)% to 30.8 (7.7)% (P < .001). Similarly, AG490 inhibited MPC restoration of cardiomyocyte apoptosis (33.3 [4.2]% vs 16.6 [3.4]%; P < .001). Both NTD and AG490 markedly suppressed STAT3 phosphorylation by 60.1% (mean difference 0.60; 95% CI, 0.27–0.93; P = .002) and 44.1% (mean difference 0.44; 95% CI, 0.06–0.83; P = .027), respectively, and also lowered the Bcl-2/Bax ratio by 85.5% (mean difference 0.86; 95% CI, 0.28–1.43; P = .006) and 68.2% (mean difference 0.68; 95% CI, 0.51–0.85; P < .001) respectively in heart tissues at the end of reperfusion.

CONCLUSIONS:

DOR protein levels increased in failing hearts of both humans and rats. Blocking cardiac DOR selectively reduced morphine-induced cardio protection by inhibiting the JAK2/STAT3 pathway. These findings indicate that cardiac DOR is a potential therapeutic target for protecting against heart failure due to I/R injury.