bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping the differential impact of spontaneous and conversational laughter on brain and mind: A fMRI study in autism
Authors: Cai Ceci Qing , Lavan Nadine , Chen Sinead H.Y. , Wang Claire Z.X. , Ozturk Ozan Cem , Gilbert Sam J. , White Sarah J. , Scott Sophie K.
Published: November 2023

Background While most research on the non-verbal communication challenges encountered by autistic people centres on visual stimuli, non-verbal vocalizations remains overlooked. Laughter serves as a socio-emotional signal for affiliative bonding in interactions. Autistic people seem to experience and produce laughter differently to non-autistic people and are known to have mentalizing difficulties. Neuroimaging evidence suggests that non-autistic people engage in mentalizing to understand the meaning behind conversational laughter. Here, we propose that autistic people’s difficulties lie not in processing all types of laughter, but only in processing conversational laughter.
Methods We used fMRI to explore the neural mechanisms underlying implicit processing of different types of laughter in autistic and non-autistic adults. 23 autistic and 23 non-autistic adults matched for age, gender, and IQ were scanned whilst passively listening to funny words followed by spontaneous laughter, conversational laughter, or noise-vocoded vocalizations. Post-scan, they listened to the word plus laughter pairs again and rated the funniness of each word.
Results Behaviourally, words plus spontaneous laughter were rated as funnier than words plus conversational laughter, and the groups did not differ. However, neuroimaging results showed increased activation in the medial prefrontal cortex only for non-autistic adults during implicit processing of words plus conversational laughter. Additionally, autistic adults showed greater activation in the supplementary motor area, a part of the sensorimotor network, when listening to words plus either type of laughter.
Limitations Our current design does not disentangle the processing of humour and laughter, with insufficient temporal resolution for their neural distinction, suggesting a need for future research with more temporally-precise techniques.
Conclusions While both non-autistic and autistic adults find laughter makes funny words funnier, there are differences in autism in the neural mechanisms that support mentalizing and contagion during implicit laughter processing. This study reinforces the idea that the essence of laughter serves both as an emotional expression and a sophisticated social signal during communication. It also highlights the challenges that autistic people face in understanding the meaning behind the conversational laughter we consistently encounter in everyday life, which may lead them to social vulnerability. Altogether, we advocate for clearer communication with autistic people.
Cultivating Compassion in Medicine: A Toolkit for Medical Students to Improve Self-Kindness and Enhance Clinical Care
Authors: Mehta Krisha , Salam Shafkat , Hake Austin , Jennings Rebecca , Rahman Afra , Post Stephen
Published: November 2023

Background: Compassionate care lies at the foundation of good patient care and is a quality that patients and providers continue to value in the fast-paced setting of contemporary medicine. Compassion is often talked about at a superficial level in medical school curricula, but the practical aspect of learning this skill is often not taught using a formal framework. In the present work, the authors present an 8-session curriculum with a mindfulness-based approach to compassion that addresses this need. It is hypothesized that students in this curriculum will improve in their levels of compassion based on validated scales.
Methods: The curriculum was delivered to fourth-year medical students at Renaissance School of Medicine at Stony Brook University who had just completed their clerkship year. It was developed as a customizable set of modules which could be delivered in various ways. The students were taught with evidence-based cognitive exercises followed by group discussions and written reflections based on compassion-focused thematic questions. All students completed a pre- and post-Self-Compassion Scale, Compassion Scale, and Toronto Mindfulness Scale. Students in this course were compared with students in different courses about non-clinical topics delivered at the same time. Paired t-tests were used to assess potential associations between pre- and post survey responses for the validated scales and subscales.
Results: 17 fourth-year medical students completed pre- and post-course tests, 11 participated in the compassion curriculum while 6 participated from the other courses. Prior to any of the courses beginning, all students performed similarly on the pre-test across all scales. The students in the compassion curriculum demonstrated a significant increase in their total Self-Compassion score by 8.7 [95% CI 4.3 to 13.2] points (p=0.001), total Compassion score by 6.0 [95% CI 1.4 to 10.6] points (p=0.015), and the curiosity component of the Toronto Mindfulness Scale by 4.4 [95% CI 1.0 to 7.7] points (p=0.015). There was no statistically significant difference between pre- and post-tests among the non-compassion curriculum students in the aforementioned scales (p=0.45, p=0.069, p=0.092, respectively).
Conclusions: Our results indicate that the students in our course developed an enhanced ability to engage in self-compassion, to understand the shared human experience, and to be motivated to act to alleviate suffering. Regardless of a program's existing compassion education, this customizable model allows for easy integration into a medical student’s crowded curriculum. Furthermore, although teaching compassion early and often in a clinician’s training is desirable, our study that targeted fourth-year medical students suggests an additional benefit of rekindling the loss of compassion well described in a medical student’s clinical years.
Assessment of Single Nucleotide Variants in hGPRC5A Gene Using in-silico Tools
Authors: KARAALİ Merve DEMİRBAĞ , UZ-YILDIRIM Elif , ÇELİKLER Serap
Published: November 2023

G-protein-couple receptor family C group 5 member A (GPRC5A) encodes a transmembrane protein and is induced by retinoic acid. Dysfunctional GPRC5A was reported to activate numerous signal transduction cascades and its tumor suppressor role was emphasized especially in lung cancer in recent studies. Furthermore, various cancers, including colorectal cancer, breast cancer, and pancreatic cancer, have also been associated with GPRC5A dysregulation. In current study, we analysed the functional consequences of single nucleotide variants (SNVs) in the human GPRC5A gene using in-silico tools. We classified 76 missense variants as pathogenic based on the combined scores of commonly used in-silico tools tools—MutationTaster2, Polyphen2, and MutPred2. Among these 76 variants, three (p.S336Y, p.Y347H, p.Y350H) were identified to be located in post-translational modification and regulatory protein binding sites, suggesting their potential as putative functional variants. Moreover, we obtained strong evidence for rs112948541 and rs767232322 variants being as regulatory important. Additionally, we identified 16 miRNA target sites for the two variants (rs200040454 and rs144308510) in the 3' untranslated region of the GPRC5A. The results of in-silico analyses highlight the functional importance of the GPRC5A variants that may contribute to the GPRC5A-associated cancer types and the importance of in vivo evaluation to reveal their role in human cancer.
Household Income Structure and Poverty Vulnerability: A differential Analysis Based on Chinese Families
Authors: Shao Wenbo , Li Qin , Ren Gui
Published: November 2023

The focus of poverty reduction has shifted from poverty incidence to poverty vulnerability in China. This paper mainly studies the influence of different income sources on the probability of poverty incidence in Chinese households. Through theoretical analysis, we can find that the diversification of income sources can significantly reduce the poverty vulnerability for all households, in which the increase of wage income shares will reduce the poverty vulnerability, and the increase of transfer income shares will do the opposite. Distinguishing between urban and rural households, the rural household's agricultural income shares has a threshold effect on poverty vulnerability, while the urban household's industrial and commercial income shares also has a threshold effect on poverty vulnerability. Firstly, promoting employment is still an important policy to prevent returning to poverty, but at the same time, we can also diversify the income structure of low-income families in line with local circumstances; Secondly, the focus of poverty alleviation for rural households and urban households should be treated differently. The former is mainly targeted at low-income families with predominance of agricultural income, while the latter are mainly targeted at low-income households with predominance of industrial and commercial incomes. Thirdly, the government can take consideration into the continuity of poverty alleviation work, and pay more attention to households with incomes below the threshold and with a single income.
The Impact of IoT and Sensor Integration on Real-Time Weather Monitoring Systems: A Systematic Review
Authors: Selvam Avines Panneer , Al-Humairi Safaa Najah Saud
Published: November 2023

The observation of weather and its impact on human life is undeniable. Weather observations are essential for various sectors, including agriculture, transportation, aviation, and disaster management. Therefore, the collection of data on weather variations is crucial. However, the transient nature of weather variations makes it difficult to collect accurate and real-time data. To overcome this challenge, researchers have developed smart real-time weather monitoring systems integrated with mobile applications. These systems utilize various frameworks, technologies, and techniques, including the Internet of Things (IoT), Arduino, machine learning algorithms, deep learning algorithms, and sensors that measure temperature, humidity, wind speed, and wind direction. These systems provide real-time data on weather conditions, enabling individuals to make informed decisions. The primary objective of this review paper is to critically examine and elaborate on multiple research studies that focus on integrating smart real-time weather monitoring systems with mobile applications. The aim is to understand the techniques, methodologies, and technologies employed in designing and developing such systems. One of the key findings of this review is that integrating smart real-time weather monitoring systems with mobile applications has significant potential to improve weather forecasting and monitoring. For instance, machine learning algorithms can analyze sensor data to identify patterns and accurately predict future weather conditions.Additionally, integrating cloud computing technology in these systems allows for secure data storage, making it accessible to validated individuals from anywhere. In conclusion, integrating smart real-time weather monitoring systems with mobile applications has enormous potential in improving weather forecasting and monitoring. Various frameworks, technologies, and techniques have enabled researchers to develop sophisticated systems that collect accurate and real-time data on weather conditions. These systems significantly affect various sectors, including agriculture, transportation, aviation, and disaster management.
Changes in inflammatory biomarkers and lipid profiles after switching to long-acting cabotegravir plus rilpivirine
Authors: Adachi Eisuke , Saito Makoto , Otani Amato , Koga Michiko , Yotsuyanagi Hiroshi
Published: November 2023

Objectives
In people with HIV, viremia is associated with chronic inflammation does not return to the level as in non-HIV-infected individuals even after viral suppression with antiretroviral therapy. The objective of this study was to determine whether long-acting cabotegravir plus rilpivirine has a different effect on reducing inflammation compared to oral antiretroviral drugs.
Design
In this retrospective cohort study, we followed the inflammation biomarkers, such as C-reactive protein and CD4/CD8 ratio, and lipid profiles from baseline to 7 months after starting injectable cabotegravir plus rilpivirine. Patients were grouped by the regimens prior to the switching.
Results
Seventy-eight patients were analyzed. Comparing baseline with 7 months after starting injectable cabotegravir plus rilpivirine, CD4/CD8 ratio and C-reactive protein did not change. CD8 count and CD4 count were significantly decreased in the group switching from dolutegravir-based regimen but not in the tenofovir alafenamide-based regimen group. High-density lipoprotein cholesterol increased resulting in the decrease in total-cholesterol/High-density lipoprotein cholesterol ratio, whereas there was no significant change in low-density lipoprotein cholesterol in all groups.
Conclusions
The change from oral antiretroviral therapy to long-acting cabotegravir plus rilpivirine did not change inflammatory biomarkers, but did improve some lipid profiles. No effect of tenofovir alafenamide on the lipid profile was observed.
Analytical solutions and conservation laws of the generalized model for propagation pulses with four powers of nonlinearity.
Authors: Kudryashov Nikolay , Lavrova Sofia , Nifontov Daniil
Published: November 2023

Analytical solutions of the generalized nonlinear Schrödinger are presented. Optical solitons corresponding to the mathematical model are given. Conservation laws of the generalized model for propagation pulses with four powers of nonlinearity are considered. The equation studied is the generalization of several well-known models, which allows us to evaluate the influence of various processes on pulse propagation. Conservative quantities for the bright optical soliton are calculated.
The Integral Manifolds of the 4 Body Problem Withequal Masses – Bifurcations at Relative Equilibria
Authors: McCord Christopher
Published: November 2023

In the N-body problem, it is classical that there are conserved quantities ofcenter of mass, linear momentum, angular momentum and energy. The level sets M(c, h) ofthese conserved quantities are parameterized by the angular momentum c and the energyh, and are known as the integral manifolds. A long-standing goal has been to identify thebifurcation values, especially the bifurcation values of energy for fixed non-zero angularmomentum, and to describe the integral manifolds at the regular values. Alain Albouyidentified two categories of singular values of energy: those corresponding to bifurcations atrelative equilibria; and those corresponding to “bifurcations at infinity”, and demonstratedthat these are the only possible bifurcation values. This work completes the identification ofbifurcations for the four-body problem with equal masses, confirming that, in this setting,Albouy’s necessary conditions for bifurcation are also sufficient conditions: bifurcations ofthe integral manifolds occur at all of the singular values of energy. A recent study examinedthe bifurcations at infinity; this work evaluates the four bifurcations at relative equilibria.To establish that the topology of the integral manifolds changes at each of these values,and to describe the manifolds at the regular values of energy, the homology groups of theintegral manifolds are computed for the five energy regions on either side of the singularvalues. The homology group calculations establish that all four energy levels are indeedbifurcation values, and allows some of the global properties of the integral manifolds to beexplored.1
2020 Mathematics Subject Classification. Primary 70F07, 58F05, 57R57; Secondary 58F14 .
Targeting the ribosome to treat multiple myeloma
Authors: Maclachlan Kylee , Gitareja Kezia , Kang Jian , Cuddihy Andrew , Cao Yuxi , Hein Nadine , Cullinane Carleen , Ang Ching-Seng , Brajanovski Natalie , Pearson Richard , Khot Amit , Sanij Elaine , Hannan Ross , Poortinga Gretchen , Harrison Simon
Published: November 2023

The high rates of protein synthesis and processing render multiple myeloma (MM) cells vulnerable to perturbations in protein homeostasis. The induction of proteotoxic stress by targeting protein degradation with proteasome inhibitors (PI) has revolutionized the treatment of MM. However, resistance to PI is inevitable and represents an ongoing clinical challenge. Our first-in-human study of the selective inhibitor of RNA polymerase I transcription of ribosomal RNA genes, CX-5461 has demonstrated a potential signal for anti-tumor activity in three of six heavily pre-treated MM patients. Here we show that CX-5461 has potent antimyeloma activity in PI-resistant MM preclinical models in vitro and in vivo. In addition to inhibiting ribosome biogenesis, CX-5461 causes topoisomerase II trapping and replication-dependent DNA damage, leading to G2/M cell cycle arrest and apoptotic cell death. Surprisingly, the addition of PI does not enhance the therapeutic benefit of CX-5461. In contrast, CX-5461 shows synergistic interaction with the histone deacetylase inhibitor panobinostat in both the Vk*MYC and the 5T33-KaLwRij mouse models of MM by targeting ribosome biogenesis and protein synthesis through distinct mechanisms. Our findings thus provide strong evidence to facilitate the clinical development of targeting the ribosome to treat relapsed and refractory MM.
Maggot Debridement Therapy in Diabetic Foot Ulcer Patients in Greece
Authors: Meimeti Evangelia , Marakomichelakis George , Provatopoulou Xenia , Psarrou Anna , Tsagkarakis Antonios , Albani Chara , Stamouli Myrto , Arapostathi Evaggelia , Mumcuoglu Kostas , Rallis Michail
Published: November 2023

Aims
Diabetic foot ulcers (DFUs) have been recognized as a serious and highly debilitating complication in patients with diabetes mellitus that may ultimately lead to lower extremity amputation. The management of DFUs arises as a major public health issue associated with significant cost. As a result, there is an ongoing quest for new effective therapies of DFUs.
Methods
Maggots of Lucilia sericata were provided from the Laboratory of Agricultural Zoology and Entomology of the Agricultural University of Athens, and they were disinfected at the Department of Pharmaceutical Technology of the National and Kapodistrian University of Athens prior to their application, according to standard protocols. A cage-like dressing, made up of gauze and micropore, of the size of the wound was prepared and placed appropriately to surround the maggots around the wounded area and to protect the surrounding tissue. The maggots were applied directly onto the wound bed using aseptic techniques.
Results
Three cases of DFU patients with previous failures to other treatments, who were successfully treated by MDT are presented. A single application of maggots for 16–24 hours resulted in a remarkable improvement of the wound area with complete removal of necrotic tissue and slough. These cases demonstrate the successful application of MDT with L. sericata larvae on patients with unresponsive to previous treatments DFUs for the first time in Greece.
Conclusion
Maggot debridement therapy is an effective, safe, low-cost treatment which can be applied in many hard-to-heal cases before amputation.
Prevalence of cerebrovascular accident among atrial fibrillation patients in Damascus Hospital
Authors: Kabalan Mhd Saleh , Shamiyeh Marwan
Published: November 2023

Introduction:
Atrial fibrillation (AF) is one of the most common types of arrhythmias. It is an irregular rhythm and often appears as an accelerated heartbeat. Atrial fibrillation can lead to blood clots forming in the heart, and this condition also increases the risk of stroke, heart failure, and other heart-related complications. Symptoms of atrial palpitations include a feeling of a fast, intermittent or strong heartbeat, chest pain, lightheadedness, fatigue, dizziness, reduced ability to exercise, shortness of breath, and weakness. Heart structure problems are the most common cause of atrial fibrillation.
Materials and methods:
Observational study of the type of cross-sectional study. This study targeted patients attending Damascus Hospital. The sample was selected randomly, and about (194) patients were selected who met specific acceptance criteria, the most important of which was the presence of sufficient information in the file, while all patients were excluded according to specific exclusion criteria.
Results:
Our study concluded that there is an important relationship and a fundamental effect of the sex of the atrial fibrillation patient on his condition, and an important relationship and a fundamental effect of the patient’s age in atrial fibrillation patients on his condition, and an important relationship and a pivotal effect of smoking and alcohol intake in atrial fibrillation patients on his condition, a clear relationship and a significant effect. For the levels of lipids, cholesterol, and blood sugar in patients with atrial fibrillation in his condition, and there is a significant relationship and a significant effect for the levels of arterial pressure and body mass index in patients with atrial fibrillation in his condition, and there is an important relationship and a significant effect of the presence of a history of a previous cerebrovascular accident in patients with atrial fibrillation in his condition. The prevalence of previous vascular events among patients with defibrillation (in the sample) was 37%.
Conclusion
We recommend following a healthy diet and exercising, quitting smoking and staying away from alcohol, monitoring blood pressure on a regular basis, performing the necessary blood tests and analyzes periodically, and monitoring patients with previous cerebrovascular accidents who have risk factors for atrial fibrillation.
Sea bottom influence on sound propagation for underwater equipment detection
Authors:   Mircea cel Batran Naval Academy, CIOCIOI I
Published: November 2023

The protection of maritime communication routes, ships and coastal installations involves the use of hydroacoustic equipment (sonars) to detect underwater equipment (means) that may operate in the aquatic environment. This paper examines the influence of seafloor topography and structure on sound propagation and sonar detection probability.
Effective Techniques in Teaching EFL
Authors:   Mircea cel Batran Naval Academy, KAITER E H
Published: November 2023

Teaching EFL (English as a Foreign Language) is a continuous struggle for teachers in their quest to use the most learner-profitable methods and techniques. The present paper deals with 2 techniques that provided enjoyable and skill-enhancing for the learners: team teaching and email writing. Team teaching is most common in the domain of foreign language teaching. Successful team teaching has the potential to benefit all concerned. Teachers stand to gain in terms of their professional development. Team teaching provides teachers with a partner to help them set objectives, make plans, implement lessons and evaluate the results, they have someone from whom they can draw inspiration and who can provide them with constructive feedback on their teaching. Learners have 2 teachers to learn from. The e-mail provides a context for real-world communication and authentic interactions. By connecting foreign language speakers outside of the classroom, e-mail also provides a context for communicating with other speakers in authentic communicative situations. Interaction via e-mail lends a feeling of reality to students and it is much like spoken language because of its informal and interactive nature.
DRIVING GRASSROOTS GENDER EQUALITY: EMPOWERING WOMEN IN BANGLADESHI LOCAL GOVERNMENT
Authors:   Assistant Director (Assistant Professor), Directorate of Secondary and Higher Education, Secondary and Higher Education Division, Ministry of Education, Bangladesh, Dhaka., Zahangir Alam Md. , Unnisa Shiuly Akther ,   Deputy Secretary, Secondary and Higher Education Division, Ministry of Education, Bangladesh, Dhaka.
Published: November 2023

Bangladesh is one of the most overpopulated countries in the world where women are involved in domestic work. Political and economic empowerment is considered a male-dominated public activity. This paper aims to explore the dimensional issues and challenges faced by women representatives in Union Parishads in the decision-making process which is crucial for ensuring womens economic empowerment at the grassroots level. This study attempts to critically assess the extent of womens economic empowerment in local government institutions in Bangladesh. This paper also investigates the low rate of women holding elected positions at the grassroots level and the reasons behind their dismal performance in the objective and decision-making process and economic empowerment. From this point of view, this study has identified some factors that are negatively affecting the active participation of women representatives in the Union Parishad such as lack of education and training facilities, lack of social and cultural norms and values, lack of awareness, social constraints, family constraints, lack. Family support, lack of economic awareness, lack of peer support, patriarchal mindset, lack of freedom of movement, sexual harassment, domestic violence, low status, unequal distribution of work and religious misinterpretation. Finally, this paper provides a summary of proposed improvements to the current system as well as alternative system options for enhancing womens economic empowerment in local governments in Bangladesh to achieve gender equality at the grassroots level.
Servant leadership and organizational performance: Mediating role of organizational culture
Authors: Anibal Luciano Alipio Rober , Xavier Arevalo Avecillas Danny , Wilfredo Quispe Santivañez Grimaldo , Jimenez Mendoza Wilber , Felipe Zavala Benites Emérito
Published: November 2023

Servant leadership positively influences the performance of organizations since it focuses on developing the most critical capital of organizations – human beings. The study aims to analyze the influence of servant leadership on organizational performance mediated by organizational culture focusing on administrative staff in Peru. It uses a quantitative approach and non-experimental design. The data were obtained transversally from 465 union members-administrative staff through a virtual survey with a 20-item Likert-type questionnaire, verifying the data for compliance with the underlying assumptions. For data processing, the SPSS AMOS program was chosen, subjecting the data to confirmatory factor analysis and using the structural equation model to test the proposed hypotheses. The results show that, for administrative staff, organizational culture partially mediates the influence of servant leadership on organizational performance at 0.127. While servant leadership positively influences organizational performance (β = 0.341, p < 0.01), it also positively influences organizational culture (β = 0.492, p < 0.01). Furthermore, organizational culture positively influences organizational performance (β= 0.262, p < 0.01). The study confirms the importance of servant leadership in the performance of organizations. Also, it provides evidence to affirm that organizational culture is fundamental in explaining this influence, thus filling the research gap.
Phyto-assisted synthesis of magnetic NiFe2O4 nanocomposite using the Pulicaria gnaphalodes methanolic extract for the efficient removal of an antibiotic from the aqueous solution: a study of equilibrium, kinetics, isotherms, and thermodynamics
Authors: Derakhshani Elham , Naghizadeh Ali , Mortazavi-Derazkola Sobhan
Published: November 2023

In this research, the magnetic NiFe2O4 nanocomposite was synthesized using Pulicaria gnaphalodes methanolic extract and applied to remove penicillin G from aqueous solutions. The results of field emission scanning electron microscopy, X-ray powder diffraction, Fourier transform infrared, Vibrating-Sample Magnetometer (VSM), and energy-dispersive spectroscopy-mapping analyses showed that this nanocomposite was well synthesized with a size of approximately 50–70 nm. The maximum adsorption capacity of the magnetic NiFe2O4 nanocomposite was 22.95 mg/g under optimal conditions. In addition, the experimental data of penicillin G adsorption by the magnetic NiFe2O4 nanocomposite showed that ΔH and ΔS values were positive and ΔG was negative and were following the Temkin isotherm model with R2 =  0.99 and follows the pseudo-second-order kinetic model.
Unraveling air–water two-phase flow patterns in water pipelines based on multiple signals and convolutional neural networks
Authors: Zhao Peng , Xu Ziyang , Liu Haixing , Yu Bing
Published: November 2023

Flow pattern identification (FPI) is crucial for evaluating air entrapment in water pipelines and ensuring the safety of pipeline operations. The presence of two-phase flow in water pipelines not only leads to pressure fluctuations but also induces pipeline vibration. However, current research has primarily focused on using pressure-related signals for FPI, and the analysis of vibration signals in FPI is rare. In this study, FPI in water pipelines is investigated based on convolutional neural networks (CNNs) using high-frequency vibration signals. The information fusion of vibration signals in FPI is newly proposed via the stacked generalization technique. The proposed method is compared with pressure signal-based FPI methods and the effect of signal sampling parameters on FPI accuracy is discussed. The results show that the performance of vibration signals (including axial or radial acceleration signals) outperforms pressure signals in both time and frequency domains. Moreover, the fusion of vibration signals shows the superior results compared to any univariate signals. The duration of sampling has a more significant impact on the results of FPI than the sampling frequency. This study provides a new way that FPI theory is applied to solve air entrapment evaluation in water pipelines.
Pediatric Pulmonary Hypertension in Left-Sided Heart Disease
Authors: Patten William F. , Krishnan Usha S.
Published: November 2023

Pulmonary hypertension (PH) from left-sided heart disease (group-II PH) is an increasingly recognized cause of PH in pediatrics. Group-II PH can result from obstruction at any level of the left heart, and can progress over time. Management can be particularly difficult, as targeted PH therapy in the setting of a fixed obstruction carries a risk of pulmonary vascular congestion and pulmonary edema. Based on existing evidence, the use of pulmonary vasodilators in group II PH is not recommended, and management centers around early identification and correction of the underlying left-sided lesion. In this review, we highlight the pathophysiology of group-II PH, the diagnostic evaluation of left heart pathology, and a general approach to both medical and surgical management, with particular attention to relevant left-sided lesions. Group-II PH is a multifaceted and progressive disease process that poses a difficult challenge to clinicians, and requires a thoughtful and individualized approach to management.
Exploring Novel Genome Instability-associated lncRNAs and their
Potential Function in Pan-Renal Cell Carcinoma
Authors: Zhu Hui-Xin , Zheng Wen-Cai , Chen Hang , Chen Jia-Yin , Lin Fei , Chen Shao-Hao , Xue Xue-Yi , Zheng Qing-Shui , Liang Min , Xu Ning , Chen Dong-Ning , Sun Xiong-Lin
Published: November 2023

Objective:

Genomic instability can drive clonal evolution, continuous modification of
tumor genomes, and tumor genomic heterogeneity. The molecular mechanism of genomic instability
still needs further investigation. This study aims to identify novel genome instabilityassociated
lncRNAs (GI-lncRNAs) and investigate the role of genome instability in pan-Renal
cell carcinoma (RCC).

Materials and Methods:

A mutator hypothesis was employed, combining the TCGA database
of somatic mutation (SM) information, to identify GI-lncRNAs. Subsequently, a training cohort
(n = 442) and a testing cohort (n = 439) were formed by randomly dividing all RCC patients.
Based on the training cohort dataset, a multivariate Cox regression analysis lncRNAs risk model
was created. Further validations were performed in the testing cohort, TCGA cohort, and different
RCC subtypes. To confirm the relative expression levels of lncRNAs in HK-2, 786-O, and
769-P cells, qPCR was carried out. Functional pathway enrichment analyses were performed for
further investigation.

Results:

A total of 170 novel GI-lncRNAs were identified. The lncRNA prognostic risk model
was constructed based on LINC00460, AC073218.1, AC010789.1, and COLCA1. This risk
model successfully differentiated patients into distinct risk groups with significantly different
clinical outcomes. The model was further validated in multiple independent patient cohorts. Additionally,
functional and pathway enrichment analyses revealed that GI-lncRNAs play a crucial
role in GI. Furthermore, the assessments of immune response, drug sensitivity, and cancer stemness
revealed a significant relationship between GI-lncRNAs and tumor microenvironment infiltration,
mutational burden, microsatellite instability, and drug resistance.

Conclusions:

In this study, we discovered four novel GI-lncRNAs and developed a novel signature
that effectively predicted clinical outcomes in pan-RCC. The findings provide valuable insights
for pan-RCC immunotherapy and shed light on potential underlying mechanisms.
Treatment Considerations to Overcome the Barriers Associated with Skin
Cancer Targeting
Authors: Kumari Pratibha , Alam Md. Aftab , Dhoundiyal Shivang , Kaur Awaneet , Yadav Shikha
Published: November 2023

:

Skin cancer is a prevalent and diverse group of malignancies affecting the skin, with three
primary types: basal cell carcinoma, squamous cell carcinoma, and melanoma. Each subtype varies in
terms of its histological origin, behavior, and potential for metastasis. Despite advances in treatment,
skin cancer poses challenges due to biological barriers that hinder drug delivery, multidrug resistance
mechanisms that limit treatment effectiveness, and the complex interplay of genetic alterations driving
tumorigenesis. Current treatment strategies encompass a spectrum of approaches, including
chemotherapies, immunotherapies, gene therapies, and innovative techniques such as photothermal
therapy, iontophoretic therapy, electroporation therapy, microneedle array therapy, and nanotechnology-
based treatments. The latter involves liposomes, niosomes, carbon nanotubes, dendrimers, hydrogels,
and gold nanoparticles, all tailored to enhance drug delivery and therapeutic efficacy. Additionally,
herbal drug-based therapy harnesses the potential of natural compounds to target various
aspects of skin cancer progression. This review provides an overview of skin cancer types, challenges
in treatment, and an extensive exploration of current therapeutic strategies, highlighting the everevolving
landscape of innovative approaches that promise to transform how skin cancer is managed.
Phytochemicals and their Potential Mechanisms against Insulin Resistance
Authors: Wal Pranay
Published: November 2023

Insulin's inception dates back to 1921 and was unveiled through a momentous revelation. Diabetes is a dangerous, long-term disease in which the body fails to generate enough insulin or utilize the insulin it creates adequately. This causes hyperglycemia, a state of high blood
sugar levels, which can even put a person into a coma if not managed. Activation of the insulin
receptor corresponds to two crucial metabolic functions, i.e., uptake of glucose and storage of
glycogen. Type 2 diabetes mellitus (T2DM) exists as one of the most challenging medical conditions in the 21st century. The sedentary lifestyle and declining quality of food products have contributed to the rapid development of metabolic disorders. Hence, there is an urgent need to lay
some reliable, significant molecules and modalities of treatment to combat and manage this epidemic. In this review, we have made an attempt to identify and enlist the major phytoconstituents
along with the associated sources and existing mechanisms against insulin resistance. The conducted study may offer potential sustainable solutions for developing and formulating scientifically validated molecules and phytoconstituents as formulations for the management of this metabolic disorder.
Breast Edema of Early-stage Invasive Ductal Carcinoma: Correlation with
Axillary Lymph Node Metastasis and Clinical-pathological Characteristics
Authors: Zhang Yang , Xin Yuqing , Zhang Nana , Hu Xiankuo , Peng Bin , Zhang Shaohua , Yuan Yushan
Published: November 2023

Objective::

This study aimed to evaluate the association of different patterns of breast edema and clinical-pathological features and axillary lymph node (ALN)
status in early invasive ductal carcinoma (IDC) for simple and readily available assessment and to guide surgeons to perform sentinel lymph node
biopsy for selected patients.

Materials and Methods::

This retrospective analysis involved 207 individuals with clinical T1-T2 stage IDC. The clinical-pathological features of the patients were
compared with different breast edema and ALN statuses. Independent risk factors for ALN metastasis were verified using multivariate logistic
regression analysis.

Results::

ALN metastasis was confirmed in 100 of 207 patients (48.3%) with early-stage IDC. Significant differences were found between different ALN
states for tumour size, clinical T stage, and breast edema (P <0.05). The clinical T2 stage (odds ratio-1.882, p=0.043) and moderate to severe
edema (odds ratio-10.869, p=0.004) were independent risk factors for ALN metastasis. Moreover, better prognostic factors, including smaller
tumour size, lower Ki-67 index and histologic grade, luminal A subtype, and lower incidence of lymph node metastasis, were more frequently
found in patients with no breast edema (p<0.05).

Conclusion::

Breast edema can be considered a promising feature to improve the predictive performance of pathological ALN status in patients with early-stage
breast cancer and thus may contribute to preoperative treatment planning.
Optimal Rituximab Monotherapy in Splenic Marginal Zone Lymphoma (SMZL): A Case Report and Brief Review
Authors: Guan Rong-Yan , Tang Xing-Ru , Huang Zou-Fang , Du Jun , Fu Xue-Hang , Lu Guang , Mou Wei-Wei
Published: November 2023

Introduction:

Splenic marginal zone Lymphoma (SMZL) is a rare, chronic B
lymphocyte proliferative disease. Generally, SMZL is accompanied by circulating atypical
villous lymphocytes, known as SMZL with villous lymphocytes. Rituximab is a chimeric
monoclonal antibody to CD20; recent but limited studies have confirmed its effectiveness
in treating SMZL. Given the low incidence and selection of treatment, statistical comparisons
of rituximab monotherapy with other available treatment options with the full range of
data from previous clinical studies remain sparse. Here, we report a case of SMZL with
villous lymphocytes treated by rituximab monotherapy, which is especially infrequently reported.

Case Report:

A 63-year-old Chinese female was presented to the hospital with complaints of
splenomegaly and pain in the spleen area. Immunohistochemistry analysis was positive for IGH,
IGK, and IGL clonal rearrangement. Villous lymphocytes were found in peripheral blood and
bone marrow, along with further immunotyping results. The case was considered as SMZL with
villous lymphocytes. Based on the SMZLSG prognosis assessment, we applied rituximab monotherapy.
After eight cycles of rituximab treatment, the patient’s condition improved markedly,
with blood constituent and size of the spleen returning to normal levels, achieving complete response,
with no significant side effect observed.

Discussion:

The patient provides a typical SMZL with villous lymphocytes case treated with
rituximab monotherapy. Currently, the main treatment options include splenectomy and rituximab.
After synthesizing a series of current views, we put forward our opinion about the selection
of therapy for SMZL patients in order to gain maximum benefits for patients in need of
treatment.

Conclusion:

Our analysis found no statistically significant difference between rituximab monotherapy
and rituximab combined with chemotherapy, while rituximab treatments resulted in better
therapeutic effects than chemotherapy. Rituximab monotherapy has favorable therapeutic
effects and minor adverse effects (AEs) in treating SMZL.
Triple Burden: The Incorrigible Threat of Tuberculosis, HIV, and
COVID-19
Authors: Gupta Parakriti , Sandhu Diljot , Gupta Varsha , Singhal Lipika
Published: November 2023

The Coronavirus-19 (COVID-19) hasn’t seen the dawn since its emergence, however
waxing and waning has resulted in the emergence of deadly variants. The effects of pandemic have
not been limited to its virulence, but have rather conferred multiple collateral effects, especially in
developing countries; thereby, designating it as a SYNDEMIC. The same culminated in neglect of
non-COVID-19 conditions like tuberculosis (TB) and human immunodeficiency virus-acquired
immunodeficiency syndrome (HIV/AIDS). Besides being the prognostic factor for severe COVID-19,
these infections in hidden pockets served as reservoir for emergence of the deadly Omicron.
Another significant impact of this juxtaposition was on the delivery of healthcare services for TB and
HIV.

2:

The unanticipated COVID-19 pandemic turned the path of ongoing progress of elimination programs.
Direct consequences of the COVID-19 pandemic were pronounced on diagnosis, treatment, and services
for patients with TB and HIV. Essential TB services were reallocated to the COVID-19 rapid
response task force. However, despite escalating the tribulations, this triple burden has simultaneously
taught lessons to escalate the progress of halted programs. The pandemic has catalyzed an unusual
level of collaboration among scientists, which can be exploited for TB and HIV. Fast-track diagnostics,
digitalization, contact tracing, and vaccine development have enabled world to envision the same
for TB/HIV.
Monitoring Over a Decade in the Serotype Prevalence of Streptococcus pneumoniae in Iran: A Systematic Review and Meta-analysis
Authors: Mamishi Setareh , Pourakbari Babak , Bahador Abbas , Sadeghi Reihaneh Hosseinpour , Pourhajibagher Maryam
Published: November 2023

Background:

There is no comprehensive information about the circulating serotypes of
Streptococcus pneumoniae in Iran in recent years. This study aimed to summarize information about
the changes over a decade in the serotype prevalence of S. pneumoniae in Iran.

Methods:

We performed a comprehensive search in PubMed/Medline, Web of Science, Science
Direct, and the Iranian Database, such as Magiran and SID, from January 2011 to February 2023.
The systematic process, in accordance with the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA), was carried out by two researchers who were both independent and
calibrated. Statistical analyses were carried out using Comprehensive Meta-Analysis software. Identifying
and measuring heterogeneity were done using I2 and the chi-square test. Finally, Begg’s rank
correlation test was used in combination with a funnel plot to evaluate any possible publication bias.

Results:

The search returned 16 relevant results, with a total of 1575 isolates. Of those studies, eight
studies reported the distribution of S. pneumoniae serotypes among patients, three studies among
healthy individuals, and five studies among both groups. As the meta-analysis revealed, the most
common serotypes were 23F (n = 299, 14.1% [95% CI: 9.7-19.9]; I2 = 84.3%; P<0.001 for heterogeneity),
19F (n = 221, 13.4% [95% CI: 9.9-17.9; I2 = 76.7%; P<0.001 for heterogeneity]), and 19A
(n = 102, 8.7% [95% CI: 6.5-11.7; I2 = 54.3%; P<0.001 for heterogeneity]). Moreover, Begg’s test
(P = 0.160, 0.173, and 0.176 for 23F, 19F, and 19A, respectively) showed no evidence of publication
bias.

Conclusion:

Based on our pooled results, the majority of the serotypes of pneumococci in the Iranian
population were 23F, 19F, and 19A, respectively, over the last decade. The findings can be valuable
in selecting effective pneumococcal vaccine candidates and targeted antibiotics in Iranian patients.
Enhanced Efficacy of Carvedilol by Utilization of Solid Dispersion and Other Novel Strategies: A Review
Authors: Rao Lakshita , Bhardwaj Bigul Yogeshver , Chugh Mahek , Sharma Ashish , Shah Rashmi , Minocha Neha , Pandey Parijat
Published: November 2023

Carvedilol is classified as a second class drug of Biopharmaceutical classification system (BCS), and it is an excellent beta blocker and vasodilating agent. It is used in a diverse range of disease states. Despite having tremendous advantages, the drug cannot be used effectively and productively due to aquaphobicity and poor bioavailability. To overcome this limitation, numerous novel approaches and tactics have been introduced over the past few years, such as Selfmicro emulsifying drug delivery systems (SMEDDS), nanoparticles, solid dispersions and liposomal drug delivery. The present review aims to accentuate the role of solid dispersion in improving the dissolution profile and aqua solubility of carvedilol and also to emphasize other novel formulations of carvedilol proposed to prevail the limitations of carvedilol. Solid dispersion and other novel approaches were found to play a significant role in overcoming the drawbacks of carvedilol, among which solid dispersion is the most feasible and effective approach being used worldwide. Reduced particle size, more wettability, and large surface area are obtained by the implementation of solid dispersion technique, hence improving carvedilol solubility and bioavailability
Assessing the Frequency of COVID-19 in Patients Undergoing Primary
Percutaneous Coronary Intervention (PCI)
Authors: Zahedi Mahdi , Davanloo Faezeh
Published: November 2023

Background:

The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global health crisis with significant morbidity and mortality

Objective:

The aim of this study was to investigate the incidence of COVID-19 in patients undergoing primary percutaneous coronary intervention (PCI) for myocardial infarction and identify associated demographic and clinical characteristics.

Methods:

In this study, a retrospective and descriptive cross-sectional design was used to examine all patients (a total of 85) who experienced acute myocardial infarction and underwent primary percutaneous coronary intervention (PCI). The study measured various parameters, such as
COVID-19 status, age, sex, ethnicity, diabetes, and hypertension. Data analysis was conducted
using SPSS version 25 software.

Results:

Out of the 85 patients who underwent primary percutaneous coronary intervention
(PCI) for myocardial infarction (MI), 14 patients (16.5%) were found to have COVID-19.
COVID-19 diagnosis was confirmed through RT-PCR testing for 2 patients, while the remaining
12 patients were diagnosed using lung CT scans. Among the COVID-19 patients, 21.4% (n = 3)
had background diabetes, and 7.1% (n = 1) had background hypertension. MI recurrence was
observed in 14.3% of COVID-19 patients (2 cases). Unfortunately, 1 COVID-19 patient, a 70-
year-old Persian woman with diabetes and hypertension, passed away. No significant differences
were found in terms of age, sex, ethnicity, underlying diabetes, or underlying hypertension between the COVID-19 and non-COVID-19 groups.

Conclusion:

The high occurrence of COVID-19 among myocardial infarction (MI) patients undergoing primary percutaneous coronary intervention (PCI) is worth noting. Further investigation is recommended to explore the impact of demographic and contextual factors on the severity
and outcomes of primary PCI in MI patients with COVID-19, as well as the underlying mechanisms involved.