bluuebunny/crossref_metadata_2025 huggingface dataset:
Antegrade femoral lengthening and simultaneous hemiepiphysiodesis for congenital femoral deficiency
Authors: Georgiadis Andrew G , Albright Patrick D , Huser Aaron J , Novotny Susan A , Dahl Mark T
Published: February 2024

Purpose:

Congenital femoral deficiency is characterized by limb length discrepancy and genu valgum. Lengthening of the femur along its anatomic axis increases valgus alignment by medial knee translation. Pairing limb lengthening with simultaneous medial distal femoral hemiepiphysiodesis can simultaneously correct two limb deformities.

Methods:

All skeletally immature patients with congenital femoral deficiency who underwent antegrade femoral lengthening and concomitant guided growth over a 4-year period were reviewed. Length and alignment data were quantified during lengthening, consolidation, and for 1 year after guided growth implants were removed or the patient reached skeletal maturity. Digital simulation was performed for all lengthenings to assess the mechanical alignment that would have been achieved had lengthening been performed without medial distal femoral hemiepiphysiodesis.

Results:

Nine patients (five males, four females, mean age = 12.3 ± 1.9 years) underwent 10 antegrade intramedullary femoral lengthenings with simultaneous medial distal femoral hemiepiphysiodesis. All had improvement in valgus alignment (average improvement in mechanical axis deviation was 18 ± 11 mm, average change in limb alignment was 6 ± 5°). In simulated lengthenings without guided growth, all limbs would have experienced increased lateral mechanical axis deviation of 5 ± 3 mm. The hemiepiphysiodesis implant and lengthening device were explanted simultaneously in 7 of 10 lengthenings.

Conclusion:

Simultaneous medial distal femoral hemiepiphysiodesis with antegrade femoral lengthening for ongenital femoral deficiency can minimize the number of surgical episodes for the skeletally immature patient. The lengthening device and guided growth construct can be removed simultaneously in a majority of cases, saving children one or two additional surgical treatments.
Essential Oils of Two Species of Zingiberaceae Family from Vietnam: Chemical Compositions and α-Glucosidase, α-Amylase Inhibitory Effects
Authors: Tran-Trung Hieu , Le Duc Giang , Hoang Van Trung , Vu Danh C. , Thang Tran Dinh , Nguyen-Ngoc Hieu , Tran Van Chen , Nguyen Thanh Triet , Tuan Nguyen Hoang , Nguyen Trang H.D.
Published: February 2024

The ginger family (Zingiberaceae) is one of the most diverse and abundant families in the plant kingdom in terms of number of species. In terms of chemistry, this is a family of plants containing much essential oil with mainly monoterpene and sesquiterpene derivatives, which has been widely used in medicine, food, and flavor industries. In our series of studies on ginger family plants, the two new species including Wurfbainia schmidtii (K. Schum.) Škorničk. & A.D. Poulsen and Zingiber atroporphyreus Škorničk. & Q.B. Nguyen has been investigated for the first time. This study aimed to identify the chemical compositions of essential oils extracted from the rhizomes and leaves of these two species using gas chromatography-mass spectrometry (GC/MS) analysis and evaluate their hypoglycemic effects through the α-glucosidase and α-amylase inhibitory assays. In terms of chemical composition, in general, the main compounds appearing in the essential oils of both leaves and rhizomes of each species are similar but they are differences in the percentage of the main components, for example, 1,8-cineole is a main component in leaves whereas fenchyl acetate is the main one in rhizomes of W. schmidtii. Several distinctive compounds, in comparison with other members in the genus Zingiber, namely β-pinene, α-pinene, β-elemene, and sabinene, were found in the essential oil of Z. atroporphyreus. Regarding hypoglycemic effects, the essential oils from the two species tested possessed weak α-glucosidase and α-amylase inhibitory effects. For the first time, this study was designed to investigate the chemical composition as well as the hypoglycemic effect of essential oils distilled from the rhizomes and leaves of two species W. schmidtii and Z. atroporphyreus have been reported, serving as a premise for further systematic research on their phytochemistry and pharmacological effects being conducted.
Approaching literary texts via online learning during COVID-19 pandemic in Jordan: Challenges and obstacles
Authors: Salam Wael J , Al-Salahat Osama F
Published: February 2024

This study investigates students’ attitude toward using asynchronous and synchronous online learning in reading literary texts at the University of Jordan-Aqaba. It examines how certain demographic variables, including gender, place of residence and the available technological means, affect their attitudes towards such a learning method in the Jordanian context. A descriptive, analytic design was used to explore students’ reception and acceptance of learning via online platforms. One hundred and forty two students majoring in English Literature from the University of Jordan-Aqaba participated in the questionnaire. We used a simple random sampling (SRS) in which each member of the population had an equal chance to respond. We distributed a questionnaire of 23 statements to participants on December 11th, 2020, via Microsoft Forms. The statements were in a multiple-choice format, using Likert scale’s five levels. This study concludes that there is no statistically significant differences at (a≤0.05) among students’ attitudes towards using online learning that can be attributed to gender, place of living, and technological tools. Though, we argue that the high number of students using mobile phone has contributed to their moderate response towards the shift to online learning. While this paper is a case study that does not intend to generalize, interrogating the efficacy of online learning is essential in understanding ethical and professional issues that may arise in the learning process. It also helps us forge new ways to deal with these issues in the future.
Review: Medical directors – Is there a need for reform?
Authors: Al-Alawy Khamis , Moonesar Immanuel Azaad
Published: February 2024

Medical leadership remains integral to the health system amidst a growing burden of ill health and disease, rising patient expectations and medical and technological advancements. The study objectives were to (a) provide a perspective through a rapid review of medical director roles and responsibilities in public and private hospital settings across several Organisation for Economic Co-operation and Development (OECD) and Non-Organisation for Economic Co-operation and Development countries, and (b) provide recommendations on how health system performance could be strengthened. A rapid review of Medical Director job descriptions in public and private hospitals was carried out. Medical Directors are influential leaders in organisational decision-making and quality improvement; however, their role has shifted from clinical oversight to several managerial and leadership roles. We report some variation in their role and responsibilities, in the ‘intensity of job requirements’ and ‘complexity of managing resources’ dimensions. The changing expectations of medical directors and the variation in their roles and responsibiliteis may contribute to inefficiencies and misalignment within health systems. There may be a need to pursue reform to assure alignment with health system objectives, albeit reform may require different approaches to meet the needs of different health systems. Further research is needed to explore how reform of medical directors’ roles and responsibilities can be quantified to demonstrate improvement within health systems.
Cutaneous T-cell lymphoma in a JAK inhibitor patient: A case report
Authors: Mo Sophy , Friedmann Dominique
Published: February 2024

Janus kinase (JAK) inhibitors are novel molecules increasingly prescribed for various dermatologic conditions. However, the Food and Drug Administration recently reported increased risks of malignancy in patients taking this class of medication. To shed more light on this potential adverse effect, we present a patient with cutaneous T-cell lymphoma possibly associated with his treatment with a JAK inhibitor for atopic dermatitis. To our knowledge, there are no reported cases of cutaneous T-cell lymphoma in association with JAK inhibitors in the literature. We highlight the importance of remaining cautious when prescribing this new class of medication, especially in patients with risk factors for malignancy. Moreover, when faced with atypical presentations of atopic dermatitis, we stress the need for a biopsy to make the correct diagnosis prior to treatment. Lastly, we encourage further studies to better characterize the malignancy risk associated with JAK inhibitors.
Rapid resolution of non-segmental vitiligo in a patient treated with abrocitinib: A case report
Authors: Satkunanathan Seyyon , Boshra Mina , Chang Janis , Bose Reetesh
Published: February 2024

Vitiligo is a common, autoimmune, depigmenting disorder of the skin. Janus Kinase inhibitors have emerged as promising topical and oral therapeutic options for vitiligo. There have been no reports of vitiligo being treated with oral Abrocitinib, a selective Janus Kinase 1 inhibitor approved for the treatment of moderate to severe atopic dermatitis. Here, we present a 61-year-old male with acrofacial vitiligo who had repigmentation plateau with twice daily tacrolimus 0.1% ointment, oral ginkgo biloba, and oral minipulse prednisone × 4 months; however, they had significant improvement after taking abrocitinib 100 mg per day for 2 months. He was able to transition topical tacrolimus twice weekly monotherapy for maintenance. This report shows that oral Janus Kinase inhibitors may be a useful option for the treatment of recalcitrant vitiligo. Results of ongoing randomized control trials are needed to determine the durability and safety of oral Janus Kinase inhibitors long-term.
Effective management of a rare case of primary renal intravascular large B-cell lymphoma with modified R-CHOP regimen: A case report
Authors: Huang Xianbo , Wu Xianhui , Wang Shasha , Mei Chen , Xu Yu , Ren Yanling , Jin Jie , Tong Hongyan , Qian Jiejing
Published: February 2024

Intravascular large B-cell lymphoma, known for its diverse organ involvement, presents significant diagnostic challenges, particularly when it affects the kidneys. This report highlights a rare case of primary renal intravascular large B-cell lymphoma in a 60-year-old male patient, who presented with persistent fever and renal dysfunction. The case underscores the intricacy of diagnosis and the efficacy of personalized treatment. Following the identification of primary renal intravascular large B-cell lymphoma, a modified R-CHOP regimen was administered, resulting in notable amelioration of symptoms and renal function following the initial treatment cycle. The patient achieved sustained complete remission without any complications after completing five subsequent R-CHOP cycles and two additional cycles of rituximab monotherapy, as confirmed by recent assessments. He is currently under regular follow-up for ongoing monitoring and improvement. This case adds to the limited yet expanding pool of knowledge concerning intravascular large B-cell lymphoma, emphasizing the necessity for personalized therapeutic strategies in atypical presentations. It also highlights the importance of early detection and customized intervention in managing rare lymphoma subtypes with unique organ involvement.
The closed carbon cycle in a managed, stable Anthropocene
Authors: Johnson Benjamin
Published: February 2024

The striking influence humans are exerting on their environment will likely result in the stabilization of a new climatic equilibrium of the Anthropocene, possibly without historical precedent. Many conceivable outcomes would reshape the planet’s biodiversity. If the Earth-human interaction is to endure in its current state, which still shares characteristics with the Holocene, one necessary development is that humans close the various biogeochemical cycles (C, N, P, K, etc) they have fundamentally altered (i.g. Haber-Bosch). Many of the technologies required to close the chemical cycles, such as the emissions-free production of methanol from industrial exhaust, already exist. Historical examples show, however, that deployment of technology can lag behind innovation resulting in an implementation gap that hinders our ability to mitigate climate change. However, assuming we close this gap, biogeochemical cycles can act as a gage for a “successful” Anthropocene in which mitigation strategies stave off much of what will otherwise become widespread forced adaption to a new, possibly hostile climate. Closed chemical cycles supporting human consumption can be causally linked to human action and precisely marked in time; they will leave an indelible global stratigraphic record, namely in that human influence decreases. Such a development would be a sign that humans had achieved a managed, stable (or at least steady) state within acceptable planetary boundaries of the Earth-human system. This article focuses on closing the carbon cycle over the following decades and proposes, as a measure of progress, the flattening of the Suess effect, a well-known indicator of human impact.
Added value of video edutainment on android handsets in home visits to improve maternal and child health in Bauchi State, Nigeria: Secondary analysis from a cluster randomised controlled trial
Authors: Ansari Umaira , Omer Khalid , Aziz Amar , Gidado Yagana , Mudi Hadiza , Jamaare Ibrahim Sabo , Andersson Neil , Cockcroft Anne
Published: February 2024

Objective

A trial of evidence-based health promotion home visits to pregnant women and their spouses in northern Nigeria found significant improvements in maternal and child health outcomes. This study tested the added value for these outcomes of including video edutainment in the visits.

Methods

In total, 19,718 households in three randomly allocated intervention wards (administrative areas) received home visits including short videos on android handsets to spark discussion about local risk factors for maternal and child health; 16,751 households in three control wards received visits with only verbal discussion about risk factors. We compared outcomes between wards with and without videos in the visits, calculating the odds ratio (OR) and 95% confidence interval (95%CI) of differences, in bivariate and then multivariate analysis adjusting for socio-economic differences between the video and non-video wards.

Results

Pregnant women from video wards were more likely than those from non-video wards to have discussed pregnancy and childbirth often with their husbands (OR 2.22, 95%CI 1.07–4.59). Male spouses in video wards were more likely to know to give more fluids and continued feeding to a child with diarrhoea (OR 1.61, 95%CI 1.21–2.13). For most outcomes there was no significant difference between video and non-video wards. The home visitors who shared videos considered they helped pregnant women and their spouses to appreciate the information about risk factors.

Conclusion

The lack of added value of the videos in the context of a research study may reflect the intensive training of home visitors and the effective evidence-based discussions included in all the visits. Further research could rollout routine home visits with and without videos and test the impact of video edutainment added to home visits carried out in a routine service context.
The moral (bio)politics of the abnormal: Situating a Southwest China border town in global AIDS governance
Authors: Fang Hongxin
Published: February 2024

This paper analyses the interaction of two models in the social process of global AIDS governance and explores the possibilities of innovation in the social response to risk. The two moral regimes by which to cope with problematized situations in the contemporary world are conceptualized as the “center” and the “border”. The center promotes a normative discourse in the name of defending society, reifying order and pursuing cost-effectiveness in operations. The border undertakes exploratory social action guided by a specific idea of “goodness”. While the two approaches engage in continuous battles, with integration and penetration between them, in the case of people living with HIV worldwide, they were first degraded into a separated biomedical pariah population, and then were brought under the strict medical regime of highly active anti-retroviral therapy (HAART). This shift between abject exclusion and exceptional inclusion indicates the meta-structure of life governance in the contemporary world. China's border cities are key outposts of global AIDS governance that reflect how the institutional deployment of exclusion and inclusion extends from global to local. The “ zuo aizibing” (doing AIDS projects) in Biancheng, a Southwest China border town, embody typically as well as uniquely the complicated “center–border” entanglement. Border-organized “infected peer groups” are embedded in the local official governance system, manifesting as “front-line foot soldiers” serving the center by facilitating a smoother integration of the city's HIV-positive population into the public health monitoring system, where they are disciplined to become docile medical subjects. However, such groups, in adaptable symbiosis with this normative deployment, have also been able to independently open up entirely new fields of social action, allowing a humanitarian vision to be mediated, “translated”, and implemented. Through the transmission of knowledge, affection, and vitality, such groups have freed their HIV-positive peers, otherwise abandoned by the normative logic of AIDS governance, from stigmatization and from being limited by disease and treatment, to start pursuing new forms of life. As a global social experiment, the border, as revealed by AIDS, has far-reaching implications for exploring the inclusive and open potential of society itself.
Impact of Initiating a GLP1 Agonist and/or SGLT2 Inhibitor Therapy on De-Escalation and Discontinuation of Insulin and Diabetes Control When Managed by an Interprofessional Collaborative Team
Authors: Champion Megan , Wills Avila Gabriel , Garcia Angelica E. , Álvarez Delgado Faviola M. , Valdez Connie A.
Published: February 2024

Background:

An FQHC in Denver, Colorado developed and implemented an interprofessional care model to collaboratively manage type 2 diabetes mellitus (T2DM). Utilizing the 340B program, the team protocolized ADA Guidelines to promote the early adoption of first-line medications, glucagon-like peptide1 receptor agonists (GLP1 RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) to improve patient outcomes.

Objectives:

To assess the impact of interprofessional collaborative management versus standard care on early initiation of a SGLT2i and/or GLP1 RA as first-line therapies to enhance (1) deprescribing of insulin, (2) reducing overbasalization of insulin through insulin de-escalation, and (3) effectively lowering A1C levels in adult primary care patients with T2DM.

Methods:

This was a retrospective chart review of adult patients with T2DM who were initiated on a GLP1 RA and/or a SGLT2i. To determine the effects of initiating GLP1 RA and/or SGLT2i therapy on insulin usage and glycemic control, the total daily dose (TDD) of insulin before initiation was compared with the most recent TDD post-initiation to evaluate deprescribing. To determine the impact on overbasalization, pre-initiation and post-initiation insulin doses were evaluated. The effectiveness of GLP1 RA and/or SGLT2i in lowering A1C levels was determined by comparing the A1C prior to initiation with the A1C postinitiation. To evaluate the influence of interprofessional collaborative care on insulin deprescribing, overbasalization, and diabetes control, relevant measures were compared between patients receiving collaborative care versus standard care.

Results:

Of the 60 total patients treated with insulin, 46.6% were deprescribed insulin, with a majority in the interprofessional collaborative group (93.1%) compared to standard care (6.9%). A total of 78.3% of patients benefited from a reduction in A1C following the initiation of a GLP1 RA and/or SGLT2i. The greatest A1C reduction was −2.9% in the group receiving metformin in addition to a GLP1 RA and a SGLT2i. Patients who received interprofessional collaborative care had an average A1c reduction of −2.9% compared to—1.1% with standard care.

Conclusion:

Most patients initially overbasalized on insulin experienced a reduction in overbasalization after initiating GLP1 RA and/or SGLT2i. There was a notable A1C reduction, de-escalation, and deprescribing of insulin in patients receiving interprofessional collaborative care.
Rheumatoid Arthritis Associated With Anti-Signal Recognition Particle Immune-Mediated Necrotizing Myopathy: A Case Report
Authors: Belkhribchia Mohamed Reda , Lobrinus Johannes Alexander , Semlil Lamyaa , Chauveau Nicolas , Ajrinija Abdelaziz , Egervari Kristof , Ennhaili Zine Elabidine
Published: February 2024

Immune-mediated necrotizing myopathy (IMNM) is a rare subtype of idiopathic inflammatory myopathy that is characterized by severe subacute proximal weakness, myofiber necrosis, and significantly elevated serum creatine kinase. Anti-signal recognition particle (SRP) and anti-3-hydroxy-3-methylglutaryl-coenzyme-A reductase autoantibodies have been found in about two-thirds of patients with IMNM. This myopathy is usually idiopathic and there is a scarce literature concerning its association with connective tissue diseases. Herein, we report an unusual case of a young woman who presented with both rheumatoid arthritis and severe anti-SRP IMNM. Thankfully to a therapeutic protocol combining rituximab and cyclophosphamide, an important improvement was achieved, and notably no serious side effect was observed.
Management of Severe Anemia in a Jehovah’s Witness Patient With Lung Abscess Secondary to Malpositioned Laparoscopic Adjustable Gastric Band: A Case Report
Authors: Ruan Nina , Shi Chloe , Al-Momani Zain , Jaber Fouad , Ghaly Ramy , Wooldridge David
Published: February 2024

Jehovah’s Witnesses is a Christian denomination widely recognized for their steadfast refusal of blood transfusions, even when facing severe anemia. We describe a unique case of a 42-year-old Jehovah’s Witness woman with severe iron deficiency anemia. She necessitated surgical correction of a malpositioned gastric band within the context of a complex necrotizing aspiration pneumonia secondary to esophageal obstruction. Medical management of this severe anemia has been a challenge as traditional approaches, like a blood transfusion, are not possible. Instead, a multifaceted approach has been described with intravenous iron infusions, recombinant human erythropoietin, vitamin B12, folate, and vitamin C administration. We emphasize the lack of consensus on guideline protocols regarding management of severe anemia for Jehovah’s Witness patients and the subsequent need for more investigation into that matter. It also underscores the significance of respecting patient autonomy through close collaboration between patients and their health care providers to ensure effective patient-centered care.
The Idea of Democracy in Israel: Theoretical Explorations
Authors: Desai Prakash S.
Published: February 2024

The standard meaning of democracy—a system of governance by the people, for the people, and of the people—has become a debatable narrative. The hesitation to enlarge the scope of democracy to all its beneficiaries or citizens is a major reason for several arguments on democracy. Israel, being a country in the Middle East wherein democracy has not yet been accepted as a mechanism of governance, makes an interesting case to be explored. Its history of democracy and dynamics is unique and has received much theoretical attention. The quintessence of the new argumentations on democracy is “will to democracy” on the part of all citizens in the sense that the will of the people constitutes a decisive factor in making democracy a system for everyone in inclusive form or unmaking democracy as a system for everyone in exclusive form as witnessed in most of the liberal democracies. One can observe that Israel as a society has the will to make the political system inclusive, given its treatment of various Jewish groups who came from different backgrounds and became part of a larger cultural and political society. This has to be and can be extended to the minority, which has the same emotional affiliation to geography and history.
Correlation between early intracranial pressure and cerebral perfusion pressure with 28-day intensive care unit mortality in patients with hemorrhagic stroke
Authors: Zhang Yang , Zhu Shuaijie , Hu Yan , Guo Heng , Zhang Jin , Hua Tianfeng , Zhang Zhongheng , Yang Min
Published: February 2024

Introduction:

Hemorrhagic stroke may cause changes in intracranial pressure (ICP) and cerebral perfusion pressure (CPP), which may influence the prognosis of patients. The aim of this study was to investigate the relationship between early ICP, CPP, and 28-day mortality in the intensive care unit (ICU) of patients with hemorrhagic stroke.

Patients and methods:

A retrospective study was performed using the Medical Information Mart for Intensive Care (MIMIC-IV) and the eICU Collaborative Research Database (eICU-CRD), including hemorrhagic stroke patients in the ICU with recorded ICP monitoring. The median values of ICP and CPP were collected for the first 24 h of the patient’s monitoring. The primary outcome was 28-day ICU mortality. Multivariable Cox proportional hazards models were used to analyze the relationship between ICP, CPP, and 28-day ICU mortality. Restricted cubic regression splines were used to analyze nonlinear relationships.

Results:

The study included 837 patients with a 28-day ICU mortality rate of 19.4%. Multivariable analysis revealed a significant correlation between early ICP and 28-day ICU mortality (HR 1.08, 95% CI 1.04–1.12, p < 0.01), whereas early CPP showed no correlation with 28-day ICU mortality (HR 1.00, 95% CI 0.98–1.01, p = 0.57), with a correlation only evident when CPP < 60 mmHg (HR 1.99, 95% CI 1.14–3.48, p = 0.01). The study also identified an early ICP threshold of 16.5 mmHg.

Discussion and conclusion:

Early ICP shows a correlation with 28-day mortality in hemorrhagic stroke patients, with a potential intervention threshold of 16.5 mmHg. In contrast, early CPP showed no correlation with patient prognosis.
The universal, contingency or configurational HRM approaches for organizational performance: Lessons from Australian performing arts
Authors: Opara Stanley , Waheduzzaman Wahed
Published: February 2024

A good understanding of Human Resource Management (HRM) approaches is vital for designing suitable management practices in any organization. Researchers have identified different HRM approaches, including the universal approach, which recommends standardized practices across organizations, the contingency approach, which emphasizes the best fit between human resources and business strategies, and the configurational approach, which integrates internal and external organizational factors into a pattern of management practices. However, HRM approaches need to adapt to the dynamic business environment and context. This is particularly relevant for performing arts organizations, where changing customer preferences and employment factors frequently impact the business environment. Therefore, it is crucial to know which HRM approach is currently being practiced in this sector. To address this issue, a qualitative study was conducted with managers, key actors, and decision-makers of performing arts organizations in Australia. The interview data analysis revealed a unique pattern of HRM practices, such as spot-recruitment, coaching for management skills, mentoring for better performance, and protean career development. These findings support the argument for the configurational HRM approach in performing arts organizations.
REM sleep obstructive sleep apnoea
Authors: Bonsignore Maria R. , Mazzuca Emilia , Baiamonte Pierpaolo , Bouckaert Bernard , Verbeke Wim , Pevernagie Dirk A.
Published: February 2024

Obstructive sleep apnoea (OSA) can occur in both rapid eye movement (REM) and non-REM sleep or be limited to REM sleep, when the upper airway is most prone to collapse due to REM sleep atonia. Respiratory events are usually longer and more desaturating in REM than in NREM sleep. The prevalence of REM OSA is higher in women than in men and REM OSA usually occurs in the context of mild–moderate OSA based on the apnoea–hypopnoea index calculated for the entire sleep study. Studies have highlighted some detrimental consequences of REM OSA; for example, its frequent association with systemic hypertension and a degree of excessive daytime sleepiness similar to that found in nonsleep-stage-dependent OSA. Moreover, REM OSA could increase cardiometabolic risk. Continuous positive airway pressure (CPAP) treatment aimed at preventing REM OSA should be longer than the 4 h usually considered as good compliance, since REM sleep occurs mostly during the second half of the night. Unfortunately, patients with REM OSA show poor adherence to CPAP. Alternative non-CPAP treatments might be a good choice for REM OSA, but data are lacking. This review summarises the available data on REM OSA and critically examines the weaknesses and strengths of existing literature.
Scleral remodeling during myopia development in mice eyes: a potential role of thrombospondin-1
Authors: Chen Junhan , Ikeda Shin-ichi , Yang Yajing , Zhang Yan , Ma Ziyan , Liang Yifan , Negishi Kazuno , Tsubota Kazuo , Kurihara Toshihide
Published: February 2024

Background

Scleral extracellular matrix (ECM) remodeling plays a crucial role in the development of myopia, particularly in ocular axial elongation. Thrombospondin-1 (THBS1), also known as TSP-1, is a significant cellular protein involved in matrix remodeling in various tissues. However, the specific role of THBS1 in myopia development remains unclear.

Method

We employed the HumanNet database to predict genes related to myopic sclera remodeling, followed by screening and visualization of the predicted genes using bioinformatics tools. To investigate the potential target gene Thbs1, we utilized lens-induced myopia models in male C57BL/6J mice and performed Western blot analysis to detect the expression level of scleral THBS1 during myopia development. Additionally, we evaluated the effects of scleral THBS1 knockdown on myopia development through AAV sub-Tenon’s injection. The refractive status and axial length were measured using a refractometer and SD-OCT system.

Results

During lens-induced myopia, THBS1 protein expression in the sclera was downregulated, particularly in the early stages of myopia induction. Moreover, the mice in the THBS1 knockdown group exhibited alterations in myopia development in both refraction and axial length changed compared to the control group. Western blotting analysis confirmed the effectiveness of AAV-mediated knockdown, demonstrating a decrease in COLA1 expression and an increase in MMP9 levels in the sclera.

Conclusion

Our findings indicate that sclera THBS1 levels decreased during myopia development and subsequent THBS1 knockdown showed a decrease in scleral COLA1 expression. Taken together, these results suggest that THBS1 plays a role in maintaining the homeostasis of scleral extracellular matrix, and the reduction of THBS1 may promote the remodeling process and then affect ocular axial elongation during myopia progression.
Hypothesis of a CD137/Eomes activating axis for effector T cells in HPV oropharyngeal cancers
Authors: Baudouin Robin , Tartour Eric , Badoual Cécile , Hans Stéphane
Published: February 2024

Chronic Human Papilloma Virus (HPV) infection is supplanting alcohol and tobacco intoxications as the leading cause of oropharyngeal cancer in developed countries. HPV-related squamous cell carcinomas of the oropharynx (HPV + OSC) present better survival and respond better to radiotherapy and chemotherapy. Regulatory T cells (TREG) are mainly described as immunosuppressive and protumoral in most solid cancers. However, TREG are paradoxically associated with a better prognosis in HPV + OSCs. The transcription factor FoxP3 is the basis for the identification of TREG. Among CD4 + FoxP3 + T cells, some have effector functions. A medical hypothesis is formulated here: the existence of a CD137 (4.1BB)-Eomesodermin (Eomes) activated pathway downstream of TCR-specific activation in a subpopulation of CD4 + FoxP3 + T cells may explain this effector function. Evidence suggest that this axis may exist either in CD4 + FoxP3 + T cells or CD8 + T cells. This pathway could lead T cells to strong antitumor cytotoxic activity in a tumor-specific manner. Furthermore, CD137 is one of the most expected targets for the development of agonist immunotherapies. The identification of CD137 + Eomes + FoxP3+/- T cells could be a key element in the selective activation of the most anti-tumor cells in the HPV + OSC microenvironment.
Anti-CD38 targeted nanotrojan horses stimulated by acoustic waves as therapeutic nanotools selectively against Burkitt’s lymphoma cells
Authors: Vighetto Veronica , Conte Marzia , Rosso Giada , Carofiglio Marco , Sidoti Abate Federica , Racca Luisa , Mesiano Giulia , Cauda Valentina
Published: February 2024

The horizon of nanomedicine research is moving toward the design of therapeutic tools able to be completely safe per se, and simultaneously be capable of becoming toxic when externally activated by stimuli of different nature. Among all the stimuli, ultrasounds come to the fore as an innovative approach to produce cytotoxicity on demand in presence of NPs, without invasiveness, with high biosafety and low cost. In this context, zinc oxide nanoparticles (NPs) are among the most promising metal oxide materials for theranostic application due to their optical and semi-conductor properties, high surface reactivity, and their response to ultrasound irradiation. Here, ZnO nanocrystals constitute the stimuli-responsive core with a customized biomimicking lipidic shielding, resembling the composition of natural extracellular vesicles. This core–shell hybrid structure provides high bio- and hemocompatibility towards healthy cells and is here proofed for the treatment of Burkitt’s Lymphoma. This is a very common haematological tumor, typically found in children, for which consolidated therapies are so far the combination of chemo-therapy drugs and targeted immunotherapy. In this work, the proposed safe-by-design antiCD38-targeted hybrid nanosystem exhibits an efficient selectivity toward cancerous cells, and an on-demand activation, leading to a significant killing efficacy due to the synergistic interaction between US and targeted hybrid NPs. Interestingly, this innovative treatment does not significantly affect healthy B lymphocytes nor a negative control cancer cell line, a CD38- acute myeloid leukemia, being thus highly specific and targeted. Different characterization and analyses confirmed indeed the effective formation of targeted hybrid ZnO NPs, their cellular internalization and the damages produced in Burkitt’s Lymphoma cells only with respect to the other cell lines. The presented work holds promises for future clinical applications, as well as translation to other tumor types.

Graphical abstract
Triage implementation in resource-limited emergency departments: sharing tools and experience from the Pacific region
Authors: Mitchell Rob , White Libby , Elton Leigh , Luke Cliff , Bornstein Sarah , Atua Vincent
Published: February 2024

According to the World Health Organization’s (WHO) Emergency Care Systems Framework, triage is an essential function of emergency departments (EDs). This practice innovation article describes four strategies that have been used to support implementation of the WHO-endorsed Interagency Integrated Triage Tool (IITT) in the Pacific region, namely needs assessment, digital learning, public communications and electronic data management.

Using a case study from Vila Central Hospital in Vanuatu, a Pacific Small Island Developing State, we reflect on lessons learned from IITT implementation in a resource-limited ED. In particular, we describe the value of a bespoke needs assessment tool for documenting triage and patient flow requirements; the challenges and opportunities presented by digital learning; the benefits of locally designed, public-facing communications materials; and the feasibility and impact of a low-cost electronic data registry system.

Our experience of using these tools in Vanuatu and across the Pacific region will be of interest to other resource-limited EDs seeking to improve their triage practice and performance. Although the resources and strategies presented in this article are focussed on the IITT, the principles are equally relevant to other triage systems.
Using body sensors for evaluating the impact of smart cycling technologies on cycling experiences: a systematic literature review and conceptual framework
Authors: Boot Mario , Ulak Mehmet Baran , Geurs Karst T. , Havinga Paul J. M.
Published: February 2024

Digital technologies in, on, and around bicycles and cyclists are gaining ground. Collectively called Smart Cycling Technologies (SCTs), it is important to evaluate their impact on subjective cycling experiences. Future evaluations can inform the design of SCTs, which in turn can help to realize the abundant benefits of cycling. Wearable body sensors and advanced driver assistance systems are increasingly studied in other domains, however evaluation methods integrating such sensors and systems in the field of cycling research were under-reviewed and under-conceptualized. This paper therefore presents a systematic literature review and conceptual framework to support the use of body sensors in evaluations of the impact of SCTs on perceptions, emotions, feelings, affect, and more, during outdoor bicycle rides. The literature review (n = 40) showed that there is scarce research on this specific use of body sensors. Moreover, existing research designs are typically not tailored to determine impact of SCTs on cycling experience at large scale. Most studies had small sample sizes and explored limited sensors in chest belts and wristbands for evaluating stress response. The evaluation framework helps to overcome these limitations, by synthesizing crucial factors and methods for future evaluations in four categories: (1) experiences with SCTs, (2) experience measurements, (3) causal analysis, (4) confounding variables. The framework also identifies which types of sensors fit well to which types of experiences and SCTs. The seven directions for future research include, for example, experiences of psychological flow, sensors in e-textiles, and cycling with biofeedback. Future interactions between cyclists and SCTs will likely resemble a collaboration between humans and artificial intelligence. Altogether, this paper helps to understand if future support systems for cyclists truly make cycling safer and more attractive.
Control-FREEC viewer: a tool for the visualization and exploration of copy number variation data
Authors: Crippa Valentina , Fina Emanuela , Ramazzotti Daniele , Piazza Rocco
Published: February 2024

Background

Copy number alterations (CNAs) are genetic changes commonly found in cancer that involve different regions of the genome and impact cancer progression by affecting gene expression and genomic stability. Computational techniques can analyze copy number data obtained from high-throughput sequencing platforms, and various tools visualize and analyze CNAs in cancer genomes, providing insights into genetic mechanisms driving cancer development and progression. However, tools for visualizing copy number data in cancer research have some limitations. In fact, they can be complex to use and require expertise in bioinformatics or computational biology. While copy number data analysis and visualization provide insights into cancer biology, interpreting results can be challenging, and there may be multiple explanations for observed patterns of copy number alterations.

Results

We created Control-FREEC Viewer, a tool that facilitates effective visualization and exploration of copy number data. With Control-FREEC Viewer, experimental data can be easily loaded by the user. After choosing the reference genome, copy number data are displayed in whole genome or single chromosome view. Gain or loss on a specific gene can be found and visualized on each chromosome. Analysis parameters for subsequent sessions can be stored and images can be exported in raster and vector formats.

Conclusions

Control-FREEC Viewer enables users to import and visualize data analyzed by the Control-FREEC tool, as well as by other tools sharing a similar tabular output, providing a comprehensive and intuitive graphical user interface for data visualization.
Oral midodrine for prophylaxis against post-spinal anesthesia hypotension during hip arthroplasty in elderly population: a randomized controlled trial
Authors: Amin Sarah , Hasanin Ahmed , Mansour Rehab , Mostafa Maha , Zakaria Dina , Arafa Amany S , Yassin Akram , Ziada Hisham
Published: February 2024

Background

We aimed to evaluate the efficacy of midodrine as a prophylaxis against post-spinal hypotension in elderly patients undergoing hip arthroplasty.

Methods

This randomized controlled trial included elderly patients undergoing hip arthroplasty under spinal anesthesia. Ninety minutes before the procedure, patients were randomized to receive either 5-mg midodrine or placebo (metoclopramide). After spinal anesthesia, mean arterial pressure (MAP) and heart rate were monitored every 2 min for 20 min then every 5 min until the end of the procedure. Post-spinal hypotension (MAP < 80% baseline) was treated with 10 mg ephedrine. The primary outcome was intraoperative ephedrine consumption. Secondary outcomes were the incidence of post-spinal hypotension, bradycardia, and hypertension (MAP increased by > 20% of the baseline reading).

Results

We analyzed 29 patients in the midodrine group and 27 in the control group. The intraoperative ephedrine consumption was lower in the midodrine group than in the control group (median [quartiles]: 10 [0, 30] mg versus 30 [20, 43] mg, respectively, P-value: 0.002); and the incidence of intraoperative hypotension was lower in the midodrine group than that in the control group. The incidence of hypertension and bradycardia were comparable between the two groups.

Conclusion

The use of 5 mg oral midodrine decreased the vasopressor requirements and incidence of hypotension after spinal anesthesia for hip surgery in elderly patients.

Clinical trial registration

This study was registered on September 22, 2022 at clinicaltrials.gov registry, NCT05548985, URL: https://classic.clinicaltrials.gov/ct2/show/NCT05548985.
Missed nursing care in emergency departments: a cross-sectional descriptive study
Authors: Rooddehghan Zahra , Karimi Hamid , Mohammadnejad Esmaeil , Sayadi Leila , Haghani Shima , Karimi Raoofeh
Published: February 2024

Background

Missed care refers to the omission or delay in performing any aspect of patient’s care (either a part of the care or the entire care). Currently, missed care has become a growing concern at the international level, which threatens the quality and safety of care and cases many unwanted consequences. This study aims to investigate the frequency and types of missed nursing care in the emergency departments of selected hospitals affiliated to Tehran University of Medical Sciences.

Methods

This is a cross-sectional and descriptive- observational study that was conducted with the aim of determining the frequency and types of missed nursing care in the emergency departments of selected hospitals affiliated to Tehran University of Medical Sciences from January 2020 to June 2020. The research community included all nursing care offered in the designated areas, as well as all nurses working in the emergency departments of selected hospitals. Finally, 146 nurses were selected by census method. The information was collected by self-reporting method and the researcher’s observation. Demographic information questionnaire, a researcher-made checklist were used to determine the frequency and types of missed nursing care. 384 observations were made for each item. Descriptive statistics methods were used to analyze the data.

Results

The area of checking equipment and emergency trolley(mean = 81.80) had the lowest and the area of patient communication(mean = 55.72) had the highest level of missed care.

Conclusions

The level of missed nursing care in the emergency departments of selected hospitals affiliated to Tehran University of Medical Sciences was found to be high and the highest amount was related to the field of communication with the patient. Therefore, it is recommended that the details of missed nursing care in each area should be considered by nursing managers.
Identifying longitudinal healthcare pathways and subsequent mortality for people living with dementia in England: an observational group-based trajectory analysis
Authors: Watson James , Green Mark A. , Giebel Clarissa , Akpan Asangaedem
Published: February 2024

Background

The number of people living with dementia (PLWD) continues to increase, particularly those with severe symptomatology. Severe symptoms and greater ill-health result in more acute care need. Early healthcare interventions can prove beneficial. Healthcare use has not been analysed as a holistic set of interlinked events. This study explores different healthcare pathways among PLWD, social or spatial inequalities in healthcare pathways and subsequent mortality risk.

Methods

Group-based trajectory models (GBTM) were applied to electronic healthcare records. We generated clusters of PLWD with similar five-year, post-diagnosis trajectories in rates of primary and secondary healthcare use. Potential social and spatial variations in healthcare use clusters were examined. Cox Proportional Hazards used to explore variation in subsequent mortality risk between healthcare use clusters.

Results

Four healthcare use clusters were identified in both early- (n = 3732) and late-onset (n = 6224) dementia populations. Healthcare use variations were noted; consistent or diminishing healthcare use was associated with lower subsequent mortality risk. Increasing healthcare use was associated with increased mortality risk. Descriptive analyses indicated social and spatial variation in healthcare use cluster membership.

Conclusion

Healthcare pathways can help indicate changing need and variation in need, with differential patterns in initial healthcare use post-diagnosis, producing similar subsequent mortality risk. Care in dementia needs to be more accessible and appropriate, with care catered to specific and changing needs. Better continuity of care and greater awareness of dementia in primary can enhance prospects for PLWD. Research needs to further illuminate holistic care need for PLWD, including health and social care use, inequalities in care, health and outcomes.