bluuebunny/crossref_metadata_2025 huggingface dataset:
Expert Consensus on Improving Stroke Care Ecosystem in India
Authors: Srivastava M. V. Padma , Mehndiratta Man Mohan , Kaul Subhash , Ichaporia N. R. , Sylaja P. N. , Pradeep M. , Alurkar Anand , Arjundas Deepak , Roy Jayanta , Pandian Jeyraj , Sundaram S. Meenakshi , Rohatgi Anshu , Sharma Arvind , Vijaya P. , Gaikwad Ankush , Suryavanshi Sachin
Published: February 2024

The stroke burden in India is alarmingly high compared to Western industrialised countries, necessitating immediate action to develop stroke systems of care. Tailored stroke-prevention strategies, adequate resource allocation for stroke management and research, and increased awareness of specialised care in acute Stroke are critical. The COVID-19 pandemic has underscored the need for improved healthcare delivery and infrastructure. To address the rising stroke burden in India, comprehensive strategies encompassing prevention, awareness, specialised care and governmental support are urgently required. While the concept of ‘stroke-ready centres’ has emerged, their limited availability hinders widespread benefits. This expert consensus examines the current state of stroke care in India, identifies challenges, and proposes strategies to enhance stroke care systems. It offers valuable insights into stroke management at different levels, empowering healthcare professionals and administrators to assess their existing systems and make necessary improvements. Special attention is given to the role of physicians, including the use of thrombolytic therapies like Tenecteplase, in reducing the stroke burden and improving outcomes across the country. Significant strides can be made in stroke management and care in India by addressing these critical areas.
“Hands across the sea”: Strikes, solidarity and diverging outcomes in port cities in Britain and Australia in the late nineteenth century
Authors: Collender Guy
Published: February 2024

This article advances the historiography of port cities, waterfront trade unionism and imperial solidarity by comparing two distant places that, despite their colonial connections, are rarely juxtaposed: Britain and Australia. It investigates the relationship between the metropole and the periphery via the Great Dock Strike of 1889 in London (a 5-week dispute that ended in victory for the dockers) and the Australian Maritime Strike of 1890 (a 12-week strike that ended in defeat for the workers). This research shows how the responses to the strikes from the other side of the world reflected the characteristics of port cities and their waterfront workers. They were also largely determined by three neglected themes - the extent of colonial ties, the uses of the new telegraph network, and the impact of trade cycles - and how these themes influenced each other. The first theme develops and complicates Bernard Porter’s argument that Britons were indifferent towards imperial affairs. On the one hand, this article confirms his position by showing the asymmetry of imperial relations between the outward-looking Australians and the mainly inward-looking Britons. On the other, it demonstrates how imperial connections led to solidarity, and how Britain’s working-class leaders embodied an elitist imperial mindset. In doing so, this article draws new parallels between Britain’s working-class leaders and colonial administrators. Despite their different roles and educational backgrounds, both groups - imbued with a sense of imperial superiority - demonstrated a similarly paternalistic approach in their work overseas. Therefore, imperial solidarity in port cities is a prism through which the prevalence and impact of the British imperial ethos - a far wider subject - can be illuminated and assessed.
Nanomaterial-based optical colorimetric sensors for rapid monitoring of inorganic arsenic species: a review
Authors: Gebremedhin Kalayou Hiluf , Kahsay Mebrahtu Hagos , Wegahita Nigus Kebede , Teklu Tesfamariam , Berhe Berihu Abadi , Gebru Asfaw Gebretsadik , Tesfay Amanuel Hadera , Asgedom Abraha Geberekidan
Published: February 2024

Health concerns about the toxicity of arsenic compounds have therefore encouraged the development of new analytical tools for quick monitoring of arsenic in real samples with improved sensitivity, selectivity, and reliability. An overview of advanced optical colorimetric sensor techniques for real-time monitoring of inorganic arsenic species in the environment is given in this review paper. Herein, several advanced optical colorimetric sensor techniques for arsenite (As+3) and arsenate (As+5) based on doping chromogenic dyes/reagents, biomolecule-modified nanomaterials, and arsenic-binding ligand tethered nanomaterials are introduced and discussed. This review also highlights the benefits and limitations of the colorimetric sensor for arsenic species. Finally, prospects and future developments of an optical colorimetric sensor for arsenic species are also proposed. For future study in this sector, particularly for field application, authors recommend this review paper will be helpful for readers to understand the design principles and their corresponding sensing mechanisms of various arsenic optical colorimetric sensors.
Catheter ablation versus medical therapy in atrial fibrillation: an umbrella review of meta-analyses of randomized clinical trials
Authors: Titus Anoop , Syeed Sakil , Baburaj Abiram , Bhanushali Karan , Gaikwad Pramod , Sooraj Mannil , Saji Anu Mariam , Mir Wasey Ali Yadullahi , Kumar Pramukh Arun , Dasari Mahati , Ahmed Mubashir Ayaz , Khan Mohammed Omer , Titus Aishwarya , Gaur Janamjey , Annappah Dilanthy , Raj Arjun , Noreen Nabeela , Hasdianda Adrian , Sattar Yasar , Narasimhan Bharat , Mehta Nishaki , Desimone Christopher V. , Deshmukh Abhishek , Ganatra Sarju , Nasir Khurram , Dani Sourbha
Published: February 2024

This umbrella review synthesizes data from 17 meta-analyses investigating the comparative outcomes of catheter ablation (CA) and medical treatment (MT) for atrial fibrillation (AF). Outcomes assessed were mortality, risk of hospitalization, AF recurrence, cardiovascular events, pulmonary vein stenosis, major bleeding, and changes in left ventricular ejection fraction (LVEF) and MLHFQ score. The findings indicate that CA significantly reduces overall mortality and cardiovascular hospitalization with high strength of evidence. The risk of AF recurrence was notably lower with CA, with moderate strength of evidence. Two associations reported an increased risk of pulmonary vein stenosis and major bleeding with CA, supported by high strength of evidence. Improved LVEF and a positive change in MLHFQ were also associated with CA. Among patients with AF and heart failure, CA appears superior to MT for reducing mortality, improving LVEF, and reducing cardiovascular rehospitalizations. In nonspecific populations, CA reduced mortality and improved LVEF but had higher complication rates. Our findings suggest that CA might offer significant benefits in managing AF, particularly in patients with heart failure. However, the risk of complications, including pulmonary vein stenosis and major bleeding, is notable. Further research in understudied populations may help refine these conclusions.
Best practice models of aged-care implemented for First Nations people: a systematic review aligned with the Good Spirit Good Life quality of life principles
Authors: Rivers Caleb , Haynes Emma , LoGiudice Dina , Smith Kate , Bessarab Dawn
Published: February 2024

Background

Aged-care programs that are based in First Nations worldviews are believed to translate to improved quality of life for First Nations Elders. First Nations perspectives of health and well-being incorporates social and cultural determinants in addition to traditional Western biomedical approaches. This is exemplified by the Good Spirit Good Life (GSGL) framework, which comprises 12 strength-based factors determined by First Nations Elders as constituting culturally appropriate ageing. Our objective was to conduct a systematic review of existing aged care models of practice to determine the degree of alignment with the GSGL framework. Recommendations of the national Australian Royal Commission into Aged Care Quality and Safety informed this work.

Methods

We conducted a systematic search of academic and grey literature in the PubMed, Scopus, Ovid Embase, and Informit online databases. Inclusion criteria comprised English language, original research describing the implementation of First Nations culturally appropriate aged care models, published before August 2022. Research that was not focused on First Nations Elders’ perspectives or quality of life was excluded. We subsequently identified, systematically assessed, and thematically analyzed 16 articles. We assessed the quality of included articles using the Aboriginal and Torres Strait Islander Quality Assessment Tool (ATSIQAT), and the Joanna Briggs Institute (JBI) critical appraisal tool for qualitative research.

Results

Most studies were of medium to high quality, while demonstrating strong alignment with the 12 GSGL factors. Nine of the included studies detailed whole service Models of care while 7 studies described a single program or service element. Thematic analysis of included studies yielded 9 enablers and barriers to implementing models of care.

Conclusions

Best-practice First Nations aged care requires a decolonizing approach. Programs with strong adherence to the 12 GSGL factors are likely to improve Elders’ quality of life.
Healthcare professionals’ experiences and views of providing continence support and advice to people living at home with dementia: “That’s a carer’s job”
Authors: Bradbury Barbara , Chester Helen , Santer Miriam , Morrison Leanne , Fader Mandy , Ward Jane , Manthorpe Jill , Murphy Catherine
Published: February 2024

Background

People living with dementia at home and their family carers often feel unsupported by healthcare professionals in managing continence problems. In turn, primary and community-based healthcare professionals have reported lacking specific knowledge on dementia-continence. This study aimed to understand more about healthcare professionals’ experiences and views of supporting people living with dementia experiencing continence problems, as part of developing acceptable resources. Having a nuanced understanding of unmet need would facilitate the design of engaging resources that enable healthcare professionals to provide more effective continence support to people living with dementia at home.

Methods

Semi-structured interviews were conducted with a range of healthcare professionals (n = 31) working in primary and community care in the South of England in 2023. Transcribed interviews were uploaded to NVivo 12, then analysed inductively and deductively using a thematic framework.

Results

Continence-related conversations were avoided by many healthcare professionals due to lack of dementia-continence specific knowledge. Many considered that continence problems of people living with dementia were largely outside their remit once a physical cause had been ruled out. This contributed to a lack of priority and proactivity in raising the subject of continence in their consultations. Challenges to providing support included limited consultation time and lack of access to specialist services with availability to support individuals.

Conclusion

There is substantial scope to support primary and community-based healthcare professionals in their provision of continence-related support and advice to people living at home with dementia. This includes addressing knowledge deficits, enhancing confidence and instilling a sense of accomplishment.
Psychometric assessment of patients with central serous chorioretinopathy and correlation with disease stage and progression: a case control study
Authors: Hufnagel Hinrich J. , Lahmann Claas , Agostini Hansjürgen , Lange Clemens , Pauleikhoff Laurenz J. B. ,   on behalf of the Retina.net CCS study group
Published: February 2024

Background

Central serous chorioretinopathy (CSC) has frequently been associated with increased stress levels as well as an increased prevalence of other psychiatric conditions. This study used standardized psychometric scores to assess stress, depression and anxiety levels of CSC patients and compared them to controls without retinal disease (“healthy”) and with branch retinal vein occlusion (BRVO).

Methods

Monocentric, longitudinal case control study on consecutive CSC patients seen at a tertiary referral center. Controls without retinal disease were recruited from the oculoplastics clinic and those with BRVO from the medical retina clinic. Patients completed pseudonymized tests measuring stress levels (PHQ-stress), depression (PHQ-9) and anxiety (GAD-7) at baseline and at 3- and 6-months follow-up. Higher scores indicated higher trait levels.

Results

65 CSC patients, 19 healthy controls and 19 BRVO patients were included in this study. CSC patients showed significantly higher stress levels at baseline compared to controls (p = 0.009), but not compared to BRVO patients (p = 1.00). At 3- and 6-months follow-up, no significant difference between groups was observed anymore. Acute CSC patients showed higher scores than those with chronic CSC, which also subsided over time. Depression and anxiety scores did not differ between groups at any timepoint.

Conclusions

Patients with CSC do not show higher initial stress levels than patients with BRVO, while anxiety and depression levels did not differ from controls. Stress may thus rather represent a consequence of the onset of visual deterioration observed in CSC or other ocular diseases.
Raising professionalism concerns as a medical student: damned if they do, damned if they don’t?
Authors: Sullivan Erica , Thampy Harish , Gay Simon
Published: February 2024

Background

Understanding professionalism is an essential component of becoming a doctor in order to ensure the trust of patients and wider society. Integrally linked to the concept of professionalism is the importance of identifying and raising concerns to ensure high quality, safe patient care. It is recognised that medical students are uniquely placed to identify and report concerns given their frequent rotations through multiple clinical placements and their peer relationships and, in so doing, develop and enact their own medical professionalism. Although there is existing literature exploring medical students’ willingness to raise concerns about observed professionalism lapses, this has largely been in the context of clinical interactions. Medical students will however undoubtedly encounter concerning behaviours or attitudes in their fellow students, an area that has not specifically been reported upon. This study therefore set out to explore medical students’ willingness to report professionalism concerns they encounter both within and away from the clinical setting, particularly focusing on peer-related concerns.

Methods

10 medical students, in later clinical years of a large UK medical school, volunteered to take part in in-depth semi-structured interviews. Interviews were recorded, transcribed and then analysed thematically to generate themes and subthemes to represent central organising concepts.

Results

Three broad themes were generated from the data. Hidden curricular effects including role models, hierarchical structures and the operational systems in place to raise concerns subconsciously influenced students’ decisions to raise concerns. Secondly, students offered a range of justifications to defend not taking action, including considering their own vulnerabilities and values alongside demonstrating empathy for perceived mitigating circumstances. The third theme highlighted the complex interplay of influencing factors that students considered when encountering professionalism issues in their peers including wider peer cohort effects and a desire to maintain individual peer-relationships.

Conclusions

Medical students will inevitably encounter situations where the professionalism of others is brought into question. However, despite clear curricular expectations to report such concerns, these findings demonstrate that students undergo a complex decision-making process in determining the threshold for reporting a concern through navigating a range of identified influencing factors. This study highlights the important role medical schools play in helping reduce the inner conflict experienced by medical students when raising concerns and in ensuring they provide supportive processes to empower their students to raise concerns as part their own developing professionalism.
Ubiquitylation of RUNX3 by RNA-binding ubiquitin ligase MEX3C promotes tumorigenesis in lung adenocarcinoma
Authors: He Zelai , Zhang Huijun , Xiao Haibo , Zhang Xiangyu , Xu Hongbo , Sun Ruifen , Li Siwen
Published: February 2024

Lung adenocarcinoma (LUAD) is the most common pathological type of lung cancer, but the early diagnosis rate is low. The RNA-binding ubiquitin ligase MEX3C promotes tumorigenesis in several cancers but its mechanism of action in LUAD is unclear. In this study, the biological activity of MEX3C was assessed in LUAD. MEX3C and RUNX3 mRNA levels in the tissues of LUAD patients were determined using reverse transcription‑quantitative PCR. The involvement of MEX3C in the growth and metastasis of LUAD cells was measured by EdU assay, CCK-8, colony formation, Transwell assay, TUNEL, and flow cytometry. Expression of apoptosis and epithelial–mesenchymal transition related proteins were determined using western blotting analysis. LUAD cells transfected with si-MEX3C were administered to mice subcutaneously to monitor tumor progression and metastasis. We found that MEX3C is strongly upregulated in LUAD tissue sections, and involved in proliferation and migration. A549 and H1299 cells had significantly higher levels of MEX3C expression compared to control HBE cells. Knockdown of MEX3C dramatically decreased cell proliferation, migration, and invasion, and accelerated apoptosis. Mechanistically, we demonstrate MEX3C induces ubiquitylation and degradation of tumor suppressor RUNX3. Moreover, RUNX3 transcriptionally represses Suv39H1, as revealed by RNA pull-down and chromatin immunoprecipitation assays. The in vivo mice model demonstrated that knockdown of MEX3C reduced LUAD growth and metastasis significantly. Collectively, we reveal a novel MEX3C-RUNX3-Suv39H1 signaling axis driving LUAD pathogenesis. Targeting MEX3C may represent a promising therapeutic strategy against LUAD.
Neutrophil CD64 index as a new early predictive biomarker for infected pancreatic necrosis in acute pancreatitis
Authors: Huang Xiangping , Wu Ling , Ouyang Qianhui , Huang Ying , Hong Lanhui , Liu Sixiang , Yang Kongzhi , Ning Ding , Tan Chao Chao
Published: February 2024

Objective

Infectious pancreatic necrosis (IPN) is a serious complication of acute pancreatitis, and early recognition and timely intervention are the keys to improving clinical outcomes. The purpose of this study was to investigate the predictive capacity of the neutrophil CD64 index (nCD64 index) on IPN in patients with acute pancreatitis

Methods

This study comprises two independent cohorts: the training cohort consisted of 202 patients from Hunan Provincial People's Hospital, and the validation cohort consisted of 100 patients from Changsha Central Hospital. Peripheral blood samples were collected on the day of admission and on the 3rd, 5th, 7th, and 10th days of hospitalization, and the nCD64 index was detected by flow cytometry. Additionally, relevant clinical characteristics and laboratory biomarkers were collected and analyzed.

Results

We observed that nCD64 index on admission was significantly higher in the IPN group than Non-IPN group (p < 0.001). In the training cohort, a higher occurrence rate of IPN was observed in the high nCD64 index group compared to the moderate and low nCD64 index group (p < 0.001). Further analysis showed that nCD64 index was significant positive correlated with the incidence rate of IPN (p < 0.001, correlation coefficient = 0.972). Furthermore, logistic regression analysis showed that high expression of the nCD64 index on admission was a risk factor for the occurrence of IPN (OR = 2.971, p = 0.038). We further found that the nCD64 index of IPN patients was significantly higher than the Non-IPN patients on the days 1, 3, and 5 after admission, and the nCD64 index of IPN patients before and after the onset (p < 0.05). At the same time, this study revealed that the nCD64 index on admission showed good predictive efficacy for IPN (AUC = 0.859, sensitivity = 80.8%, specificity = 87.5%), which was comparable to APACHE II score. And this finding was further validated in an independent cohort of 100 participants (AUC = 0.919, Sensitivity = 100.0%, Specificity = 76.6%).

Conclusion

This study demonstrated the clinical value of nCD64 index in patients with IPN patients for the first time through two independent cohort studies. The nCD64 index can be used as an early prediction and risk assessment tool for the occurrence of IPN, contributing to the improvement of patient outcomes and efficiency of medical resource allocation.
Causal links between sedentary behavior, physical activity, and psychiatric disorders: a Mendelian randomization study
Authors: Ba Hongjun , Zhang Lili , Peng Huimin , He Xiufang , Wang Yao
Published: February 2024

Background

Studies suggest a correlation between excessive sedentary behavior, insufficient physical activity, and an elevated likelihood of experiencing psychiatric disorder. Nonetheless, the precise influence of sedentary behavior and physical activity on psychiatric disorder remains uncertain. Hence, the objective of this research was to investigate the possible causal relationship between sedentary behavior, physical activity, and the susceptibility to psychiatric disorder (depression, schizophrenia and bipolar disorder), utilizing a two-sample Mendelian randomization (MR) approach.

Methods

Potential genetic instruments related to sedentary leisure behaviors were identified from the UK Biobank database, specifically a summary-level genome-wide association study (GWAS) involving 422,218 individuals of European descent. The UK Biobank database also provided the GWAS data for physical activity. Primary analysis was performed using inverse variance weighting (IVW) to assess the causal relationship between sedentary behavior, physical activity, and the risk of psychiatric disorder (depression, schizophrenia and bipolar disorder). Sensitivity analysis was conducted using Cochran’s Q test, the MR–Egger intercept test, the MR-pleiotropy RESidual sum and outlier test, leave-one-out analysis, and funnel plot analysis.

Results

According to the IVW analysis, there was a significant association between genetically predicted leisure television watching and an increased risk of depression (odds ratio [OR] = 1.027, 95% confidence interval [CI]: 1.001–1.053; P = 0.04). The IVW analysis also indicated that there was a decreased risk of depression associated with fraction accelerations of > 425 milligravities, as measured by accelerometers (OR = 0.951, 95%CI: 0.914–0.989; P = 0.013). The other MR methods obtained consistent but non-significant results in the same direction. However, there was no evidence of a causal association between genetic liability for moderate-to-vigorous physical activity, accelerometer-assessed physical activity, computer use, or driving and the risk of depression. Furthermore, IVW analysis has also found that driving has a slight effect in reducing the risk of schizophrenia (OR = 0.092, 95%CI: 0.010–0.827; P = 0.033), while leisure television viewing has a significant protective effect against the onset of bipolar disorder (OR = 0.719, 95%CI: 0.567–0.912; P = 0.006).

Conclusion

The study provides compelling evidence of a link between depression, bipolar disorder, and excessive TV watching. Furthermore, it suggests that higher accelerometer-assessed fraction accelerations of > 425 milligravities can serve as a genetic protective factor against depression. To mitigate the risk of developing depression, it is advisable to reduce sedentary activities, particularly television watching, and prioritize engaging in vigorous physical exercise.
The role of physiotherapy interventions in the management of temporomandibular joint ankylosis: a systematic review and meta-analysis
Authors: Saini Ravinder S. , Ibrahim Mohammed , Khader Mohasin Abdul , Kanji Masroor Ahmed , Mosaddad Seyed Ali , Heboyan Artak
Published: February 2024

Background

The main aim of this systematic review and meta-analysis was to identify peer-reviewed scholarly journal articles reporting the significance of physiotherapy interventions in managing TMJ ankylosis. In addition, this study aimed to critically appraise the existing evidence on the prevalence and clinical presentation, physiotherapy intervention approaches, efficacy of physiotherapy interventions, adverse effects, and safety of physiotherapy interventions in TMJ ankylosis management.

Methods

An all-inclusive literature search was conducted using the PubMed, Google Scholar, and Scopus electronic databases. The researchers screened the potential articles and assessed for eligibility based on the reported inclusion and exclusion criteria. The quality evaluation tool for observational cohort and cross-sectional studies developed by the National Institutes of Health (NIH) and the Cochrane Collaboration's Risk of Bias Tool were used to assess the quality of the included studies. Researchers also comprehensively analyzed the data, reported the results, and discussed them according to the predominant themes.

Results

The primary electronic database search yielded 409 articles, of which 25 were included in this review. A secondary search was conducted from citations of the included studies, yielding 74 articles, of which six were included in the study. A significantly higher prevalence of bony ankylosis than fibrous ankylosis, with an overall effect size of p < 0.00001. In addition, there were significantly more unilateral than bilateral presentations with an overall effect size of p < 0.00001. Moreover, there were 78 reported complications out of 245 subjects according to five included studies demonstrating a significant effect size with p = 0.001 following the treatment protocols.

Conclusion

This study highlighted the prevalence of bony ankylosis in temporomandibular joint ankylosis, emphasizing its impact on patients' well-being. On the other hand, the results show that physiotherapy is essential to optimize postoperative outcomes and minimize adverse events such as re-ankylosis. Practitioners and healthcare professionals must monitor postoperative recovery and ensure strict adherence to physiotherapy protocols for optimal outcomes.
MRI T2 mapping and shear wave elastography for identifying main pain generator in delayed-onset muscle soreness: muscle or fascia?
Authors: Fu Congcong , Xia Yu , Wang Bingshan , Zeng Qiang , Pan Shinong
Published: February 2024

Introduction

The main generator of delayed onset muscle soreness (DOMS) is still unknown. This study aimed to clarify the main generator of DOMS.

Methods

Twelve participants performed eccentric exercise (EE) on lower legs. MRI and ultrasound were used to assess changes of calf muscle and deep fascia before and after EE. These results were then compared to the muscle pain level.

Results

Compared to baseline, muscle pain peaked at 24–48 h after EE (downstairs 22.25 ± 6.196, 57.917 ± 9.298, F = 291.168, p < 0.01; resting 5.833 ± 1.899, 5.083 ± 2.429, F = 51.678, p < 0.01). Shear wave speed (SWE) of the deep fascia and T2 values of the gastrocnemius muscle and deep fascia all increased and peaked at 48 h after EE (1.960 ± 0.130, F = 22.293; 50.237 ± 2.963, F = 73.172; 66.328 ± 2.968, F = 231.719, respectively, p < 0.01). These measurements were positively correlated with DOMS (downstairs: r = 0.46, 0.76, 0.87, respectively, p < 0.001; resting: r = 0.42, 0.70, 0.77, respectively, p < 0.001). There was a significant positive correlation between SWE and T2 values of deep fascia (r = 0.54, p < 0.01).

Conclusion

DOMS is a common result of muscle and fascia injuries. Deep fascia edema and stiffness play a crucial role in DOMS, which can be effectively evaluated MR-T2 and SWE.

Critical relevance statement

Delayed-onset muscle soreness is a common result of muscle and deep fascia injuries, in which the edema and stiffness of the deep fascia play a crucial role. Both MRI and shear wave elastography can be effectively used to evaluate soft tissue injuries.

Key points

• The deep fascia is the major pain generator of delayed-onset muscle soreness.

• There is a significant correlation between fascia injury and delayed-onset muscle soreness.

• MRI and shear wave elastography are preferred methods for assessing fascia injuries.

Graphical Abstract
Functional intestinal monolayers from organoids derived from human iPS cells for drug discovery research
Authors: Inui Tatsuya , Uraya Yusei , Yokota Jumpei , Yamashita Tomoki , Kawai Kanae , Okada Kentaro , Ueyama-Toba Yukiko , Mizuguchi Hiroyuki
Published: February 2024

Background

Human induced pluripotent stem (iPS) cell-derived enterocyte-like cells (ELCs) are expected to be useful for evaluating the intestinal absorption and metabolism of orally administered drugs. However, it is difficult to generate large amounts of ELCs with high quality because they cannot proliferate and be passaged.

Methods

To solve the issue above, we have established intestinal organoids from ELCs generated using our protocol. Furthermore, monolayers were produced from the organoids. We evaluated the usefulness of the monolayers by comparing their functions with those of the original ELCs and the organoids.

Results

We established organoids from ELCs (ELC-org) that could be passaged and maintained for more than a year. When ELC-org were dissociated into single cells and seeded on cell culture inserts (ELC-org-mono), they formed a tight monolayer in 3 days. Both ELC-org and ELC-org-mono were composed exclusively of epithelial cells. Gene expressions of many drug-metabolizing enzymes and drug transporters in ELC-org-mono were enhanced, as compared with those in ELC-org, to a level comparable to those in adult human small intestine. The CYP3A4 activity level in ELC-org-mono was comparable or higher than that in primary cryopreserved human small intestinal cells. ELC-org-mono had the efflux activities of P-gp and BCRP. Importantly, ELC-org-mono maintained high intestinal functions without any negative effects even after long-term culture (for more than a year) or cryopreservation. RNA-seq analysis showed that ELC-org-mono were more mature as intestinal epithelial cells than ELCs or ELC-org.

Conclusions

We have successfully improved the function and convenience of ELCs by utilizing organoid technology.
Corona virus anxiety and Chinese students’ cognitive, affective, and behavioral engagement, and academic resilience: correlations and perceptions
Authors: Yang Xiaoling , Geng Yanmeng
Published: February 2024

Background

This study delves into the correlation between Corona Virus Anxiety (CVA) and the engagement as well as academic resilience of Chinese students. The context is set against the backdrop of the global pandemic, highlighting the potential psychological impact of COVID-19 on students’ well-being and academic performance.

Objectives

The primary objectives of this research are to investigate the relationship between CVA and various dimensions of student engagement, including affective, behavioral, and cognitive aspects. Additionally, the study aims to explore how CVA influences academic resilience, with a focus on persistence and self-regulation. The dual-objective approach employs both quantitative and qualitative methods to provide a comprehensive understanding of the subject matter.

Methodology

A mixed-methods approach is employed, combining quantitative data from scales measuring CVA, engagement, and academic resilience with qualitative insights obtained through interviews. The research sample consists of 390 students from Mudanjiang Medical University. Quantitative data are analyzed using Pearson correlation tests, while thematic analysis is applied to interpret the qualitative findings from interviews.

Results

Quantitative data analysis reveals significant negative correlations between CVA and multiple dimensions of student engagement, indicating that higher CVA levels are associated with lower engagement levels. Academic resilience, though relatively high among participants, also exhibits negative correlations with CVA, particularly in terms of persistence and self-regulation. The qualitative findings uncover six main themes elucidating the impact of CVA on students, ranging from emotional and cognitive engagement to the social and technological challenges posed by the pandemic.

Conclusions and implications

The research concludes that CVA significantly influences students’ engagement and academic resilience. The qualitative insights contribute to a nuanced understanding of the diverse challenges students face during the pandemic. These findings have broad implications for students, university administrators, educators, and educational psychologists, highlighting the importance of addressing mental health concerns and providing adequate support systems in the context of global crises.
Evaluating the effects of simulation training on stroke thrombolysis: a systematic review and meta-analysis
Authors: Aljuwaiser Sameera , Abdel-Fattah Abdel Rahman , Brown Craig , Kane Leia , Cooper Jamie , Mostafa Alyaa
Published: February 2024

Background

Ischaemic strokes are medical emergencies, and reperfusion treatment, most commonly intravenous thrombolysis, is time-critical. Thrombolysis administration relies on well-organised pathways of care with highly skilled and efficient clinicians. Simulation training is a widespread teaching modality, but results from studies on the impact of this intervention have yet to be synthesised. This systematic review and meta-analysis aimed to synthesise the evidence and provide a recommendation regarding the effects of simulation training for healthcare professionals on door-to-needle time in the emergency thrombolysis of patients with ischaemic stroke.

Methods

Seven electronic databases were systematically searched (last updated 12th July 2023) for eligible full-text articles and conference abstracts. Results were screened for relevance by two independent reviewers. The primary outcome was door-to-needle time for recombinant tissue plasminogen activator administration in emergency patients with ischaemic stroke. The secondary outcomes were learner-centred, improvements in knowledge and communication, self-perceived usefulness of training, and feeling ‘safe’ in thrombolysis-related decision-making. Data were extracted, risk of study bias assessed, and analysis was performed using RevMan™ software (Web version 5.6.0, The Cochrane Collaboration). The quality of the evidence was assessed using the Medical Education Research Study Quality Instrument.

Results

Eleven studies were included in the meta-analysis and nineteen in the qualitative synthesis (n = 20,189 total patients). There were statistically significant effects of simulation training in reducing door-to-needle time; mean difference of 15 min [95% confidence intervals (CI) 8 to 21 min]; in improving healthcare professionals’ acute stroke care knowledge; risk ratio (RR) 0.42 (95% CI 0.30 to 0.60); and in feeling ‘safe’ in thrombolysis-related decision-making; RR 0.46 (95% CI 0.36 to 0.59). Furthermore, simulation training improved healthcare professionals' communication and was self-perceived as useful training.

Conclusion

This meta-analysis showed that simulation training improves door-to-needle times for the delivery of thrombolysis in ischaemic stroke. However, results should be interpreted with caution due to the heterogeneity of the included studies.
Neutrophil–lymphocyte ratio and platelet–lymphocyte ratio as predictors of MS severity: a retrospective cohort study
Authors: Fathy Sabah E. , AbdAllah Amany M. , Helal Rania Y.
Published: February 2024

Background

Multiple sclerosis (MS) is a disabling immune-mediated disease of the central nervous system. Ministry of Health and Population’s statistics show that MS comprise 1.4% of all neurological diseases, putting into consideration, current economic crisis; it is needed to predict disease severity with an acceptable cost-effective method. Complete blood count (CBC) parameters are supposed to be cheap, and simple markers for the systemic inflammatory state. This study aims at evaluating role of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in predicting the severity of MS. Therefore, this retrospective cohort study was done on 150 MS patients attending MS clinic during year 2022. All patients were subjected to complete medical history. Estimation of the disability was done through the extended disability status scale (EDSS) and analysis of different parameters of baseline CBC before starting therapy.

Results

A cutoff value of NLR ≥ 2.95 and PLR ≥ 201.5 could predict prognosis of MS. Risk factors of sever MS are high NLR, PLR, high body mass index and absence of disease-modifying therapy.

Conclusions

Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio are cheap valid useful predictors of increased relapse rate and severity in MS. Highlighting the role of both ratios at time of first diagnosis helps physicians to predict prognosis of patients in context of severity. Paying special attention to those with higher ratios can lead to improve patient outcome and reducing disease burden.
12-month risk factor evaluation for persistent pulmonary symptoms in long COVID-19 patients
Authors: Emad Eldin Eman M. , Mohammed Randa S. , Batanony Mahmoud M. E. L. , Al-Sharawy Laila A.
Published: February 2024

Background

Knowledge of the sequelae of new coronavirus disease 2019 (COVID-19) is still limited owing to the relative recent onset of the disease. However, the study of other different types of coronavirus infections prior to COVID-19 infection reports that the patients may experience persistent symptoms following the infection.

The aim of this study

Assessment and follow-up of persistent respiratory symptoms in patients recovered from acute COVID-19 infection.

Methods

In this prospective cohort study, COVID-19 patients diagnosed at Beni-Suef University hospital and followed up prospectively at 3, 6, and 12 months after discontinuation of quarantine. Patients were interviewed for persistent respiratory symptoms then underwent assessment by physical examination and routine labs.

Results

Seventy-one patients were evaluated and participated in this study. The mean age of the patients was 47 years and 46 (64%) of them were females. After 3 months, 77.5% of the patients had persistent dyspnea, 57.7% persistent fatigue, 15.5% persistent cough, and 8.5% persistent chest pain. At the 6th month, dyspnea and fatigue persisted in 33.8% and 22.5% of cases respectively while at the 12th month dyspnea persisted in 22.5% of cases. Old age, smoking, diabetes mellitus, severity of the disease, and hypoxemia on admission were associated factors with persistent symptoms.

Conclusion

Our result added to the growing evidence that there are pulmonary sequelae in COVID-19 survivors, which may become a significant chronic global pulmonary health problem.
Right ventricular assessment of the adolescent footballer’s heart
Authors: Augustine D. X. , Willis J. , Sivalokanathan S. , Wild C. , Sharma A. , Zaidi A. , Pearce K. , Stuart G. , Papadakis M. , Sharma S. , Malhotra A.
Published: February 2024

Introduction

Athletic training can result in electrical and structural changes of the right ventricle that may mimic phenotypical features of arrhythmogenic right ventricular cardiomyopathy (ARVC), such as T-wave inversion and right heart dilatation. An erroneous interpretation may have consequences ranging from false reassurance in an athlete vulnerable to cardiac arrhythmias, to unnecessary sports restriction in a healthy individual. The primary aim of this study was to define normal RV dimension reference ranges for academy adolescent footballers of different ethnicities. Secondary aims include analysis of potential overlap between this adolescent group with ARVC criteria and comparison with normal adult ranges.

Results

Electrocardiographic (ECG) and echocardiographic data of 1087 academy male footballers aged between 13 and 18 years old (mean age 16.0 ± 0.5 years), attending mandatory cardiac screening were analysed. Ethnicity was categorised as white (n = 826), black (African/Caribbean; n = 166) and mixed-race (one parent white and one parent black; n = 95). Arrhythmogenic right ventricular cardiomyopathy major criteria for T-wave inversion was seen in 3.3% of the cohort. This was more prevalent in black footballers (12%) when compared to mixed race footballers (6.3%) or white footballers (1%), P < 0.05. Up to 59% of the cohort exceeded adult reference ranges for some of the right ventricular parameters, although values were similar to those seen in adult footballers. There were no differences in right ventricular dimensions between ethnicities. In particular, the right ventricular outflow tract diameter would fulfil major criteria for ARVC dimension in 12% of footballers. Overall, 0.2% of the cohort would fulfil diagnosis for ‘definite’ arrhythmogenic right ventricular cardiomyopathy and 2.2% would fulfil diagnosis for ‘borderline’ arrhythmogenic right ventricular cardiomyopathy for RV dimensions and ECG changes. This was seen more frequently in black footballers (9.9%) than mixed race footballers (3.9%) or white footballer (0.6%), P < 0.05. Among athletes meeting definite or borderline arrhythmogenic right ventricular cardiomyopathy criteria, no cardiomyopathy was identified after comprehensive clinical assessment, including with cardiac magnetic resonance imaging, exercise testing, ambulatory electrocardiograms and familial evaluation.

Conclusion

Right heart sizes in excess of accepted adult ranges occurred in as many as one in two adolescent footballers. Structural adaptations in conjunction with anterior T-wave inversion may raise concern for ARVC, highlighting the need for evaluation in expert settings.
Epilepsia Partialis Continua as a Sequelae of Measles Infection in Children With Hematolymphoid Malignancies
Authors: Sharma Sudivya , Dhamne Chetan , Bhosale Shilpushp , Parambil Badira , Divatia Jigeeshu , Chinnaswamy Girish , Patil Vasundhara , Joshi Rishikesh , Epari Sridhar , Mahadevan Anita , Vaidya Sunil , Kulkarni Shilpa , Kulkarni Atul , Patil Vijaya , Srinivasan Shyam , Gollamudi Venkata Rama Mohan , Roy Moulik Nirmalya , Prasad Maya , Narula Gaurav , Banavali Shripad
Published: February 2024

PURPOSE

To share our clinical experience with the diagnosis and management of children with hematolymphoid malignancies presenting with epilepsia partialis continua (EPC) as a sequelae of measles infection.

MATERIALS AND METHODS

In December 2022, a series of children in our hemato-oncology unit presented with focal status epilepticus with no conclusive evidence pointing toward any underlying etiology. One such child had a typical measles rash a few weeks before the onset of this focal status epilepticus. After a series of cases with a similar presentation, a clinical pattern suspicious for measles became evident. cerebrospinal fluid polymerase chain reaction was positive for measles virus with measles immunoglobin M detected in the serum. This led to the diagnosis of measles inclusion-body encephalitis in a series of children who presented with EPC over a period of 3 months. EPC is a rare manifestation of measles that is seen only in immunocompromised patients.

RESULTS

Among the 18 children reported in this series, only 10 had a history of rashes. The rash was mostly transient and elicited only on retrospective history taking. Five of the 18 children who did not lose consciousness during the prolonged seizure episode survived the disease but had residual neurologic sequelae. Among the 18 children, two were unimmunized and immunization status could not be confirmed in three other children.

CONCLUSION

This case series highlights the threats posed by measles infection in children with cancer who are immunosuppressed because of the underlying disease and ongoing chemotherapy. Loss of herd immunity because of declining measles immunization rates secondary to vaccine hesitancy and COVID-19 lockdown pose a greater risk of measles infection and its complications for patients with deficient immune systems.
Clinical Outcomes and Implications of Radioactive Iodine Therapy on Cancer-specific Survival in WHO Classification of FTC
Authors: Li Genpeng , Ye Ziyang , Wei Tao , Zhu Jingqiang , Li Zhihui , Lei Jianyong
Published: February 2024

Background

The clinical outcomes and implications of radioactive iodine therapy (RAIT) on cancer-specific survival (CSS) in World Health Organization classification of follicular thyroid carcinoma (FTC) are not well established.

Material and Methods

The data of eligible patients with minimally invasive FTC (mi-FTC), encapsulated angioinvasive FTC (ea-FTC), or widely invasive FTC (wi-FTC) between 2000 and 2020 were extracted from the Surveillance, Epidemiology, and End Results database. CSS, the primary outcome, was compared among the 3 subtypes of patients with FTC before and after adjusting for differences using propensity score matching (PSM). The patients with FTC in different subtypes were then divided into 2 groups: the RAIT group and the no-RAIT group. Cox proportional hazards regression analyses were applied to discover the relationships of factors associated with CSS in the each PSM cohort.

Results

A total of 2433 patients with mi-FTC, 216 patients with ea-FTC, and 554 patients with wi-FTC were enrolled in the original cohorts, respectively. Patients with mi-FTC or ea-FTC had similar CSS (P = .805), which was better than that of patients with wi-FTC (P < .001; P = .021). Cox proportional hazards regression analysis revealed that RAIT was not associated with improved CSS in either the mi-FTC PSM cohort (hazard ratio [HR], 1.21; 95% CI, .46-3.18; P = .705) or the wi-FTC PSM cohort (HR, 0.56; 95% CI, .35-1.08; P = .086). However, subgroup analysis demonstrated that patients with wi-FTC and N1 stage (HR, 0.44; 95% CI, .20-.99; P = .018) or M1 stage (HR, 0.25; 95% CI, .11-.53; P < .001) could gain CSS advantage from RAIT.

Conclusion

The RAIT can provide a CSS advantage for patients with wi-FTC who with N1-stage or M1-stage disease.
Roundtable: Queer/Trans of Color Transits and the Imaginaries of Racial Capitalism
Authors: Açıkgöz Şahin , Chiang Howard , DasGupta Debanuj , Gabriel Joao , Hanssmann Christoph , Jaleel Rana M. , Mitra Durba , Savcı Evren
Published: February 2024

In this roundtable, scholars respond to the following guiding questions of the special issue: Racial capitalism in US scholarship is necessarily and rightfully narrated through the Transatlantic slave trade. While this is a globally relevant history for understanding the past and the present of transnational racial orders, what other histories and present modes of capitalist accumulation are relevant to telling a global history of racial capitalism? How do queer hermeneutics reckon with global and transnational histories of social differentiation that ground in other or additional intellectual traditions of what we might expansively call “race”? How would queer of color critique as an analytic be useful to question the very making of abject and abnormal bodies, the structures of knowledge and regimes of truth that produce them, and the political economies that necessitate them? To what extent does positioning queer and trans of color critique as methods objects and subjects, “beyond identity politics,” or even “the Human,” alleviate or otherwise reconfigure these issues?