bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of perforated corrugated steel columns subjected to bilateral cyclic loading
Authors: Albarram Ahmed , Al-Kaseasbeh Qusay
Published: February 2024

This research unveils numerical analysis of corrugated-shaped steel columns (CSCs) with perforations during seismic events. Using ABAQUS software, 34 tests were examined under constant and bilateral cyclic loads. Varying parameters involved numbers and levels of perforations, corrugation geometries, and steel thickness. Findings exhibited a favorable performance of CSCs with six corrugated geometries as compared with ones with four corrugated geometries. The enhancement in load capacities and ductility were reported at 25–32% and 40%, respectively. CSCs were seen most vulnerable to experience load capacity deterioration when perforations were located in the lower quarter zone of height. The maximum corresponding decline exceeded 30% among tests having all corrugated geometry faces perforated. Local buckling failure in the lower quarter zone was dominant in most cases with severe deformation observed by the presence of perforations in such zone. Increasing the steel thickness of CSCs improved load capacities satisfactorily and shifted the local buckling to outward buckling, and controlling the failure patterns. This research emphasizes the need for perforations in such innovative cross-section steel columns to play as service conducing area and cost-effective factor. The research also provides applicable solutions to optimize the structural behavior of CSCs and maintain safer design during seismic incidents.
Intrinsic and Extrinsic Factors as Motivation Roles in Scientific Research Activities of Professors at Several Vietnamese Universities
Authors: Le Anh Thi Tram , Tran Thao Viet , Tran Trang Mai , Phan Thao Huong
Published: February 2024

Scientific research is the important task of lecturers in universities. However, university lecturers often struggle to balance research and teaching and focus more on teaching than research. In addition, the motivation for lecturers to do research is a little. This article surveys lecturers at some universities in Vietnam to find the factors that motivate lecturers to do science. The motivating factors include intrinsic factors (creativity, passion…), extrinsic factors (financial, promotion ..), and barriers to the scientific research activities of lecturers. Research results show that intrinsic and extrinsic factors positively impact the scientific research activities of lecturers, and the barrier factors negatively affect the research activities of lectures. Based on the research results, the authors make some suggestions to strengthen further the research activities of lecturers at universities in Vietnam.
The Use of Digital Technologies to Develop Young Children’s Language and Literacy Skills: A Systematic Review
Authors: Liu Sylvia , Reynolds Barry Lee , Thomas Nathan , Soyoof Ali
Published: February 2024

This review was conducted to explore the use of digital technologies with young children in early childhood language and literacy education. It centers on peer-reviewed empirical journal articles published during the past two decades. An initial sample of refereed journal articles ( N = 631) was compiled from systematically searching the Web of Science Core Collection databases. Following strict inclusion and exclusion criteria, 89 articles were included in the review. Five major dimensions of the selected studies were coded: demographic information, setting, digital technology used, research designs, and research findings. All of the articles selected for inclusion were systematically mapped to provide a valuable resource for researchers in this area. The main findings of the review were categorized and are reported in five subsections: print knowledge, alphabet knowledge, phonological awareness, early vocabulary knowledge, and narrative skills. Each subsection is framed with practical implications gleaned from the empirical studies.
Impact of Information Quality on Satisfaction with E-Learning Platforms: Moderating Role of Instructor and Learner Quality
Authors: Alterkait Mariam A. , Alduaij Manal Y.
Published: February 2024

Based on the information system success and situational strength theories, this study explores the moderating effect of learner quality and instructor quality on the relationship between information quality and student satisfaction with e-learning. Survey data were collected from 333 college students, and the proposed relationships were assessed using the SMARTPLS structural equation modeling tool. The direct relationship between information quality and student satisfaction is significant; however, the moderating effect of learner quality and instructor quality is insignificant. The moderating effects of learner and instructor quality have been less researched in the existing literature. This study contributes to uncovering the complex interactions between these variables and the relationship between information quality and satisfaction.
Systematic Review of Bracing After Proximal Hamstring Repair
Authors: Wyatt Phillip B. , Ho Tiffany D. , Hopper Haleigh M. , Satalich James R. , O’Neill Conor N. , Cyrus John , Vap Alexander R. , O’Connell Robert
Published: February 2024

Background:

Traditionally, postoperative rehabilitation protocols after proximal hamstring repair (PHR) for avulsion of the proximal hamstring tendon from its ischial insertion recommend bracing the hip and/or knee to protect the fixation. However, because of the cumbersome nature of these orthoses, recent studies have investigated outcomes in patients with postoperative protocols that do not include any form of postoperative bracing.

Purpose:

To synthesize the current body of evidence concerning bracing versus nonbracing postoperative management of PHR.

Study Design:

Systematic review; level of evidence, 4.

Methods:

Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted a thorough search of the PubMed/Medline, Cochrane, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Embase (OVID) databases on March 24, 2023. We analyzed complication rates, reoperation rates, patient satisfaction, return to sport, and patient-reported outcomes of studies that used postoperative bracing versus studies that used no postoperative bracing after PHR with at least 12 months of follow-up. A total of 308 articles were identified after initial search.

Results:

In total, 25 studies were included in this review: 18 studies (905 patients) on bracing and 7 studies (291 patients) on nonbracing after PHR. The overall complication rate in the braced patients was found to be 10.9%, compared with 12.7% in nonbraced patients. The rate of reoperation due to retear of the proximal hamstring was found to be 0.05% in braced patients and 3.1% in nonbraced patients. Patient-reported outcome measures were found to be higher at the final follow-up in braced versus nonbraced patients, and patient satisfaction was found to be 94.7% in braced studies compared with 88.9% in nonbraced studies. The rate of 12-month return to sport in athletic patients was 88.4% with bracing and 82.7% without bracing.

Conclusion:

The findings of this review demonstrated lower complication and reoperation rates, higher patient-reported outcome scores, higher patient satisfaction, and a higher rate of return to sport in braced patients compared with nonbraced patients.
Arthroscopic Remplissage for Anterior Shoulder Instability
Authors: Patel Akshar V. , Wagner Daniel , Vaghani Parth A. , Gibbs David , Mallory Noah , Munjal Vikas , Hoge Connor , Cvetanovich Gregory L. , Rauck Ryan C.
Published: February 2024

Background:

There are several approaches such as the Bankart repair, Latarjet, and Remplissage to treat recurrent glenohumeral instability.

Indications:

We chose to augment an arthroscopic Bankart repair with a Remplissage in this 26-year-old patient given the presence of a Hill-Sachs lesion, history of recurrent shoulder dislocations, and young age of the patient.

Technique Description:

We established four portals using previously well-documented techniques. The Hill-Sachs lesion was evaluated using the anterosuperior portal. Two anchors were placed, one on both the superior and inferior aspects of the Hill-Sachs lesion. The sutures were shuttled through the knotless anchor mechanism and tensioned after confirming the cannula was through the deltoid. Then, we completed the Remplissage by repairing the infraspinatus tendon and capsule into the posterior humeral head.

Results:

The Remplissage procedure is very successful at reducing recurrent instability in young, active patients. Previous studies have reported very low rates, even 0% recurrent instability, after surgery with 80% to 90% of patients returning to sports. Studies have also documented excellent patient-reported outcomes at short- to mid-term follow-up. Complication rates are historically lower when the Remplissage is done with an arthroscopic Bankart repair than the Bankart repair alone.

Discussion/Conclusion:

The Remplissage procedure is a safe, effective option at reducing future instances of shoulder dislocations in conjunction with Bankart repairs. Patients can expect to return to their active lifestyles, with many patients achieving the same level of activity as before the initial shoulder dislocation.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Exploring the prospects for Lees’ ‘engaged dialogue’ as meaningful exchange at the urban research publishing table
Authors: Rantisi Norma M.
Published: February 2024

Building on Lees’ call for ‘engaged dialogue’ between academics and non-academics (practitioners and activists) through collaborative writing and publishing, this commentary considers the approaches and relations that can enhance such efforts. I draw on my experiences as a managing editor of an online magazine, Progressive City: Radical Alternatives – a magazine that seeks to transcend the academic-practice divide – and the lessons they offer (opportunities and challenges) for realising more inclusive forms of engagement in the realm of publishing.
Retraction Note: Effect of apoptosis in neural stem cells treated with sevoflurane
Authors: Qiu Jianlei , Shi Pengcai , Mao Wude , Zhao Yuyi , Liu Wenshuai , Wang Yuelan
Published: February 2024

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12871-024-02448-2.
Project nature: promoting outdoor physical activity in children via primary care
Authors: Griffin Georgia M. , Nieto Carolina , Senturia Kirsten , Brown Marshall , Garrett Kimberly , Nguyen Elizabeth , Glassy Danette , Kroshus Emily , Tandon Pooja
Published: February 2024

Background

Families face a range of barriers in supporting their children’s active play in nature including family circumstances, environmental constraints, and behavioral factors. Evidence-based strategies to address these barriers are needed. We aimed to develop and pilot test a primary care-based family-centered behavioral intervention to promote active outdoor play in 4–10 year-old children.

Methods

Project Nature, a provider-delivered intervention that provides informational resources and an age-appropriate toy for nature play, was initially developed for children ages 0–3. With stakeholder input, we adapted existing materials for 4–10 year-olds and conducted usability testing at an urban clinic serving families from diverse backgrounds. Subsequently, we conducted a mix-methods pilot study to evaluate intervention feasibility and acceptability. Parents of 4–10 year-olds completed pre- and post-surveys (n = 22), and a purposive subset (n = 10) completed qualitative interviews. Post-intervention, pediatric providers (n = 4) were interviewed about their implementation experiences.

Results

The majority (82%) of parents liked the information provided and the remaining (18%) were neutral. Qualitatively, parents reported that: the toy provided a tangible element to help children and parents be active, they did not use the website, and they wished the intervention emphasized strategies for physical activity during cold and wet seasons. Providers felt the materials facilitated discussion about behavior change with families. There were no statistically significant changes in PA and outdoor time pre- and post-intervention.

Conclusions

Project Nature was welcomed by providers and families and may be a practical intervention to promote outdoor active play during well-child visits. Providing an age-appropriate nature toy seemed to be a critical component of the intervention, and may be worth the additional cost, time and storage space required by clinics. Building from these results, Project Nature should be revised to better support active outdoor play during suboptimal weather and evaluated to test its efficacy in a fully-powered trial.
Mechanism of action, resistance, interaction, pharmacokinetics, pharmacodynamics, and safety of fostemsavir
Authors: Heidary Mohsen , Shariati Saeedeh , Nourigheimasi Shima , Khorami Mona , Moradi Melika , Motahar Moloudsadat , Bahrami Parisa , Akrami Sousan , Kaviar Vahab Hassan
Published: February 2024

The Food and Drug Administration (FDA) has licensed many antiretroviral medications to treat human immunodeficiency virus type 1 (HIV-1), however, treatment options for people with multi-drug resistant HIV remain limited. Medication resistance, undesirable effects, prior tolerance, and previous interlacement incapacity to deliver new drug classes all lead to the requirement for new medication classes and drug combination therapy. Fostemsavir (FTR) is a new CD-4 attachment inhibitor medicine that was recently authorized by the United States FDA to treat HIV-1. In individuals with multidrug-resistant (MDR) HIV-1, FTR is well tolerated and virologically active. According to recent investigations, drug combination therapy can positively affect MDR-HIV. The mechanism of action, resistance, interaction, pharmacokinetics, pharmacodynamics, and safety of FTR has been highlighted in this review.
Impact of vaccination status on clinical outcomes of hospitalized COVID-19 patients
Authors: Gholinataj Jelodar Mohsen , Mirzaei Samaneh , Saghafi Fatemeh , Rafieian Shahab , Rezaei Soheil , Saatchi Alireza , Dehghani Avare Ziba , Dehghan Niri Mahdie
Published: February 2024

Introduction

It is important to identify the relationship between the COVID-19 vaccination status and the prognosis of this disease in hospitalized patients to gain a more accurate picture of their status and the effect of vaccination, as well as take necessary measures to improve their medical care. Thus, the present study was conducted to investigate the relationship between the vaccination status of hospitalized COVID-19 patients and the disease severity index in terms of clinical, imaging, and laboratory criteria.

Methods

This research is a descriptive-analytical cross-sectional study. the study population consisted of patients with a positive RT-PCR test for coronavirus, admitted to COVID-19 departments of teaching hospitals in Yazd, Iran, during two months in the sixth peak of COVID-19. The patients’ data comprised demographic information (age, sex, and underlying disease), clinical information (length of hospital stay, length of ICU stay, and vaccination status), disease outcome (mortality and intubation), laboratory information (ESR, CRP, and NLR), and imaging information (lung involvement percentage), and finally, the relationship between patients’ vaccination status and disease severity indices were analyzed with the chi-square test, independent t-test, and logistic regression analysis at a 95% confidence interval (CI).

Findings

According to research findings, the duration of hospitalization was 5.25 ± 2.34 and 6.11 ± 3.88 days in groups of patients with complete and incomplete vaccination, respectively (P = 0.003). The lengths of ICU stay were 6 ± 4.63 and 5.23 ± 3.73 days in both groups of patients admitted to the ICU (P = 0.395). Furthermore, there were significant relationships between the ICU admission rates, endotracheal intubation, mortality rate, the lung involvement score in the chest CT scan, and the NLR with the vaccination status.Multivariate regression analysis indicated that DM, IHD, NLR, CT scan score and vaccination status were related to patients’ in-hospital mortality.

Conclusion

Complete vaccination of COVID-19 led to a milder disease in terms of clinical, imaging, and laboratory criteria of patients and decreased the possibility of hospitalization in ICUs, intubation, and mortality in patients.
Prognostic value of transthoracic echocardiography score for the prognosis of continuous ambulatory peritoneal dialysis patients
Authors: Wan Sheng , Hu Yanglin , Cheng Li , He Da , Wang Zengsi , Zhang Yanmin
Published: February 2024

Background

We devoted ourselves to proving that the initial transthoracic echocardiography score (TTES) had predictive significance for patients with continuous ambulatory peritoneal dialysis (CAPD).

Methods

In this retrospective analysis, 274 CAPD patients who had PD therapy were recruited sequentially. TTE exams were performed three months following the start of PD therapy. All patients were divided into two groups based on the strength of their TTES levels. TTES’s predictive value for CAPD patients was then determined using LASSO regression and Cox regression.

Results

During a median of 52 months, 46 patients (16.8%) died from all causes, and 32 patients (11.7%) died from cardiovascular disease (CV). The TTES was computed as follows: 0.109 × aortic root diameter (ARD, mm) − 0.976 × LVEF (> 55%, yes or no) + 0.010 × left ventricular max index, (LVMI, g/m2) + 0.035 × E/e’ ratio. The higher TTES value (≥ 3.7) had a higher risk of all-cause death (hazard ratio, HR, 3.70, 95% confidence index, 95%CI, 1.45–9.46, P = 0.006) as well as CV mortality (HR, 2.74, 95%CI 1.15–19.17, P = 0.042). Moreover, the TTES had an attractive predictive efficiency for all-cause mortality (AUC = 0.762, 95%CI 0.645–0.849) and CV mortality (AUC = 0.746, 95%CI 0.640–0.852). The introduced nomogram, which was based on TTES and clinical variables, exhibited a high predictive value for all-cause and CV mortality in CAPD patients.

Conclusion

TTES is a pretty good predictor of clinical outcomes, and the introduced TTES-based nomogram yields an accurate prediction value for CAPD patients.
PLA2R-positive membranous nephropathy in IgG4-related disease
Authors: Ushio Yusuke , Akihisa Taro , Karasawa Kazunori , Seki Momoko , Kobayashi Shizuka , Miyabe Yoei , Kataoka Hiroshi , Ito Naoko , Taneda Sekiko , Akiyama Shin’ichi , Hebisawa Akira , Kawano Mitsuhiro , Honda Kazuho , Hoshino Junichi
Published: February 2024

Background

IgG4-related disease (IgG4-RD) is a fibroinflammatory disease that affects multiple organs, including the pancreas, lacrimal glands, salivary glands, periaortic/retroperitoneum, and kidney. Interstitial nephritis is a typical renal disorder associated with IgG4-RD, but membranous nephropathy is also seen in some cases.

Case presentation

Herein we report on the case of a 77-year-old male patient with nephrotic syndrome and IgG4-related lung disease. His serum phospholipase A2 receptor (PLA2R) antibody was positive. His renal biopsy specimen was also positive for PLA2R.

The renal biopsy specimen showed membranous nephropathy with equal IgG3 and IgG4 immunofluorescence staining and no interstitial nephritis, suggesting IgG4-RD manifesting as membranous nephropathy.

Conclusions

Nephrotic syndrome caused by membranous nephropathy is sometimes associated with IgG4-RD. In such cases, even if serum PLA2R antibody is positive, it should be considered that the membranous nephropathy may be secondary to IgG4-RD.
Association of maternal serum uric acid levels with LBW/SGA: a large retrospective cohort study
Authors: Xiong Yaoxi , Zheng Panchan , Chen Chao , He Chengrong , Yang Xingyu , Cheng Weiwei
Published: February 2024

Background

Elevated maternal serum uric acid (UA) levels were associated with adverse perinatal outcomes. This study aimed to examine the association between UA and the risk of low birth weight (LBW) / small for gestational age (SGA).

Methods

A cohort study of women delivered in Shanghai maternity hospital was included between 2017 and 2021. Electronic medical records were utilized to extract information and antenatal care records. The cut-off value of UA was 360 μmol/L. The outcome was LBW/SGA, with LBW defined as birth weight below 2500 g and SGA indicating birth weight below the 10th percentile of average weight for gestational age. The assessment of SGA was based on the Chinese standard curve for birth weight at various gestational ages. Univariate, multivariate logistic regression models, restricted cubic spline were used in this study, with adjustments made for confounding factors.

Results

Sixty-nine thousand six hundred seventy-four live births and singleton pregnancies were included. The ratio of LBW/SGA was 3.3%/9%. Maternal UA levels were significantly negatively correlated with birth weight. High UA levels were associated with high risk of LBW/SGA, especially in third trimester. In BMI < 25 group, the risk of LBW increased to 2.35-fold (95%CI, 1.66–3.31) in hyperuricemic group (UA > 360 μmol/L). The SGA risk was 1.66-fold (95%CI, 1.37–2.00). Gestational hypertension (GH) with hyperuricemica increased the risk of LBW (aOR = 4.00, 95%CI, 2.01–7.93) and SGA (aOR = 2.63, 95%CI, 1.83–3.78). Preeclampsia (PE) with hyperuricemia increased the risk of LBW (aOR = 1.38, 95%CI, 0.63–3.03) and SGA (aOR = 1.81, 95%CI, 1.18–2.78). In delivery gestational week (DGW) ≥ 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.46-fold (95%CI, 1.62, 3.73) and the incidence of SGA increased to 1.52-fold (95%CI, 1.24, 1.87). In DGW < 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.70-fold (95%CI, 1.92, 3.80) and the incidence of SGA increased to 2.13-fold(95%CI, 1.50, 3.02).

Conclusions

The study found an inverse correlation between UA levels and birth weight. High UA levels were associated with increased risk of LBW/SGA, particularly in third trimester. GH or PE complicated by hyperuricemia were found to have significantly higher risk of developing LBW/SGA. This relationship also existed in pregnant women with BMI < 25.
Prediction of unplanned cesarean section using measurable maternal and fetal characteristics, Ethiopia, a retrospective cohort study
Authors: Fente Bezawit Melak , Asaye Mengstu Melkamu , Gudayu Temesgen Worku , Mihret Muhabaw Shumye , Tesema Getayeneh Antehunegn
Published: February 2024

Background

When a pregnant woman experiences unusual circumstances during a vaginal delivery, an unplanned cesarean section may be necessary to save her life. It requires knowledge and quick assessment of the risky situation to decide to perform an unplanned cesarean section, which only occurs in specific obstetric situations. This study aimed to develop and validate a risk prediction model for unplanned cesarean sections among laboring women in Ethiopia.

Method

A retrospective follow-up study was conducted. The data were extracted using a structured checklist. Analysis was done using STATA version 14 and R version 4.2.2 software. Logistic regression was fitted to determine predictors of unplanned cesarean sections. Significant variables were then used to develop a risk prediction model. Performance was assessed using Area Under the Receiver Operating Curve (AUROC) and calibration plot. Internal validation was performed using the bootstrap technique. The clinical benefit of the model was assessed using decision curve analysis.

Result

A total of 1,000 laboring women participated in this study; 28.5% were delivered by unplanned cesarean section. Parity, amniotic fluid status, gestational age, prolonged labor, the onset of labor, amount of amniotic fluid, previous mode of delivery, and abruption remained in the reduced multivariable logistic regression and were used to develop a prediction risk score with a total score of 9. The AUROC was 0.82. The optimal cut-off point for risk categorization as low and high was 6, with a sensitivity (85.2%), specificity (90.1%), and accuracy (73.9%). After internal validation, the optimism coefficient was 0.0089. The model was found to have clinical benefits.

Conclusion

To objectively measure the risk of an unplanned Caesarean section, a risk score model based on measurable maternal and fetal attributes has been developed. The score is simple, easy to use, and repeatable in clinical practice.
Prediction model based on MRI morphological features for distinguishing benign and malignant thyroid nodules
Authors: Zheng Tingting , Wang Lanyun , Wang Hao , Tang Lang , Xie Xiaoli , Fu Qingyin , Wu Pu-Yeh , Song Bin
Published: February 2024

Background

The low specificity of Thyroid Imaging Reporting and Data System (TI-RADS) for preoperative benign-malignant diagnosis leads to a large number of unnecessary biopsies. This study developed and validated a predictive model based on MRI morphological features to improve the specificity.

Methods

A retrospective analysis was conducted on 825 thyroid nodules pathologically confirmed postoperatively. Univariate and multivariate logistic regression were used to obtain β coefficients, construct predictive models and nomogram incorporating MRI morphological features in the training cohort, and validated in the validation cohort. The discrimination, calibration, and decision curve analysis of the nomogram were performed. The diagnosis efficacy, area under the curve (AUC) and net reclassification index (NRI) were calculated and compared with TI-RADS.

Results

572 thyroid nodules were included (training cohort: n = 397, validation cohort: n = 175). Age, low signal intensity on T2WI, restricted diffusion, reversed halo sign in delay phase, cystic degeneration and wash-out pattern were independent predictors of malignancy. The nomogram demonstrated good discrimination and calibration both in the training cohort (AUC = 0.972) and the validation cohort (AUC = 0.968). The accuracy, sensitivity, specificity, PPV, NPV and AUC of MRI-based prediction were 94.4%, 96.0%, 93.4%, 89.9%, 96.5% and 0.947, respectively. The MRI-based prediction model exhibited enhanced accuracy (NRI>0) in comparison to TI-RADSs.

Conclusions

The prediction model for diagnosis of benign and malignant thyroid nodules demonstrated a more notable diagnostic efficacy than TI-RADS. Compared with the TI-RADSs, predictive model had better specificity along with a high sensitivity and can reduce overdiagnosis and unnecessary biopsies.
Endostar acts as a pneumonitis protectant in patients with locally advanced non-small cell lung cancer receiving concurrent chemoradiotherapy
Authors: Chen Kuifei , Li Shuling , Chen Meng , Jin Zhicheng , Sun Xuefeng , Zhou Suna , Yang Haihua
Published: February 2024

Background

CCRT is presently the standard treatment for LA-NSCLC. RP is one of the main obstacles to the completion of thoracic radiation therapy, resulting in limited survival benefits in NSCLC patients. This research aims to explore the role of Endostar in the occurrence of grade≥2 RP and clinical curative effect in LA-NSCLC patients.

Methods

This study retrospectively analyzed 122 patients with stage III NSCLC who received CCRT from December 2008 to December 2017, or Endostar intravenous drip concurrently with chemoradiotherapy (Endostar + CCRT group). Standard toxicity of the pneumonitis endpoint was also collected by CTCAE V5.0. We further summarized other available studies on the role of Endostar in the prognosis of NSCLC patients and the incidence of RP.

Results

There were 76 cases in the CCRT group and 46 cases in the CCRT+ Endostar group. In the CCRT+ Endostar group, the occurrence of grade ≥2 RP in patients with V20Gy ≥25% was significantly higher than that in patients with V20Gy < 25% (p = 0.001). In the cohorts with V20Gy < 25%, 0 cases of 29 patients treated with Endostar developed grade ≥2 RP was lower than in the CCRT group (p = 0.026). The re-analysis of data from other available studies indicated that Endostar plus CCRT could be more efficient and safely in the occurrence of grade≥2 RP with LA-NSCLC.

Conclusions

When receiving CCRT for LA-NSCLC patients, simultaneous combination of Endostar is recommended to enhance clinical benefit and reduce pulmonary toxicity.
Assessment of physical activity levels and back pain among poles and Portuguese in the further year of the COVID-19 pandemic - a pilot study
Authors: Gałczyk Monika , Zalewska Anna , Sobolewski Marek , Fernandes Hélder
Published: February 2024

Background

The vast majority of people have experienced the problem of back pain at least once in their lives for a variety of reasons. It is well known that regular physical activity at a moderate level has a number of health benefits regardless of age or gender with positive effects on the musculoskeletal, cardiovascular, respiratory or nervous systems improving fitness levels. During the pandemic, Poland experienced one of the longest periods of school lockdown in Europe. In Portugal, this period was considerably shorter. The aim of this study was to determine the level of physical activity and back pain as well as relationship between physical activity and back pain in a group of Polish and Portuguese students in the following year the COVID-19 pandemic.

Methods

The study was conducted via the Internet among students from Poland and Portugal (398 respondents − 229 from Poland and 169 from Portugal) in October 2022. In the pilot study, the International Physical Activity Questionnaire and The Oswestry Disability Index and Neck Disability Index questionnaires were used to assess the level of back pain.

Results

There are no statistically significant differences in the level of physical activity and pain complaints of respondents from the two countries. At least half of the students do not report any pain complaints (median in some groups being 0). In the Portuguese men, there is a correlation between the level of physical activity and the Neck Disability Index score (p = 0.0304).

Conclusions

The following year, after the pandemic COVID-19 was declared, the prevalence of back pain among students in Poland and Portugal is still significant.
The stress distribution of a primary molar tooth restored with stainless steel crown using different luting cements
Authors: Guler Mehmet Sami , Guler Cigdem , Belduz Kara Nihal , Odabasi Didem , Bekci Muhammed Latif
Published: February 2024

Background

The aim of this study is to evaluate the stress distributions of a primary molar tooth restored with a stainless steel crown (SSC) using resin and glass ionomer luting cements by Finite Element Analysis (FEA).

Methods

Original DICOM data of a primary molar was used to create a 3D model. One model was prepared as a tooth model with SSC. A 30 μm cement layer was used in model. Two different luting cements were tested in the study: self-cure adhesive resin cement, and glass ionomer cement. Vertical and oblique loads of 330 N were applied to simulate maximum bite force and lateral forces in the occlusal contact areas of the models. Maximum von Mises stress values in the models were evaluated as MPa.

Results

The maximum von Mises stress value was observed in the force application and general occlusal contact areas for all models. The maximum von Mises stress values were higher in the tooth model with SSC using self-cure adhesive resin cement (478.09 MPa and 214.62 MPa) than in the tooth model with SSC using glass ionomer cement (220.06 MPa and 198.72 MPa) in both vertical and oblique loading, respectively.

Conclusions

Depending on the magnitude of the bite force on the SSC, fracture of the luting cement materials could occur if the stress exceeds the endurance limit of the luting cement. Cementation with glass ionomer cement may help to reduce stress levels in SSC restorations of primary molars in children.
Rewiring care delivery through Digital Therapeutics (DTx): a machine learning-enhanced assessment and development (M-LEAD) framework
Authors: Carrera Alessandro , Manetti Stefania , Lettieri Emanuele
Published: February 2024

Background

Digital transformation has sparked profound change in the healthcare sector through the development of innovative digital technologies. Digital Therapeutics offer an innovative approach to disease management and treatment. Care delivery is increasingly patient-centered, data-driven, and based on real-time information. These technological innovations can lead to better patient outcomes and support for healthcare professionals, also considering resource scarcity. As these digital technologies continue to evolve, the healthcare field must be ready to integrate them into processes to take advantage of their benefits. This study aims to develop a framework for the development and assessment of Digital Therapeutics.

Methods

The study was conducted relying on a mixed methodology. 338 studies about Digital Therapeutics resulting from a systematic literature review were analyzed using descriptive statistics through RStudio. Machine learning algorithms were applied to analyze variables and find patterns in the data. The results of these analytical analyses were summarized in a framework qualitatively tested and validated through expert opinion elicitation.

Results

The research provides M-LEAD, a Machine Learning-Enhanced Assessment and Development framework that recommends best practices for developing and assessing Digital Therapeutics. The framework takes as input Digital Therapeutics characteristics, regulatory aspects, study purpose, and assessment domains. The framework produces as outputs recommendations to design the Digital Therapeutics study characteristics.

Conclusions

The framework constitutes the first step toward standardized guidelines for the development and assessment of Digital Therapeutics. The results may support manufacturers and inform decision-makers of the relevant results of the Digital Therapeutics assessment.
Impact of litter size on the hematological and iron status of gilts, sows and newborn piglets: a comparative study of domestic pigs and wild boars
Authors: Kopeć Zuzanna , Mazgaj Rafał , Starzyński Rafał Radosław , Wang Xiuying , Opiela Jolanta , Smorąg Zdzisław , Gajda Barbara , Nicpoń Jakub , Lenartowicz Małgorzata , Ogłuszka Magdalena , Gralak Mikołaj Antoni , Lipiński Paweł
Published: February 2024

Background

The critically low hepatic iron stores of newborn piglets are considered to be a major cause of neonatal iron deficiency in modern breeds of domestic pig (Sus domestica). The main factor believed to contribute to this phenomenon is large litter size, which has been an objective of selective breeding of pigs for decades. As consequence, iron transferred from the pregnant sow has to be distributed among a greater number of fetuses.

Results

Here, we investigated whether litter size influences red blood cell (RBC) indices and iron parameters in Polish Large White (PLW) piglets and gilts. Small and large litters were produced by the transfer of different numbers of embryos, derived from the same superovulated donor females, to recipient gilts. Piglets from large litters obtained following routine artificial insemination were also examined. Our results clearly demonstrated that varying the number of piglets in a litter did not affect the RBC and iron status of 1-day-old piglets, with all showing iron deficiency anemia. In contrast, gilts with small litters displayed higher RBC and iron parameters compared to mothers with large litters. A comparative analysis of the RBC status of wild boars (having less than half as many piglets per litter as domestic pigs) and PLW pigs, demonstrated higher RBC count, hemoglobin level and hematocrit value of both wild boar sows and piglets, even compared to small-litter PLW animals.

Conclusions

These findings provide evidence that RBC and iron status in newborn PLW piglets are not primarily determined by litter size, and indicate the need to study the efficiency of iron transport across the placenta in domestic pig and wild boar females.
Genetic and pharmacologic p32-inhibition rescue CHCHD2-linked Parkinson’s disease phenotypes in vivo and in cell models
Authors: Tio Murni , Wen Rujing , Choo Cai Ning , Tan Jian Bin , Chua Aaron , Xiao Bin , Sundaram Jeyapriya Rajameenakshi , Chan Christine Hui Shan , Tan Eng-King
Published: February 2024

Background

Mutations in CHCHD2 have been linked to Parkinson’s disease, however, their exact pathophysiologic roles are unclear. The p32 protein has been suggested to interact with CHCHD2, however, the physiological functions of such interaction in the context of PD have not been clarified.

Methods

Interaction between CHCHD2 and p32 was confirmed by co-immunoprecipitation experiments. We studied the effect of p32-knockdown in the transgenic Drosophila and Hela cells expressing the wild type and the pathogenic variants of hCHCHD2. We further investigated the rescue ability of a custom generated p32-inhibitor in these models as well as in the human fibroblast derived neural precursor cells and the dopaminergic neurons harboring hCHCHD2-Arg145Gln.

Results

Our results showed that wildtype and mutant hCHCHD2 could bind to p32 in vitro, supported by in vivo interaction between human CHCHD2 and Drosophila p32. Knockdown of p32 reduced mutant hCHCHD2 levels in Drosophila and in vitro. In Drosophila hCHCHD2 models, inhibition of p32 through genetic knockdown and pharmacological treatment using a customized p32-inhibitor restored dopaminergic neuron numbers and improved mitochondrial morphology. These were correlated with improved locomotor function, reduced oxidative stress and decreased mortality. Consistently, Hela cells expressing mutant hCHCHD2 showed improved mitochondrial morphology and function after treatment with the p32-inhibitor. As compared to the isogenic control cells, large percentage of the mutant neural precursor cells and dopaminergic neurons harboring hCHCHD2-Arg145Gln contained fragmented mitochondria which was accompanied by lower ATP production and cell viability. The NPCs harboring hCHCHD2-Arg145Gln also had a marked increase in α-synuclein expression. The p32-inhibitor was able to ameliorate the mitochondrial fragmentation, restored ATP levels, increased cell viability and reduced α-synuclein level in these cells.

Conclusions

Our study identified p32 as a modulator of CHCHD2, possibly exerting its effects by reducing the toxic mutant hCHCHD2 expression and/or mitigating the downstream effects. Inhibition of the p32 pathway can be a potential therapeutic intervention for CHCHD2-linked PD and diseases involving mitochondrial dysfunction.
The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use – results of a scoping review
Authors: Bammert Philip , Schüttig Wiebke , Novelli Anna , Iashchenko Iryna , Spallek Jacob , Blume Miriam , Diehl Katharina , Moor Irene , Dragano Nico , Sundmacher Leonie
Published: February 2024

Background

Besides macrolevel characteristics of a health care system, mesolevel access characteristics can exert influence on socioeconomic inequalities in healthcare use. These reflect access to healthcare, which is shaped on a smaller scale than the national level, by the institutions and establishments of a health system that individuals interact with on a regular basis. This scoping review maps the existing evidence about the influence of mesolevel access characteristics and socioeconomic position on healthcare use. Furthermore, it summarizes the evidence on the interaction between mesolevel access characteristics and socioeconomic inequalities in healthcare use.

Methods

We used the databases MEDLINE (PubMed), Web of Science, Scopus, and PsycINFO and followed the ‘Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols extension for scoping reviews (PRISMA-ScR)’ recommendations. The included quantitative studies used a measure of socioeconomic position, a mesolevel access characteristic, and a measure of individual healthcare utilisation. Studies published between 2000 and 2020 in high income countries were considered.

Results

Of the 9501 potentially eligible manuscripts, 158 studies were included after a two-stage screening process. The included studies contained a wide spectrum of outcomes and were thus summarised to the overarching categories: use of preventive services, use of curative services, and potentially avoidable service use. Exemplary outcomes were screening uptake, physician visits and avoidable hospitalisations. Access variables included healthcare system characteristics such as physician density or distance to physician. The effects of socioeconomic position on healthcare use as well as of mesolevel access characteristics were investigated by most studies. The results show that socioeconomic and access factors play a crucial role in healthcare use. However, the interaction between socioeconomic position and mesolevel access characteristics is addressed in only few studies.

Conclusions

Socioeconomic position and mesolevel access characteristics are important when examining variation in healthcare use. Additionally, studies provide initial evidence that moderation effects exist between the two factors, although research on this topic is sparse. Further research is needed to investigate whether adapting access characteristics at the mesolevel can reduce socioeconomic inequity in health care use.
Hyperphagia and impulsivity: use of self-administered Dykens’ and in-house impulsivity questionnaires to characterize eating behaviors in children with severe and early-onset obesity
Authors: Arnouk Lara , Chantereau Hélène , Courbage Sophie , Tounian Patrick , Clément Karine , Poitou Christine , Dubern Béatrice
Published: February 2024

Background

The determinants of early-onset obesity (< 6 years) are not completely elucidated, however eating behavior has a central role. To date no study has explored eating behavior in children with severe, early-onset obesity. Self-administered questionnaire data from these children were examined to evaluate eating behavior and the etiology of early-onset obesity.

Methods

Children with severe, early-onset obesity (body mass index [BMI] > International Obesity Task Force [IOTF] 30) of different etiologies (hypothalamic obesity [HO], intellectual disability with obesity [IDO], common polygenic obesity [CO]) were prospectively included. BMI history and responses from the Dykens’ Hyperphagia Questionnaire and an in-house Impulsivity Questionnaire at first visit were compared between groups.

Results

This cohort of 75 children (39 girls; mean age ± standard deviation [SD] 10.8 ± 4.4 years) had severe, early-onset obesity at an age of 3.8 ± 2.7 years, with a BMI Z-score of 4.9 ± 1.5. BMI history varied between the 3 groups, with earlier severe obesity in the HO group versus 2 other groups (BMI > IOTF40 at 3.4 ± 1.6 vs. 4.6 ± 1.6 and 8.4 ± 4.1 years for the IDO and CO groups, respectively [P < 0.01]). Absence of adiposity rebound was more prevalent in the HO group (87% vs. 63% and 33% for the IDO and CO groups, respectively [P < 0.01]). The Dykens’ mean total score for the cohort was 22.1 ± 7.2 with no significant between-group differences. Hyperphagia (Dykens’ score > 19) and impulsivity (score > 7) were found in 50 (67%) and 11 children (15%), respectively, with no difference between the HO, IDO and CO groups regarding the number of patients with hyperphagia (10 [67%], 14 [74%], and 26 [63%] children, respectively) or impulsivity (2 [13%], 1 [7%], and 8 [19%] children, respectively). Children with food impulsivity had significantly higher total and severity scores on the Dykens’ Questionnaire versus those without impulsivity.

Conclusion

The Dykens’ and Impulsivity questionnaires can help diagnose severe hyperphagia with/without food impulsivity in children with early-onset obesity, regardless of disease origin. Their systematic use can allow more targeted management of food access control in clinical practice and monitor the evolution of eating behavior in the case of innovative therapeutic targeting hyperphagia.
Synergistic suppression of ovarian cancer by combining NRF2 and GPX4 inhibitors: in vitro and in vivo evidence
Authors: Li Ning , Jiang Xingmei , Zhang Qingyu , Huang Yongmei , Wei Jinbin , Zhang Haitao , Luo Hui
Published: February 2024

Ovarian cancer is a significant challenge in women's health due to the lack of effective screening and diagnostic methods, often leading to late detection and the highest mortality rate among all gynecologic tumors worldwide. Recent research has shown that ovarian cancer has an "iron addiction" phenotype which makes it vulnerable to ferroptosis inducers. We tested the combination of NRF2-targeted inhibitors with GPX4-targeted inhibitors in ovarian cancer through in vitro and in vivo experiment. The data showed that combination treatment effectively suppressed adherent cell growth, inhibited suspended cell spheroid formation, and restrained the ability of spheroid formation in 3D-culture. Mechanistically, the combination induced accumulation of ROS, 4-HNE, as well as activation of caspase-3 which indicates that this combination simultaneously increases cell ferroptosis and apoptosis. Notably, inhibition of GPX4 or NRF2 can suppress ovarian cancer spreading and growth in the peritoneal cavity of mice, while the combination of NRF2 inhibitor ML385 with GPX4 inhibitors showed a significant synergistic effect compared to individual drug treatment in a syngeneic mouse ovarian cancer model. Overall, these findings suggest that combining NRF2 inhibitors with GPX4 inhibitors results in a synergy suppression of ovarian cancer in vitro and in vivo, and maybe a promising therapeutic strategy for the treatment of ovarian cancer.