bluuebunny/crossref_metadata_2025 huggingface dataset:
Time to improvement of pain, morning stiffness, fatigue, and disease activity in patients with ankylosing spondylitis treated with tofacitinib: a post hoc analysis
Authors: Navarro-Compán Victoria , Deodhar Atul , Bahiri Rachid , Bushmakin Andrew G. , Cappelleri Joseph C. , Rammaoui Jihane
Published: May 2024

Background

Tofacitinib is an oral Janus kinase inhibitor for treatment of ankylosing spondylitis (AS). Time to improvement in core domains of AS was estimated in tofacitinib-treated patients with AS.

Methods

This post hoc analysis used phase 3 trial data from patients with AS receiving tofacitinib 5 mg twice daily or placebo to week (W)16; all patients received open-label tofacitinib W16–48. Outcomes: nocturnal pain; total back pain; fatigue, spinal pain, peripheral joint pain/swelling, enthesitis, and morning stiffness (Bath AS Disease Activity Index [BASDAI] questions 1–6); BASDAI total score; AS Disease Activity Score (ASDAS). Median time to improvement events was estimated using non-parametric Kaplan-Meier models. Improvement events were defined as initial (first post-baseline observation) and continued (sustained for 2 consecutive visits) ≥ 30% and ≥ 50% improvement in back/nocturnal pain or BASDAI questions/total scores, or ASDAS improvement ≥ 1.1 and ≥ 2.0 points.

Results

269 patients (tofacitinib: n = 133; placebo-to-tofacitinib: n = 136) were assessed. Median time to improvement was shorter, and more patients experienced improvements with tofacitinib vs. placebo-to-tofacitinib; differences observed from W2 (first post-baseline assessment). Median time to initial (continued) ≥ 30% pain improvement was 4 (4–8) weeks for tofacitinib vs. 24 (24) weeks for placebo-to-tofacitinib (8 [8] weeks post-switch). Median time to initial (continued) ≥ 50% improvement of pain, peripheral joint pain/swelling and enthesitis, morning stiffness, BASDAI total score, and fatigue was 8–24 (12–40) weeks with tofacitinib vs. 24–32 weeks (32 weeks–not estimable [NE]) with placebo-to-tofacitinib. Median time to initial (continued) ASDAS improvement ≥ 1.1 points was 4 (8) weeks for tofacitinib vs. 24 (24) weeks for placebo-to-tofacitinib, and NE for improvement ≥ 2.0 points with either treatment.

Conclusions

Improvements in AS core domains occurred more rapidly with tofacitinib vs. placebo-to-tofacitinib. Half of tofacitinib-treated patients with AS will likely experience improvements ≥ 30% in pain and ≥ 1.1 points in ASDAS during month (M)1, ≥ 50% improvement in nocturnal pain and enthesitis by M2, and in morning stiffness by M3. Results show that initiating tofacitinib as soon as possible is associated with quicker improvements in AS core domains vs. delaying treatment.

Trial registration

ClinicalTrials.gov, NCT03502616, 11 April 2018.
Development of scoring-assisted generative exploration (SAGE) and its application to dual inhibitor design for acetylcholinesterase and monoamine oxidase B
Authors: Lim Hocheol
Published: May 2024

De novo molecular design is the process of searching chemical space for drug-like molecules with desired properties, and deep learning has been recognized as a promising solution. In this study, I developed an effective computational method called Scoring-Assisted Generative Exploration (SAGE) to enhance chemical diversity and property optimization through virtual synthesis simulation, the generation of bridged bicyclic rings, and multiple scoring models for drug-likeness. In six protein targets, SAGE generated molecules with high scores within reasonable numbers of steps by optimizing target specificity without a constraint and even with multiple constraints such as synthetic accessibility, solubility, and metabolic stability. Furthermore, I suggested a top-ranked molecule with SAGE as dual inhibitors of acetylcholinesterase and monoamine oxidase B through multiple desired property optimization. Therefore, SAGE can generate molecules with desired properties by optimizing multiple properties simultaneously, indicating the importance of de novo design strategies in the future of drug discovery and development.

Scientific contribution

The scientific contribution of this study lies in the development of the Scoring-Assisted Generative Exploration (SAGE) method, a novel computational approach that significantly enhances de novo molecular design. SAGE uniquely integrates virtual synthesis simulation, the generation of complex bridged bicyclic rings, and multiple scoring models to optimize drug-like properties comprehensively. By efficiently generating molecules that meet a broad spectrum of pharmacological criteria—including target specificity, synthetic accessibility, solubility, and metabolic stability—within a reasonable number of steps, SAGE represents a substantial advancement over traditional methods. Additionally, the application of SAGE to discover dual inhibitors for acetylcholinesterase and monoamine oxidase B not only demonstrates its potential to streamline and enhance the drug development process but also highlights its capacity to create more effective and precisely targeted therapies. This study emphasizes the critical and evolving role of de novo design strategies in reshaping the future of drug discovery and development, providing promising avenues for innovative therapeutic discoveries.
Critical insights on “Association of the C allele of rs479200 in the EGLN1 gene with COVID‑19 severity in Indian population: a novel finding”
Authors: Deora Nimita , Agrohi Priya , Mallick Prashant K , Sinha Abhinav
Published: May 2024

The recent article by Harit et al. in Human Genomics reported a novel association of the C allele of rs479200 in the human EGLN1 gene with severe COVID-19 in Indian patients. The gene in context is an oxygen-sensor gene whose T allele has been reported to contribute to the inability to cope with hypoxia due to increased expression of the EGLN1 gene and therefore persons with TT genotype of EGLN1 rs479200 are more susceptible to severe manifestations of hypoxia. In contrast to this dogma, Harit et al. showed that the C allele is associated with the worsening of COVID-19 hypoxia without suggesting or even discussing the scientific plausibility of the association. The article also suffers from certain epidemiological, statistical, and mathematical issues that need to be critically elaborated and discussed. In this context, the findings of Harit et al. may be re-evaluated.
The neuropathological landscape of small vessel disease and Lewy pathology in a cohort of Hispanic and non-Hispanic White decedents with Alzheimer disease
Authors: Wang Hsin-Pei , Scalco Rebeca , Saito Naomi , Beckett Laurel , Nguyen My-Le , Huie Emily Z. , Honig Lawrence S. , DeCarli Charles , Rissman Robert A. , Teich Andrew F. , Mungas Dan M. , Jin Lee-Way , Dugger Brittany N.
Published: May 2024

Cerebrovascular and α-synuclein pathologies are frequently observed alongside Alzheimer disease (AD). The heterogeneity of AD necessitates comprehensive approaches to postmortem studies, including the representation of historically underrepresented ethnic groups. In this cohort study, we evaluated small vessel disease pathologies and α-synuclein deposits among Hispanic decedents (HD, n = 92) and non-Hispanic White decedents (NHWD, n = 184) from three Alzheimer’s Disease Research Centers: Columbia University, University of California San Diego, and University of California Davis. The study included cases with a pathological diagnosis of Intermediate/High AD based on the National Institute on Aging– Alzheimer’s Association (NIA-AA) and/or NIA-Reagan criteria. A 2:1 random comparison sample of NHWD was frequency-balanced and matched with HD by age and sex. An expert blinded to demographics and center origin evaluated arteriolosclerosis, cerebral amyloid angiopathy (CAA), and Lewy bodies/Lewy neurites (LBs/LNs) with a semi-quantitative approach using established criteria. There were many similarities and a few differences among groups. HD showed more severe Vonsattel grading of CAA in the cerebellum (p = 0.04), higher CAA density in the posterior hippocampus and cerebellum (ps = 0.01), and increased LBs/LNs density in the frontal (p = 0.01) and temporal cortices (p = 0.03), as determined by Wilcoxon’s test. Ordinal logistic regression adjusting for age, sex, and center confirmed these findings except for LBs/LNs in the temporal cortex. Results indicate HD with AD exhibit greater CAA and α-synuclein burdens in select neuroanatomic regions when compared to age- and sex-matched NHWD with AD. These findings aid in the generalizability of concurrent arteriolosclerosis, CAA, and LBs/LNs topography and severity within the setting of pathologically confirmed AD, particularly in persons of Hispanic descent, showing many similarities and a few differences to those of NHW descent and providing insights into precision medicine approaches.
Understanding science data literacy: a conceptual framework and assessment tool for college students majoring in STEM
Authors: Qiao Cuilan , Chen Yuqing , Guo Qing , Yu Yunwei
Published: May 2024

Background

In the era defined by the fourth paradigm of science research, the burgeoning volume of science data poses a formidable challenge. The established data-related requisites within science literacy now fall short of addressing the evolving needs of researchers and STEM students. Consequently, the emergence of science data literacy becomes imperative. However, notwithstanding the escalating importance of science data literacy, a comprehensive definition and conceptual framework are still elusive, posing challenges to effective assessment.

Results

This study analyzes the science literacy frameworks of six international organizations and countries, including the OECD, and reviews 16 data literacy-related literature sources identified using the PRISMA process. We also consider the characteristics of science data. Based on these sources, we clarify the connotation of science data literacy and construct a tailored conceptual framework for college students majoring in STEM. The framework undergoes two rounds of Delphi method refinement to enhance its applicability. Subsequently, we created and piloted a set of questions using physics, astronomy, geography, and other STEM subjects as examples to assess science data literacy. The revised assessment tool was then used in a formal test with 198 university students, employing Rasch modeling to evaluate its effectiveness. The tool’s validity in assessing science data literacy was confirmed.

Conclusions

This study offers a systematic and comprehensive conceptual framework for science data literacy tailored to STEM undergraduates. Endorsed by experts, the framework outlines essential literacies for STEM students in handling science data. The developed assessment tool enables educators to measure students’ science data literacy levels and serves as a scientific guide to enhance their competencies in this area.
Ultra-low foetal radiation exposure in 18F-FDG PET/CT imaging with a long axial field-of-view PET/CT system
Authors: Smith Charlotte L. C. , Yaqub Maqsood , Wellenberg Ruud H. H. , Knip Jelijn J. , Boellaard Ronald , Zwezerijnen Gerben J. C.
Published: May 2024

Purpose

Long axial field-of-view (LAFOV) PET/CT systems enable PET/CT scans with reduced injected activities because of improved sensitivity. With this study, we aimed to examine the foetal radiation dose from an 18F-FDG PET/CT scan on a LAFOV PET/CT system with reduced injected activity.

Methods

Two pregnant women were retrospectively included and received an 18F-FDG PET/CT scan on a LAFOV PET/CT system with an intravenous bolus injection of 0.30 MBq/kg. Foetal radiation exposure from the PET was estimated using dose conversion factors from three published papers. Radiation exposure from the CT scans was estimated using CT-Expo.

Results

Foetal radiation dose from the PET scan ranged between 0.11 and 0.44 mGy. Foetal radiation exposure from the CT scan ranged between < 0.10 – 0.90 mGy depending if the foetus was included in the field-of-view.

Conclusion

Foetal radiation dose could be reduced to < 1.5 mGy when scanning pregnant patients on a LAFOV PET/CT system. The radiation dose to the foetus was reduced significantly in our study due to the increased sensitivity of the LAFOV PET/CT system.
How do emotions affect giving? Examining the effects of textual and facial emotions in charitable crowdfunding
Authors: Lu Baozhou , Xu Tailai , Fan Weiguo
Published: May 2024

Drawing on emotional contagion theory and language-mediated association theory, this study develops a research model to examine how textual and facial emotions affect charitable crowdfunding performance. We use computer-aided techniques to extract and measure specific textual and facial emotions in pitches. The proposed model is tested via regression analysis with a sample of 1372 campaigns collected from the largest charitable crowdfunding platform in China—Tencent Gongyi. Moreover, we conducted a fuzzy-set qualitative comparative analysis to examine the complementarity of textual and facial emotions, which supplements the regression analysis results. Our findings show that both textual and facial emotions can impact funding outcomes. However, the effects of specific emotions vary: some (e.g., textual sadness and facial anger) are positive, some (e.g., textual anger and facial fear) are negative, and others (e.g., textual fear, textual disgust, and facial sadness) are insignificant. Moreover, facial emotions complement textual emotions in their effects on funding outcomes. This research outlines a framework to offer a more detailed and comprehensive understanding of emotions in charitable crowdfunding. It also contributes to existing research by revealing the vital but complex role of emotions in the persuasive process of prosocial behaviors and by uncovering the different cognitive mechanisms underlying the impacts of textual and facial emotions.
Predictive model for post-induction hypotension in patients undergoing transcatheter aortic valve implantation: a retrospective observational study
Authors: Noto Kohei , Uchida Satoshi , Kinoshita Hirotaka , Takekawa Daiki , Kushikata Tetsuya , Hirota Kazuyoshi
Published: May 2024

Purpose

Post-induction hypotension (PIH) is an independent risk factor for prolonged postoperative stay and hospital death. Patients undergoing transcatheter aortic valve implantation (TAVI) are prone to develop PIH. This study aimed to develop a predictive model for PIH in patients undergoing TAVI.

Methods

This single-center retrospective observational study included 163 patients who underwent TAVI. PIH was defined as at least one measurement of systolic arterial pressure <90 mmHg or at least one incident of norepinephrine infusion at a rate >6 µg/min from anesthetic induction until 20 min post-induction. Multivariate logistic regression analysis was performed to develop a predictive model for PIH in patients undergoing TAVI.

Results

In total, 161 patients were analyzed. The prevalence of PIH was 57.8%. Multivariable logistic regression analysis showed that baseline mean arterial pressure ≥90 mmHg [adjusted odds ratio (aOR): 0.413, 95% confidence interval (95% CI): 0.193–0.887; p=0.023] and higher doses of fentanyl (per 1-µg/kg increase, aOR: 0.619, 95% CI: 0.418–0.915; p=0.016) and ketamine (per 1-mg/kg increase, aOR: 0.163, 95% CI: 0.062–0.430; p=0.002) for induction were significantly associated with lower risk of PIH. A higher dose of propofol (per 1-mg/kg increase, aOR: 3.240, 95% CI: 1.320–7.920; p=0.010) for induction was significantly associated with higher risk of PIH. The area under the curve (AUC) for this model was 0.802.

Conclusion

The present study developed predictive models for PIH in patients who underwent TAVI. This model may be helpful for anesthesiologists in preventing PIH in patients undergoing TAVI.
Junction formation rates, residence times, and the rate of plastic flow in FCC metals
Authors: Zhang Yurui , Sills Ryan B.
Published: May 2024

During plastic flow in metals, dislocations from slip systems with different glide planes collide to form junctions. After being in-residence within the dislocation network for some period of time, these junctions then break, thereby liberating the attached dislocation lines. In this work we use random forest discrete dislocation dynamics simulations to quantify the junction formation rate and junction residence time as a function of stress for all junction types in face-centered cubic metals. We then relate these quantities to the dislocation link-length distribution, which is found to exhibit an exponential form. This enables us to quantify the mean junction strength and also the slip system interaction coefficients. Finally, using the link-length model we obtain a flow rule for our systems which is physics-based with all parameters determined from DDD simulations. The insights here provide a path forward for a dislocation network theory of plastic flow based on the link-length distribution.
Anthropogenic gadolinium in the Tone River (Japan): an update showing a 7.7-fold increase from 1996 to 2020
Authors: Kumasaka Soma , Kartamihardja A. Adhipatria P. , Kumasaka Yuka , Kameo Satomi , Koyama Hiroshi , Tsushima Yoshito
Published: May 2024

Background

Anthropogenic gadolinium (Gd), originating from Gd-based contrast agents (GBCAs) used in magnetic resonance imaging (MRI), is widely identified in the aquatic environment with concerns about toxicity and accumulation. We aimed to present new data on anthropogenic Gd in the Tone River, which has the largest drainage area in Japan, and then to compare the current data with those obtained in 1996.

Methods

The water samples were collected on August 9−10, 2020, at 15 different locations of the Tone River in Japan. The concentrations of the rare earth elements (REEs) were measured by inductively coupled plasma-mass spectrometry and normalized to Post-Archean Australian Shale to construct shale-normalized REE patterns. The degree of Gd-anomaly was defined as the percentage of anthropogenic Gd to the geogenic background and used to compare the water samples from different locations. Pearson’s correlation coefficients were calculated.

Results

All the samples displayed positive Gd anomalies. The Gd-anomaly ranged from 121 to 6,545% and displayed a repeating decrease-and-increase trend. The Gd-anomaly showed strong positive correlations to the number of hospitals (r = 0.88; p < 0.001) and their MRI units (r = 0.89; p < 0.001).

Conclusions

Our study revealed notable anomalies of Gd concentrations in river water in Japan, with strong positive correlations to the number of major hospitals and their MRI units. Compared with the previous report in 2000, the Gd-anomaly in Tone River increased from 851% (sampled in 1996) to 6,545%, i.e., 7.7 times, reflecting the increased use of GBCAs in hospitals.

Relevance statement

Notable Gd concentration anomalies in river water in Japan were observed. This result underlines the importance of more extensive research on anthropogenic gadolinium, and investigations of risks to human health as well as the development of effective removal technologies may be necessary.

Key points

• All water samples from Tone River displayed positive Gd anomalies.

• The Gd anomalies increased to 7.7 times higher over the past 24 years.

• Correlations between Gd values and the number of hospitals and MRI units were observed.

Graphical Abstract
Predicting game-induced emotions using EEG, data mining and machine learning
Authors: Lim Min Xuan , Teo Jason
Published: May 2024

Background

Emotion is a complex phenomenon that greatly affects human behavior and thinking in daily life. Electroencephalography (EEG), one of the human physiological signals, has been emphasized by most researchers in emotion recognition as its specific properties are closely associated with human emotion. However, the number of human emotion recognition studies using computer games as stimuli is still insufficient as there were no relevant publicly available datasets provided in the past decades. Most of the recent studies using the Gameemo public dataset have not clarified the relationship between the EEG signal’s changes and the emotion elicited using computer games. Thus, this paper is proposed to introduce the use of data mining techniques in investigating the relationships between the frequency changes of EEG signals and the human emotion elicited when playing different kinds of computer games. The data acquisition stage, data pre-processing, data annotation and feature extraction stage were designed and conducted in this paper to obtain and extract the EEG features from the Gameemo dataset. The cross-subject and subject-based experiments were conducted to evaluate the classifiers’ performance. The top 10 association rules generated by the RCAR classifier will be examined to determine the possible relationship between the EEG signal's frequency changes and game-induced emotions.

Results

The RCAR classifier constructed for cross-subject experiment achieved highest accuracy, precision, recall and F1-score evaluated with over 90% in classifying the HAPV, HANV and LANV game-induced emotions. The 20 experiment cases’ results from subject-based experiments supported that the SVM classifier could accurately classify the 4 emotion states with a kappa value over 0.62, demonstrating the SVM-based algorithm’s capabilities in precisely determining the emotion label for each participant’s EEG features’ instance.

Conclusion

The findings in this study fill the existing gap of game-induced emotion recognition field by providing an in-depth evaluation on the ruleset algorithm’s performance and feasibility of applying the generated rules on the game-induced EEG data for justifying the emotional state prediction result.
Effects of suboccipital inhibition versus soft tissue manipulation on pain intensity and disability in tension-type headache among undergraduate physiotherapy students
Authors: Venugopal Pavithra , Manoharlal Manoj Abraham , Rajaram Yuvashree
Published: May 2024

Background

Tension-type headache (TTH) is prevalent among collegiate students due to academic stress. Manual therapies like suboccipital inhibition and soft tissue manipulation have shown efficacy in TTH management. However, comparative studies between these interventions in collegiate populations are scarce. Understanding their relative effectiveness can enhance treatment strategies and improve outcomes, shedding light on optimal manual therapy approaches for TTH among collegiate students. This study aimed to investigate the effects of suboccipital inhibition and soft tissue manipulation on pain intensity and disability in tension-type headache (TTH) among undergraduate physiotherapy students.

Methods

Forty undergraduate physiotherapy students diagnosed with TTH were randomly assigned to the suboccipital inhibition group (group A, n =  20) and the soft tissue manipulation group (group B, n =  20). The suboccipital inhibition group received manual therapy targeting the suboccipital muscles, while the soft tissue manipulation group received manipulation techniques focusing on the cervical and shoulder girdle muscles. Pain intensity and disability were assessed using Visual Analogue Scale (VAS) and Headache Disability Index (HDI) Questionnaire at baseline and after 6 weeks of intervention. The data were collected and analysed using independent t test.

Results

Both interventions demonstrated significant reductions in pain intensity and disability after 6 weeks, with the t value − 4.3150 and − 3.3106 at p < 0.05 for VAS and HDI respectively.

Conclusion

Suboccipital inhibition and soft tissue manipulation are effective interventions for reducing pain intensity and disability among undergraduate physiotherapy students with TTH. However, the suboccipital inhibition group showed improvement in pain intensity and disability and it has been statistically significant when compared to the soft tissue manipulation group.
COVID-19 and hospital activity: experience of the Nephrology Department of Ibn Sina Hospital-Rabat
Authors: El Maakoul Sara , Benamar Loubna , Ouzeddoun Naima , Bouattar Tarik
Published: May 2024

The COVID-19 pandemic has led to a major health crisis, responsible for a very high morbidity in the world. This context represented an organizational challenge and required an adaptation of health services. The purpose of this study is to evaluate the activity of the Nephrology Department of Ibn Sina Hospital of Rabat during the period of confinement of the COVID-19 pandemic.

Material and methods Retrospective study of hospitalization, dialysis and consultation activities in the nephrology, and dialysis and kidney transplantation department, during the period of confinement in Morocco from March 12 to June 16, 2020.

Results We have identified, for the considered period of three months, 65 patients hospitalized in the nephrology department versus 218 patients during the 3 months preceding the start of confinement in Morocco, which corresponds to a decrease of 70%. The mean age of the patients was 50 ± 16 years with a male predominance. Kidney biopsy was performed in 14 patients. Lupus nephritis was found in 5 patients. Twelve patients received a bolus of methylprednisolone, 7 patients required intravenous cyclophosphamide, and only 1 patient was treated with rituximab. One-hundred twenty-nine patients underwent dialysis, and 554 patients benefited from telemedicine during this period.

Conclusion Data collected in this study highlights that the global pandemic due to COVID-19 had a great impact on the activity of our department. The continuity of care for our patients has been ensured by the implementation of telemedicine and the reorganization of our hospital activity.
Relationship between climate change and environmental microplastics: a one health vision for the platysphere health
Authors: Oliveri Conti Gea , Rapisarda Paola , Ferrante Margherita
Published: May 2024

The production, dispersal, and accumulation of microplastics (MPs) are interconnected with climate change. Plastic production, which involves fossil resources like oil, generates greenhouse gas emissions during extraction and processing, contributing to global warming. Simultaneously, climate change influences the dispersion, fragmentation, and accumulation of MPs; extreme weather events facilitate plastic transport to the sea and natural environments. The increasing environmental impact of MPs poses a global challenge. This review focuses on the dispersion of MPs due to climate change, with attention given to the "One Health" approach. This promotes interdisciplinary collaboration, recognizing the interrelationship of human, animal, and ecosystem health. Crucial for a broad perspective on global health, the "One Health" approach emphasizes the need to understand and address MPs in the environment. In conclusion, implementing protocols for health monitoring and educating the public on responsible plastic management are essential. These preventive indications can help mitigate the effects of MPs, promoting a sustainable lifestyle from a One Health perspective.

Graphical Abstract
Perinatal mental health care in the Italian mental health departments: a national survey
Authors: Lega Ilaria , Mastroeni Simona , Ferraro Claudia , Bauer Annette , Bucciarelli Mauro , Andreozzi Silvia , Pizzi Enrica , Donati Serena ,   the Group for Maternal Mental Health in the first 1,000 days of life
Published: May 2024

Background

Evidence on the negative outcomes of untreated mental disorders during pregnancy and in the first year after childbirth on women’s and children’s health has stimulated interest in how to develop and sustain high-quality mental health care during the perinatal period. In Italy, there is a lack of knowledge about how mental health services support women with perinatal mental disorders (PMDs). This study aims to describe the adoption of good practices for the prevention and care of PMDs by the Italian mental health departments (MHDs).

Methods

This is a nationwide cross-sectional survey conducted online using LimeSurvey. Starting from the Ministry of Health Registry’s 127 MHDs were invited to participate between February and March, 2023. Characteristics of the participating MHDs were reported as descriptive statistics.

Results

One hundred nineteen MHDs participated, with a response rate of 93.7%. Regarding the prevention of PMDs, 69 (58.0%) MHDs offer preconception counseling, whereas only 6 (5.0%) have information material for this purpose. Written integrated care pathways for PMDs are not available in 94 (79.7%) MHDs. A reference professional for psychopharmacological treatment during pregnancy or breastfeeding is available in 55 (46.2%) MHDs, while a specific treatment plan for women with PMDs is adopted by 27 (22.7%) MHDs. Thirty-four (28.6%) MHDs have established an outpatient clinic for PMDs, whereas there are no inpatient psychiatric facilities designed for mothers and infants (mother-baby units).

Conclusions

There is a need to improve the care of women with PMDs in Italy. The provision of pre-conception counseling, integrated care pathways, and specialist skills and facilities for PMDs should be prioritized.
Clinical Applications of the Gut Microbiome in Genitourinary Cancers
Authors: Nguyen Charles B. , Vaishampayan Ulka N.
Published: May 2024

Recently recognized as one of the hallmarks of cancer, the microbiome consists of symbiotic microorganisms that play pivotal roles in carcinogenesis, the tumor microenvironment, and responses to therapy. With recent advances in microbiome metagenomic sequencing, a growing body of work has demonstrated that changes in gut microbiome composition are associated with differential responses to immune checkpoint inhibitors (ICIs) because of alterations in cytokine signaling and cytotoxic T-cell recruitment. Therefore, strategies to shape the gut microbiome into a more favorable, immunogenic profile may lead to improved responses with ICIs. Immunotherapy is commonly used in genitourinary (GU) cancers such as renal cell carcinoma, urothelial cancer, and to a limited extent, prostate cancer. However, a subset of patients do not derive clinical benefit with ICIs. Gut microbiome-based interventions are of particular interest given the potential to boost responses to ICIs in preclinical and early-phase prospective studies. Novel approaches using probiotic therapy (live bacterial supplementation) and fecal microbiota transplantation in patients with GU cancers are currently under investigation.
Updates in the Use of Targeted Therapies for Gynecologic Cancers
Authors: Cantillo Evelyn , Blanc-Durand Felix , Leary Alexandra , Slomovitz Brian M. , Fuh Katherine , Washington Christina
Published: May 2024

Targeted therapies have changed the treatment landscape in gynecologic cancer. Studies released over the past year have led to the incorporation of immunotherapy (IO) into the treatment for all patients with endometrial and cervical cancers at some point during their disease course. Poly(ADP-ribose) polymerase (PARP) inhibitors continue to play a role in women with ovarian carcinoma, particularly in homologous repair deficient tumors. Furthermore, the benefit of PARP inhibitors in challenging subgroups continues to be elucidated. Biomarker identification has led to the approval or compendium listing of several antibody-drug conjugates (ADCs). This review will update on IO, ADCs, and PARP inhibition for the treatment of gynecologic cancers.
Abiraterone in Classic Congenital Adrenal Hyperplasia: Results of Medical Therapy Before Adrenalectomy
Authors: Stuckey Bronwyn G A , Dedic Deila , Zhang Rui , Rabbah Amira , Turcu Adina F , Auchus Richard J
Published: May 2024

We present the case of a 20-year-old woman with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency, with uncontrolled hyperandrogenemia despite supraphysiological glucocorticoid therapy. We used abiraterone acetate, an inhibitor of the 17-hydroxylase/17,20-lyase enzyme, to suppress adrenal androgen synthesis and allow physiological glucocorticoid and mineralocorticoid therapy, as a proof-of-concept, before proceeding to bilateral adrenalectomy. We report the patient's clinical course, the changes in adrenal steroids, and the immunohistochemistry of the adrenals.
The Influence of Pubertal Development on Autoantibody Appearance and Progression to Type 1 Diabetes in the TEDDY Study
Authors: Warncke Katharina , Tamura Roy , Schatz Desmond A , Veijola Riitta , Steck Andrea K , Akolkar Beena , Hagopian William , Krischer Jeffrey P , Lernmark Åke , Rewers Marian J , Toppari Jorma , McIndoe Richard , Ziegler Anette-G , Vehik Kendra , Haller Michael J , Elding Larsson Helena
Published: May 2024

Context

The 2 peaks of type 1 diabetes incidence occur during early childhood and puberty.

Objective

We sought to better understand the relationship between puberty, islet autoimmunity, and type 1 diabetes.

Methods

The relationships between puberty, islet autoimmunity, and progression to type 1 diabetes were investigated prospectively in children followed in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Onset of puberty was determined by subject self-assessment of Tanner stages. Associations between speed of pubertal progression, pubertal growth, weight gain, homeostasis model assessment of insulin resistance (HOMA-IR), islet autoimmunity, and progression to type 1 diabetes were assessed. The influence of individual factors was analyzed using Cox proportional hazard ratios.

Results

Out of 5677 children who were still in the study at age 8 years, 95% reported at least 1 Tanner Stage score and were included in the study. Children at puberty (Tanner Stage ≥2) had a lower risk (HR 0.65, 95% CI 0.45-0.93; P = .019) for incident autoimmunity than prepubertal children (Tanner Stage 1). An increase of body mass index Z-score was associated with a higher risk (HR 2.88, 95% CI 1.61-5.15; P < .001) of incident insulin autoantibodies. In children with multiple autoantibodies, neither HOMA-IR nor rate of progression to Tanner Stage 4 were associated with progression to type 1 diabetes.

Conclusion

Rapid weight gain during puberty is associated with development of islet autoimmunity. Puberty itself had no significant influence on the appearance of autoantibodies or type 1 diabetes. Further studies are needed to better understand the underlying mechanisms.
Seattle’s Episodic Companies of Color
Authors: Mahmoud Jasmine
Published: May 2024

Two early twenty-first century ensembles of color in Seattle—and their methods—anchor this article. The first: sis Productions, which started in 2000 as “Sex in Seattle,” an episodic and humorous theatrical series about the romantic relationships of Asian American women. Conceived of by theater artists Kathy Hsieh, Moi, Serin Ngai, and Amy Villarama Waschke, sis developed brainstorming and scripting methods to collectively storytell at Theatre Off Jackson, Annex Theatre, Nippon Kan Theatre, Center House Theatre, Bathhouse Theatre, and Hugo House, and other venues across Seattle. The second: the Black Collectivity Project, a movement-based ensemble led by Nia-Amina Minor, David Rue, marco farroni, and Akoiya Harris, which conducted historical research about the lives and movements of twentieth century Seattle-based Black artists, including dancer Syvilla Fort, and staged their embodied histories via workshops and productions at 12th Avenue Arts, On the Boards, and other Seattle venues. Through an ethnographic and archival approach, Jasmine Mahmoud argues that both ensembles created specific methods to unearth and represent stories in exceptionally unexpected ways that formally emancipated how minoritized people and their histories are portrayed.
Queer Césaire
Authors: Omelsky Matthew
Published: May 2024

This essay is a response to calls in Black studies in the last decade, by Jafari Allen and others, to excavate Black queer histories and experiences, including in archives where we least expect them. The author offers a queer reading of a foundational work in global Black literature often assumed to be irrelevant to such critical conversations: Aimé Césaire’s Notebook of a Return to the Native Land. He puts Césaire’s poem in dialogue with one of the three sketches produced by the Cuban painter Wifredo Lam for the 1943 Cuban translation of the Notebook—a drawing at once surrealist and decidedly queer. Using Lam’s multispecies interpretations as method and guide, the author teases out the few yet remarkable queer fragments that appear in Césaire’s subsequent revisions of the Notebook. What if in addition to an anticolonial Black poet, we also thought of Césaire as a queer poet?
Pullin’ Notes Out
Authors: Moe Peter Wayne
Published: May 2024

It is easy to fall into different modes of reading: books for pleasure, student papers for teaching. This essay considers what it might look like to read student work generously, arguing such generosity shifts a teacher's relationship to student writing.
Stereotactic Radiosurgery for Ependymoma in Pediatric and Adult Patients: A Single-Institution Experience
Authors: Yoo Kelly H. , Marianayagam Neelan J. , Park David J. , Persad Amit , Zamarud Aroosa , Shaghaghian Elaheh , Tayag Armine , Ustrzynski Louisa , Emrich Sara C. , Gu Xuejun , Ho Quoc-Anh , Soltys Scott G. , Meola Antonio , Chang Steven D.
Published: May 2024

BACKGROUND AND OBJECTIVES:

Ependymoma is commonly classified as World Health Organization grade 2 with the anaplastic variant categorized as grade 3. Incomplete resection or anaplastic features can result in unfavorable outcomes. Stereotactic radiosurgery (SRS) provides a minimally invasive approach for recurrent ependymomas. Our study investigates the efficacy and safety of SRS for grade 2 and 3 ependymomas in pediatric and adult populations.

METHODS:

We conducted a retrospective analysis on 34 patients with 75 ependymomas after CyberKnife SRS between 1998 and 2023. Fourteen were pediatric (3-18 years), and 20 were adult (19-75 years) patients. The median age was 21 years, and the median tumor volume was 0.64 cc. The median single-fraction equivalent dose was 16.6 Gy, with SRS administered at 77% of the median isodose line.

RESULTS:

After a median follow-up of 42.7 months (range: 3.8-438.3), 22.7% of ependymomas progressed. The 5-year local tumor control rate was 78.1%, varying between 59.6% and 90.2% for children and adults, with grade 2 at 85.9% compared with 58.5% for grade 3 tumors. The 5-year overall survival rate was 73.6%, notably higher in adults (94.7%) than in children (41%), and 100% for grade 2 but decreased to 35.9% for grade 3 patients. The 5-year progression-free survival rate was 68.5%, with 78.3% and 49.2% for adults and children, respectively, and a favorable 88.8% for grade 2, contrasting with 32.6% for grade 3 patients. Symptom improvement was observed in 85.3% of patients. Adverse radiation effects occurred in 21.4% of pediatric patients.

CONCLUSION:

Our study supports SRS as a viable modality for pediatric and adult patients with grade 2 and 3 ependymomas. Despite lower local tumor control in pediatric and grade 3 cases, integrating SRS holds promise for improved outcomes. Emphasizing careful patient selection, personalized treatment planning, and long-term follow-up is crucial for optimal neurosurgical outcomes.
Planejamento para o desenvolvimento: Lições dos processos de planejamento na China
Authors: Fleider Theo , Puppim de Oliveira Jose Antonio
Published: May 2024

Planejamento tem sido uma ferramenta fundamental para organizar o processo de desenvolvimento dos países. Os processos de planejamento tiveram um papel-chave no desenvolvimento da China, mas ainda são pouco discutidos na literatura internacional, e praticamente inexistentes na literatura brasileira. Assim, o presente artigo faz uma análise histórica e crítica dos planos quinquenais (PQs) chineses realizados no período compreendido entre 1953 e 2020. Foi realizada uma análise qualitativa das principais características de cada plano, tal como a discussão sobre quais são as mais importantes lições que podem ser obtidas de cada plano à luz da literatura de planejamento e gestão pública. Asprincipais delas são: a importância da descentralização no planejamento, a necessidade de dinâmica bottom-up, colocar planos como política de Estado e de governo, pensar desenvolvimento como processo diversificado, planos e metas seguirem estratégias de flexibilidade e incentivo e obter aprendizado com o processo de tentativa e erro.
Effect of ranibizumab combined with laser photocoagulation in the treatment of diabetic macular edema
Authors: Hu Junhua , Liao Hongfei , Xia Houli , Liao Yinglin , Yuan Dan
Published: May 2024

Objective: To explore the clinical effect of ranibizumab combined with laser photocoagulation (LP) in treating diabetic macular edema (DME).
Methods: We retrospectively reviewed the clinical data of 118 patients with DME admitted to The Affiliated Eye Hospital of Nanchang University from May 2021 to March 2023. Among them, 38 patients received LP alone (Laser-group), 39 patients received ranibizumab alone (Ranibizumab-group), and 41 patients received LP combined with ranibizumab (Combined-group). The improvement of macular edema (ME), visual acuity, and complications between the groups were compared.
Results: The time of ME regression, exudation absorption and fundus hemorrhage absorption in the Combined-group was shorter than in the Laser-group and the Ranibizumab-group (P<0.05). After treatment, the CMT and RNV of the three groups decreased compared to pretreatment levels and were lower in the Combined-group compared to the Laser-group and the Ranibizumab-group (P<0.05). BCVA increased after the treatment in all groups, and was markedly higher in the Combined-group than in the Laser and the Ranibizumab-groups (P<0.05). NO were higher in the Combined-group compared to the Laser-group and the Ranibizumab-group. The post-treatment VEGF levels decreased in all groups, and were significantly lower in the Combined-group compared to the Laser-group and the Ranibizumab-group (P<0.05). The incidence of complications in the Combined-group was lower than in the Laser-group and the Ranibizumab-group (P<0.05).
Conclusions: Compared to ranibizumab or LP alone, ranibizumab combined with LP is more effective in reducing ME in patients with DEM, and is associated with fewer complications.
doi: https://doi.org/10.12669/pjms.40.6.9213
How to cite this: Hu J, Liao H, Xia H, Liao Y, Yuan D. Effect of ranibizumab combined with laser photocoagulation in the treatment of diabetic macular edema. Pak J Med Sci. 2024;40(6):1099-1104. doi: https://doi.org/10.12669/pjms.40.6.9213
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Risk factors and prediction model of delirium in elderly patients after hip arthroplasty
Authors: Duan Yanli , Zhang Ruzhen
Published: May 2024

Objective: To analyze the risk factors of delirium in elderly patients after hip arthroplasty and to construct a prediction model.
Methods: Clinical data of 248 elderly patients who underwent hip arthroplasty in the Department of Traumatology and Orthopedics at Wuhan Fourth Hospital were retrospectively collected from November 2021 to February 2023. Logistic regression analysis was used to identify the risk factors of delirium after hip arthroplasty, and a nomogram prediction model was constructed using the RMS package of R4.1.2 software. The accuracy and stability of the model was evaluated based on the Hosmer-Lemeshow goodness-of-fit test and the receiver operating characteristic (ROC) curve.
Results: Age, nighttime sleep, anesthesia method, intraoperative blood loss, hypoxemia, and C-reactive protein (CRP) level were all risk factors of delirium after the hip arthroplasty (P<0.05). These factors were used to construct a nomogram prediction model that was internally validated using the Bootstrap method. The prediction model had the area under ROC curve (AUC) of 0.980 (95% CI: 0.964-0.996), indicating that it has certain predictive value for postoperative delirium. When the optimal cut off value was selected, the sensitivity and specificity were 92.7% and 92.3%, respectively, indicating that the prediction model is effective.
Conclusions: Age, short nighttime sleep, general anesthesia, high intraoperative blood loss, hypoxemia, and high CRP levels are independent risk factors for delirium after hip arthroplasty. The nomogram prediction model constructed based on these risk factors can effectively predict delirium in elderly patients after hip arthroplasty.
doi: https://doi.org/10.12669/pjms.40.6.9306
How to cite this: Duan Y, Zhang R. Risk factors and prediction model of delirium in elderly patients after hip arthroplasty. Pak J Med Sci. 2024;40(6):1077-1082. doi: https://doi.org/10.12669/pjms.40.6.9306
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Group processes in community responses to flooding
Authors: Ντόντης Ευάγγελος
Published: May 2024

Η ανάπτυξη της ανθεκτικότητας της κοινότητας είναι μία από τις στρατηγικές που εφαρμόζουν οι κυβερνήσεις του Ηνωμένου Βασιλείου για την προστασία από τις σοβαρές και μακροχρόνιες επιπτώσεις των πλημμυρών. Ωστόσο, οι τρέχουσες προσεγγίσεις για την ανθεκτικότητα της κοινότητας υπογραμμίζουν τον ρόλο των προϋπαρχόντων δικτύων, αγνοώντας σε μεγάλο βαθμό την αναδυόμενη ενότητα μεταξύ αγνώστων που συχνά χαρακτηρίζει τις καταστροφές. Ο στόχος μου σε αυτή τη διατριβή είναι να χρησιμοποιήσω την προσέγγιση κοινωνικής ταυτότητας στη συλλογική ανθεκτικότητα προκειμένου να διερευνήσω τις αντιδράσεις της κοινότητας στις πλημμύρες και να προτείνω μια θεωρητικά καθοδηγούμενη προσέγγιση για την ανθεκτικότητα της κοινότητας. Παρουσιάζω μια κριτική ανασκόπηση του τρόπου με τον οποίο οι κοινότητες και η ανθεκτικότητά τους όσον αφορά τις πλημμύρες αντιπροσωπεύονται στα επίσημα έγγραφα καθοδήγησης. Η ανάλυση δείχνει ότι υπάρχουν τόσο στατικές όσο και πραγμοποιημένες, καθώς και πιο σύνθετες αντιλήψεις για την ανθεκτικότητα της κοινότητας που βασίζονται σε διάφορες ψυχολογικές, γνωστικές και σχεσιακές έννοιες. Οι κοινότητες απεικονίζονται είτε ως ορθολογικές και πρακτικές, είτε ως παθητικοί δέκτες εξειδικευμένης γνώσης. Ωστόσο, τα έγγραφα αγνοούν ως επί το πλείστον τις ψυχολογικές αντιλήψεις των κοινοτήτων, καθώς και τις αντιλήψεις κοινωνικής ταυτότητας για τη συλλογική ανθεκτικότητα σε καταστροφές. Η εμπειρική έρευνα σε αυτή τη διατριβή πραγματοποιήθηκε στο York, UK, το οποίο πλημμύρισε τον Δεκέμβριο του 2015, και περιλάμβανε δύο μελέτες συνεντεύξεων που πραγματοποιήθηκαν 2 και 15 μήνες μετά τις πλημμύρες και τρεις συγχρονικές έρευνες που πραγματοποιήθηκαν 8, 15 και 21 μήνες μετά την πλημμύρα. Τα αποτελέσματα δείχνουν ότι η κοινή ταυτότητα της κοινότητας αναδύεται λόγω της κοινής μοίρας και οδηγεί σε υψηλότερες προσδοκίες και παροχή υποστήριξης, κοινούς στόχους, ενισχυμένη συλλογική αποτελεσματικότητα και αυξημένη ευημερία μεταξύ των κατοίκων. Η κοινή μοίρα, η κοινή ταυτότητα και η δύναμη της σχέσης τους μειώνονται με την πάροδο του χρόνου, αλλά η επικοινωνία μπορεί να διαδραματίσει κρίσιμο ρόλο στη διατήρηση της κοινής ταυτότητας. Τα αποτελέσματα δείχνουν ότι οι διαδικασίες κοινωνικής ταυτότητας παίζουν ρόλο στον τρόπο με τον οποίο οι κοινότητες αντιδρούν στις πλημμύρες. Επομένως, υποστηρίζω ότι οι τρέχουσες προσεγγίσεις για την ανθεκτικότητα της κοινότητας μπορούν να ωφεληθούν ενσωματώνοντας τις αντιλήψεις κοινωνικής ταυτότητας των ψυχολογικών κοινοτήτων και της συλλογικής ανθεκτικότητας στη θεωρία και την πράξη.