bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing survival in sphingosine phosphate lyase insufficiency syndrome: a retrospective cross-sectional natural history study of 76 patients
Authors: Keller Nancy , Midgley Julian , Khalid Ehtesham , Lesmana Harry , Mathew Georgie , Mincham Christine , Teig Norbert , Khan Zubair , Khosla Indu , Mehr Sam , Guran Tulay , Buder Kathrin , Xu Hong , Alhasan Khalid , Buyukyilmaz Gonul , Weaver Nicole , Saba Julie D.
Published: September 2024

Background

Sphingosine-1-phosphate lyase insufficiency syndrome (SPLIS) is a recently recognized inborn error of metabolism associated with steroid-resistant nephrotic syndrome as well as adrenal insufficiency and immunological, neurological, and skin manifestations. SPLIS is caused by inactivating mutations in SGPL1, encoding the pyridoxal 5’phosphate-dependent enzyme sphingosine-1-phosphate lyase, which catalyzes the final step of sphingolipid metabolism. Some SPLIS patients have undergone kidney transplantation, and others have been treated with vitamin B6 supplementation. In addition, targeted therapies including gene therapy are in preclinical development. In anticipation of clinical trials, it will be essential to characterize the full spectrum and natural history of SPLIS. We performed a retrospective analysis of 76 patients in whom the diagnosis of SPLIS was established in a proband with at least one suggestive finding and biallelic SGPL1 variants identified by molecular genetic testing. The main objective of the study was to identify factors influencing survival in SPLIS subjects.

Results

Overall survival at last report was 50%. Major influences on survival included: (1) age and organ involvement at first presentation; (2) receiving a kidney transplant, and (3) SGPL1 genotype. Among 48 SPLIS patients with nephropathy who had not received a kidney transplant, two clinical subgroups were distinguished. Of children diagnosed with SPLIS nephropathy before age one (n = 30), less than 30% were alive 2 years after diagnosis, and 17% were living at last report. Among those diagnosed at or after age one (n = 18), ~ 70% were alive 2 years after diagnosis, and 72% were living at time of last report. SPLIS patients homozygous for the SPL R222Q variant survived longer compared to patients with other genotypes. Kidney transplantation significantly extended survival outcomes.

Conclusion

Our results demonstrate that SPLIS is a phenotypically heterogeneous condition. We find that patients diagnosed with SPLIS nephropathy in the first year of life and patients presenting with prenatal findings represent two high-risk subgroups, whereas patients harboring the R222Q SGPL1 variant fare better than the rest. Time to progression from onset of proteinuria to end stage kidney disease varies from less than one month to five years, and kidney transplantation may be lifesaving.
One immune cell to bind them all: platelet contribution to neurodegenerative disease
Authors: Rodriguez Moore Gabriela , Melo-Escobar Isabel , Stegner David , Bracko Oliver
Published: September 2024

Alzheimer’s disease (AD) and related dementias (ADRD) collectively affect a significant portion of the aging population worldwide. The pathological progression of AD involves not only the classical hallmarks of amyloid beta (Aβ) plaque buildup and neurofibrillary tangle development but also the effects of vasculature and chronic inflammatory processes. Recently, platelets have emerged as central players in systemic and neuroinflammation. Studies have shown that patients with altered platelet receptor expression exhibit accelerated cognitive decline independent of traditional risk factors. Additionally, platelets from AD patients exhibit heightened unstimulated activation compared to control groups. Platelet granules contain crucial AD-related proteins like tau and amyloid precursor protein (APP). Dysregulation of platelet exocytosis contributes to disease phenotypes characterized by increased bleeding, stroke, and cognitive decline risk. Recent studies have indicated that these effects are not associated with the quantity of platelets present in circulation. This underscores the hypothesis that disruptions in platelet-mediated inflammation and healing processes may play a crucial role in the development of ADRD. A thorough look at platelets, encompassing their receptors, secreted molecules, and diverse roles in inflammatory interactions with other cells in the circulatory system in AD and ADRD, holds promising prospects for disease management and intervention. This review discusses the pivotal roles of platelets in ADRD.
Joint effect of docosahexaenoic acid intake and tobacco smoke exposure on learning disability in children and adolescents: a cross-sectional study from the NHANES database
Authors: Liu Ling , Shu Xiuli , Xu Zijun , Jiang Haibo
Published: September 2024

Background

Docosahexaenoic acid (DHA) has been reported to be associated with the children’s neurodevelopment, who may be exposed to tobacco smoke simultaneously. The evidence about joint effect of DHA intake and tobacco smoke exposure on children and adolescents’ learning disabilities (LD) was limited. The objective of this study was to assess the joint effect of DHA intake and tobacco smoke exposure on children and adolescents’ LD.

Methods

A cross-sectional analysis of the NHANES 1999–2004 was performed. Children and adolescents aged 6–15 years old were included. The outcome was diagnosed by parental report of ever health professionals or school representative-identified LD. Dietary DHA intake data were obtained by food frequency questionnaire and tobacco smoke exposure levels were evaluated by serum cotinine levels. Weighted univariable and multivariate logistic regression analyses were conducted to determine the joint effect of DHA intake and tobacco smoke exposure on LD in children and adolescents, with odds ratios (ORs) and 95% confidence intervals (CIs). This joint association was further assessed after stratification by age, gender, body mass index, the history of attention deficit disorder and seen mental health professional.

Results

We identified 5,247 children and adolescents in present study, of whom 593 (11.30%) had LD. After adjusting covariates, we observed children and adolescents with DHA intake (OR = 0.76, 95%CI: 0.61–0.96) was related to lower incidence of LD; children who exposure to tobacco smoke was related to higher incidence of LD (OR = 1.54, 95%CI: 1.07–2.23); children and adolescents who exposure to tobacco smoke and without DHA intake were related to highest odds of LD (OR = 2.08, 95%CI: 1.37–3.17, P for trend = 0.042), that was, DHA and tobacco smoke exposure may have a joint effect on the odds of LD in children and adolescents. Subgroup analyses suggested this joint effect was robust especially among children and adolescents with normal & underweight BMI and without the history of attention deficit disorder and seen mental health professional.

Conclusion

Increasing the DHA intake and reducing tobacco smoke exposure may have a potential role in the prevention of LD in children and adolescents. This joint effect warrants further investigation by large-scale prospective study.
A rare cause of epileptic encephalopathy: case report of a novel patient with PEHO-like phenotype and CCDC88A gene pathogenic variants
Authors: Papuc Sorina-Mihaela , Glangher Adelina , Erbescu Alina , Arsene Oana Tarta , Arghir Aurora , Budisteanu Magdalena
Published: September 2024

Background

The Coiled-Coil Domain-Containing Protein 88 A (CCDC88A) gene encodes the actin-binding protein Girdin, which plays important roles in maintaining the actin cytoskeleton and in cell migration and was recently associated with a specific form of epileptic encephalopathy. Biallelic protein-truncating variants of CCDC88A have been considered responsible for progressive encephalopathy with edema, hypsarrhythmia, and optic atrophy (PEHO)-like syndrome. To date, only three consanguineous families with loss-of-function homozygous variants in the CCDC88A gene have been reported. The described patients share many clinical features, such as microcephaly, neonatal hypotonia, seizures, profound developmental delay, face and limb edema, and dysmorphic features, with a similar appearance of the eyes, nose, mouth, and fingers.

Case presentation

We report on a child from a nonconsanguineous family who presented with profound global developmental delay, severe epilepsy, and brain malformations, including subcortical band heterotopia. The patient harbored two heterozygous pathogenic variants in the trans configuration in the CCDC88A gene, which affected the coiled-coil and C-terminal domains.

Conclusions

We detail the clinical and cerebral imaging data of our patient in the context of previously reported patients with disease-causing variants in the CCDC88A gene, emphasizing the common phenotypes, including cortical malformations, that warrant screening for sequence variants in this gene.
Student ultrasound education, current view and controversies. Role of Artificial Intelligence, Virtual Reality and telemedicine
Authors: Daum Nils , Blaivas Michael , Goudie Adrian , Hoffmann Beatrice , Jenssen Christian , Neubauer Ricarda , Recker Florian , Moga Tudor Voicu , Zervides Constantinos , Dietrich Christoph Frank
Published: September 2024

The digitization of medicine will play an increasingly significant role in future years. In particular, telemedicine, Virtual Reality (VR) and innovative Artificial Intelligence (AI) systems offer tremendous potential in imaging diagnostics and are expected to shape ultrasound diagnostics and teaching significantly. However, it is crucial to consider the advantages and disadvantages of employing these new technologies and how best to teach and manage their use. This paper provides an overview of telemedicine, VR and AI in student ultrasound education, presenting current perspectives and controversies.
Porto-mesenteric four-dimensional flow MRI: a novel non-invasive technique for assessment of gastro-oesophageal varices
Authors: Karam Rasha , Elged Basma A. , Elmetwally Omar , El-Etreby Shahira , Elmansy Mostafa , Elhawary Mohammed
Published: September 2024

Objectives

To assess the role of 4D flow MRI in the assessment of gastro-oesophageal varices and in the prediction of high-risk varices in patients with chronic liver disease.

Methods

Thirty-eight patients diagnosed with either oesophageal or gastric varices were included in this single-centre prospective study. 4D flow MRI was used to calculate peak flow, average flow and peak velocity at the portal vein confluence (PV1) and hilum (PV2), splenic vein hilum (SV1) and confluence (SV2), and superior mesenteric vein (SMV). PV and SV fractional flow changes were also measured.

Results

ROC analysis revealed that both PV2 average flow and PV fractional average flow change had 100% sensitivity to predict high-risk patients with the PV fractional peak flow change having the widest area under the curve (AUC) and the highest specificity (92.3%). SV1 average flow, SV2 average flow, SV2 peak flow, and SV2 peak velocity increased significantly in patients with oesophageal compared to gastric varices included (p = 0.022, < 0.001, < 0.001 and 0.001, respectively).

Conclusion

Based on certain porto-mesenteric blood flow, velocity, and fractional flow change parameters, 4D flow MRI showed excellent performance in identifying high-risk patients and giving an idea about the grade and location of varices.

Critical relevance statement

Variceal bleeding is a major consequence of unidentified risky upper GI varices. Thus, by identifying and locating high-risk varices early, either oesophageal or gastric, using a non-invasive method like MRI, adverse events might be avoided.

Key Points

4D flow MRI can be used as a potential alternative for endoscopy to predict patients with high-risk varices.

Based on portal vein fractional flow change, splenic flow and velocity, 4D MRI can predict and locate high-risk varices.

Earlier identification of high-risk varices can allow for interventions to prevent adverse events.

Graphical Abstract
Dynamic priority-based bandwidth allocation scheme for machine type communications
Authors: Amitu David Martin , Akol Roseline N , Serugunda Jonathan
Published: September 2024

The burgeoning realm of Machine Type Communications (MTC) has ushered in a paradigm shift in wireless communication, necessitating innovative strategies to efficiently manage diverse application requirements. This paper presents a pioneering Dynamic Priority-based Bandwidth Allocation (DPBA) scheme tailored specifically for MTC scenarios, encompassing both MTC and Human Type Communications (HTC) coexistence. DPBA employs an adaptive framework addressing dynamic MTC traffic, optimizing resource use while meeting latency constraints and sporadic data patterns. By dynamically prioritizing MTC applications based on requirements, the scheme allocates bandwidth for reliable data delivery. DPBA extends to MTC and HTC coexistence, managing diverse quality demands. This underlines its versatility and capacity to serve distinct needs in a shared spectrum. To substantiate its performance, the DPBA scheme is rigorously evaluated against a spectrum of related allocation methods like Proportional Fairness (PF), Static Priority Scheduling (SPS), and the Machine Learning-based Scheme (MLS), DPBA excels in simulations, minimizing packet loss, latency, enhancing throughput and ensuring fairness, surpassing benchmarks. This research underscores the critical importance of tailored bandwidth allocation strategies in advancing MTC and HTC coexistent environments. With its adaptability, efficiency, and remarkable performance, the DPBA scheme emerges as a cornerstone in the trajectory of wireless communication networks, catering to the distinct requirements of both MTC and HTC applications.
Differences in seasonal dynamics, ecological driving factors and assembly mechanisms of planktonic and periphytic algae in the highly urban Fenhe River
Authors: Zhao Kangxu , Wang Wei , Huang Hanjie , Lv Junping , Liu Xudong , Nan Fangru , Shi Ying , Xie Shulian , Feng Jia
Published: September 2024

Background

Algae play important roles in urban river ecosystems and are the cornerstones of most water quality monitoring programs. Thus, a better understanding of algal community dynamics is needed to support sustainable management of water resources in urban rivers.

Results

In this study, we quantified the seasonal variations in planktonic and periphytic algal community structure in the highly urban Fenhe River and identified environmental factors affecting algal community structure and diversity. We monitored planktonic (drifting) and periphytic (attached) algal communities in the Taiyuan section of the Fenhe River over one year. The results indicated that Cyanophyta was the dominant phylum in both communities, followed by Bacillariophyta and Chlorophyta. Significant differences were observed in the composition of the planktonic and periphytic algal communities. In particular, the periphytic algal community was more diverse than the planktonic community. Water temperature and pH were the main environmental factors affecting planktonic and periphytic algal community structure, respectively, while nutrients were the most significant factor affecting planktonic and periphytic algal diversity. Ecological modeling indicated that the variations in the algal communities of the Fenhe River are mainly driven by stochastic processes. A co-occurrence network developed for the communities displayed positive interactions between the planktonic and periphytic algae.

Conclusions

These findings deepen our understanding of the seasonal interaction between planktonic and periphytic algae and the driving factors affecting community structure in the Fenhe River. They also provide a theoretical basis for the managing and protecting water resources in urban river ecosystems.
A novel application of the micro-wire-electro-discharge-grinding (µ-WEDG) method for the generation of tantalum and brass nanoparticles
Authors: Korgal Akash , Karanth P. Navin , Shettigar Arun Kumar , Madhavi J. Bindu
Published: September 2024

The synthesis of a co-precipitated mixture of tantalum and brass nanoparticles (Ta and Cu/Zn) using a micro-wire-electro-discharge-grinding (µ-WEDG) with a combination of multiple process parameters is explained in this article. Tantalum and brass nanoparticles are produced in a dielectric medium Diel-7500 EDM oil. µ-WEDG represents a cutting-edge mechanical micro-machining technique extensively employed for machining micro rods. This method uses a grinding process that expels debris via melting and evaporation. This process disperses a fraction of nanometre-sized debris within the dielectric medium. Traditionally, this debris consisting of nanoparticles has been classified as unwanted substances and subsequently eliminated from the system. However, it now requires a thorough reassessment for possible usage. Hence, the characterization of tantalum and brass nanoparticles is conducted through Field emission Scanning Electron Microscopy (FE-SEM), energy-dispersive spectroscopy (EDS), and X-ray diffraction (XRD) analyses. The process parameters are capacitance, voltage and spindle speed. The investigation reveals that the mean nanoparticle size of produced tantalum nanoparticles range from 25 to 200 nm, while brass nanoparticles range from 300 to 950 nm. Furthermore, a notable correlation is observed between decreasing capacitance and the corresponding reduction in the shape and size of nanoparticles.
Multi-agent system-based framework for an intelligent management of competency building
Authors: Outay Fatma , Jabeur Nafaa , Bellalouna Fahmi , Al Hamzi Tasnim
Published: September 2024

To measure the effectiveness of learning activities, intensive research works have focused on the process of competency building through the identification of learning stages as well as the setup of related key performance indictors to measure the attainment of specific learning objectives. To organize the learning activities as per the background and skills of each learner, individual learning styles have been identified and measured by several researchers. Despite their importance in personalizing the learning activities, these styles are difficult to implement for large groups of learners. They have also been rarely correlated with each specific learning stage. New approaches are, therefore, needed to intelligently coordinate all the learning activities while self-adapting to the ongoing progress of learning as well as to the specific requirements and backgrounds of learners. To address these issues, we propose in this paper a new framework for an intelligent management of the competency building process during learning. Our framework is based on a recursive spiral Assess-Predict-Oversee-Transit model that is orchestrated by a multi-agent system. This system is particularly responsible of enabling smart transitions between learning stages. It is also responsible of assessing and predicting the process of competency building of the learner and, then, making the right decisions about the learning progress, accordingly. Results of our solution were demonstrated via an Augmented Reality app that we created using the Unity3D engine to train learners on Air Conditioner maintenance.
A novel acoustic micro-perforated panel (MPP) based on sugarcane fibers and bagasse
Authors: Beheshti Mohammad Hosein , Khavanin Ali , Jafarizaveh Mostafa , Tabrizi Akram
Published: September 2024

Natural materials are becoming a reliable alternative to traditional artificial materials used in sound absorption insulation. The present study was conducted to investigate the acoustic insulation of micro-perforated panel (MPP) based on sugarcane fibers and bagasse as an available and environmentally friendly material. The absorption properties of single- and double-leaf natural micro-perforated panels (MPP) made of bagasse and also nonnatural MPPs made of Plexiglass were measured using an impedance tube based on ISO 10534–2. Then the effect of bagasse and sugarcane fibers composite on the air gap of MPP was investigated. The results showed the peak sound absorption of the bagasse composite is in the range of 1000 to 2000 Hz, and the sugarcane fiber composite has a higher sound absorption coefficient than the bagasse composite. Also, natural MPPs have a higher absorption coefficient than nonnatural MPPs at all frequencies, and as the panel thickness increases, the peak absorption coefficient shifts to lower frequencies. The peak sound absorption coefficient of double-leaf MPPs made of bagasse is 76%, in the range of 160 to 200 Hz. Using sugarcane fiber composite in the air gap of single- and double-leaf natural MPPs causes the absorption peak to shift to frequencies below 100 Hz. According to the results, natural MPPs have a high sound absorption coefficient at low frequencies. These panels can control sounds with much lower frequencies, especially in a double layer and along with cane fiber composite in their air gap.
Effects of Holistically Conceptualised School-Based Interventions on Children’s Physical Literacy, Physical Activity, and Other Outcomes: A Systematic Review
Authors: Jerebine Alethea , Arundell Lauren , Watson-Mackie Kimberley , Keegan Richard , Jurić Petra , Dudley Dean , Ridgers Nicola D. , Salmon Jo , Barnett Lisa M.
Published: September 2024

Background

Schools are a key setting for promoting children’s physical literacy development. This review aimed to identify school-based interventions that adopted a holistic conceptualisation of physical literacy and examine the effects on children’s physical literacy and any other outcomes, including physical activity (PA).

Methods

Searches were conducted in seven databases (APA PsycINFO, EMBASE, ERIC, CINAHL, Global Health, MEDLINE Complete, SPORTDiscus with Full Text), and Google and Google Scholar, to identify articles published since 1/1/2017. Studies were included if they (i) adopted a holistic conception of physical literacy as represented by the Australian Physical Literacy Framework (APLF), (ii) were grounded in movement, (iii) assessed three or more domains of learning (either quantitatively or qualitatively), and (iv) included children aged 5–14 years. Quantitative research designs needed to provide pre-and post-intervention measures, whereas qualitative designs (e.g. post-intervention interviews) did not. Study selection, data extraction and quality assessment were conducted independently by teams of two authors. For intervention effects, quantitative and qualitative data were synthesised separately. For quantitative data, level of evidence for intervention effects was assessed by physical literacy domain and/or elements/items by examining the proportion of tests with a significant change in the expected direction. Qualitative data were synthesised using the framework synthesis method and mapped to a framework that included APLF domains/elements, PA, and additional outcomes.

Results

Twelve interventions with 1,427 participants from seven countries were identified: six physical education-based, three afterschool, one structured recess, and two multicomponent. All studies assessed the physical domain quantitatively, with strong positive evidence of intervention effects for the controlled designs (10 of 15 tests). For the affective and cognitive domains, evidence was mixed, and there was no evidence for interventions improving the social components of children’s physical literacy (although this was understudied). Most studies assessed PA and one measured cognitive performance; however, there was no evidence for positive intervention effects (i.e. ≥35% of tests reporting an improvement) for either outcome. Five studies assessed intervention effects qualitatively, with positive results reported for all physical literacy domains, PA, and cognitive performance.

Conclusions

Holistic interventions in schools can improve the physical domain of children’s physical literacy. For wider benefits, future interventions should aim to develop all facets of physical literacy, especially domains of learning less frequently targeted and examined.

Trial Registration

PROSPERO CRD42022351317.
What do we Know about Complex-Contrast Training? A Systematic Scoping Review
Authors: Thapa Rohit K. , Weldon Anthony , Freitas Tomás T. , Boullosa Daniel , Afonso José , Granacher Urs , Ramirez-Campillo Rodrigo
Published: September 2024

Background

The complex-contrast training (CCT) method utilizes two exercises with different loads and movement velocities in a set-by-set fashion to induce multiple neuromuscular adaptations. The speculated primary mechanism involves the post-activation potentiation or post-activation performance enhancement (PAPE) of the muscles used during the heavy load (low velocity) exercise, thereby improving the performance of lower load (high velocity) exercise. However, no previous study has attempted to systematically synthesize the available evidence on CCT (e.g., if post-activation potentiation or PAPE was measured during the training sessions during the intervention period). This study aimed to synthesize the available evidence on CCT using a systematic scoping review approach. More specifically, we identified gaps in the literature using an evidence gap map (EGM), and provided future directions for research.

Methods

Three electronic databases (PubMed, Scopus, and Web of Science) were searched up to 20th February 2024. Data were extracted under a PICO framework: (a) Participants-related data (e.g., age, sex, type of sport); (b) Intervention-related data (e.g., duration of training); (c) Comparators (when available); and (d) Outcomes (e.g., measures of physical fitness). Interactive EGMs were created using the EPPI mapper software.

Results

From the 5,695 records screened, 68 studies were eligible for inclusion, involving 1,821 participants (only 145 females from 5 studies). All CCT interventions lasted ≤ 16 weeks. More than half of the studies assessed countermovement jump, sprint, and maximal strength performances. No studies were identified which examined upper-body CCT exercises alone, and no study assessed PAPE during the CCT sessions. Overall, the available evidence was rated with a low level of confidence.

Conclusions

In conclusion, whether CCT produces a PAPE that translates into longitudinal performance gains remains unclear. Moreover, the available evidence on the effects of CCT on various outcomes provides low confidence regarding the most effective way to implement this training method, particularly among females, and beyond long-term interventions.
Role of Cardiorespiratory Fitness, Aerobic, Exercise and Sports Participation in Female Cognition: A Scoping Review
Authors: Weber Vinicius Muller Reis , Queiroga Marcos Roberto , Puranda Jessica L. , Semeniuk Kevin , Macdonald Meaghan Lindsay , Dantas Diego Bessa , da Silva Danilo Fernandes , Adamo Kristi Bree
Published: September 2024

Background

The impact of cardiorespiratory fitness (CRF) on cognition is thought to be mediated by brain-derived neurotrophic factor. Aerobic exercise can increase CRF through various activities, including sports participation. The relationship between these factors in females has yet to be elucidated.

Objective

This review aims to map the current literature on the effects of aerobic exercise, sports participation, and CRF in healthy adult females, with sub-topics of pregnancy and menstrual cycle periodicity.

Methods

A scoping review of the literature was conducted following PRISMA guidelines and the PCC mnemonic (population, concept, and context). The following five databases were screened: CINAHL, Medline, Web of Science, SPORTDiscus, and Scopus. Eligible articles included healthy adult females, investigated aerobic exercise, sports participation or CRF, and linked outcomes to cognition. Data from included manuscripts was extracted and analyzed. Two sub-population groupings (pregnant individuals and menstrual cycle) were established to further aid the interpretation of the findings.

Results

Of the 300 titles and abstracts screened, 74 were eligible for full-text screening, and 28 were included in the scoping review. Of the 28 included, 14 did not control for or report on menstrual cycle phase or sex hormones.

Conclusion

This scoping review found an inverse ‘U’ relationship between aerobic exercise and cognition, demonstrating an optimal dose of aerobic exercise to benefit cognitive functions. As estrogen may impact the relationship between CRF and neural growth factors, more research is needed on this pathway, independent of the menstrual cycle, to determine potential beneficial effects. It is currently unknown whether sports participation can independently impact cognition.
Vascular access in a post-lung transplant patient on maintenance hemodialysis: a case report
Authors: Kawamura Mariko , Nakamura Motonobu , Matsuura Ryo , Odawara Motoki , Kurata Yu , Sakashita Midori , Yamada Daisuke , Hamasaki Yoshifumi , Konoeda Chihiro , Sato Masaaki , Kume Haruki , Nangaku Masaomi
Published: September 2024

Background

An arteriovenous fistula (AVF) is the most common type of vascular access for hemodialysis. As it causes volume overload and sometimes increases pulmonary artery pressure, it is unsuitable for some patients. Herein, we describe a patient with acute kidney disease who required maintenance hemodialysis with vascular access other than an AVF owing to post-lung transplant pulmonary hypertension.

Case presentation

A 50-year-old man with interstitial pneumonia underwent living-donor lobar lung transplantation at our hospital. Weaning from venoarterial extracorporeal membrane oxygenation was achieved; however, the patient required mechanical ventilation owing to pulmonary hypertension. He developed acute kidney disease and required maintenance hemodialysis with sustainable vascular access. Although echocardiography showed a normal ejection fraction, we expected volume overload after arteriovenous access construction to worsen his pulmonary hypertension because of his inadequate pulmonary vascular bed. Therefore, a tunneled central vein catheter was implanted into the right femoral vein as a bridge, and superficialization of the right brachial artery was performed for long-term vascular access.

Conclusions

As this patient had sustained post-transplant pulmonary hypertension and small grafts, we avoided creating arteriovenous access because of concern over the aggravation of pulmonary hypertension. Evaluation of right heart function and pulmonary hypertension is important before arteriovenous access construction.
Adaptation of the normative rating procedure for the International Affective Picture System to a remote format
Authors: Lemos Thayane C. , Silva Laiz A. A. , Gaspar Sara D. J. , Coutinho Guilherme M. S. , Stariolo Jasmin B. , Oliveira Pedro G.M.R , Conceicao Lethicia S. , Volchan Eliane , David Isabel A.
Published: September 2024

Background

The Self-Assessment Manikin (SAM), a pictorial scale for the measurement of pleasure and arousal dimensions of emotions, is one of the most applied tools in the emotion research field.

Objective

We present a detailed description of a remote method to collect affective ratings in response to pictures by using the SAM scale.

Methods

To empirically validate our remote method, we conducted a study using a digitized version of the SAM scale and delivered online didactic instructions that followed the normative rating procedure for the International Affective Picture System (IAPS) to the participants. We presented 70 pictures from the IAPS and an additional set of 22 food pictures to the participants.

Results

We found strong correlations between the ratings of IAPS pictures obtained in our sample and those reported by North American and Brazilian participants in previous in-person studies that applied the same pictures and methodology. We were also able to obtain an additional standardized set of food pictures.

Conclusion

The protocols described here may be useful for researchers interested in collecting remotely valid and reliable affecting ratings.
Development and validation of an infectious disease control competency scale for public health professionals
Authors: Zhou Yiguo , Zhang Wan-Xue , Zhang Shan-Shan , Huang Ning-Hua , Zeng Jing , Yang Han , Ma Qin-Yi , Ao Le , Liu Ya-Qiong , Du Juan , Tian Xiao-Ling , Lu Qing-Bin , Cui Fuqiang
Published: September 2024

Background

Infectious diseases persistently pose global threats, and it is imperative to accelerate the professionalization of public health workforce. This study aimed to develop and validate the infectious disease control competency scale (IDCCS) for public health professionals to fill a theoretical gap and elevate practical capabilities by informing public health professionals’ development goals.

Methods

The initial item pool was generated through a literature review, and categorized into three dimensions (knowledge, practical skills, and leadership) based on the competency iceberg model and public health leadership framework. A two-round Delphi process was conducted to determine indicators within the scale. A pilot survey was utilized for item analysis and exploratory factor analysis (EFA). A formal survey was employed for confirmatory factor analysis (CFA). The weight value of each indicator was calculated using the analytic hierarchy process.

Results

An initial scale with three primary items, 14 secondary items, and 81 tertiary items was generated. Twenty experts participated in the two rounds of the Delphi process. Authority coefficients exceeded 0.9 in both rounds. Kendall's W was 0.29 and 0.19, respectively (both P < 0.001). Item analysis presented a Cronbach's Alpha of 0.98, with corrected item-total correlation coefficients ranging from 0.33 to 0.78. EFA demonstrated that cumulative variance explanations for the four primary dimensions (knowledge, practical skills, leadership, and personal quality) were 77.463%, 73.976%, 81.174%, and 68.654%, respectively. CFA indicated that all composite reliability values and average variance extracted surpassed 0.8 and 0.5, respectively. The standardized factor loadings of the items ranged from 0.630 to 0.977. Among the seven model fit indices, each of the four dimensions satisfied at least five criteria. A final three-level scale comprising four primary items, 14 secondary items, and 64 tertiary items was constructed. The weight values for the four primary items were 0.4064, 0.2878, 0.2082, and 0.0981, respectively.

Conclusions

The IDCCS was established to evaluate the competencies of knowledge, practical skills, leadership, and personal quality for public health professionals in infectious disease control. This scale demonstrates good reliability and validity, and can be used for performance evaluation, recruitment processes, curriculum development, and individual self-assessment.
Successful coronary angioplasty of a spontaneous occlusion of the conus artery causing a ST-segment elevation myocardial infarction and electrical storm
Authors: Hatoum Ibrahim
Published: September 2024

Background

Conus artery occlusion is a rare life-threatening event, typically secondary to iatrogenic etiology, and is treated mainly with conservative therapy and/or balloon angioplasty without stenting. However, treatment remains challenging.

Case presentation

We report the case of a 60-year-old man with a known history of coronary artery disease presenting with multiple internal defibrillator cardioversions due to an electrical storm (recurrent ventricular fibrillation). The coronary angiography showed an acute occlusion of the conus artery arising from the proximal segment of the right coronary artery, treated by percutaneous transluminal coronary angioplasty with stenting (drug-eluting stent) without any serious complications.

Conclusions

To our knowledge, this is the first case in the literature where a non-iatrogenic occlusion of the conus artery causing a ST-segment elevation myocardial infarction and electrical storm was treated with percutaneous coronary intervention with drug-eluting stenting.

Graphical abstract
Genetic variations in PADI4 and CCR6: a comprehensive meta-analysis on rheumatoid arthritis susceptibility
Authors: Muruganantham Jethendra Kumar , Thomas Sheena Mariyam , Kalarani Iyshwarya Bhaskar , Veerabathiran Ramakrishnan
Published: September 2024

Background

Rheumatoid arthritis is a long-term autoimmune condition that causes damage and inflammation to the joints. Genetic factors, including polymorphisms in the PADI4 and CCR6 genes, contribute significantly to RA susceptibility.

Methods

To find research on RA, PADI4, CCR6, gene polymorphisms, and SNPs, we performed a meta-analysis using PubMed, Scopus, Medline, Google Scholar, and EMBASE. Inclusion criteria comprised case–control studies providing genotypic data and allele frequencies. Review Manager 5.4 was used to conduct statistical analysis and evaluate odds ratios with 95% confidence intervals.

Results

Heterogeneity analyses of CCR6 rs3093024 showed no significant associations across genetic models: allele (OR = 0.69, 95% CI [0.36–1.32]), homozygous (OR = 2.18, 95%CI [0.58–8.22]), heterozygous (OR = 0.60, 95% CI [0.31–1.16]), dominant (OR = 1.60, 95% CI [0.64–3.95]), and recessive (OR = 1.79, 95% CI [0.75–4.27]). Similarly, PADI4 rs1748033 and rs2240340 showed insignificant associations across all genetic models.

Conclusion

This meta-analysis identifies a substantial relationship between CCR6 rs3093024 and RA susceptibility in Asian populations. However, heterogeneity analyses indicate inconsistent associations for PADI4 rs1748033 and rs2240340 across different populations and genetic models, suggesting varied genetic influences. Further large-scale studies are required to confirm these results and investigate the complex genetic and environmental interactions underlying RA pathogenesis.
Assessment of Piper longum L. (Piperaceae) leaves toxicity on the adults of Tribolium castaneum (Herbst, 1797) (Coleoptera: Tenebrionidae)
Authors: Kumar Justin , Marin Grace , Arivoli Subramanian , Tennyson Samuel
Published: September 2024

Background

Numerous insect pests attack stored grains causing both qualitative and quantitative losses. The most damaging pest that infests dry stored produce is the red flour beetle, Tribolium castaneum, a secondary pest of stored goods. This pest, especially in its adult stage, exhibits resistance to chemical insecticides, thereby rendering the traditional pesticides ineffective in controlling it. Phyto-derivatives, which are strong insecticides and also ecologically benign, have gained interest as non-chemical solutions for controlling this pest. Hence, the objective of this study was to investigate the potential of Piper longum leaf extract insecticidal action as an environmentally benign insecticide for the first time against the adults of T. castaneum. In this study, P. longum leaf ethanol extract was tested against the adults of T. castaneum by petri dish bioassay method. Ad hoc studies to verify significant mortality for the initial confirmation of adulticidal activity were conducted for 24 h at different dosages of 62.5, 125, 250, 500 and 1000 mg/L of P. longum leaf ethanol extract. Thereafter, dosages set at 10, 20, 30 and 40 mg/L for the fractions of P. longum leaf ethanol extract were conducted. Prior to this, the leaf extract of this plant was subjected to column chromatography for fractionation. The fractions tested for adulticidal activity were subjected to gas chromatography–mass spectroscopy.

Results

Significant adulticidal action with 100% adult mortality was observed in ethanol extract of P. longum leaves. Among the fourteen fractions (F0–F13) obtained tested, only fractions, F5, F10 and F13, demonstrated adulticidal activity, and the remaining fractions displayed poor activity. One hundred per cent morality was noted in T. castaneum adults after 96 h at 40 mg/L in F5 and F10, and in F13 at 20 mg/L, and their respective LD50 values were 17.6, 26.6 and 10.0 mg/L. The fractions F5, F10 and F13 contained fatty acids, viz., hexadecanoic acid, dotriacontane and heptacosane in F5; tetradecanoic acid and nonadecanoic acid in F10; and octadecanoic acid, aspartame and tridecanoic acid in F13, revealed through gas chromatography–mass spectroscopy.

Conclusions

The results of the study showed that P. longum ethanol leaf extract revealed significant adulticidal activity and is a promising toxic agent to the adults of T. castaneum. The fatty acids in the ethanolic leaf extract fractions of P. longum could have caused toxicity to the adults of T. castaneum. According to the current literature survey, this is the first research report on the adulticidal activity of P. longum leaf extracts against the adults of T. castaneum.
Effectiveness of topical bupivacaine versus topical lidocaine/adrenaline mixture for post-adenotonsillectomy pain management
Authors: Oyedepo Olanrewaju Olubukola , Ige Olufemi Adebayo , Oparanozie Emmanuel Ikechukwu , Bolaji Benjamin Olusomi , Idris Sa’adudeen Olanrewaju , Afolabi Abdulrahman Olusola , Mohammed Akeem , Dunmade Adekunle David
Published: September 2024

Background

This study aims to compare the topical administration of bupivacaine hydrochloride and lidocaine hydrochloride with epinephrine in alleviating post-tonsillectomy pain. Post-tonsillectomy pain has remained a challenge to both patient and doctors, and local anaesthetic agents applied to the tonsillar fossae post-operatively look promising.

Methods

One hundred and twenty ASA I or II children aged 2–15 years of consenting parents undergoing adenoidectomy and/or tonsillectomy were enrolled in the study. This was a randomized double-blind study in which the children were allocated into either of two groups to receive 5 ml of 0.125% bupivacaine or equal volume of lidocaine plus 1:200,000 adrenaline-soaked swab applied directly on the tonsillar floor within the fossae and/or nasopharynx after haemostasis was secured for 5 min before discontinuation of anaesthesia.

Results

Patients in the bupivacaine group had better extubating condition (p = 0.0001). There was no difference in the time to eye opening in both groups (p-value 0.316). Patients in the lidocaine group had a time to first analgesic request between 1 and 6 h, whereas in the bupivacaine group, about 25 patients (44% of the group) had a time to first analgesic request that exceeded 6 h (6–10 h). The only complication recorded in both groups following oral feeds was vomiting, and there was no difference in both groups (p = 0.968). Overall parental satisfaction was better with bupivacaine group (p = 0.00001).

Conclusion

Topical application of bupivacaine was associated with better extubation conditions and parental satisfaction when compared to topical lidocaine plus adrenaline while both demonstrated similar time to eye opening, analgesic request, haemodynamic parameters and incidence of complications.
Does reflux symptom index and reflux finding score have clinical utility in the diagnosis of laryngopharyngeal reflux disease?
Authors: Soni Annanya , Gupta Ankit , Jotdar Arijit , Gupta Amit Kumar , Yadav Manoj
Published: September 2024

Background

Reflux symptom index(RSI) and reflux finding score (RFS) are widely used scoring systems used to diagnose laryngopharyngeal reflux disease(LPRD). However many patients do visit the outpatient department with minimal symptoms not sufficient to fit the criteria described by Belafsky et al. for diagnosing LPRD. Most of these patients are provisionally diagnosed and treated for LPRD. Reflux symptom index(RSI) and reflux finding score (RFS) are widely used scoring systems used to diagnose(LPRD) (Belafsky PC et al., J Voice 16(2):274–7, 2002, Belafsky PC et al, Laryngoscope 111(8):1313–7, 2001).

RSI has nine questions that the patient must grade from 0 to 5. An abnormal score is greater than 13. Laryngopharyngeal reflux (LPR) may or may not be diagnosed using the RSI and RFS especially when patients present with minimum symptoms not sufficient to score more than 13 and 7 respectively. These patients may miss the diagnosis and have to be treated empirically. Pepsin’s presence in the saliva is indicative of reflux as pepsin is a gastric enzyme (NICE advice on Peptest for diagnosing gastro-oesophageal reflux, 2015, Wood JM et al., J Laryngol Otol 125(12):1218–24, 2011). Patients with minimum symptoms may be missed if diagnosis relies only on RSI AND RFS. The present study aims to see the correlation of pepsin-proven LPRD and RSI and RFS.

Methods

This is a prospective study, 49 patients with symptoms suggestive of LPRD who tested positive for the pepsin test were further analysed for RSI and RFS. A cut-off value of > 25 ng/mL was considered diagnostic of LPRD (Dhillon VK et al., Curr Gastroenterol Rep 18(8):44, 2016).

Result

The average RSI and RFS were respectively 10 and 4. The mean age of the patients in the study was 39 years and the mean weight was 60 kg. The association between RSI and PEPSIN detection is considered to be not statistically significant. Chi-squared equals 0.086 with 1 degree of freedom. The two-tailed P value equals 0.7698. Chi-squared equals 0.233 with 1 degree of freedom. The two-tailed P value equals 0.6295. The association between RFS and PEPSIN detection is considered to be not statistically significant.

In terms of correlation analysis, neither the RSI nor the RFS had Pearson’s correlation coefficient that was statistically significant.

Conclusion

Since salivary pepsin detection and the RSI do not have any significant correlation, the RSI is not a valid diagnostic method for LPR and should not be used exclusively.

Level of evidence

4.
Successful treatment of AA amyloidosis with tocilizumab, resulting in the disappearance of amyloid deposits: a case-based review
Authors: Tortosa-Cabañas Marina , Acosta Batlle José , Perna Cristian , Bachiller-Corral Javier
Published: September 2024

Background

AA amyloidosis is a multisystem disease characterized by the deposition of serum amyloid A protein, which is secondary to chronic inflammation. Tocilizumab (an interleukin-6 inhibitor monoclonal antibody) was effective in suppressing inflammation, normalizing serum amyloid A protein levels, and inducing remission in patients with amyloidosis. Recently, tocilizumab treatment has been associated with the disappearance of amyloid deposits.

Case presentation

A 61-year-old woman was referred to our hospital in 2011 due to oligoarthritis of both knees and elevation of acute-phase reactants. Corticosteroids and methotrexate were prescribed for the possibility of polymyalgia rheumatica, without clinical response. Two years later, the patient presented with foamy urine, nocturia, sweating, and dizziness. An elevated C-reactive protein (CRP), erythrocyte sedimentation rate, and nephrotic-range proteinuria were found. Autoantibodies and complements levels were normal. No signs of acute infections or cardiovascular disease were evidenced and amyloidosis was suspected. Rectal and oral mucosa biopsies were performed and amyloid AA deposits were detected in both. Magnetic resonance imaging (MRI) of the right knee showed arthropathy due to amyloid deposition. Intravenous monthly tocilizumab was prescribed with rapid improvement of CRP, proteinuria, and nephrotic syndrome symptoms. Arthritis also improved significantly. Two years later, a new biopsy of the rectal mucosa did not show amyloid deposits and the right knee MRI was normal, without evidence of amyloid synovitis. In 2017, isotopic synoviorthesis of both knees was performed due to repeated episodes of arthritis. Eight years after the start of Tocilizumab, the patient continues treatment and remains clinically stable, with no evidence of recurrence.

Conclusions

Tocilizumab treatment controls chronic inflammatory disease and improves symptoms of AA amyloidosis. According to the latest evidence, long-term treatment with tocilizumab may remove amyloid deposits from tissues, leading to a definitive cure for this disease. To our knowledge, this is the first case of regression of amyloid deposits both in biopsy and magnetic resonance after treatment with tocilizumab.