bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantifying anterior pelvic roll during total hip arthroplasty in the lateral decubitus position
Authors: Kurmis Andrew P. , Lourens Ernest C.
Published: November 2023

Background

Unintended pelvic positional change is an acknowledged intra-operative problem for hip arthroplasty, seen commonly with procedures performed in the lateral position. If unrecognised, such changes can dramatically alter final acetabular component anteversion potentially resulting in suboptimal construct performance. It has previously been suggested that pelvic roll of just 13° may be enough to place an otherwise perfectly orientated cup outside of conventional ± 10° safe zones. Using the real-time tracking capacity of a commercially available optical navigation system, we aimed to accurately quantify pelvic roll occurring during total hip arthroplasties (THAs) performed in the decubitus position.

Methods

Prospectively collected data for 107 consecutive, unilateral, THAs were interrogated to determine the magnitude of pelvic movement around a central longitudinal axis (i.e. AP roll). Correlation statistics with patient age and body mass index (BMI) were also calculated.

Results

A mean pelvic roll of 9.5° was observed, being anterior in 96% of cases. Of these, 18.3% of hips had a magnitude of roll greater than 13°. There were no statistically significant independent correlations observed between age (p = 0.87) or BMI (p = 0.59) and mean roll.

Conclusions

Errors in achieving acetabular target version may result in numerous post-operative concerns including instability/dislocation, bearing wear, squeaking, range-of-movement limitation and increased revision rate. In a general cohort, our findings suggest a mean anterior pelvic roll during THA of nearly 10°. Without purposeful correction, this may cause substantial deviation from intended target positions. Future work is indicated to map changing pelvic roll during THA which is likely to follow a nonlinear trajectory.

Level of evidence: IV.

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Unexpected fibrous mediastinitis in a patient with myasthenia gravis - a case report
Authors: Wang Xuyang , Zuo Xiaoping , Wang Fuqiang , Wang Yun
Published: November 2023

Background

Fibrous mediastinitis (FM) is a rare mediastinal lesion characterized by proliferation of fibrous tissue within the mediastinum. Previous reports have shown that this lesion can be caused by histoplasmosis and tuberculosis. In extremely rare cases, FM can also be caused by autoimmune diseases such as antineutrophil cytoplasmic antibody-associated vasculitis and large-vessel arteritis.

Case presentation

In our case, we report unexpected fibrous mediastinitis found after robotic thymectomy in a patient with myasthenia gravis (MG). The preoperative imaging indicated no obvious lesion in the mediastinum and the patient denied histories of both histoplasmosis and tuberculosis. After the operation, both proliferation of fibrous tissue and ectopic germinal centres (GCs) could be found in the thymus.

Conclusion

This rare case might enrich our knowledge of the relationship between FM and autoimmune diseases.
Survival outcomes of lung metastases from colorectal cancer treated with pulmonary metastasectomy or modern systemic chemotherapy: a single institution experience
Authors: Shishido Yutaka , Ishii Masayuki , Maeda Tetsuo , Kokado Yujiro , Masuya Daiki , Kusama Toshiyuki , Fujimoto Koji , Higashiyama Hiroshi
Published: November 2023

Background

Although pulmonary metastasectomy is an accepted treatment strategy for resectable lung metastases (LM) from colorectal cancer (CRC), its survival benefits are controversial. In contrast, recent advancements in chemotherapy have significantly improved metastatic CRC prognosis. This study aimed to evaluate survival outcome of LM from CRC in the age of newly developed chemotherapy.

Methods

We retrospectively reviewed 50 patients who underwent complete resection and 22 patients who received chemotherapy as definitive treatment for LM from resected CRC at our hospital. The present study was limited to patients who started treatment for isolated LM after molecular targeted drugs became available in Japan.

Results

Overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS) rates after pulmonary resection were 64.5%, 66.4%, and 32.6% at five years, respectively. OS and CSS rates of chemotherapy patients were 26.8% and 28.3% at five years, with a median progression-free survival time of 10.0 months. When compared the characteristics of surgical and chemotherapy patients, patients with pN factors of CRC (p = 0.013), smaller size (p < 0.001), larger number (p < 0.001), and bilateral (p < 0.001) LM received chemotherapy. Univariate analysis showed that multiple LM and rectal lesions were poor prognostic factors for OS (p = 0.012) and DFS (p = 0.017) in surgical patients, and rectal lesions were a poor prognostic factor for OS (p = 0.013) in chemotherapy patients.

Conclusions

Pulmonary metastasectomy showed a favorable survival in patients with LM from CRC. Despite the high recurrence rate after metastasectomy and recent advances in chemotherapy, surgical resection could still be considered as a valid option among multidisciplinary treatments.

Trial registration

The research plan was approved by the Institutional Review Board of Shinko Hospital (No. 2142) on February 7, 2022.
The bleeding diathesis in patients with hereditary haemorrhagic telangiectasia is not due to impaired platelet function
Authors: Lyster Anne Lørup , Biørn Signe Hedengran , Kjeldsen Anette Drøhse , Nielsen Christian , Lange Bibi , Fialla Annette Dam , Vinholt Pernille Just
Published: November 2023

Background

Patients with the rare disease; Hereditary haemorrhagic telangiectasia (HHT) often bleed from telangiectatic lesions in mucosal surfaces. Studies suggest that impaired platelet function may also play a role in their bleeding tendency. The aim of the present study was to investigate whether HHT-patients with epistaxis have impaired platelet function.

Method

We conducted a case–control study based on a sample size calculation and included 22 HHT-patients (inclusion criteria: epistaxis severity score ≥ 4, no intake of medicine affecting platelet function the last 5 days, HHT-type 1 or 2, age ≥ 18 years) and 20 controls. We assessed the platelet function with standard haemostasis parameters, flow cytometry (platelet function and micro aggregation), rotational thromboelastometry and Platelet Function Analyzer 200.

Results

We found no significant difference in mean platelet volume and immature platelet fraction and no difference in platelet activation as measured by exposure of CD62P, CD63P and PAC1 binding. Nor did we find a significant difference in platelet aggregation response in HHT-patients compared with the control group for all agonists (thrombin receptor activating peptide, adenosine diphosphate and collagen-related peptide). The PFA-200 analysis was without difference between the two groups and thromboelastometry showed no impairment of global haemostasis.

Conclusion

Reduced platelet function is unlikely to contribute to the frequent and long bleeding episodes that HHT-patients suffer from. We propose that further studies should focus on whether patients with HHT have hypercoagulability.
From tradition to innovation: a comparison of the traditional 4-step approach versus a blended learning modification for technical skills teaching
Authors: Bergmans Elonka , Billington Alistair , Thies Karl-Christian
Published: November 2023

Background

This experimental study was performed to evaluate the role of blended learning for technical skill teaching on the European Trauma Course (ETC). While online modules are extensively used for theoretical teaching, their role in skills training remains less well explored. The ETC currently relies on the established 4-step technique for teaching technical skills. However, the required large cohort of skilled instructors and the time intensity prove increasingly challenging in a current climate of staff shortages and funding constraints. This study assesses if blended learning, combining pre-course online elements with face-to-face training matches the effectiveness of the traditional 4-step approach whilst being more time-efficient.

Methods

In a randomised, multi-centre trial, the conventional face-to-face 4-step technique for teaching a skill of medium complexity, the application of a pelvic binder, was compared with an innovative blended approach. It was hypothesised that the blended approach was non-inferior for skill performance measured after the teaching session and after two days (skill retention) with the time needed for teaching and student/teacher satisfaction as secondary outcomes.

Results

Ninety participants, divided into 44 traditional and 46 blended method students, were analysed. Independent-samples t-test showed no significant difference in performance scores and non-inferiority of the blended approach with a half of one standard deviation margin. A statistically significant difference in mean retention scores favored the blended approach. A Mann–Whitney U Test revealed no significant difference in candidate satisfaction levels but a statistically significant difference in instructors' satisfaction levels in favour of the blended approach. Analysis with Welch' t-test demonstrated that the face-to-face teaching time needed for the blended approach was significantly shorter (by 6 min).

Conclusions

The integration of a blended approach with the 4-step technique for teaching pelvic binder application in the ETC streamlined teaching without compromising skill acquisition quality. This innovative approach addresses traditional limitations and shows promise in adapting medical education to modern learning and teaching demands. We suggest that blended learning could also be applied for other skills taught on life support courses.

Trial registration: University of Dundee (Schools of Medicine and Life sciences Research Ethics Committee, REC number 22/59, 28th June 2022).
LncRNA WAC-AS1 promotes osteosarcoma Metastasis and stemness by sponging miR-5047 to upregulate SOX2
Authors: Yang Zhining , Liu Zhaoyong , Lu Weiqing , Guo Huancheng , Chen Jianzhou , Zhang Ying
Published: November 2023

Cancer stemness and osteosarcoma (OS) malignant progression are closely associated. However, the molecular mechanisms underlying this association have not been fully demonstrated. Long noncoding RNAs (lncRNAs) are an intriguing class of widely prevalent endogenous RNAs involved in OS progression, the vast majority of which have not been characterized functionally. Here, we identified tumor promoter lncRNA WAC-AS1 to be highly expressed in OS tumors and associated with worse survival. Further analysis revealed that WAC-AS1 increased tumorsphere formation of OS cells and promoted metastasis, as confirmed by cell proliferation, transwell and wound healing assays. MiR-5047 was identified as a downstream target of WAC-AS1. Subsequently, based on bioinformatics analysis, RIP assay and luciferase reporter assay, SOX2 mRNA was verified as a target of miR-5047. WAC-AS1 enhanced OS cell proliferation and stemness via acting as a ceRNA by binding to miR-5047, thereby increasing SOX2 expression. In addition, SOX2 bound to the promoter region of WAC-AS1 and promoted its transcription, thereby forming a positive feedback loop to regulate OS malignancy. Taken together, our findings show WAC-AS1 is a tumor promoter and a key regulator of OS cell stemness and metastasis via a miR-5047/SOX2 axis.
The SWiFT trial (Study of Whole Blood in Frontline Trauma)—the clinical and cost effectiveness of pre-hospital whole blood versus standard care in patients with life-threatening traumatic haemorrhage: study protocol for a multi-centre randomised controlled trial
Authors: Smith Jason E. , Barnard Ed B. G. , Brown-O’Sullivan Charlie , Cardigan Rebecca , Davies Jane , Hawton Annie , Laing Emma , Lucas Joanne , Lyon Richard , Perkins Gavin D. , Smith Laura , Stanworth Simon J. , Weaver Anne , Woolley Tom , Green Laura
Published: November 2023

Background

Early blood transfusion improves survival in patients with life-threatening bleeding, but the optimal transfusion strategy in the pre-hospital setting has yet to be established. Although there is some evidence of benefit with the use of whole blood, there have been no randomised controlled trials exploring the clinical and cost effectiveness of pre-hospital administration of whole blood versus component therapy for trauma patients with life-threatening bleeding. The aim of this trial is to determine whether pre-hospital leukocyte-depleted whole blood transfusion is better than standard care (blood component transfusion) in reducing the proportion of participants who experience death or massive transfusion at 24 h.

Methods

This is a multi-centre, superiority, open-label, randomised controlled trial with internal pilot and within-trial cost-effectiveness analysis. Patients of any age will be eligible if they have suffered major traumatic haemorrhage and are attended by a participating air ambulance service. The primary outcome is the proportion of participants with traumatic haemorrhage who have died (all-cause mortality) or received massive transfusion in the first 24 h from randomisation. A number of secondary clinical, process, and safety endpoints will be collected and analysed. Cost (provision of whole blood, hospital, health, and wider care resource use) and outcome data will be synthesised to present incremental cost-effectiveness ratios for the trial primary outcome and cost per quality-adjusted life year at 90 days after injury. We plan to recruit 848 participants (a two-sided test with 85% power, 5% type I error, 1-1 allocation, and one interim analysis would require 602 participants—after allowing for 25% of participants in traumatic cardiac arrest and an additional 5% drop out, the sample size is 848).

Discussion

The SWiFT trial will recruit 848 participants across at least ten air ambulances services in the UK. It will investigate the clinical and cost-effectiveness of whole blood transfusion versus component therapy in the management of patients with life-threatening bleeding in the pre-hospital setting.

Trial registration

ISRCTN: 23657907; EudraCT: 2021-006876-18; IRAS Number: 300414; REC: 22/SC/0072, 21 Dec 2021.
Protocol update and baseline characteristics for the TRIal to slow the Progression of Diabetes (TRIPOD) randomized controlled trial
Authors: Bairavi Joann , Gardner Daphne Su-Lyn , Yeoh Ester , Tham Kwang Wei , Gandhi Mihir , Tan Ngiap Chuan , Lee Phong Ching , Lim Robyn Su May , Adamjee Thofique , Cheung Yin Bun , Bee Yong Mong , Finkelstein Eric Andrew
Published: November 2023

Background

Type 2 diabetes (T2D), a major risk factor for cardiovascular disease and other adverse health conditions, is on the rise in Singapore. TRIPOD is a randomized controlled trial aimed to determine whether complementing usual care with an evidence-based diabetes management package (DMP) —comprising access to an evidence-based app, health coaching, pedometer, glucometer and weighing scale, with or without a financial rewards scheme (M-POWER rewards), can improve mean HbA1c levels at months 6 and 12.

Methods

The protocol was published in Trials, accessible via https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3749-x1. This manuscript updates the protocol with changes to the study design due to challenges with recruitment and presents baseline characteristics. Key updates include changing the arm allocation ratio from 1:1:1 (Arm 1-Usual Care: Arm 2-DMP: Arm 3-DMP+M-POWER rewards) to 10:1:10, the sample size from 339 to 269, the intervention period from two to one year, and the primary hypothesis to focus solely on differences between Usual Care and DMP+M-POWER rewards. Recruitment for the study began on 19 October 2019 and ended on 4 June 2022.

Results

The average age of participants was 55.0 (SD9.7) years old and 64.2% were male. The majority of participants (76.8%) were Chinese, 4.9% Malay and 18.3% Indian and of other ethnicities. 67.0% had a monthly household income of SGD$4000 or more. The mean baseline HbA1c was 8.10% (SD 0.95) and the mean body mass index was 26.8 kg/m2 (SD 5.3).

Discussion

The final participant completed month 12 follow-up data collection on 8 June 2023. All pre-planned analyses will be conducted and final results reported.

Trial registration

ClinicalTrials.govNCT03800680. Registered on 11 January 2019.
Comparison of METS-IR and HOMA-IR for predicting new-onset CKD in middle-aged and older adults
Authors: Yoon Jihyun , Heo Seok-Jae , Lee Jun-Hyuk , Kwon Yu-Jin , Lee Jung Eun
Published: November 2023

Background

Chronic kidney disease (CKD) has emerged as a mounting public health issue worldwide; therefore, prompt identification and prevention are imperative in mitigating CKD-associated complications and mortality rate. We aimed to compare the predictive powers of the homeostatic model assessment for insulin resistance (HOMA-IR) and the metabolic score for insulin resistance (METS-IR) for CKD incidence in middle-aged and older adults.

Methods

This study used longitudinal prospective cohort data from the Korean Genome and Epidemiology Study. A total of 10,030 participants, aged 40–69 years, residing in the Ansung or Ansan regions of the Republic of Korea, were recruited between 2001 and 2002 through a two-stage cluster sampling method. We compared the predictive powers of METS-IR and HOMA-IR for CKD prevalence and incidence, respectively. CKD prevalence was measured by the area under the receiver operating characteristic (ROC) curve (AUC), and the indices’ predictive performance for CKD incidence were assessed using Harrell’s concordance index and time-dependent ROC curve analysis.

Results

A total of 9261 adults aged 40–69 years at baseline and 8243 adults without CKD were included in this study. The AUCs and 95% confidence intervals (CIs) of HOMA-IR and METS-IR for CKD prevalence at baseline were 0.577 (0.537–0.618) and 0.599 (0.560–0.637), respectively, with no significant difference (p = 0.337). The Heagerty’s integrated AUC for METS-IR in predicting CKD incidence was 0.772 (95% CI 0.750–0.799), which was significantly higher than that of HOMA-IR (0.767 [95% CI 0.742–0.791], p = 0.015).

Conclusion

METS-IR surpassed HOMA-IR in predicting CKD incidence and was as effective as HOMA-IR in predicting CKD prevalence. This implies that METS-IR could be a valuable indicator for early detection and prevention of CKD among Korean adults.
Sex differences in the rapid detection of neutral faces associated with emotional value
Authors: Saito Akie , Sato Wataru , Yoshikawa Sakiko
Published: November 2023

Background

Rapid detection of faces with emotional meaning is essential for understanding the emotions of others, possibly promoting successful interpersonal relationships. Although few studies have examined sex differences in the ability to detect emotional faces, it remains unclear whether faces with emotional meaning capture the attention of females and males differently, because emotional faces have visual saliency that modulates visual attention. To overcome this issue, we tested the rapid detection of the neutral faces associated with and without learned emotional value, which are all regarded as free from visual saliency. We examined sex differences in the rapid detection of the neutral female and male faces associated with emotional value.

Methods

First, young adult female and male participants completed an associative learning task in which neutral faces were associated with either monetary rewards, monetary punishments, or no monetary outcomes, such that the neutral faces acquired positive, negative, and no emotional value, respectively. Then, they engaged in a visual search task in which previously learned neutral faces were presented as discrepant faces among newly presented neutral distractor faces. During the visual search task, the participants were required to rapidly identify discrepant faces.

Results

Female and male participants exhibited comparable learning abilities. The visual search results demonstrated that female participants achieved rapid detection of neutral faces associated with emotional value irrespective of the sex of the faces presented, whereas male participants showed this ability only for male faces.

Conclusions

Our results demonstrated that sex differences in the ability to rapidly detect neutral faces with emotional value were modulated by the sex of those faces. The results suggest greater sensitivity to faces with emotional significance in females, which might enrich interpersonal communication, regardless of sex.
Benefits, concerns and prospects of using goat manure in sub-Saharan Africa
Authors: Washaya Soul , Washaya Dorine D.
Published: November 2023

Livestock production has undergone an industrial revolution over the past few decades. This has resulted in the enormous generation of livestock manure, particularly in agro-pastoral systems. Agricultural productivity in these systems largely depends on livestock manure. However, some of these communities are struggling with goat manure disposal. In addition, livestock manure requires proper treatment before application to agricultural land, because it contains toxic heavy metals and pathogenic microorganisms. The review aimed to demonstrate that poor manure management has environmental consequences; thus, interventions that will promote local community livelihood benefits from animal wastes are germane. In many other communities in sub-Saharan Africa (SSA), horticulture or crop production is minimal, due to erratic rainfall hence, most of the manure lies idle in abandoned kraal pens or is heaped outside the pens with no designed plan. Manure should be viewed as a resource, rather than a waste product. The environmental consequences associated with such manure management are not known and should be probed further. Deliberate efforts to explore the land and environmental risks associated with the non-use of livestock manure are germane to promoting environmental stewardship. The use of manure as feedstock for anaerobic digesters offers the greatest potential for sustainable management in SSA.
Clinical biomarkers for Lewy body diseases
Authors: Abdelmoaty Mai M. , Lu Eugene , Kadry Rana , Foster Emma G. , Bhattarai Shaurav , Mosley R. Lee , Gendelman Howard E.
Published: November 2023

Synucleinopathies are a group of neurodegenerative disorders characterized by pathologic aggregates of neural and glial α-synuclein (α-syn) in the form of Lewy bodies (LBs), Lewy neurites, and cytoplasmic inclusions in both neurons and glia. Two major classes of synucleinopathies are LB disease and multiple system atrophy. LB diseases include Parkinson’s disease (PD), PD with dementia, and dementia with LBs. All are increasing in prevalence. Effective diagnostics, disease-modifying therapies, and therapeutic monitoring are urgently needed. Diagnostics capable of differentiating LB diseases are based on signs and symptoms which might overlap. To date, no specific diagnostic test exists despite disease-specific pathologies. Diagnostics are aided by brain imaging and cerebrospinal fluid evaluations, but more accessible biomarkers remain in need. Mechanisms of α-syn evolution to pathologic oligomers and insoluble fibrils can provide one of a spectrum of biomarkers to link complex neural pathways to effective therapies. With these in mind, we review promising biomarkers linked to effective disease-modifying interventions.
Biosorption potential of Purpureocillium lilacinum biomass for chromium (VI) removal: isolation, characterization, and significance of growth limiting factors
Authors: Kerga Gizachew Assefa , Shibeshi Nurelegne Tefera , Prabhu Sundramurthy Venkatesa , Varadharajan Venkatramanan , Yeshitla Alazar
Published: November 2023

Chromium (VI) is known to be harmful element that commonly found industrial waste, mining activities, and wastewater discharges from various industries. When released into the environment, Cr (VI) can contaminate soil, water, and air, posing a serious threat to living organisms. Aiming to Cr decontamination, this work was framed to isolate the fungal species having high Cr tolerance capacity and to exploit as bio-sorbent for the removal of Cr (VI) from aqueous solutions by biosorption. Among the fungal species isolated from the Cr (VI) contaminated soil sample, the filamentous fungus of Ophiocordycipitaceae family, Purpureocillium lilacinum was identified using molecular sequencing technique, showed maximum tolerance against Cr (VI) with a tolerance index of 1.19 ± 0.23. Further, Plackett Burman Design was applied to investigate for ascertaining the significance of different carbon and nitrogen sources on P. lilacinus growth, as well as the influence of environmental factors, such as pH, temperature, and Cr (VI) concentration. The results explicated that glucose was the most preferred carbon source for P. lilacinus, while yeast extract was the most preferred for nitrogen source. The optimum pH value and temperature were found to be 6.0 and 26 °C, respectively. In addition, P. lilacinus isolate was identified to survive in high concentrations of Cr (VI), indicating its potential for employing effective bioremediation of chromium-contaminated site.
Grid2 interacting protein is a potential biomarker related to immune infiltration in colorectal cancer
Authors: Zhao Jiajing , Quan Jiazheng , Chen Weilin , Xie Xiaojun
Published: November 2023

Background

Colorectal cancer (CRC) is one of the three deadliest malignant tumors in the world, posing a severe hazard to human health. Nonetheless, the 5-year survival rate for advanced CRC remains unsatisfactory. Grid2 interacting protein (GRID2IP) is a Purkinje fiber postsynaptic scaffold protein implicated in a number of signal transduction pathways in the nervous system. Previous studies have shown that Grid2 is closely related to the occurrence and prognosis of gastric cancer and many other diseases. Therefore, we aim to identify the relationship between GRID2IP and the occurrence and prognosis of CRC.

Methods

Transcriptome data were retrieved from The Cancer Genome Atlas (TCGA) database to analyze the differential expression of GRID2IP in a variety of malignant tumors and then validate it by quantitative real time polymerase chain reaction(Q-PCR) and Western Blot in HT29 and SW480 cells. "DESeq2" package was used to analyze the differentially expressed genes (DEGs) between the high- and low-GRID2IP subgroups. In relation to DEGs, Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed. In addition, gene set enrichment analysis (GSEA) and single-sample gene set enrichment analysis (ssGSEA) were employed to examine DEGs-associated signaling pathways and GRID2IP-associated immune cell infiltration levels. Besides, overall survival (OS), disease-specific survival (DSS), and progression-free interval (PFI) were compared between the two subgroups using a Kaplan–Meier analysis. In addition, a prognostic model for GRID2IP and clinical characteristics was developed using the univariate Cox regression method. The "pRRophetic" package was applied to predict the drug sensitivity of different subgroups. Moreover, we also performed single-cell analysis of GRID2IP using the TISCH database.

Results

GRID2IP is upregulated in CRC patients. The rise of GRID2IP inhibits the invasion of tumor-associated immune cells resulting in a lower immune score. In addition, high GRID2IP expression was associated with poor prognosis in different clinical subgroups. Analysis of single cells revealed that GRID2IP was predominantly expressed in immune cells, myofibroblasts, and cancerous cells. In terms of chemotherapy drug sensitivity, the subgroup with high GRID2IP expression was less sensitive to gemcitabine.

Conclusions

Our results suggest that rising GRID2IP promotes tumor-associated immune cell infiltration and suggests adverse outcomes in CRC patients, which may be a useful biomarker for determining the prognosis of CRC and a potential target molecule for CRC therapy.
CRISPR/Cas9 system: recent applications in immuno-oncology and cancer immunotherapy
Authors: Chen Chen , Wang Zehua , Qin Yanru
Published: November 2023

Clustered regulatory interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) is essentially an adaptive immunity weapon in prokaryotes against foreign DNA. This system inspires the development of genome-editing technology in eukaryotes. In biomedicine research, CRISPR has offered a powerful platform to establish tumor-bearing models and screen potential targets in the immuno-oncology field, broadening our insights into cancer genomics. In translational medicine, the versatile CRISPR/Cas9 system exhibits immense potential to break the current limitations of cancer immunotherapy, thereby expanding the feasibility of adoptive cell therapy (ACT) in treating solid tumors. Herein, we first explain the principles of CRISPR/Cas9 genome editing technology and introduce CRISPR as a tool in tumor modeling. We next focus on the CRISPR screening for target discovery that reveals tumorigenesis, immune evasion, and drug resistance mechanisms. Moreover, we discuss the recent breakthroughs of genetically modified ACT using CRISPR/Cas9. Finally, we present potential challenges and perspectives in basic research and clinical translation of CRISPR/Cas9. This review provides a comprehensive overview of CRISPR/Cas9 applications that advance our insights into tumor-immune interaction and lay the foundation to optimize cancer immunotherapy.
Experiences of living with binge eating disorder and facilitators of recovery processes: a qualitative study
Authors: Bremer Marit Fjerdingren , Garnweidner-Holme Lisa , Nesse Linda , Molin Marianne
Published: November 2023

Background

Binge eating disorder (BED) is the most prevalent eating disorder worldwide. BED is often associated with low quality of life and mental health problems. Given the complexity of the disorder, recovery may be challenging. Since BED was only recently specified as a diagnostic category by the World Health Organization (2021), little is known about how patients experience living with BED in everyday life. This study aimed to explore how patients experience living with BED and to investigate factors perceived as facilitating recovery.

Method

Individual interviews were conducted with six patients in a rehabilitation programme for recovery from BED. Interviews were conducted digitally and verbally transcribed between December 2020 and January 2021. The analysis was based on Malterud’s systematic text condensation.

Results

Being diagnosed with BED could be experienced as a relief. The participants perceived living with BED as a challenging addiction. They struggled with a low self-image and experienced a lack of understanding from others, resulting in shame. Self-compassion and social support from friends and family and through participation in a rehabilitation programme were important facilitators of recovery.

Conclusion

Participants perceived living with BED as a challenging addiction. They struggled with low self-esteem and experienced a lack of understanding from others, resulting in shame. Being diagnosed with BED was perceived as a relief. They appreciated that issues related to mental health were addressed during rehabilitation to better understand the complexity of BED. Knowledge about BED, as well as the difficulties of living with BED among family members and friends might help patients with BED feel less ashamed of their disorder and could thus contribute to increased self-compassion.
Distinct rupture processes on a fault where M6-class earthquakes reoccurred in a short period: analysis of the 2011 and 2016 Northern Ibaraki, Japan, earthquakes using near-field waveforms
Authors: Hikima Kazuhito
Published: November 2023

Crustal earthquakes are generally recognized as having recurrence periods of more than 1000 years. However, in northern Ibaraki Prefecture, Japan, two moderate-sized earthquakes occurred on almost the same fault plane in 2011 and 2016. Moreover, it has been reported that the slip distributions derived from crustal deformation data from these two events are almost identical. We performed a near-field waveform inversion analysis to estimate the details of the spatiotemporal distribution of the co-seismic rupture. Our results reveal large slip areas during each earthquake at different locations across the bend of the fault plane. These results indicate that the shear stress of the fault area where the main slip occurred during the 2011 event was not rebuilt in such a short period, a phenomenon that had not previously been discussed for this sequence. Our results also suggest that the fault geometry affected such complex fault ruptures.

Graphical Abstract
Prevalence and risk factors of diabetes foot ulcers in Kano, northwestern Nigeria
Authors: Aliyu Raliyatu , Gezawa Ibrahim D. , Uloko Andrew E. , Ramalan Mansur A.
Published: November 2023

Background

Foot complications account for more hospital admissions than any other diabetes mellitus (DM) complications with adverse outcomes being foot ulcers and amputation.

Objective

To determine the prevalence and risk factors of diabetic foot ulcers in Kano, Northwestern Nigeria.

Methods

A descriptive cross-sectional study was conducted in the diabetes outpatient clinics and medical and surgical wards of two hospitals in Kano, Nigeria. Data were collected on socio-demographic characteristics, type, and duration of DM. The study subjects were assessed for the presence of and risk factors for foot ulcers.

Results

We recruited 394 patients with DM (163 males and 231 females) with a mean (SD) age and duration of DM of 50.8 ± 12.5 years and 7.72 ± 6.65 years respectively. Type 2 DM was present in 95% of the study subjects. Diabetic foot ulcer (DFU) was present in 57 (14.5%) of the patients. Risk factors associated with DFU assessed using univariate analysis were older age, longer duration of DM, presence of peripheral neuropathy (PN), peripheral arterial disease (PAD), diabetic retinopathy, nephropathy, foot deformities, previous DFU, and poor glycemic control. The independent determinants of DFU were previous DFU, foot deformities, retinopathy, PN, PAD, and poor glycemic control.

Conclusion

DFU can be found in our setting and the predominant risk factors for DFU are common and remain unchanged in our environment. This study, therefore, buttresses the effect of early detection and treatment of DM in preventing the complications that arise from the disease.
Anatomical and functional results after vitrectomy with conventional ILM peeling versus inverted ILM flap technique in large full-thickness macular holes
Authors: Dera Adrianna U. , Stoll Doerte , Schoeneberger Verena , Walckling Marcus , Brockmann Claudia , Fuchsluger Thomas A. , Schaub Friederike
Published: November 2023

Background

Aim of the study was to compare success rate and functional outcome following pars plana vitrectomy (PPV) with conventional internal limiting membrane (ILM) peeling versus ILM flap technique for full-thickness idiopathic macular holes (FTMH).

Methods

Retrospective analysis of consecutive eyes with FTMH having undergone vitrectomy with sulfur hexafluoride (SF6) endotamponade 25% at the University Medical Center Rostock, Germany (2009–2020). Eyes were divided according to applied surgical technique (ILM peeling [group P] versus ILM flap [group F]). Inclusion criteria were macular hole base diameters (MH-BD) ≥ 400 μm plus axial length ≤ 26.0 mm. Each group was divided into two subgroups based on macular hole minimum linear diameter (MH-MLD): ≤ 400 μm and > 400 μm. Exclusion criteria were FTMH with MH-BD < 400 μm, trauma, myopia with axial length > 26.0 mm or macular schisis. Demographic, functional, and anatomical data were obtained pre- and postoperatively. Preoperative MH-BD and MH-MLD were measured using optical coherence tomography (OCT; Spectralis®, Heidelberg Engineering GmbH, Heidelberg, Germany). Main outcome parameter were: primary closure rate, best-corrected visual acuity (BCVA), and re-surgery rate.

Results

Overall 117 eyes of 117 patients with FTMH could be included, thereof 52 eyes underwent conventional ILM peeling (group P) and 65 additional ILM flap (group F) technique. Macular hole closure was achieved in 31 eyes (59.6%) in group P and in 59 eyes (90.8%) in group F (p < 0.001). Secondary PPV was required in 21 eyes (40.4%) in group P and in 6 eyes (9.2%) in group F. Postoperative BCVA at first follow-up in eyes with surgical closure showed no significant difference for both groups (MH-MLD ≤ 400 μm: p = 0.740); MH-MLD > 400 μm: p = 0.241).

Conclusion

Anatomical results and surgical closure rate following ILM flap technique seems to be superior to conventional ILM peeling for treatment of FTMH.
Awareness of and participation in mass drug administration programs used for onchocerciasis control in the Atwima Nwabiagya North District, Ghana
Authors: Osei Francis Adjei , Newton Sam Kofi Tekyi , Nyanor Isaac , Osei-Yeboah Eugene , Amuzu Evans Xorse , Mensah Nicholas Karikari , Nyarko Obed Ofori , Amanor Ernest , Odoom Samuel Frimpong , Abubakar Suraj Yawnumah , Dongyele Mathias , Mohammed Aliyu , Asare Ofeibea , Boadi Stephanie , Furu Peter , Meyrowitsch Dan Wolf , Owusu-Dabo Ellis
Published: November 2023

Background

Studies on Mass drug administration (MDA) in Ghana targeting various diseases, have mostly focused on factors that affect coverage and compliance to MDA with limited focus on evidence regarding awareness and community perception of the program. Therefore, this study sought to provide empirical evidence on the knowledge of onchocerciasis, and awareness of and participation in the MDA among community members.

Methods

A community-based cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District, Ghana. Data was collected from 2,008 respondents. Bivariate and multivariate logistic regression analyses were performed to measure the associations between socio-demographics, having heard of onchocerciasis and its prevention, and levels of awareness of the MDA program.

Results

A total of 1268 respondents (63.2%) were aware of the MDA program. The majority ofMost respondents (74.4%) were of the view that the information given about the program was not enough and 45.4% of the respondents had no idea about the relevance of the MDA program. Respondents who had ever heard about onchocerciasis prevention and persons who had previously participated in the MDA program were more likely to be aware of the MDA program during implementation (AOR = 2.32; 95% CI 1.79–3.01 and AOR = 9.31; 95% CI 7.06–12.26, respectively).

Conclusions

We observed a significant association between being aware of MDA campaigns and knowledge of onchocerciasis and its preventive methods, and participation in previous MDA campaigns. We recommend intensification and improvement of prevention campaigns regarding the onchocerciasis MDA program as key to ensuring increased MDA program participation.
Denoising diffusion-based MRI to CT image translation enables automated spinal segmentation
Authors: Graf Robert , Schmitt Joachim , Schlaeger Sarah , Möller Hendrik Kristian , Sideri-Lampretsa Vasiliki , Sekuboyina Anjany , Krieg Sandro Manuel , Wiestler Benedikt , Menze Bjoern , Rueckert Daniel , Kirschke Jan Stefan
Published: November 2023

Background

Automated segmentation of spinal magnetic resonance imaging (MRI) plays a vital role both scientifically and clinically. However, accurately delineating posterior spine structures is challenging.

Methods

This retrospective study, approved by the ethical committee, involved translating T1-weighted and T2-weighted images into computed tomography (CT) images in a total of 263 pairs of CT/MR series. Landmark-based registration was performed to align image pairs. We compared two-dimensional (2D) paired — Pix2Pix, denoising diffusion implicit models (DDIM) image mode, DDIM noise mode — and unpaired (SynDiff, contrastive unpaired translation) image-to-image translation using “peak signal-to-noise ratio” as quality measure. A publicly available segmentation network segmented the synthesized CT datasets, and Dice similarity coefficients (DSC) were evaluated on in-house test sets and the “MRSpineSeg Challenge” volumes. The 2D findings were extended to three-dimensional (3D) Pix2Pix and DDIM.

Results

2D paired methods and SynDiff exhibited similar translation performance and DCS on paired data. DDIM image mode achieved the highest image quality. SynDiff, Pix2Pix, and DDIM image mode demonstrated similar DSC (0.77). For craniocaudal axis rotations, at least two landmarks per vertebra were required for registration. The 3D translation outperformed the 2D approach, resulting in improved DSC (0.80) and anatomically accurate segmentations with higher spatial resolution than that of the original MRI series.

Conclusions

Two landmarks per vertebra registration enabled paired image-to-image translation from MRI to CT and outperformed all unpaired approaches. The 3D techniques provided anatomically correct segmentations, avoiding underprediction of small structures like the spinous process.

Relevance statement

This study addresses the unresolved issue of translating spinal MRI to CT, making CT-based tools usable for MRI data. It generates whole spine segmentation, previously unavailable in MRI, a prerequisite for biomechanical modeling and feature extraction for clinical applications.

Key points

• Unpaired image translation lacks in converting spine MRI to CT effectively.

• Paired translation needs registration with two landmarks per vertebra at least.

• Paired image-to-image enables segmentation transfer to other domains.

• 3D translation enables super resolution from MRI to CT.

• 3D translation prevents underprediction of small structures.

Graphical Abstract
Responses of Swiss interest rates and stock prices to ECB policy surprises
Authors: Hager Diego M. , Nitschka Thomas
Published: November 2023

We employ local projections to analyse the responses of Swiss asset prices to scheduled policy decisions of the European Central Bank (ECB) as a case study of ECB policy spillovers to European countries outside the euro area. Focusing on ECB policy shocks that are related to different policy instruments of the ECB, our empirical results leave the impression that surprises related to the ECB target policy rate and to the ECB’s longer-term forward guidance or its asset purchases tend to move Swiss interest rates and stock prices in the same direction. Shocks explicitly designed to capture pure ECB monetary policy and information effect shocks are weakly associated with movements in Swiss asset prices on average.
Efficacy of Bacillus licheniformis: a biocontrol agent against Colletotrichum gloeosporioides Penz. (Penz. & Sacc.) causing anthracnose in greater yam (Dioscorea alata L.)
Authors: Ravindran Amrutha Pandirikkal , Lajapathy Jeeva Muthulekshmi , Lalithakumari Sreelatha Gopalakrishnan , Mohan Akhil Kannolickal , Cyriac Tom , Usha Shilpa Sreekumar
Published: November 2023

Background

Anthracnose, caused by Colletotrichum gloeosporioides, is the most dangerous fungal disease of greater yam (Dioscorea alata L.), and leads to significant crop loss. Microbial technology in cropping systems is currently focused on biological control agents (BCAs), which include plant endophytes like bacteria, which contribute well to sustainable production. In the present study, the ability of an endophytic bacterium, Bacillus licheniformis (CTCRI EB12), isolated from Aloe vera was investigated to prevent the disease.

Results

The bacterium, CTCRI EB12, was characterized as a member of the Bacillus genus by morphological and biochemical tests and confirmed as B. licheniformis via 16S ribosomal gene analysis. The effectiveness of the endophytic bacterium was affirmed through cell confrontation assays and scanning electron microscopy. In cell confrontation assay, the isolate inhibited all the three C. gloeosporioides isolates used in the study with more than 80% inhibition. The effect of culture filtrate of the isolate was also tested against pathogens that were compliant with the outcome of dual culture technique. The culture and culture filtrate could effectively restrain the spreading of C. gloeosporioides in greater yam leaf. The isolate could completely inhibit the growth of the pathogen through an antibiosis study, and the same could be explained through scanning electron microscopy results, in which the endophyte-treated C. gloeosporioides hyphae appeared longer and distorted compared to control and conidia possess disfigurement in endophyte-treated sample when compared to control.

Conclusions

The study showed that Bacillus licheniformis (CTCRI EB12), the endophytic bacterium that has the capacity to enhance the protection of greater yam plants, could be further developed as a microbial pesticide to reduce the effect of anthracnose in greater yam fields. Additional investigation will reveal the endophytic isolate's antifungal capabilities and assessment of their performance in the open field. The present study depicted that it might be a potent biological control agent against C. gloeosporioides causing greater yam anthracnose.
Synthetic cannabinoids impact on cognitive functions
Authors: Elrassas Hanan Hany , Elsayed Yasser Abdel Razek , Abdeen Mai SeifElDin , Mohamed Aya Taha , El Nagar Zeinab Mohamed
Published: November 2023

Background

Synthetic cannabinoids SC are now becoming progressively popular among young people worldwide; little is known about their negative effects. Anger, anxiety, hallucinations, and perceptual changes were the most common psychoactive findings. Substance abuse causes cognitive impairment (CI). This study’s goal is to raise public awareness about the dangers that synthetic cannabinoid intoxication poses to public health. As well as the magnitude of CI in synthetic cannabinoids in comparison with healthy controls. The study included 30 synthetic cannabinoids SC addicts and 30 healthy people. The Wechsler memory scale (WMS), the Benton visual retention test (BVRT), and Trail Making Test (TMT) A and B were used to assess cognitive functions. Addiction Severity Index (ASI), Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I), and Structured Clinical Interview for DSM-IV Axis II Disorder (SCID II).

Results

Using BVRT, (96.7%) of the SC use disorder cases had more impaired performance than controls (0%) (P < 0.001). Almost three quarters of the cases had impaired performance on the trail making tests A and B compared to none of the controls (P < 0.001). Similarly, there was a high statistically significant difference between SC use disorder cases and controls in all domains of the WMS. There was no statistically significant correlation between the cognitive scales (BVRT, WMS and TMT) results in relation to age of SC use patients or duration of use.

Conclusions

Patients who used synthetic cannabinoids SC were more likely than controls to develop CI, which manifested as impaired visual, auditory, immediate, delayed, and working memory.