bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in Trampoline-Related Knee Injuries Between Children and Adults: A Cross-Sectional Study
Authors: Husen Martin , Engrav Samantha K. , Saul Dominik , Stuart Michael J. , Milbrandt Todd A. , Levy Bruce A. , Krych Aaron J. , Saris Daniël B.F.
Published: November 2023

Background:

Little is known about the specific risk of knee injuries due to trampoline accidents in adults compared with children.

Purpose:

To investigate the differences in trampoline-related knee injuries between children and adults and identify risk factors and protective strategies to reduce injury incidence.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Data on 229 consecutive patients treated for trampoline-related knee injuries in a single institution were prospectively collected, analyzed, and included. Risk factors, injury patterns, and clinical treatments were compared between skeletally immature and skeletally mature patients. Logistic regression was used to determine the odds ratios for specific risk factors for trampoline-related injuries—including body mass index (BMI), trauma mechanism, patient age, and accident location.

Results:

A total of 229 patients met the inclusion criteria; 118 (52%) patients (women, 54.2%; mean age, 8.5 ± 4.1 years) were skeletally immature at the time of injury, and 111 (48%) patients (women, 72%; mean age, 31.9 ± 13.1 years) had closed physes on initial presentation and were classified as skeletally mature. A total of 63 patients (28%) required surgical treatment for their knee injury. Overall, 50 anterior cruciate ligament (ACL) tears, 46 fractures, 39 meniscal tears, 31 ligamentous tears other than ACL, 22 patellar dislocations, and 38 soft tissue injuries, such as lacerations, were recorded. Skeletally mature patients had 7.8 times higher odds (95% CI, 1.6-46.8; P < .05) and 19.1 increased odds (95% CI, 5.5-74.9; P < .05) of an ACL tear or another ligamentous tear, respectively, compared with skeletally immature patients. Patients who described instability and giving way of the knee as relevant trauma mechanisms had odds of 3.11 (95% CI, 0.9-14.8; P < .05) of an ACL tear compared with other trauma mechanisms. Meniscal tears were observed more frequently in the skeletally mature cohort ( P < .05). An elevated BMI was associated with a significantly higher relative risk of an ACL tear, a ligamentous tear other than the ACL, and an injury requiring surgery. A third of surgically treated patients were subject to a delayed diagnosis.

Conclusion:

Adults had a significantly increased risk of ligamentous and meniscal tears and required operative intervention more often than skeletally immature individuals. Elevated BMI, age, and instability events in terms of trauma mechanism conveyed an increased risk of structural damage to the knee.
Competencies Needed by Business Professionals in the AI Age: Character and Communication Lead the Way
Authors: Cardon Peter , Fleischmann Carolin , Logemann Minna , Heidewald Jeanette , Aritz Jolanta , Swartz Stephanie
Published: November 2023

Many experts project generative AI will impact the types of competencies that are valued among working professionals. This is the first known academic study to explore the views of business practitioners about the impacts of generative AI on skill sets. This survey of 692 business practitioners showed that business practitioners widely use generative AI, with the most common uses involving research and ideation, drafting of business messages and reports, and summarizing and revising text. Business practitioners report that character-based traits such as integrity and soft skills will become more important. Implications for teaching business communication are discussed.
Breath–Body–Mind Core Techniques to Manage Medical Student Stress
Authors: Gerbarg Patricia L , Cruz-Cordero Yaidy L , Conte Vincent A , García Martha E , Braña Angel , Estape Estela S , Brown Richard P
Published: November 2023

Objectives

This pilot study evaluated the feasibility of a live, interactive, synchronous, online, manualized intervention, Breath–Body–Mind Introductory Course (BBM-IC), for medical students. BBM-IC includes breathing, movement, and attention-focus techniques for stress management and better emotion regulation, energy, sleep, and mental focus.

Methods

Medical students attending a 2-h BBM demonstration were invited to participate in the 12-h BBM-IC and weekly 45-min 6-week group practice. Measures were obtained using Survey Monkey: patient health questionnaire (PHQ9), generalized anxiety disorder-7 (GAD-7), exercise-induced feeling inventory (EFI), sleep quality scale (SQS), and body perception questionnaire-short form (BPQ-SF) at pre-BBM-IC (T1), post-BBM-IC (T2), and 6 weeks post (T3). Perceived stress scale (PSS) and meditation practices questionnaire (MPQ) were measured at baseline (T1) only.

Results

Twelve medical students participated in BBM-IC 4-h daily for 3 days. Six attended practice sessions and completed 6-week post-tests. Mean scores comparison identified two variable sets with significant improvements: EFI tranquility ( p < .005) and supradiaphragmatic reactivity ( p < .040). Two measures reached near significance: SQS ( p ≤ .060) and PHQ9 ( p ≤ .078).

Conclusion

This pilot study provided preliminary evidence that BBM-IC may reduce stress and anxiety symptoms while improving mood, energy, mental focus, and other correlates of psychophysiological state in medical students. Taking time for self-care is challenging for medical students, as reflected in the small study enrollment. Designating time for BBM as a requirement within the medical curriculum would probably enable more students to participate and acquire skills to reduce the effects of stress on their physical and psychological health, as well as the health of their patients.
Depressed and Ostracized: Scrutinizing the Condition of Dalit Women in India and Their Fight for Justice Against Barbarism
Authors: Sarkar Swagata
Published: November 2023

Dalit women bear the heaviest burden of discrimination since they are the focus of the repressive social tiers. This is an attempt to highlight the situation of these marginalized groups using many factors that sociologists frequently use to assess the status of a class. Although depressed women’s literacy rates have grown from 41.9% in 2001 to 56.5% in 2011, there is still a long way to go before they reach the general category’s literacy rate of 64.6%. As a result, Dalit women continue to live in appalling circumstances. Regardless of the unfair terms and circumstances of employment, they are forced to work in poverty that compels them to toil irrespective of the unjust terms and conditions of employment. Even among the depressed castes, the men get precedence over any job. Discrimination and oppression are the most common words that can be used to describe the position of Dalit women. Weak physique and unhealthy living condition are other issues which, contributes to their misery, making them vulnerable to the competitive world. The words ‘violence’, ‘suffering’ and ‘agony’ seem synonymous with these women. Atrocities against Dalit women are only emphasized by caste standards. Hence, much awaits to be done to guarantee justice based on gender and ensure equality in all instances. They are true ‘The Depressed and Ostracized’.
Representation in Higher Education: Diversity, Evenness and Inequality among Communities of Scheduled Castes of Selected States in India
Authors: Sivanandan Vini , Shivnekar Vandana
Published: November 2023

The present research attempts to understand the fair representation of communities in scheduled castes (SCs) with educational achievement graduates and above in selected states of India. Diversity, Evenness and Inequality are examined by applying the indices Shannon-Weinner diversity, Buzas and Gibson evenness, and Theil inequality. We analysed census 2011 data comprising all graduates in the age group 20–24 years of age. Analysis of the Shannon diversity index affirms that not all the communities of SCs are equitably represented with education level graduation and above. The study illustrates that only a few communities with huge populations have education level attainment of graduates and above. Whereas the communities with smaller populations are underrepresented, and in some communities, the representation is nil. This corroborates the importance of identifying communities that are still underrepresented even after implementing affirmative action. The Shannon-winner index assessment indicates that the level of diversification across the communities within SCs of selected states does not differ. Further comparison of the quintessential value of and the perfect value of diversification by community’s attainment in education level graduates and above reveals discrepancy and was the highest in the state of Tamil Nadu, with a differing value of 2.5, and the least in the state of Punjab, with a value of 1.6. The first step of the investigation identified the least diversification, lack of evenness, and inequalities between the communities of SCs by representation in education level graduate and above in the selected states of India. Hence, prioritizing rarely represented communities needs immediate attention.
Lessons Learned From a Community–University Partnership to Increase HIV Testing Services for Emerging Adults at a Minority-Serving Institution
Authors: Fernandez Sofia B. , Clarke Rachel D. , Langwerden Robbert J. , Perez Katherine R. , Howard Melissa , Hospital Michelle M. , Morris Staci Leon , Wagner Eric F.
Published: November 2023

The success and advancement of HIV prevention efforts with emerging adults from minority communities requires continued and diligent collaboration between researchers, community members, and community-based organizations. This paper provides an overview of a 3-year collaboration between a Minority Serving Institution of Higher Education, and a grassroots, minority servicing HIV prevention agency. In South Florida, a geographic area with high incidence of HIV, we relied on community-based participatory research (CBPR) to guide the implementation of culturally, linguistically, and developmentally appropriate HIV prevention programming for 18 to 24-year-old Latinx university students. The project partnership was organized around: (a) integrating community knowledge through formative research to understand needs and determine relevant risk factors, (b) building a highly collaborative relationship between a large academic institution and community-based service provider, and (c) designing and implementing ongoing, strategic environmental prevention activities through community-involved research. We describe the collaborative partnership and multiple prevention strategies that were implemented. The success of the community–university partnership was highly dependent on the depth and breadth of collaboration, mutual support, and respect among collaborators. To advance sexual health promotion programs designed for Latinx emerging adults, we describe lessons learned for future CBPR implementation that focus on involving members of priority populations in research teams, aligning project voices, navigating internal governmental systems, creating mutual and direct benefits of partnership, and utilizing networks to enhance sustainability.
The Use of Doppler to Assess Hemodynamic Alterations in Maternal Common Femoral Veins in Uncomplicated Pregnancies: A Cohort Study
Authors: Yasin Erah , Mehmood Ifra , Fatima Zareen , Liaqat Mahjabeen , Butt Sabar , Haider Zeshan
Published: November 2023

Objective:

Pregnancy can induce the slowing of blood flow in the lower extremity veins and associated complications such as varicose veins. The objective of this study was to report the hemodynamic alterations in uncomplicated pregnancies during second and third trimesters using spectral Doppler. The specific aim was to compare the venous diameter and mean flow velocities of maternal common femoral veins (CFVs) during second and third trimesters of pregnancy. This was designed to assess the extent of pregnancy-induced hemodynamic changes as well as to establish a normative range of these values.

Materials and Methods:

This cohort study was conducted with 230 women during second and third trimesters of pregnancy. Grayscale sonography and spectral Doppler were used to record the diameter and mean flow velocity of maternal CFVs bilaterally. An independent sample t test was performed for the comparison of these between women with second and third trimesters of pregnancy. Statistical significance was set a P ≤ .05, a priori.

Results:

There was significant dilatation and a corresponding decrease in mean blood flow velocities in the CFVs in the participants in their third trimester compared with the second trimester of pregnancy.

Conclusion:

In this large cohort of participants, the CFV demonstrated statistically significant distension and slowing of blood flow with the advancement of their pregnancies.
Long-term safety and efficacy of elexacaftor/tezacaftor/ivacaftor in people with cystic fibrosis and at least oneF508delallele: 144-week interim results from a 192-week open-label extension study
Authors: Daines Cori L. , Tullis Elizabeth , Costa Stefano , Linnemann Rachel W. , Mall Marcus A. , McKone Edward F. , Polineni Deepika , Quon Bradley S. , Ringshausen Felix C. , Rowe Steven M. , Selvadurai Hiran , Taylor-Cousar Jennifer L. , Withers Nicholas J. , Ahluwalia Neil , Moskowitz Samuel M. , Prieto-Centurion Valentin , Tan Yaoyuan Vincent , Tian Simon , Weinstock Tanya , Xuan Fengjuan , Zhang Yaohua , Ramsey Bonnie , Griese Matthias
Published: November 2023

Background

In two pivotal phase 3 trials, up to 24 weeks of treatment with elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) was efficacious and safe in patients with cystic fibrosis (CF) ≥12 years of age who have at least oneF508delallele. The aim of this study is to assess long-term safety and efficacy of ELX/TEZ/IVA in these patients.

Methods

In this phase 3, open-label, single-arm extension study, participants withF508del–minimal function (from a 24-week parent study; n=399) orF508del–F508del(from a 4-week parent study; n=107) genotypes receive ELX/TEZ/IVA at the same dose (ELX 200 mg once daily, TEZ 100 mg once daily and IVA 150 mg every 12 h). The primary end-point is safety and tolerability. A prespecified interim analysis was conducted when the last participant reached the Week 144 visit.

Results

At the Week 144 interim analysis, mean duration of exposure to ELX/TEZ/IVA in the extension study was 151.1 weeks. Exposure-adjusted rates of adverse events (AEs) (586.6 events per 100 participant-years) and serious AEs (22.4 events per 100 participant-years) were lower than in the ELX/TEZ/IVA treatment group in the 24-week parent study (1096.0 and 36.9 events per 100 participant-years, respectively); most participants had AEs classified as mild (16.4% of participants) or moderate (60.3% of participants) in severity. 14 participants (2.8%) had AEs that led to treatment discontinuation. Following initiation of ELX/TEZ/IVA, participants had increases in forced expiratory volume in 1 s (FEV1) percentage predicted, Cystic Fibrosis Questionnaire-Revised respiratory domain score and body mass index, and had decreases in sweat chloride concentration and pulmonary exacerbation rates that were maintained over the interim analysis period. The mean annualised rate of change in FEV1% pred was +0.07 (95% CI −0.12–0.26) percentage points among the participants.

Conclusions

ELX/TEZ/IVA was generally safe and well tolerated, with a safety profile consistent with the 24-week parent study. Participants had sustained improvements in lung function, respiratory symptoms, CF transmembrane conductance regulator function, pulmonary exacerbation rates and nutritional status. These results support the favourable safety profile and durable, disease-modifying clinical benefits of ELX/TEZ/IVA.
Management of tracheobronchial amyloidosis: a review of the literature
Authors: Smesseim Illaa , Cobussen Paul , Thakrar Ricky , Daniels Hans
Published: November 2023

Introduction

Tracheobronchial amyloidosis is a rare idiopathic disorder characterised by extracellular deposition of misfolded protein fibrils in the tracheobronchial tree. It presents with nonspecific symptoms. Deciding on the best treatment approach can be challenging due to the lack of a treatment guideline. We undertook a review to assess the therapeutic options for tracheobronchial amyloidosis and to highlight gaps within the existing evidence.

Methods

We performed a literature search from 1 January 1990 until 1 March 2022 to identify relevant literature regarding patient characteristics, symptoms, management and prognosis for patients with tracheobronchial amyloidosis.

Results

77 studies consisting of 300 patients were included. We found a great heterogeneity in the management of tracheobronchial amyloidosis patients. Although a fifth of the reported patients were managed with a wait-and-see approach, many different treatments were used as a single intervention, or multiple treatments were combined. An interesting finding is the slightly higher percentage of patients with Sjögren syndrome (n=5, 1.7%) and tracheobronchial amyloidosis compared to the normal population (0.5–1.0%).

Conclusions

There is a great heterogeneity in the management of tracheobronchial amyloidosis patients. The treatment is still based on expert opinion due to the lack of a treatment guideline. Various treatment approaches include a wait-and-see approach, external beam radiotherapy, therapeutic bronchoscopy, immunosuppressive treatment and surgery.
Clinical effects of different center of rotation reconstructions in total hip arthroplasty after femoral neck fractures: a cohort study including a follow-up analysis on patient’s mobility and daily living ability
Authors: Nieschk Christopher , Abelmann-Brockmann Johanna , Lisitano Leonard , Fenwick Annabel , Röttinger Heinz , Ecker Michael , Mayr Edgar , Röttinger Timon
Published: November 2023

Background

The aim of this study is a clinical evaluation of the center of rotation (COR) placement towards a patient’s recovery with respect to daily living ability and mobility. In past experiments based on three-dimensional (3D) models, medialization of the COR in total hip arthroplasty (THA) showed a negative influence on muscle strength of the abductors and reaction force of the hip joint. This contradicts paradigms, where reduced hip loading forces are claimed to increase functional outcomes.

Methods

The plain X-rays of 110 patients who underwent THA after a femoral neck fracture between January 2019 and January 2021 were retrospectively evaluated. A Barthel Index on discharge was obtained in 69 cases. 47 patients were available for a follow-up interview concerning the Barthel Index, Parker mobility score (PMS), and pain levels (NRS) 6 and 12 months after surgery.

Results

Medialization of the COR had a significantly negative effect on the need for care (Barthel Index) at patient discharge (Spearman correlation 0.357, p = 0.013). The effect on the PMS is still existent at 6 and 12 months (Spearman correlation 0.471, p = 0.009 at 6 months; 0.472, p = 0.008 at 12 months). Mann–Whitney U tests showed that the groups with medialized COR performed significantly worse than the lateralized groups. This was seen for the Barthel Index at discharge and at 6 months after surgery and for the PMS at 6 and 12 months. The accurately reconstructed CORs showed no significant differences from the lateralized rotation centers in need of care and mobility.

The superior COR placement group showed significantly reduced mobility at 12 months in contrast to the inferior COR placement group (p = 0.008), and the group of accurately reconstructed rotation centers showed significantly less pain than the inferior COR placement group (p = 0.007 after 6 months, p = 0.026 after 12 months). Especially the combination of both (superomedialization) leads to reduced mobility (Spearman correlation 0.67, p =  < 0.001).

Conclusions

COR superior displacement, COR medialization, and the combination of both (superomedialization, Spearman p =  < 0.001) lead to reduced mobility while inferior displacement showed increased pain. According to our results, we recommend an exact vertical COR restoration, while horizontal medial displacement needs to be avoided.

Level of evidence

III.
Regulation of hormone pathways in wheat infested by Blumeria graminis f. sp. tritici
Authors: Bai Shuangyu , Long Jiaohui , Cui Yuanyuan , Wang Zhaoyi , Liu Caixia , Liu Fenglou , Wang Zhangjun , Li Qingfeng
Published: November 2023

Background

Wheat powdery mildew is an obligate biotrophic pathogen infecting wheat, which can pose a serious threat to wheat production. In this study, transcriptome sequencing was carried out on wheat leaves infected byBlumeria graminisf. sp.triticifrom 0 h to 7 d.

Results

KEGG and GO enrichment analysis revealed that the upstream biosynthetic pathways and downstream signal transduction pathways of salicylic acid, jasmonic acid, and ethylene were highly enriched at all infection periods. Trend analysis showed that the expressions of hormone-related genes were significantly expressed from 1 to 4 d, suggesting that 1 d-4 d is the main period in which hormones play a defensive role. During this period of time, the salicylic acid pathway was up-regulated, while the jasmonic acid and ethylene pathways were suppressed. Meanwhile, four key modules and 11 hub genes were identified, most of which were hormone related.

Conclusion

This study improves the understanding of the dynamical responses of wheat toBlumeria graminisf. sp.triticiinfestation at the transcriptional level and provides a reference for screening core genes regulated by hormones.
Prevalence, patterns and associated risk factors for dyslipidaemia among individuals attending the diabetes clinic at a tertiary hospital in Central Malawi
Authors: Filisa-Kaphamtengo Florence , Ngoma Jonathan , Mukhula Victoria , Matemvu Zaithwa , Kapute Deborah , Banda Peter , Phiri Tamara , Mipando Mwapatsa , Hosseinipour Mina C. , Katundu Kondwani G. H.
Published: November 2023

Background

Dyslipidaemia among individuals with diabetes is a significant modifiable risk factor for atherosclerotic cardiovascular diseases (ASCVDs). ASCVDs are a major cause of mortality and morbidity globally, especially in people with diabetes. In Malawi, limited data exist on the prevalence and biochemical characteristics of diabetic dyslipidaemia. This study investigated the prevalence and biochemical characteristics of dyslipidaemia in individuals attending the diabetes clinic at Kamuzu Central Hospital, the largest tertiary referral hospital in Central Malawi.

Methods

Using a cross-sectional design, sociodemographic, medical and anthropometric data were collected from 391 adult participants who were enrolled in the study. Blood samples were analysed for glycosylated haemoglobin (HBA1c) and fasting lipid profiles. The prevalence of dyslipidaemia was calculated, and the biochemical characteristics of the dyslipidaemia were defined. The associations between dyslipidaemia and risk factors such as sociodemographic characteristics, obesity, and HBA1c levels were evaluated using logistic regression analysis.

Results

Prevalence of dyslipidaemia was observed in 71% of the participants, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality among the study participants. None of the participants were receiving any lipid-lowering therapy. On bivariate analysis, dyslipidemia was positively associated with female sex [OR 1.65 (95% CI 1.05- 2.58); p = 0.09], age ≥ 30 years [OR 3.60 (95% CI 1.17-7.68); p = 0.001] and overweight and obesity [OR 2.11 (95% CI 1.33-3.34); p = 0.002]. On multivariate analysis, being overweight or obese was an independent predictor of dyslipidaemia [AOR 1.8;(95% CI 1.15- 3.37); p = 0.04].

Conclusion

Dyslipidaemia was highly prevalent among individuals with diabetes in this study, and elevated low-density lipoprotein cholesterol was the most frequent lipid abnormality. Overweight and obesity were also highly prevalent and positively predicted dyslipidaemia. This study highlights the importance of appropriately addressing dyslipidaemia, overweight and obesity among individuals with diabetes in Malawi and other similar settings in Africa as one of the significant ways of reducing the risk of ASCVDs among this population.
Leptospirosis-associated meningitis in a patient with sjögren’s syndrome: a case report
Authors: Zhang Yifan , Zheng Yong
Published: November 2023

Background

Leptospirosis is a zoonotic disease that afflicts both humans and animals. It progresses from flu-like symptoms to more severe hepatic and renal failure, and may also lead to aseptic meningitis. Individuals with autoimmune diseases (ADs) are potentially more susceptible to Leptospirosis. Thus far, limited data has documented the association between Leptospirosis and autoimmune disorders.

Case presentation

The patient had a definitive pathological diagnosis of Sjögren’s syndrome (SS). Due to recurrent headaches, the patient sought consultation with a neurologist. Lumbar puncture revealed elevated white blood cells and protein levels in the cerebrospinal fluid, along with decreased glucose. Tuberculous meningitis was suspected. Radiographic imaging exhibited meningeal enhancement, ventricular enlargement, and hydrocephalus. The patient commenced treatment with anti-tuberculosis therapy and corticosteroids. Subsequently, high-throughput sequencing (HTS) of cerebrospinal fluid identified the presence of Leptospira interrogans. The patient was ultimately diagnosed with Leptospiral meningitis, and underwent antimicrobial and immunosuppressive therapy, resulting in stabilization of the condition and gradual symptom recovery.

Conclusions

The case highlights the challenges in diagnosing and managing leptospirosis-related meningitis in the presence of ADs and emphasizes the importance of utilizing HTS for accurate pathogen detection. The potential correlation between leptospirosis and SS warrants further investigation, as does the need for multidisciplinary involvement in treatment strategies for such complex cases.
A phase I study of the combination of atezolizumab, tiragolumab, and stereotactic body radiation therapy in patients with metastatic multiorgan cancer
Authors: Roussot Nicolas , Fumet Jean-David , Limagne Emeric , Thibaudin Marion , Hervieu Alice , Hennequin Audrey , Zanetta Sylvie , Dalens Lorraine , Fourrier Théo , Galland Loick , Jacob Pierre , Bertaut Aurélie , Rederstorff Emilie , Chevalier Cédric , Ghirardi Sarah , Gilbert Elodie , Khoukaz Azzat , Martin Etienne , Nicolet Constance , Quivrin Magali , Thibouw David , Vulquin Noémie , Truc Gilles , Rouffiac Magali , Ghiringhelli Francois , Mirjolet Céline
Published: November 2023

Background

Immunotherapy targeting the PD-1/PD-L1 pathway is a standard of care in a number of metastatic malignancies, but less than a fifth of patients are expected to respond to ICIs (Immune Checkpoint Inhibitors). In a clinical trial, combining the anti-TIGIT (T cell immunoreceptor with Ig and ITIM domains) Mab (monoclonal antibody) tiragolumab with atezolizumab improved outcomes in non-small cell lung cancer. In preclinical models, SBRT (Stereotactic Body Radiation Therapy) could increase expression levels of the inhibitory co-receptors TIGIT and PD-L1. We aim to assess the combination of tiragolumab with atezolizumab and SBRT in metastatic, previously treated by ICIs, non-small cell lung cancer, head and neck cancer, bladder cancer, and renal cell cancer.

Methods

This phase I study (ClinicalTrials.gov NCT05259319) will assess the efficacy and safety of the combination of atezolizumab with tiragolumab and stereotactic body radiation therapy in patients with histologically proven metastatic non-small cell lung cancer, renal cell cancer, bladder cancer, and head and neck cancer previously treated. First part: 2 different schedules of SBRT in association with a fixed dose of atezolizumab and tiragolumab will be investigated only with metastatic non-small cell lung cancer patients (cohort 1). The expansion cohorts phase will be a multicentric, open-label study at the recommended scheme of administration and enroll additional patients with metastatic bladder cancer, renal cell cancer, and head and neck cancer (cohort 2, 3 and 4). Patients will be treated until disease progression, unacceptable toxicity, intercurrent conditions that preclude continuation of treatment, or patient refusal in the absence of progression or intolerance. The primary endpoint of the first phase is the safety of the combination in a sequential or concomitant scheme and to determine the expansion cohorts phase recommended scheme of administration. The primary endpoint of phase II is to evaluate the efficacy of tiragolumab + atezolizumab + SBRT in terms of 6-month PFS (Progression-Free Survival). Ancillary analyses will be performed with peripheral and intratumoral immune biomarker assessments.

Trial registration

This study is registered on ClinicalTrials.gov: NCT05259319, since February 28th, 2022.
School-based high-intensity interval exercise program in children with overweight induce a greater improvements in body composition and physical fitness than moderate-intensity continuous exercise
Authors: Zuo Chongwen , Ma Xiaoyan , Yang Yuan , Cui Yupeng , Ye Chaoqun
Published: November 2023

Background

High-intensity interval running exercise (HIIE) is emerging as a time-efficient exercise modality for improving body composition and fitness in comparison with moderate-intensity continuous aerobic exercise (MICE); however, existing evidence is still unclear in children with overweight and thus we compared the effects of HIIE and MICE on body composition, muscular, and cardiorespiratory fitness in children with overweight.

Methods

In this randomized study, 40 male children with overweight aged 7–10 years were divided into an 8-week exercise regime: (1) HIIE group [n = 20; 2 sets of 15 × 20s at 85–95% maximal aerobic speed (MAS) separated by 15 × 20s recovery at 50% MAS, 3 days per week] and (2) MICE group [n = 20; 30 min at 60–70% MAS, 3 days per week]. Body composition, muscular and cardiorespiratory fitness were assessed before and after the 8-week intervention at similar times and conditions of the day.

Results

Following the 8-week HIIE protocol, weight, BMI, and fat mass decreased significantly (weight: − 1.4% vs. 0.2%, p < 0.05; BMI: − 3.1% vs. − 0.7%, p < 0.05; fat mass: − 7.7% vs. − 1.6%, p < 0.01) as compared with MICE; while the VO2peak and MAS increased significantly in both groups, the increase in HIIE group was significantly greater than that of MICE group (VO2peak: 10.3% vs. 3.5%, p < 0.01; MAS:7.7% vs. 4.5%, p < 0.05). Although significant improvements in muscular fitness were observed in HIIE and MICE groups [counter movement jump (CMJ): 7.8% vs. 5.4%; sprinting ability: − 3.7% vs. − 1.7%], no significant differences were seen between them (p > 0.05).

Conclusion

Our findings suggested that school-based HIIE intervention was highly in improving body composition and cardiorespiratory fitness of children with overweight than the MICE regime; however, MICE still provided improvements over time that were just not to the same magnitude of HIIE.
Anti-malarial and haematological evaluation of the ethanolic, ethyl acetate and aqueous fractions of Chromolaena odorata
Authors: Elebiyo Tobiloba Christiana , Oluba Olarewaju Michael , Adeyemi Oluyomi Stephen
Published: November 2023

Malaria is a global health challenge with endemicity in sub-Saharan Africa, where there are multiple drug-resistant strains and limited access to modern health care facilities, especially in rural areas. Studies indicate that African traditional medicine could make a substantial contribution to the reduction of malaria-related deaths and achievement of universal health coverage (UHC), particularly in these regions. Thus, this study evaluated the curative antimalarial effects of Chromolaena odorata leaf extract using mouse model. Forty-five (45) albino mice weighing between 18 and 22 g were grouped into nine groups of 5 animals each. Animals in groups 2–9 were infected with the chloroquine-resistant strain of Plasmodium berghei, while animals in groups 3–9 were subsequently treated with 10 mg/kg chloroquine, a combination of 1.4 mg/kg artemether and 8.75 mg/kg lumefantrine (Coartem), and varying concentrations of the fraction from the aqueous leaf extract of C. odorata at day 3 post-infection. The findings from this study indicate that treatment with 400 mg/kg of the ethanolic fraction of the crude extract resulted in a significant decrease in parasite load (97.6%), which was comparable to the activities of the conventional drugs chloroquine (98.6%) and Coartem (98.8%). The ethyl acetate and ethanolic fractions at 400 mg/kg also ameliorated the significant alterations in the red blood cells, white blood cells, and platelets of the infected animals. The high antimalarial activity displayed by the ethanolic fraction could be due to the presence of quercetin and kaempferol, as detected by high performance liquid chromatography (HPLC) analysis. The findings suggest that the fractions from C. odorata could serve as an alternative source of malaria therapy, particularly in sub-Saharan Africa.
Associations between demographics and clinical ideology, beliefs, and practice patterns: a secondary analysis of a survey of randomly sampled United States chiropractors
Authors: Cupler Zachary A. , Gliedt Jordan A. , Perle Stephen M. , Puhl Aaron A. , Schneider Michael J.
Published: November 2023

Background

The chiropractic profession in the United States (US) has a long history of intra-professional discourse surrounding ideology and beliefs. Large-scale efforts have evaluated 3 distinctive subgroups of US chiropractors focused on these areas of practice: spine/neuromusculoskeletal, primary care, and vertebral subluxation. To our knowledge, there have not been any prior studies exploring the factors associated with these ideology and belief characteristics of these subgroups. The purpose of this study was to explore, describe, and characterize the association of US chiropractors’ ideology, beliefs, and practice patterns with: 1) chiropractic degree program of graduation, 2) years since completion of chiropractic degree, and 3) US geographic region of primary practice.

Methods

This was a secondary analysis of a cross-sectional survey of a random sample of US licensed chiropractors (n = 8975). A 10% random sample was extracted from each of the 50 states and District of Columbia chiropractic regulatory board lists. The survey was conducted between March 2018-January 2020. The survey instrument consisted of 7 items that were developed to elicit these differentiating ideologies, beliefs, and practice patterns: 1) clinical examination/assessment, 2) health conditions treated, 3) role of chiropractors in the healthcare system, 4) the impact of chiropractic adjustments [spinal manipulation] in treating patients with cancer, 5) vaccination attitudes, 6) detection of subluxation on x-ray, and 7) x-ray utilization rates. Multinomial regression was used to analyze associations between these 7 ideology and practice characteristic items from the survey (dependent variables) and the 3 demographic items listed above (independent variables).

Results

Data from 3538 respondents (74.6% male) were collected with an overall response rate of 39.4%. Patterns of responses to the 7 survey items for ideologies, beliefs, and practice characteristics were significantly different based on chiropractic degree program of graduation, years since completion of chiropractic degree, and geographic region of primary practice.

Conclusions

Among US chiropractors, chiropractic program of graduation, years since completion of chiropractic degree, and geographic region of primary practice are associated with variations in clinical ideology, beliefs, and practice patterns. The wide variation and inconsistent beliefs of US chiropractors could result in public confusion and impede interprofessional integration.
LEARNHIV: development and validation of a mobile application for primary health care nurses focused on HIV care/prevention
Authors: de Assunção Gaia Melyane , Botelho Eliã Pinheiro , Ferreira Glenda Roberta Oliveira Naiff , Aben-Athar Cintia Yolette Urbano Pauxis , Parente Andressa Tavares , de Jesus Dias de Sousa Fabianne , dos Santos Marielna Silva , Pereira-Caldeira Natalia Maria Vieira , da Silva Richardson Augusto Rosendo , Ramos Aline Maria Pereira Cruz
Published: November 2023

Introduction

Human immunodeficiency virus (HIV) infection is a relevant public health problem is worldwide. From the change in the health care of people living with HIV (PLHIV) in Primary Health Care (PHC), nurses gained autonomy in their workflow, which requires a significant technological arsenal for the planning, organization and functioning of services. It is believed that the development of a mobile application for the care/prevention of HIV will contribute to the strengthening of care, resulting in greater autonomy and empowerment of nurses in Primary Health Care.

Objective

To develop and validate a content script for a mobile application for nurses in PHC containing information about PLHIV management/care in PHC.

Methods

This is a methodological study developed in three phases: exploratory study, content elaboration process and validation by the 16 judges.

Results

The application was evaluated and validated satisfactorily in terms of content and appearance, with an average Content Validity Index (CVI) of 0.99 (99%), Item Content Validity Index (I-CVI) and Medium Content Validity (S-IVC/AVE) also obtained satisfactory levels.

Conclusions

The construction of the prototype of an application called LearnHIV, is considered a valid instrument in terms of content and appearance, according to the judges.

Trial registration

None because it is not an intervention study.
Designing for community engagement: user-friendly refugee wellness center planning process and concept, a health design case study
Authors: Solomon Ellen , Joa Brandon , Coffman Shandon , Faircloth Billie , Altshuler Marc , Ku Bon
Published: November 2023

Background

Refugee and immigrant populations have diverse cultural factors that affect their access to health care and must be considered when building a new clinical space. Health design thinking can help a clinical team evaluate and consolidate these factors while maintaining close contact with architects, patients’ community leaders, and hospital or institutional leadership. A diverse group of clinicians, medical students, community leaders and architects planned a clinic devoted to refugee and immigrant health, a first-of-its-kind for South Philadelphia.

Methods

The planning process and concept design of this wellness center is presented as a design case study to demonstrate how principles and methods of human-centered design were used to create a community clinic. Design thinking begins with empathizing with the end users’ experiences before moving to ideation and prototyping of a solution. These steps were accomplished through focus groups, a design workshop, and iterations of the center’s plan.

Results

Focus groups were thematically analyzed and generated two themes of access and resources and seven subthemes that informed the design workshop. A final floor plan of the wellness center was selected, incorporating priorities of all stakeholders and addressing issues of disease prevention, social determinants of health, and lifestyle-related illness that were relevant to the patient population.

Conclusions

Design thinking methods are useful for health care organizations that must adapt to the needs of diverse stakeholders and especially populations that are underserved or displaced. While much has been written on the theory and stages of design thinking, this study is novel in describing this methodology from the beginning to the end of the process of planning a clinical space with input from the patient population. This study thus serves as a proof of concept of the application of design thinking in planning clinical spaces.
Engineered domain-inlaid Nme2Cas9 adenine base editors with increased on-target DNA editing and targeting scope
Authors: Zhao Ding , Gao Xun , Zhou Jiale , Li Jinze , Qian Yuqiang , Wang Di , Niu Wenchao , Zhang Tao , Hu Mingyang , Xiong Haoyang , Lai Liangxue , Li Zhanjun
Published: November 2023

Background

Nme2ABE8e has been constructed and characterized as a compact, accurate adenine base editor with a less restrictive dinucleotide protospacer-adjacent motif (PAM: N4CC) but low editing efficiency at challenging loci in human cells. Here, we engineered a subset of domain-inlaid Nme2Cas9 base editors to bring the deaminase domain closer to the nontarget strand to improve editing efficiency.

Results

Our results demonstrated that Nme2ABE8e-797 with adenine deaminase inserted between amino acids 797 and 798 has a significantly increased editing efficiency with a wide editing window ranging from 4 to 18 bases in mammalian cells, especially at the sites that were difficult to edit by Nme2ABE8e. In addition, by swapping the PAM-interacting domain of Nme2ABE8e-797 with that of SmuCas9 or introducing point mutations of eNme2-C in Nme2ABE8e-797, we created Nme2ABE8e-797Smu and Nme2ABE8e-797−C, respectively, which exhibited robust activities at a wide range of sites with N4CN PAMs in human cells. Moreover, the modified domain-inlaid Nme2ABE8e can efficiently restore or install disease-related loci in Neuro-2a cells and mice.

Conclusions

These novel Nme2ABE8es with increased on-target DNA editing and expanded PAM compatibility will expand the base editing toolset for efficient gene modification and therapeutic applications.
Tissue S100/calgranulin expression and blood neutrophil-to-lymphocyte ratio (NLR) in prostatic disorders in dogs
Authors: Weinekötter Jana , Gurtner Corinne , Protschka Martina , von Bomhard Wolf , Böttcher Denny , Alber Gottfried , Kiefer Ingmar , Steiner Joerg M. , Seeger Johannes , Heilmann Romy M.
Published: November 2023

Background

Prostatic carcinoma (PCA) is a rare but severe condition in dogs that is similar to the androgen-independent form of PCA in men. In contrast to humans, PCA is difficult to diagnose in dogs as reliable biomarkers, available for PCA screening in human medicine, are currently lacking in small animal oncology. Calprotectin (S100A8/A9) and S100A12 are Ca2+-binding proteins of the innate immune system with promising potential to distinguish malignant from benign urogenital tract conditions, similar to the blood neutrophil-to-lymphocyte-ratio (NLR). However, both have not yet been extensively investigated in dogs with PCA. Thus, this study aimed to evaluate the expression of the S100/calgranulins (calprotectin, S100A12, and their ratio [Cal-ratio]) in prostatic biopsies from nine dogs with PCA and compare them to those in dogs with benign prostatic lesions (eight dogs with prostatitis and ten dogs with benign prostatic hyperplasia [BPH]) as well as five healthy controls. In addition, blood NLRs were investigated in twelve dogs with PCA and 22 dogs with benign prostatic conditions.

Results

Tissue S100A8/A9+cell counts did not differ significantly between tissue from PCA and prostatitis cases (P = 0.0659) but were significantly higher in dogs with prostatitis than BPH (P = 0.0013) or controls (P = 0.0033). S100A12+cell counts were significantly lower in PCA tissues than in prostatitis tissue (P = 0.0458) but did not differ compared to BPH tissue (P = 0.6499) or tissue from controls (P = 0.0622). Cal-ratios did not differ significantly among the groups but were highest in prostatitis tissues and significantly higher in those dogs with poor prostatitis outcomes than in patients that were still alive at the end of the study (P = 0.0455). Blood NLR strongly correlated with prostatic tissue S100A8/A9+cell counts in dogs with PCA (ρ = 0.81,P = 0.0499) but did not differ among the disease groups of dogs.

Conclusions

This study suggests that the S100/calgranulins play a role in malignant (PCA) and benign (prostatic inflammation) prostatic conditions and supports previous results in lower urinary tract conditions in dogs. These molecules might be linked to the inflammatory environment with potential effects on the inflammasome. The blood NLR does not appear to aid in distinguishing prostatic conditions in dogs. Further investigation of the S100/calgranulin pathways and their role in modulation of tumor development, progression, and metastasis in PCA is warranted.
Association between insulin resistance and uncontrolled hypertension and arterial stiffness among US adults: a population-based study
Authors: Tan Liao , Liu Yubo , Liu Jie , Zhang Guogang , Liu Zhaoya , Shi Ruizheng
Published: November 2023

Background

Prior research has established the correlation between insulin resistance (IR) and hypertension. While the association between triglyceride-glucose (TyG) index, a reliable surrogate marker of IR, and uncontrolled hypertension as well as arterial stiffness among individuals with hypertension remains undisclosed.

Methods

In this study, a total of 8513 adults diagnosed with hypertension from the National Health and Nutrition Examination Survey 1999–2018 were included. The primary outcome of the study are arterial stiffness (represented with estimated pulse wave velocity, ePWV) and uncontrolled hypertension. Logistic regression model, subgroup analysis, restricted cubic spine, and smooth curve fitting curve were conducted to evaluate the association between the IR indicators and uncontrolled hypertension and arterial stiffness in individuals with hypertension.

Results

Among included participants, the overall prevalence of uncontrolled hypertension was 54.3%. After adjusting for all potential covariates, compared with the first quartile of TyG index, the risk of uncontrolled hypertension increased about 28% and 49% for participants in the third quartile (OR, 1.28; 95% CI 1.06–1.52) and the fourth quartile (OR, 1.49; 95% CI 1.21–1.89) of TyG index, respectively. The higher OR of TyG index was observed in participants taking antihypertensive medication [fourth quartile versus first quartile (OR, 2.03; 95% CI 1.37–3.11)]. Meanwhile, we explored the potential association between TyG index and arterial stiffness and found that TyG index was significantly associated with increased arterial stiffness (β for ePWV, 0.04; 95% CI 0.00–0.08; P = 0.039). However, traditional IR indicator HOMA-IR showed no significant positive correlation to uncontrolled hypertension as well as arterial stiffness in US adults with hypertension.

Conclusion

Elevated levels of the TyG index were positive associated with prevalence of uncontrolled hypertension and arterial stiffness among US adults with hypertension.