Browse Articles

Pembrolizumab in Early-Stage Triple-Negative Breast Cancer

Evaluation of the role of thyroid hormones, vitamin B12, vitamin D3, folic acid and ferritin serum levels in pterygium development

Author Correction: Single nucleotide polymorphisms are associated with strain-specific virulence differences among clinical isolates of Cryptococcus neoformans

Structured follow-up pathway to address unmet needs after transient ischaemic attack and minor stroke (SUPPORT TIA): Feasibility study and process evaluation

Background Care following transient ischaemic attack (TIA) and minor stroke is variable and often leaves patients feeling abandoned and uncertain. We developed a theoretically-informed, multifaceted intervention which comprised nurse-led, structured follow-up at 4 weeks after TIA/minor stroke to identify and address patient needs. This study evaluated the feasibility and acceptability of both the intervention and procedures to inform a future randomised controlled trial. Method We conducted a multicentre, randomised feasibility study with mixed-methods process evaluation (ISRCTN registry reference: ISRCTN39864003). We collected patient reported outcome measures (PROMs) at 1, 12 and 24 weeks and clinical data at baseline and 24 weeks. The process evaluation comprised qualitative interviews with a sub-sample, feedback questionnaires, and observations of intervention delivery. Results We recruited 54 patients over 12 months, achieving 90% of the target sample size (n = 60). PROMs return rates were 94.4% (51/54), 85.2% (46/54) and 71.1% (27/38) at 1, 12, and 24-weeks, respectively. Intervention fidelity was high and the intervention largely aligned with the theoretical underpinnings. The process evaluation illustrated how patients benefitted from the intervention through support they would not have received through usual care. This included direct referral or signposting to support services, information and education, actionable advice, and reassurance about and normalisation of recovery. The trial design was feasible and acceptable for both patients and clinicians. Conclusion Nurse-led, structured follow-up after TIA and minor stroke is feasible, acceptable and valued by patients and clinicians. Our intervention can identify and help address unmet needs. A definitive randomised trial to evaluate intervention effectiveness and cost-effectiveness is feasible and acceptable.

Linear IgA Bullous Dermatosis of Childhood

Study on the mechanical mechanism and control optimization of station subsurface excavation by pile-beam-arch method

A feedback circuitry involving γ-actin, β-actin and nonmuscle myosin-2 A controls tight junction and apical cortex mechanics

Pooled prevalence and associated factors of ECG abnormality among type 2 diabetic patients in the last ten years: Systematic review and meta-analysis

Background Type 2 diabetes mellitus is a global epidemic affecting millions of individuals worldwide. It is considered a chronic metabolic disorder of impaired glucose homeostasis, associated with various long-term complications and poor prognosis of cardiovascular performance. Therefore, this systematic review aimed to determine the pooled prevalence of ECG abnormality among type 2 diabetic patients both in the hospital setting and the general population based on the existing literature. Methods This systematic review has been conducted on the ECG abnormality of patients with Type 2 diabetes. Following the establishment of eligibility criteria, a literature search was conducted using three databases and two search engines. Included articles were then screened, critically appraised, and data extracted independently by two reviewers, and any disagreements were handled by the involvement of a third party. The quality of the included studies had been assessed using the New Castle Ottawa quality assessment scale tool. Pooled prevalence and sensitivity were determined by random effect analysis. Heterogeneity was assessed by Higgins’s I2, and its presence was alleviated by using sub-group analysis. Result Following the identification of 32, 785 studies, 33 publications were eligible for the review with a sample size of 31, 449. The pooled prevalence of ECG abnormality among Type 2 diabetic patients was 31% (95% CI: 25, 36%). It was 26% (95% CI: 1, 51%), and 31% (95% CI: 24, 37%) in the hospital and general/ community population, respectively. Body mass index (AOR =  5.90; 95%CI: 4.96, 7.03), duration of diabetic mellitus (AOR = 9.21; 95%CI: 9.12, 9.31), and being hypertensive (AOR = 5.17; 95%CI: 4.90, 5.46), were significantly associated factors with ECG abnormality among patients with Type 2 diabetic mellitus. Conclusion The pooled prevalence of ECG abnormality among Type 2 diabetic mellitus patients was high, while its magnitude was higher among patients attending hospital settings than in the community. Duration of diabetic mellitus, high body mass index and presence of hypertension were significant factors in this review. Moreover, we advise more longitudinal researches to determine the incidence of ECG abnormality among patients with diabetes considering time duration and sex differences. Ethical consideration Since our study was on the review of secondary data, ethical issues are not necessary

Advancing Transgender Health amid Rising Policy Threats

Weight loss dynamics after laparoscopic sleeve gastrectomy: a retrospective single center analysis with age and preoperative weight stratification

Flexible hippocampal representation of abstract boundaries supports memory-guided choice

Examining dose-response of an outdoor walk group program in the Getting Older Adults Outdoors (GO-OUT) trial

Objective The Getting Older Adults Outdoors (GO-OUT) randomized trial showed that a 10-week outdoor walk group (OWG) program was not superior to 10 weekly phone reminders in increasing physical and mental health; however, OWG attendance varied. This study examined whether dose-response relationships existed between OWG attendance and improvement in physical and mental health among older adults with mobility limitations. Methods We analyzed data from 76 OWG participants with pre- and post-intervention scores on at least one of seven measures of health outcomes (walking endurance, comfortable and fast walking speed, balance, lower extremity strength, walking self-efficacy, and emotional well-being). Participants were classified as attending 0–9, 10–15, and 16–20 OWG sessions based on attendance tertiles. We adjusted for participant sex and study site in regression analyses. Results Among the 76 participants, mean age was 74.9 ± 6.6 years and 72% were female. Compared to those attending 0–9 OWG sessions, participants attending 16–20 sessions exhibited a 56.3-meter greater improvement in walking endurance (95% CI: 17.3, 95.4, p = 0.005); 0.15-meter/second greater improvement in comfortable walking speed (95% CI: 0.01, 0.29, p = 0.034); and 0.18-meter/second greater improvement in fast walking speed (95% CI: 0.03, 0.34, p = 0.020). Higher attendance was associated with greater odds of improvement in comfortable walking speed (OR = 7.1; 95% CI: 1.1, 57.8, p = 0.047) and fast walking speed (OR = 10.1, 95% CI: 1.8, 72.0, p = 0.014). No significant dose-response relationships for the remaining outcomes were observed. Conclusions Higher attendance in a park-based, supervised, task-oriented and progressive OWG program is associated with greater improvement in walking endurance and walking speed among older adults with mobility limitations. Attendance likely impacted walking capacity and not balance, lower extremity strength, walking self-efficacy or emotional well-being due to task-specificity of training. This study highlights the importance of attendance when designing and implementing OWG programs to enhance walking endurance and speed among older adults.

A Smooth Transition

Pattern change of precipitation extremes in Svalbard

Abstract Besides global attention on extreme precipitation, a limited research has been done in the Arctic due to constraints of data availability. In this backdrop, we attempt to analyze extreme precipitation events at three Arctic stations (Bjørnøya, Ny-Ålesund, and Svalbard Lufthavn) in Svalbard using extreme value theory. The analysis revealed that these high-latitudinal Arctic stations were characterized by heavy-tailed distributions for the exceedances, suggesting a higher probability of the occurrence of extreme precipitation events. Ny-Ålesund and Bjørnøya have exhibited a significant increase in return values over the last three decades. Among the three stations, Ny-Ålesund displayed the strongest return values, especially in winter post-1994 when the atmospheric temperature was characterized by an enhanced positive trend. Significant seasonal variability in return values has also been observed; the fall in Ny-Ålesund was characterized by a low-intensity regime as indicated by the shape parameter. Ny-Ålesund precipitation had shifted from heavy-tailed distribution in pre-1994 to bounded tail distribution post-1994 during spring. Bjørnøya’s extremes are driven by cyclonic circulation, while southerly winds drive extremes in Ny-Ålesund and Svalbard Lufthavn. Even though, Svalbard Lufthavn, displayed regime changes, showed low variability, likely due to its position in a rain shadow region. This research highlights the nuanced responses of Arctic hydrology to warming, emphasizing the need for localized studies and active collaboration with policymakers to translate these insights into effective climate adaptation and mitigation strategies.

Selective regulation of corticostriatal synapses by astrocytic phagocytosis

Evaluating the protective effects of the Toll-like receptor (TLR) 21 ligand, CpG ODN, against necrotic enteritis in broiler chickens

Necrotic enteritis (NE), caused by Clostridium perfringens (C. perfringens), presents a challenge to the global broiler industry. Evidence suggests that Toll-like receptor (TLR) ligands can enhance the immune responses in chickens and protect them against infectious diseases. This study investigated the protective effects of TLR21 ligand class B CpG oligonucleotides (ODN) against NE in broiler chickens. On day 21 of age, chickens were injected with 50 or 100 μg CpG intramuscularly, and one group was injected with 50 μg CpG followed by a booster dose on day 22. Subsequently, birds were orally challenged with C. perfringens twice daily for three days, starting on day 22. On day 22, intestinal samples were collected for gene expression analysis. On day 25, all birds were euthanized, intestinal lesions were scored, and tissue samples were collected from the intestine for gene expression analysis, lymphocyte subset determination, and histomorphological analysis. Cecal contents were also collected for microbiome analysis. The results demonstrated that CpG pre-treatment, either at a single dose of 100 μg or two doses of 50 μg per bird, reduced lesion scores compared to the positive control. C. perfringens infection increased crypt depth in both the jejunum and ileum in the positive control group compared to both the CpG-treated group. At 22 days of age, CpG administration at doses of 100 μg per bird enhanced expression of TLR21, interleukin (IL)-2, CXCL8, IL-10, and interferon (IFN)-γ mRNA transcripts in both the jejunum and ileum. Additionally, at 25 days of age, the group pretreated with two doses of 50 μg of CpG per bird showed increased expression of all cytokines in both the jejunum and ileum compared to the control groups. The percentage of intestinal lymphocytes was not affected by CpG pre-treatment. However, CpG pretreatment at doses of 100 μg resulted in a higher abundance of the members of families Lactobacillaceae and Bacteroidaceae, which are crucial for maintaining gut health. In conclusion, our findings suggest that pretreatment of chickens with intramuscular administration of CpG may be effective in maintaining gut health during C. perfringens infection.

What I Wish I Had Done for a Grieving Father

Dual beam and dual circular polarized multiplexing reflectarray for Ku band satellite communication

Observation of quantum criticality of a four-dimensional phase transition

Abstract Understanding how a system’s behavior extrapolates beyond 3D is a fundamental question in physics, spanning topics from unification theories to critical phenomena. In statistical physics, fluctuations’ strength is highly sensitive to dimensionality, affecting phase transitions. In low dimensions, phase transitions are suppressed, while high-dimensional systems exhibit simpler mean-field behavior. In some cases, like the Anderson localization-delocalization transition in disordered media, criticality remains non-trivial even in dimensions larger than three, presenting challenges to existing frameworks. In this work, using a periodically-driven ultracold atomic gas to engineer disorder and synthetic dimensions, we experimentally observe a phase transition between localized and delocalized phases. The results display three key features of the 4D transition: 1) observables follow d=4 critical scale invariance, 2) critical exponents match numerical predictions for the 4D Anderson transition, and 3) they agree with Wegner’s relation in 4D. These findings provide a new avenue for exploring complex critical phenomena in higher dimensions.

Ecological footprints, global sustainability, and the roles of natural resources, financial development, and economic growth

The prevailing ecological deficit is devastating the ecosystem which is leading toward the unsustainability by endangering the livings on earth. The important drivers of this environment degradation are natural resources depletion, financial development and the economic growth which are investigated to test their impact on ecological footprints. The EKC hypothesis is evaluated to test the growth led environment pattern. This study incorporated twenty years (2002–2021) data of 146 countries and the group of countries are investigated into various quantiles, geographical regions and income wise groups formed by the World Bank. Keeping in view the heterogeneous data established through the Shapiro-Francia W test and graphical analysis, the panel quantile regression is used which is insensitive to heterogeneous data. Firstly, the impact of dependent variables is estimated on environment degradation using the 10th, 20th, 30th,40th, 50th, 60th, 70th, 80th, 90th and 99th quantiles. The results suggested that the natural resources depletion and financial development are deteriorating the ecological footprints, which varies from smaller in initial quantiles to large in later quantiles. NR in North America and FD in the Middle East & North Africa are severely deteriorating the environment quality. The economic growth is improving the ecology in East Asia and the Pacific. The negative impact of natural resources on environment degradation is found in all income groups albeit with varying intensities. The financial development in upper middle income and lower middle income groups is deteriorating the environment quality. The EKC hypothesis remained undetermined for the estimated quantiles and geographical regions whereas it is established in high income group only. The policy intervention is recommended to restrict the natural resources depletion and binding the credit facilities to invest in ecosystem friendly projects by curtailing the process of ecological deficit for global sustainability which may be initiated from the most environment degraded quantiles, geographical region and income group.