bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental study of internal solitary wave evolution beneath an ice keel model
Authors: Wang Guanjing , Du Hui , Fei Jianfang , Wang Shaodong , Xuan Pu , Guo Hailong , Xu Junnan , Gu Zhiyuan
Published: June 2024

Internal solitary waves (ISWs) propagating in polar seas are affected by the sea ice at upper boundary of seas and thus exhibit complex evolution characteristics. Herein, spatiotemporal changes in the wave element, flow field, and energy of ISWs beneath an ice keel model were investigated to examine the evolution of ISWs. For this purpose, laboratory experiments were conducted using dye-tracing labeling, conductivity probes, Schlieren technology, and particle image velocimetry. The results show that ice keel causes an increase in the thickness of the pycnocline and even the occurrence of breaking and internal surging of ISW. Additionally, the waveform becomes narrower or wider at different positions, and wave amplitude and speed decrease, with a maximum reduction 30%–40%. Furthermore, the ice keel strengthens the shear of the ISW-induced flow field, generating vortices and mixing. The energy of ISWs undergoes internal conversion majorly at the front slope of the ice keel, while energy dissipation occurs largely at the back slope, with dissipation rates as high as 60%.
Optimization of the position of TaOx:N-based barrier layer in TaOx RRAM devices
Authors: Ravindra Pramod , Liehr Maximilian , Mathkari Rajas , Beckmann Karsten , Tokranova Natalya , Cady Nathaniel
Published: June 2024

Resistive Random-Access Memory (RRAM) presents a transformative technology for diverse computing and artificial intelligence applications. However, variability in the high resistance state (HRS) has proved to be a challenge, impeding its widespread adoption. This study focuses on optimizing TaOx-based RRAMs by strategically placing a nitrogen-doped TaOx barrier-layer (BL) to mitigate variability in the HRS. Through comprehensive electrical characterization and measurements, we uncover the critical influence of BL positioning on HRS variability and identify the optimal location of the BL to achieve a 2x lowering of HRS variability as well as an expanded range of operating voltages. Incremental reset pulse amplitude measurements show that the TaOx:N maintains a low HRS variability even at higher operating voltages when the position of the BL is optimized. Our findings offer insights into stable and reliable RRAM operation, highlighting the potential of the proposed BL to enhance the functionality of TaOx-based RRAMs and elevate overall device performance.
Effects of grit on medical students’ wellbeing during clerkships: a longitudinal observational cohort study
Authors: Lin Yung Kai , Lin Chia-Der , Chen Der-Yuan , Lin Blossom Yen-Ju
Published: May 2024

Introduction

In medical education, the clerkship phase is a demanding period during which medical students learn to navigate the responsibilities of medical school and clinical medicine. Grit, a personal quality regarded as a non-cognitive trait, refers to perseverance and passion; specifically, it represents the ability to endure hardship and work industriously toward a goal. Most studies analysed grit as a single concept and few studies have investigated the effect of grit on the well-being of medical students through the whole-specialty training (i.e. surgical and non-surgical specialty rotations) required in clinical clerkships. Therefore, this study investigated whether associations exist between medical students’ grit, measured by the two subconstructs of perseverance and passion, and their well-being during clerkships in surgical and non-surgical specialty units.

Methods

This one-year prospective web-based questionnaire study enrolled fifth-year medical students at a tertiary medical centre in central Taiwan between September 2017 and July 2018 in their first-year clerkship. The students’ sex, age, and grit were measured at the start of their clerkship. Routine surveys were conducted over one year to assess burnout and compassion satisfaction for students’ well-being, and the training specialty characteristics of the surgical and non-surgical specialty departments were recorded. This study included 92 medical students and 1,055 survey responses from individual specialty rotations. Descriptive, univariate and multivariate analyses were performed.

Results

Our results revealed that medical students’ perseverance, as part of grit, was related to lower burnout and higher compassion satisfaction during clerkships, but not the subconstruct of passion. Moreover, the positive trait of perseverance measured in our study had greater explanatory power for compassion satisfaction than for burnout. Furthermore, the results revealed that older medical students suffered from less burnout than their younger counterparts, and that male medical students expressed higher compassion satisfaction than their female counterparts.

Discussion

Perseverance, as a subconstruct of grit, is a positive personal quality for medical students’ clerkships, and methods driving the cultivation of perseverance in medical education should be considered. In addition, even though positive traits such as perseverance equipped medical students for compassion satisfaction, additional factors attributed to medical students’ burnout must be identified.
Artificial intelligence in healthcare: an Italian perspective on ethical and medico-legal implications
Authors: Sablone Sara , Bellino Mara , Cardinale Andrea Nicola , Esposito Massimiliano , Sessa Francesco , Salerno Monica
Published: June 2024

Artificial intelligence (AI) is a multidisciplinary field intersecting computer science, cognitive science, and other disciplines, able to address the creation of systems that perform tasks generally requiring human intelligence. It consists of algorithms and computational methods that allow machines to learn from data, make decisions, and perform complex tasks, aiming to develop an intelligent system that can work independently or collaboratively with humans. Since AI technologies may help physicians in life-threatening disease prevention and diagnosis and make treatment smart and more targeted, they are spreading in health services. Indeed, humans and machines have unique strengths and weaknesses and can complement each other in providing and optimizing healthcare. However, the healthcare implementation of these technologies is related to emerging ethical and deontological issues regarding the fearsome reduction of doctors’ decision-making autonomy and acting discretion, generally strongly conditioned by cognitive elements concerning the specific clinical case. Moreover, this new operational dimension also modifies the usual allocation system of responsibilities in case of adverse events due to healthcare malpractice, thus probably imposing a redefinition of the established medico-legal assessment criteria of medical professional liability. This article outlines the new challenges arising from AI healthcare integration and the possible ways to overcome them, with a focus on Italian legal framework. In this evolving and transitional context emerges the need to balance the human dimension with the artificial one, without mutual exclusion, for a new concept of medicine “with” machines and not “of” machines.
Biological pretreatment with white rot fungi for preparing hierarchical porous carbon from Banlangen residues with high performance for supercapacitors and dye adsorption
Authors: Kong Wen , Zhang Xinyu , Fu Xiao , Zhou Can , Fan Linjiang , Zhang Wanju
Published: May 2024

White rot fungi possess superior infiltrability and biodegradability on lignocellulosic substrates, allowing them to form tailored microstructures which are conducive to efficient carbonization and chemical activation. The present research employed white rot fungus pretreatment as a viable approach for preparing porous carbon from Banlangen residues. The resultant F-A-BLGR-PC prepared by pretreating Banlangen residues with white rot fungi followed by carbonization and activation has a hierarchical porous structure with a high specific surface area of 898 m2 g−1, which is 43.4% greater than that of the unprocessed sample (R-BLGR-PC). When used as an electrode for supercapacitors, the F-A-BLGR-PC demonstrated a high specific capacitance of 308 F g−1 at 0.5 A g-1 in 6 M KOH electrolyte in three-electrode configuration. Moreover, the F-A-BLGR-PC based symmetric supercapacitor device achieved a superb cyclic stability with no obvious capacitance decay after 20,000 cycles at 5 A g−1 in 1 M Na2SO4 electrolyte. Additionally, the F-A-BLGR-PC sample was found to be an ideal adsorbent for removing methyl orange (MO) from water, exhibiting an adsorption ability of 173.4 mg g−1 and a maximum removal rate of 86.6%. This study offers a promising method for the preparation of a porous carbon with a high specific surface area in a biological way using white rot fungi pretreatment, and the derived carbon can not only be applied in energy storage but also in environmental remediation, catalysis, and so on.
ACSS2 enables melanoma cell survival and tumor metastasis by negatively regulating the Hippo pathway
Authors: Zhang Baolu , Zhu Qing , Qu Di , Zhao Mao , Du Juan , Zhang Hengxiang , Wang Hao , Jiang Linhan , Yi Xiuli , Guo Sen , Wang Huina , Yang Yuqi , Guo Weinan
Published: June 2024

Introduction

Acetyl-CoA synthetase 2 (ACSS2), one of the enzymes that catalyze the conversion of acetate to acetyl-CoA, has been proved to be an oncogene in various cancers. However, the function of ACSS2 is still largely a black box in melanoma.

Methods

The ACSS2 expression was detected in melanoma cells and melanocytes at both protein and mRNA levels. Cell viability, apoptosis, migration and invasion were investigated after ACSS2 knockdown. RNA sequencing (RNA-Seq) technology was employed to identify differentially expressed genes caused by ACSS2 knockdown, which were then verified by immunoblotting analysis. Animal experiments were further performed to investigate the influence of ACSS2 on tumor growth and metastasis in vivo.

Results

Firstly, we found that ACSS2 was upregulated in most melanoma cell lines compared with melanocytes. In addition, ACSS2 knockdown dramatically suppressed melanoma cell migration and invasion, whereas promoted cell apoptosis in response to endoplasmic reticulum (ER) stress. Furthermore, tumor growth and metastasis were dramatically suppressed by ACSS2 knockdown in vivo. RNA-Seq suggested that the Hippo pathway was activated by ACSS2 knockdown, which was forwardly confirmed by Western blotting and rescue experiments. Taken together, we demonstrated that ACSS2 enables melanoma cell survival and tumor metastasis via the regulation of the Hippo pathway.

Discussion

In summary, this study demonstrated that ACSS2 may promote the growth and metastasis of melanoma by negatively regulating the Hippo pathway. Targeting ACSS2 may be a promising target for melanoma treatment.
Motor dysfunction in Parkinson’s patients: depression differences in a latent growth model
Authors: Wang QiuShuang , Bian Jing , Sun Yi , Shi YaoZhou , Zhao ZiXuan , Zhao HuaShuo
Published: June 2024

Objective

This study aims to utilize latent growth model (LGM) to explore the developmental trajectory of motor dysfunction in Parkinson’s disease (PD) patients and investigate the relationship between depression and motor dysfunction.

Methods

Four-year follow-up data from 389 PD patients were collected through the Parkinson’s Progression Marker Initiative (PPMI). Firstly, a univariate LGM was employed to examine the developmental trajectory of motor dysfunction in PD patients. Subsequently, depression levels were introduced as covariates into the model, and depression was further treated as a parallel growth latent variable to study the longitudinal relationship between motor dysfunction and depression.

Results

In the trajectory analysis of motor dysfunction, the fit indices for the quadratic growth LGM model were χ2 = 7.419, df = 6, CFI = 0.998, TLI = 0.997, SRMR = 0.019, and RMSEA = 0.025, indicating that the growth trend of motor dysfunction follows a quadratic curve rather than a simple linear pattern. Introducing depression symptoms as time-varying covariates to explore their effect on motor dysfunction revealed significant positive correlations (β = 0.383, p = 0.026; β = 0.675, p < 0.001; β = 0.385, p = 0.019; β = 0.415, p = 0.014; β = 0.614, p = 0.003), suggesting that as depression levels increase, motor dysfunction scores also increase. Treating depression as a parallel developmental process in the LGM, the regression coefficients for depression intercept on motor dysfunction intercept, depression slope on motor dysfunction slope, and depression quadratic factor on motor dysfunction quadratic factor were 0.448 (p = 0.046), 1.316 (p = 0.003), and 1.496 (p = 0.038), respectively. These significant regression coefficients indicate a complex relationship between depression and motor dysfunction, involving not only initial level associations but also growth trends over time and possible quadratic effects.

Conclusion

This study indicates a quadratic growth trajectory for motor dysfunction in PD, suggesting a continuous increase in severity with a gradual deceleration in growth rate. The relationship between depression and motor dysfunction is complex, involving initial associations, evolving trends over time, and potential quadratic effects. Exacerbation of depressive symptoms may coincide with motor function deterioration.
Development and validation of a predictive model for severe white matter hyperintensity with obesity
Authors: Chen Fu , Cao Lin-hao , Ma Fei-yue , Zeng Li-li , He Ji-rong
Published: June 2024

Purpose

The purpose of the present study was to identify predictors of severe white matter hyperintensity (WMH) with obesity (SWO), and to build a prediction model for screening obese people with severe WMH without Nuclear Magnetic Resonance Imaging (MRI) examination.

Patients subjects and methods

From September 2020 to October 2021, 650 patients with WMH were recruited consecutively. The subjects were divided into two groups, SWO group and non-SWO group. Univariate and Logistic regression analysis were was applied to explore the potential predictors of SWO. The Youden index method was adopted to determine the best cut-off value in the establishment of the prediction model of SWO. Each parameter had two options, low and high. The score table of the prediction model and nomogram based on the logistic regression were constructed. Of the 650 subjects, 487 subjects (75%) were randomly assigned to the training group and 163 subjects (25%) to the validation group. By resampling the area under the curve (AUC) of the subject’s operating characteristics and calibration curves 1,000 times, nomogram performance was verified. A decision curve analysis (DCA) was used to evaluate the nomogram’s clinical usefulness. By resampling the area under the curve (AUC) of the subject’s operating characteristics and calibration curves 1,000 times, nomogram performance was verified. A decision curve analysis (DCA) was used to evaluate the nomogram’s clinical usefulness.

Results

Logistic regression demonstrated that hypertension, uric acid (UA), complement 3 (C3) and Interleukin 8 (IL-8) were independent risk factors for SWO. Hypertension, UA, C3, IL-8, folic acid (FA), fasting C-peptide (FCP) and eosinophil could be used to predict the occurrence of SWO in the prediction models, with a good diagnostic performance, Areas Under Curves (AUC) of Total score was 0.823 (95% CI: 0.760–0.885, p < 0.001), sensitivity of 60.0%, specificity of 91.4%. In the development group, the nomogram’s AUC (C statistic) was 0.829 (95% CI: 0.760–0.899), while in the validation group, it was 0.835 (95% CI: 0.696, 0.975). In both the development and validation groups, the calibration curves following 1,000 bootstraps showed a satisfactory fit between the observed and predicted probabilities. DCA showed that the nomogram had great clinical utility.

Conclusion

Hypertension, UA, C3, IL-8, FA, FCP and eosinophil models had the potential to predict the incidence of SWO. When the total score of the model exceeded 9 points, the risk of SWO would increase significantly, and the nomogram enabled visualization of the patient’s WMH risk. The application prospect of our models mainly lied in the convenient screening of SWO without MRI examination in order to detect SWO and control the WMH hazards early.
A new methodological approach to characterize selective motor control in children with cerebral palsy
Authors: Graci Valentina , O’Neill Mitchel , Bloss Meredith , Akkem Rahul , Paremski Athylia C. , Sanders Ozell , Prosser Laura A.
Published: May 2024

Introduction

Despite being a primary impairment in individuals with cerebral palsy (CP), selective motor control (SMC) is not routinely measured. Personalized treatment approaches in CP will be unattainable without the ability to precisely characterize the types and degrees of impairments in motor control. The objective of this study is to report the development and feasibility of a new methodological approach measuring muscle activation patterns during single-joint tasks to characterize obligatory muscle co-activation patterns that may underly impaired SMC.

Methods

Muscle activation patterns were recorded during sub-maximal voluntary isometric contraction (sub-MVIC) tasks at the hip, knee, and ankle with an interactive feedback game to standardize effort across participants. We calculated indices of co-activation, synergistic movement, mirror movement, and overflow (indices range 0–2, greater scores equal to greater impairment in SMC) for each isolated joint task in 15 children – 8 with typical development (TD) (mean age 4.7 ± 1.0 SD years) and 7 with CP (mean age 5.8 ± 0.7 SD years). Indices were compared with Mann–Whitney tests. The relationships between the indices and gross motor function (GMFM-66) were examined with Pearson’s r.

Results

Mean indices were higher in the CP vs. the TD group for each of the six tasks, with mean differences ranging from 0.05 (abduction and plantarflexion) to 0.44 (dorsiflexion). There was great inter-subject variability in the CP group such that significant group differences were detected for knee flexion mirroring (p = 0.029), dorsiflexion coactivation (p = 0.021), and dorsiflexion overflow (p = 0.014). Significant negative linear relations to gross motor function were found in all four indices for knee extension (r = −0.56 to −0.75), three of the indices for ankle dorsiflexion (r = −0.68 to −0.78) and in two of the indices for knee flexion (r = −0.66 to −0.67), and ankle plantarflexion (r = −0.53 to −0.60).

Discussion

Indices of coactivation, mirror movement, synergy, and overflow during single-joint lower limb tasks may quantify the type and degree of impairment in SMC. Preliminary concurrent validity between several of the indices of SMC and gross motor function was observed. Our findings established the feasibility of a new methodological approach that quantifies muscle activation patterns using electromyography paired with biofeedback during single-joint movement.
Meta-analysis of experimental factors influencing single-pulse TMS effects on the early visual cortex
Authors: Zhang Yan , Song Bian , Zhao Xingyue , Jin Zhenlan , Zhang Junjun , Li Ling
Published: June 2024

Background

Single-pulse transcranial magnetic stimulation (spTMS) applied to the Early Visual Cortex (EVC) has demonstrated the ability to suppress the perception on visual targets, akin to the effect of visual masking. However, the reported spTMS suppression effects across various studies have displayed inconsistency.

Objective

We aim to test if the heterogeneity of the spTMS effects can be attributable to variations in experimental factors.

Methods

We conducted a meta-analysis using data collected from the PubMed and Web of Science databases spanning from 1995 to March 2024. The meta-analysis encompassed a total of 40 independent experiments drawn from 33 original articles.

Results

The findings unveiled an overall significant spTMS suppression effect on visual perception. Nevertheless, there existed substantial heterogeneity among the experiments. Univariate analysis elucidated that the spTMS effects could be significantly influenced by TMS intensity, visual angle of the stimulus, coil type, and TMS stimulators from different manufacturers. Reliable spTMS suppression effects were observed within the time windows of −80 to 0 ms and 50 to 150 ms. Multivariate linear regression analyses, which included SOA, TMS intensity, visual angle of the stimulus, and coil type, identified SOA as the key factor influencing the spTMS effects. Within the 50 to 150 ms time window, optimal SOAs were identified as 112 ms and 98 ms for objective and subjective performance, respectively. Collectively, multiple experimental factors accounted for 22.9% (r = 0.3353) and 39.9% (r = 0.3724) of the variance in objective and subjective performance, respectively. Comparing univariate and multivariate analyses, it was evident that experimental factors had different impacts on objective performance and subjective performance.

Conclusion

The present study provided quantitative recommendations for future experiments involving the spTMS effects on visual targets, offering guidance on how to configure experimental factors to achieve the optimal masking effect.
Influence of baking time and formulation of part-baked wheat sourdough bread on the physical characteristics, sensory quality, glycaemic index and appetite sensations
Authors: Temkov Mishela , Rocha João Miguel , Rannou Cécile , Ducasse Maren , Prost Carole
Published: June 2024

Raw materials and process parameters in bread production can modulate the glycemic index, which on itself has been linked with provision of better hunger satisfaction and maintaining better satiation. The objective of this research was to investigate if using unrefined wheat flour or the addition of intact cereals in formulation or alternating the baking time would have an effect on physical characteristics, sensory quality, glycaemic index and appetite sensations in wheat sourdough bread. In the study, three types of commercial part-baked frozen sourdough bread, baked to the final baking for two different times (long and short baking time) were used. A randomized controlled crossover trial was performed with 10 healthy adults who consumed sufficient quantity of bread to ingest 50 g available carbohydrates. Participants self-reported appetite sensations (desire to eat, hunger, fullness, satisfaction, appetite) on a 10 cm visual analog scale (VAS) scale in a course of 180 min. In addition, bread products were subjected to overall acceptability and different sensory attributes were examined on JAR “just about right” scale. Different bread formulations (refined flour, unrefined wheat flour, cereal flour or intact cereals) and different length of baking time significantly influenced (p < 0.005) physical, textural and sensory features of products. The alternation of aforementioned parameters decreased the glycemic index, but not significantly (p > 0.005). No correlation was found between lower GI, satiety and satiation. Liking score and incremental area under the curve (iAUC) of satiety and satiation were calculated as highest in sourdough bread with added cereals.
Trends in urine lead and associated mortality in US adults: NHANES 1999–2018
Authors: Wang Qiong , Wu Jing , Dong Xiaoqun , Niu Wenquan
Published: May 2024

Objectives

This study aimed to describe the trends of urine lead among US adults aged ≥45 years and to explore its association with all-cause and disease-specific mortality.

Methods

This study enrolled 9,669 participants from the National Health and Nutrition Examination Survey, 1999–2018. Trends in urine lead were described by logistic regression analysis using the survey cycle as a continuous variable. Cox proportional hazard regression analyses were used to quantify the association between urine lead and mortality.

Results

There was an obvious decline in urine lead concentrations from 1.203 μg/L (95% confidence interval [CI]: 1.083–1.322) in 1999–2000 to 0.478 μg/L (95% CI: 0.433–0.523) in 2017–2018, and this decline was statistically significant (P < 0.001). Referring to the first tertile of urine lead concentrations, risk magnitude for all-cause mortality was significantly and linearly increased after adjustment (P = 0.026 and 0.020 for partially and fully adjusted models, respectively), and significance was attained for the comparison of the third vs. first tertile after full adjustment (hazard ratio [HR]: 1.17, 95% CI: 1.01 to 1.35). Treating urine lead continuously, the risk for all-cause mortality was statistically significant (HR: 1.18 and 1.19, 95% CI: 1.01 to 1.39 and 1.00 to 1.40 for partially and fully adjusted models). For cardiovascular disease-specific and cancer-specific mortality, there was no hint of statistical significance.

Conclusions

Our findings indicated that urine lead exhibited a declining trend from 1999–2000 to 2017–2018 in US adults aged ≥45 years, and high urine lead was a significant and independent risk factor for all-cause mortality.
Methods of prolonging the effect of caudal block in children
Authors: Xu Weiyi , Wei Haixu , Zhang Tao
Published: June 2024

Caudal epidural blockade is one of the most frequently administered regional anesthesia techniques in children. It is a supplement during general anesthesia and for providing postoperative analgesia in pediatrics for sub-umbilical surgeries, especially for genitourinary surgeries. However, the duration of the analgesic effect is occasionally unsatisfactory. In this review, we discuss the main advantages and disadvantages of different techniques to prolong postoperative analgesia for single-injection caudal blockade in children. A literature search of the keywords “caudal”, “analgesia”, “pediatric”, and “children” was performed using PubMed and Web of Science databases. We highlight that analgesic quality correlates substantially with the local anesthetic's type, dose, the timing relationship between caudal block and surgery, caudal catheterization, and administration of epidural opioids or other adjuvant drugs.
Juvenile dermatomyositis with central nervous system involvement: two case reports from a retrospective single-center cohort, with literature review
Authors: Yang Ling , Guan Wanzhen , Liu Haimei , Li Yifan , Gong Yinv , Lv Qianying , Zeng Qiaoqian , Wei Qijiao , Zhang Xiaomei , Chen Weiming , Chen Chao , Sun Li
Published: May 2024

Background

Juvenile dermatomyositis (JDM) is a systemic autoimmune disease primarily involving the muscles and skin; it can also affect the central nervous system (CNS). The relevant literature provides limited information regarding the characteristics of JDM with CNS involvement.

Method

We reviewed patients with JDM who were hospitalized at our center between January 2016 and August 2023, with a focus on those with CNS involvement. The aim was to provide detailed case reports on these patients, and to summarize the relevant literature about the characteristics of similar cases.

Results

Among 193 hospitalized patients with JDM, two (1.03%) had CNS involvement. Two patients, a 5.5-year-old girl and an 11-year-old boy, were admitted with severe proximal muscle weakness and seizures, and presented with active cutaneous vasculitis. Both were ultimately diagnosed with JDM, with CNS involvement. Both patients had confirmed presence of anti-NXP2 antibody through myositis-specific antibody analysis. Additionally, they all exhibited hyperferritinemia and thrombocytopenia. Salvage therapies like intravenous methylprednisolone (IVMP) pulse therapy and/or plasma exchange were administered successfully. At final follow-up, both patients had achieved complete clinical response and full neurological recovery. Our literature review identified nine similar case studies. CNS involvement usually occurred within the first 10 months of the disease course, and most of these patients had fatal outcomes, with a mortality rate of 66.6% (6/9). Including the two patients described herein, the median age for disease onset is 10.5 years (range 4–17 years), and the male: female ratio is 6:5. Seizures are the most common neurological symptom, accompanied by active cutaneous vasculitis. The brain biopsies showed two distinct pathological presentations: one was central nervous system vasculitis, and the other was cerebral macrophage activation syndrome.

Conclusions

CNS involvement is a rare but life-threatening JDM complication. Herein, our cases and the literature indicate that it typically occurs within the first 10 months of the disease course and manifests as seizures, often accompanied by active cutaneous vasculitis, with fatal outcomes. Timely implementation of salvage therapies, like IVMP pulse therapy and plasma exchange, may significantly impact patient outcomes.
Pharmaceutical interventions for drug-related problems in the neonatal intensive care unit: incidence, types, and acceptability
Authors: Ahmed Norhan Attia , Fouad Ehab Ahmed , El-Asheer Osama M. , Ghanem A. S. M.
Published: May 2024

Background: Drug-related problems (DRPs) are widespread in hospitalized neonates, but studies on the prevalence of DRPs in this population are limited. The presence of clinical pharmacists on multidisciplinary teams helps prevent and reduce DRPs.

Aim: This investigation aimed to identify and classify the incidence of DRPs in the neonatal intensive care unit (NICU), to determine the determining factors associated with DRPs and to document clinical pharmacists’ interventions, outcomes, acceptance rates and clinical significance.

Method: A prospective descriptive hospital study was conducted from August to November 2023 at the NICU of Children’s University Hospital, Assiut University, Egypt. DRPs were classified using the Pharmaceutical Care Network of Europe (PCNE) classification V9.1.

Results: Three hundred sixteen neonates were included in the study, with a mean gestational age of 34 ± 4 weeks and a mean birth weight of 2.03 ± 0.85 kg. A total of 1723 DRPs occurred among 283 neonates (89.6%), an average of 5.5 ± 5.1 DRPs per patient. The main types were treatment effectiveness (P1) (799, 46.4%), followed by others (P3) (469, 27.2%), and treatment safety (P2) (455, 26.4%). The leading causes were dose selection (C3) (1264, 61.9%) and “other domain” (C9) (543, 26.6%). Of the 2149 interventions introduced by pharmacists, 98.8% were accepted and 93% were accepted, and fully implemented. As a result, 92% of the DRPs were resolved. Both length of hospital stay and number of medications were significantly associated with DRPs.

Conclusion: DRPs are common in the NICU; this study demonstrated the crucial role of clinical pharmacists in identifying and resolving DRPs.
Limbal stem cells carried by a four-dimensional -printed chitosan-based scaffold for corneal epithelium injury in diabetic rabbits
Authors: Wang Mengyuan , Liu Kaibin , Wang Xiaomin , Shang Zhen , Liu Yiming , Pan Nailong , Sun Xueqing , Xu Wenhua
Published: June 2024

Methods: Herein, we obtained and characterized deltaN p63- and adenosine triphosphate-binding cassette subfamily G member 2-expressing limbal stem cells (LSCs). Chitosan and carboxymethyl chitosan (CTH) were cross-linked to be an in situ thermosensitive hydrogel (ACH), which was printed through four-dimensional (4D) printing to obtain a porous carrier with uniform pore diameter (4D-CTH). Rabbits were injected with alloxan to induce diabetes mellitus (DM). Following this, the LSC-carrying hydrogel was spread on the surface of the cornea of the diabetic rabbits to cure corneal epithelium injury.

Results: Compared with the control group (LSCs only), rapid wound healing was observed in rabbits treated with LSC-carrying 4D-CTH. Furthermore, the test group also showed better corneal nerve repair ability. The results indicated the potential of LSC-carrying 4D-CTH in curing corneal epithelium injury.

Conclusion: 4D-CTH holds potential as a useful tool for studying regenerative processes occurring during the treatment of various diabetic corneal epithelium pathologies with the use of stem cell-based technologies.
Effect of blueberry intervention on endothelial function: a systematic review and meta-analysis
Authors: Deng Bixin , Lei Yupeng , Zhou Ruixi , Ruan Tiechao , Lu Wenting , Ying Junjie , Yue Yan , Mu Dezhi
Published: June 2024

Introduction: Endothelial dysfunction indicates blood vessel injury and is a risk factor for cardiovascular diseases. Blueberry has been approved for its benefits on human health, especially on cardiovascular function. However, its effect on endothelial function remains unclear. We conducted a systematic review and meta-analysis to explore the impact of blueberries on endothelial function in adults.

Methods: We searched PubMed, Web of Science, Embase, and the Cochrane Library, 16 studies were included in the systematic review, and 11 were used for the meta-analysis. Data associated with endothelial function were extracted and pooled as mean differences (MD) with 95% confidence intervals (CI).

Results: Blueberry consumption significantly improved flow-mediated dilation (FMD) by 1.50% (95% CI: 0.81, 2.20; I2 = 87%) and reactive hyperemia index (RHI) by 0.26 (95% CI: 0.09, 0.42; I2 = 72%). A significant decrease in diastolic blood pressure (DBP) was also observed (MD: −2.20 mm Hg; 95% CI: −4.13, −0.27; I2 = 11%). Subgroup analysis indicated a significant decrease in blood pressure (Systolic blood pressure [SBP]: −3.92 mmHg; 95% CI: −6.88, −0.97; I2 = 20% and DBP: −2.20 mmHg; 95% CI: −4.13, −0.27; I2 = 11%) in the smoking population. However, SBP levels (MD: −1.43 mm Hg; 95% CI: −3.11, 0.26; I2 = 20%) and lipid status (high-density lipoprotein cholesterol [HDL-C]: 0.06; 95% CI: −0.04, 0.16; I2 = 77%; low-density lipoprotein cholesterol [LDL-C]: 0.05; 95% CI: −0.14, 0.24; I2 = 0%) did not significantly improve.

Conclusion: Blueberry intervention improved endothelial function and DBP. Subgroup analysis revealed a notable improvement in blood pressure among the smoking population. However, no significant effects were observed on SBP, HDL-C, and LDL-C levels. Future research should delve into the mechanisms of endothelial improvement and verify blood pressure reduction in specific subpopulations through large-scale trials.

Clinical Trial Registration:https://www.crd.york.ac.uk/PROSPERO/, Identifier CRD42023491277.
Investigating the spatiotemporal expression of CBTS genes lead to the discovery of tobacco root as a cembranoid-producing organ
Authors: Du Zaifeng , Tian Tian , Gao Yulong , Guan Jian , Ju Fuzhu , Bian Shiquan , Wang Jiahao , Lin Xiaoyang , Wang Bingwu , Liao Zhihua , Du Yongmei , Zhang Zhongfeng , Zhang Hongbo
Published: May 2024

Tobacco cembranoids, known for their anti-insect and antifungal properties, were shown to be mainly present on the surface of leaves and flowers, being biosynthesized by their trichomes. It remains unclear whether they could be biosynthesized in other organs without trichomes. Cembratrien-ol synthases (CBTSs) catalyze the conversion of GGPP to CBT-ols and thus play an important role in cembranoid biosynthesis. This study identified the CBTS family genes in tobacco and examined their spatiotemporal expression patterns. The CBTS genes showed diverse expression patterns in tobacco organs, with the majority highly expressed in leaves and a few highly expressed in flowers. The expression of CBTS genes were also correlated with the development of tobacco plants, and most of them showed the highest expression level at the budding stage. Furthermore, their expression is mediated by the JA (jasmonate) signaling in all tobacco organs. Several CBTS genes were found to be highly expressed in tobacco roots that have no trichomes, which prompted us to determine the cembranoid production in roots and other organs. GC-MS and UPLC assays revealed that cembranoids were produced in all tobacco organs, which was supported by the bioactivity assay results that almost all these CBTS enzymes could catalyze CBT-ol biosyntheis in yeast, and that the content ratio of CBT-ols and CBT-diols in tobacco roots was different to that in leaves. This work sheds insights into the expression profiles of tobacco CBTS genes and provides a feasibility to engineer tobacco roots for industrial production of cembranoids.
Profile of gym-goers who do not use performance-enhancement substances
Authors: Tavares Ana Sofia R. , Carolino Elisabete , Teques Pedro , Calmeiro Luis , Serpa Sidonio
Published: May 2024

Introduction

Currently the use of prohibited performance-enhancing substances (PES) in fitness and gym settings is a public health concern as adverse health consequences are emerging. Understanding the characteristics of gym-goers who do not use these substances could lead to an important complement to the ongoing research about risk factors for PES use. The aim of this study was to identify the profile of PES non-use in gym-goers.

Methods

In total, 453 gym-goers (mean age = 35.64 years; SD = 13.08 – measure of central tendency location and measure of absolute dispersion, respectively) completed an online survey assessing sociodemographic factors, exercise characteristics, gym modalities, peers, social influence, attitudes, subjective norms, beliefs, intentions, and self-reported use of PES.

Results

Decision Trees showed that being a woman, training less frequently, not practicing bodybuilding and having a negative intention to consume PES were identified as characteristics of non-users of PES.

Discussion

These results may support evidence-based anti-doping interventions to prevent abusive use of PES in the fitness context.
Influence of socio-family variables on parental assessment of the pragmatic development of children under 4 years of age
Authors: Botana Iria , Peralbo Manuel
Published: May 2024

Introduction

Interest in pragmatic development and its assessment has increased in recent years, not only because of the predictive value of pragmatic impairments as warning signs in the detection of multiple developmental disorders, but also because of the consideration that pragmatics has received in the field of mental disorders. Current contexts of child development assessment require pragmatic assessment instruments that accurately define profiles and take into account the immediate context in which they develop. Parents' knowledge of their children's abilities is supported by exhaustive observation over time of regularities in their behavior. But it is true that the way a caregiver interprets behavior is mediated by multiple variables. The aim of the present study, therefore, is to shed light on the possible influence of parental belief systems on the assessment of children's pragmatic development by analyzing the relationship between sociofamilial variables and the assessment of pragmatic competence.

Method

A total of 215 educational centers across Spain participated in the study. The final sample was of 262 parents of boys and girls between 6 and 48 months of age. The parental questionnaire for the evaluation of pragmatic development, The Pragmatics Profile, in an adapted Spanish version, was applied along with a number of items for the evaluation of parental beliefs.

Results

Analyses confirm the existence of an effect of child development conceptions and other socio-familial variables on the assessment of pragmatic development between 6 and 48 months of age. Furthermore, the results indicate that better scores on pragmatic development are associated with parents with higher socioeconomic and educational levels, greater number of children and more interactionist conceptions and realistic.

Conclusion

The effect of parental conceptions on the evaluation of pragmatics points to the need to obtain convergent measures in an area as complex as that of communicative development in early childhood, especially taking into account that an evaluation which is neutral and free from context is not possible or indeed desirable. Pragmatic development must be evaluated within this contextual framework and should take into account each of the variables present therein. Hence the complementarity between parental reports and performance-based test.
Assessing perceptions of stigmatization by others for seeking help in China: psychometric characteristics and measurement invariance across gender and therapy experience
Authors: Cheng Kun , Yang Wenxian , Zhang Yan-Hong , She Zhuang
Published: May 2024

The stigma of social networks may be more noticeable in collectivist societies like China, but research in this area has largely been overlooked due to a lack of reliable measurement. To address this gap, this study tested the psychometric properties of the Chinese version of the Perceptions of Stigmatization by Others for Seeking Help (PSOSH) scale in the Chinese general population, and tested its invariance across gender and prior therapy experience. In a national online survey, 640 adults completed the PSOSH and conceptually related scales: Self-stigma of Seeking Help (SSOSH), Stigma of Seeking Professional Psychological Help Scale (SSPPH, i.e., public stigma) and Attitudes toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF). Confirmatory factor analysis supported the unidimensional structure of the original PSOSH. The Cronbach’s α coefficient was 0.84 and the 3-week test–retest reliability of was 0.77. The PSOSH showed moderate correlations with the three conceptually related scales, supporting its concurrent validity. Importantly, the PSOSH significantly predicted self-stigma scores, even when considering demographic variables and public stigma, supporting its incremental validity. The scale also demonstrated scalar invariance across gender and across subgroups who had vs. did not have previous therapy experience, supporting comparisons of latent means across these groups. The PSOSH is a reliable and valid instrument for assessing social network stigmatization of professional help-seeking in Chinese community samples.
Applying systems thinking in youth-centred participatory action research for health promotion in an underserved neighbourhood
Authors: Emke Helga , Altenburg Teatske , Dijkstra Coosje , Pinzon Angie Luna , Stronks Karien , Waterlander Wilma , Kremers Stef , Chinapaw Mai
Published: June 2024

Purpose

Childhood overweight is considered a complex problem influenced by a range of factors, including energy balance-related behaviours (EBRBs) and interacting drivers of these behaviours. There is growing support that applying a systems approach is required to tackle complex problems resulting in actions that attempt to change the system’s dynamics. Additionally, a participatory approach is advocated to include the lived experience of the population of interest both in the understanding of the system as well as the development, implementation and evaluation of relevant actions. We therefore combined Intervention Mapping, Participatory Action Research (PAR) and system dynamics in the development, implementation and evaluation of actions contributing to healthy EBRBs together with adolescents.

Methods

Four PAR groups comprising of 6–8 adolescent co-researchers (10–14 years) and 1–2 adult facilitators met weekly during 3–4 years. The structured Intervention Mapping protocol guided the process of the systematic development, implementation and evaluation of actions. System dynamics tools were included for the creation of Causal Loop Diagrams and development of systemic actions.

Results

Our approach comprised six steps that were executed by the PAR groups: (1) build Causal Loop Diagrams for each EBRB through peer research and identify overarching mechanisms, (2) determine leverage points using the Intervention Level Framework, (3) develop action ideas, (4) develop detailed actions including an implementation plan, (5) implement and, (6) evaluate the actions. PAR ensured that the actions fitted the lived experience of the adolescents, whilst system dynamics promoted actions at different levels of the system. The Intervention Mapping protocol ensured that the actions were theory-based. The main challenge involved integrating system dynamics within our practise in cooperation with adolescent co-researchers.

Conclusion

We experienced that combining Intervention Mapping, PAR and system dynamics worked well in developing, implementing and evaluating actions that target different levels of the system that drive adolescents’ EBRBs. This study serves as an example to other studies aimed at developing, implementing and evaluating actions using a participatory and systems approach.
A study on the physical aging characteristics of the older people over 70 years old in China
Authors: Shen Jin-Bo , Ma Yuan-Yuan , Niu Qian
Published: June 2024

Aim

In China, with the increase of life expectancy and the decrease of fertility rate, the aging problem has become increasingly prominent, and the physical problems of the older people over 70 years are the key and difficult problems.

Method

Based on the interactive logic between the aging problem and the older people health, in the study, a questionnaire survey and a nationwide physical fitness test were carried out on the older people over 70, to divide into different age groups (70–74 years old, 75–79 years old, 80–84 years old, 85 years old and older) and different genders. There were 8,400 valid samples, and 1,050 persons in each group. One-way ANOVA was used to compare the differences among groups of different ages, and a broken line chart was drawn to discuss the aging characteristics of various physical indexes of the older people over 70 in China.

Result

(1) Body morphology: male waist circumference, male waist-to-height ratio and female BMI showed a gradual downward trend with the increase of age; (2) Physiological function: male and female vital capacity showed a decreasing trend with the increase of age, while female pulse pressure showed a gradual upward trend. (3) Physical quality: the indicators of male and female muscle strength, flexibility quality, aerobic endurance and balance showed a downward trend with the increase of age.

Conclusion

Vital capacity, flexibility quality, muscle strength, aerobic endurance, balance ability and so on, decreased significantly with the growth of age. 80 years old is the inflection point of the rapid decline of various indicators. Blood pressure, silent pulse, BMI, waist-to-hip ratio, waist-to-height ratio and other indicators did not change regularly with age. Indicators such as blood pressure, BMI, waist-to-hip ratio and waist-to-height ratio were in the high-risk range of metabolic diseases and cardiovascular and cerebrovascular diseases. The study conducted physical fitness test on the older people over 70 years old in 7 geographical regions of China, which is the first nationwide physical fitness test for the older people, which is an extension and expansion of the national physical fitness monitoring system, and also shows that the test indicators involved in the “Health fitness scale” are simple and feasible. And the study added a series of test data over 70 years old, which is the basis for scientific and reasonable formulation of physical fitness evaluation standards for the older people, and is of great significance for improving the national physical fitness database and grasping the dynamic changes of national physical health status, and providing data support for scientific guidance of physical exercise for the older people.