bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing One-at-a-Time Therapy in community addiction and mental health centres: a retrospective exploration of the implementation process and initial outcomes
Authors: Harris-Lane Laura M. , Keeler-Villa Natalie R. , Bol Alexa , Burke Katie , Churchill AnnMarie , Cornish Peter , Fitzgerald Sarah F. , Goguen Bernard , Gordon Kristina , Jaouich Alexia , Lang Rino , Michaud Mylène , Mahon Kaitlyn N. , Rash Joshua A.
Published: September 2023

Background

The Department of Health of the Government of New Brunswick and Regional Health Authorities elected to implement Stepped Care 2.0 (SC2.0) in 2021, and began with One-at-a-Time (OAAT) therapy in Community Addiction and Mental Health Centres (CAMHCs) to facilitate rapid access to addiction and mental healthcare. This study: 1) explicated the process of implementing OAAT therapy as it aligned to evidence-based implementation frameworks and strategies; 2) assessed readiness for change among providers during the implementation; and 3) evaluated initial client and system outcomes.

Methods

The process of implementing OAAT therapy within CAMHCs was documented and retrospectively aligned with the Active Implementation Frameworks-Stages of Implementation, Consolidated Framework for Implementation Research, and incorporated strategies endorsed by the Expert Recommendations for Implementing Change. Providers working in CAMHCs completed online asynchronous courses in OAAT therapy and SC2.0, and were recruited to participate in research on perceptions of organizational readiness. Initial outcomes of the implementation were evaluated through client satisfaction surveys administered in CAMHCs and system performance indicators.

Results

Aligning with implementation stages, key strategies included: 1) continuously monitoring readiness and soliciting stakeholder feedback for iterative improvement; 2) building a representative implementation team with engaged leaders; 3) creating a comprehensive implementation plan on staff training, communication, and system changes; and 4) supporting sustainability. Providers who participated in research (N = 170, ~ 50% response rate) agreed that their organization was ready for implementation, and that OAAT therapy delivered within a SC2.0 framework was acceptable, appropriate, and feasible. More than 3,600 OAAT therapy sessions were delivered during the initial implementation stage, and waitlists were reduced by 64.1%. The majority of clients who completed surveys (N = 1240, ~ 35% response rate) reported that their OAAT therapy session was helpful, with a minority reporting that additional intervention was needed.

Conclusions

Thoughtful planning and execution, aligned with evidence-based implementation frameworks and strategies, played an important role in this provincial change initiative. Implementation steps outlined can help inform others looking to enact large-scale change.
Effects of different running intensities on the micro-level failure strain of rat femoral cortical bone structures: a finite element investigation
Authors: Fan Ruoxun , Liu Jie , Jia Zhengbin
Published: September 2023

Background

Running with the appropriate intensity may produce a positive influence on the mechanical properties of cortical bone structure. However, few studies have discussed the effects of different running intensities on the mechanical properties at different levels, especially at the micro-level, because the micromechanical parameters are difficult to measure experimentally.

Methods

An approach that combines finite element analysis and experimental data was proposed to predict a micromechanical parameter in the rat femoral cortical bone structure, namely, the micro-level failure strain. Based on the previous three-point bending experimental information, fracture simulations were performed on the femur finite element models to predict their failure process under the same bending load, and the micro-level failure strains in tension and compression of these models were back-calculated by fitting the experimental load–displacement curves. Then, the effects of different running intensities on the micro-level failure strain of rat femoral cortical bone structure were investigated.

Results

The micro-level failure strains of the cortical bone structures expressed statistical variations under different running intensities, which indicated that different mechanical stimuli of running had significant influences on the micromechanical properties. The greatest failure strain occurred in the cortical bone structure under low-intensity running, and the lowest failure strain occurred in the structure under high-intensity running.

Conclusions

Moderate and low-intensity running were effective in enhancing the micromechanical properties, whereas high-intensity running led to the weakening of the micromechanical properties of cortical bone. Based on these, the changing trends in the micromechanical properties were exhibited, and the effects of different running intensities on the fracture performance of rat cortical bone structures could be discussed in combination with the known mechanical parameters at the macro- and nano-levels, which provided the theoretical basis for reducing fracture incidence through running exercise.
Self-reported continuing professional development needs of medical laboratory professionals in Ghana
Authors: Essuman Mainprice Akuoko , Addy Nii Armah , Essien-Baidoo Samuel , Donkoh Irene Esi , Botchway Felix A. , Afrifa Justice , Agyeman Prince , Amaama Leticia Awontayami , Amoah Samuel , Sorvor Felix B. K. , Ephraim Richard K. D.
Published: September 2023

Background

Because of the essential nature of the work of medical laboratory professionals, continuing development in knowledge and skills is indispensable. The study aimed at identifying and prioritizing the development and training needs of medical laboratory professionals in Ghana. This is expected to help in developing focused continuing professional development (CPD) that meets the needs of practitioners as well as the changing medical trends.

Methods

An online cross-sectional survey in February 2022 using a structured questionnaire was conducted. Respondents were asked questions that collected demographic and work-related data about them, their participation, preference, and challenges in being part of CPDs. Finally, a list of topics based on (i) quality management systems, (ii) technical competence, (iii) laboratory management, leadership, and coaching, (iv) pathophysiology, and (iv) data interpretation and research were asked with the option to rate them on a 3-point scale (most, moderate, and least) in order of importance.

Results

A total of 316 medical laboratory professionals participated in the study. Overall, the most frequently selected topics for training based on domains for CPD training and ranking as most important were (i) quality management systems, (mean = 80.59 ± 9.024; 95% CI = 73.04–88.13); (ii) pathophysiology, data interpretation, and research (mean = 78.0 ± 6.973; 95% CI = 73.97–82.03); (iii) technical competence (mean = 73.97 ± 10.65; 95% CI = 66.35–81.59); and (iv) laboratory management, leadership, and coaching (mean = 72.82 ± 9.719; 95% CI = 67.44–78.2). The factors affecting the choice of training needs included the medical laboratory professionals’ current place of work, years in service, the reason for attending CPD activities, the period for attending the last CPD, being in a supervisory role, and the number of staff being supervised. Face-to-face presentations, training workshops, and hands-on workshops were the most preferred modes of CPD delivery with financial implications and workload/time constraints being the main challenges impeding CPD participation.

Conclusion

The identified needs will help in developing CPD programs that address what medical laboratory professionals prioritize as training needs. Stakeholders should incorporate these training needs into future programs and address the challenges highlighted in this study to have more relevant training for medical laboratory professionals.
Addressing schoolteacher food and nutrition-related health and wellbeing: a scoping review of the food and nutrition constructs used across current research
Authors: Jakstas Tammie , Follong Berit , Bucher Tamara , Miller Andrew , Shrewsbury Vanessa A. , Collins Clare E.
Published: September 2023

Background

Teachers form a large and essential workforce globally. Their wellbeing impacts personal health-related outcomes with flow on effects for the health, and wellbeing of their students. However, food and nutrition (FN) interventions that include teachers, typically neglect the impact of personal FN factors on a teachers’ ability to achieve optimal nutrition-related health and wellbeing, and successfully fulfil their professional FN roles as health promoters, gate keepers, educators’, and role models. The aim of this review was to scope FN constructs that have been studied internationally regarding teacher FN-related health and wellbeing.

Methods

Six databases were searched, and papers extracted in June/July 2021. Eligibility criteria guided by the population, concept, context mnemonic included studies published after 2000, in English language, with an aspect of personal FN-related health and wellbeing, among in-service (practising) and pre-service (training), primary, and secondary teachers. Screening studies for inclusion was completed by two independent researchers with data extraction piloted with the same reviewers and completed by lead author, along with complete descriptive and thematic analysis.

Results

Ten thousand six hundred seventy-seven unique articles were identified with 368 eligible for full text review and 105 included in final extraction and analysis. Sixty-nine descriptive studies were included, followed by 35 intervention studies, with the main data collection method used to assess both personal and professional FN constructs being questionnaires (n = 99 papers), with nutrition knowledge and dietary assessment among the most commonly assessed.

Conclusion

FN constructs are used within interventions and studies that include teachers, with diversity in constructs included and how these terms are defined. The evidence from this scoping review can be used to inform data collection and evaluation in future epidemiological and interventional research that addresses teacher FN-related health and wellbeing.
The association between dietary quality scores with C-reactive protein and novel biomarkers of inflammation platelet-activating factor and lipoprotein-associated phospholipase A2: a cross-sectional study
Authors: English Carolyn J. , Lohning Anna E. , Mayr Hannah L. , Jones Mark , MacLaughlin Helen , Reidlinger Dianne P.
Published: September 2023

Healthy dietary patterns are associated with lower inflammation and cardiovascular disease (CVD) risk and adherence can be measured using diet quality scores. Inflammation is traditionally measured with C-reactive protein (hsCRP), however there is interest in novel pro-inflammatory markers platelet-activating factor (PAF) and lipoprotein-associated phospholipase A2 (Lp-PLA2) that are specifically involved in endothelial dysfunction and inflammation. This cross-sectional study investigated the association between PAF, Lp-PLA2, hsCRP, and six diet scores. One hundred adults (49 ± 13 years, 31% male) with variable CVD risk were recruited. Fasting PAF, Lp-PLA2 and hsCRP and usual dietary intake were measured. Adherence to Dietary Approaches to Stop Hypertension (DASH), Dairy-adjusted DASH, Vegetarian Lifestyle Index, Healthy Eating Index for Australians (HEIFA), Mediterranean Diet Adherence Screener (MEDAS) and PREDIMED-Plus (erMedDiet) scores were calculated. Correlations and multiple regressions were performed. hsCRP, but not PAF, independently correlated with several diet scores. Lp-PLA2 independently correlated with Vegetarian Lifestyle Index only in unadjusted models. A one-point increase in adherence to the DASH Index, the Dairy-adjusted DASH Index and the Vegetarian Lifestyle Index was associated with a 30%, 30%, and 33% reduction in hsCRP levels, respectively. Smaller effects were seen with the other diet scores with a one-point increase in adherence resulting in a 19%, 22% and 16% reduction in hsCRP with HEIFA, MEDAS, erMedDiet scores, respectively. The lack of stronger associations between the novel markers of inflammation and diet scores may be due to confounding by COVID-19 infection and vaccination programs, which prevents any firm conclusion on the relationship between PAF, Lp-PLA2 and healthy dietary patterns. Future research should aim to examine the relationship with these novel markers and healthy dietary patterns in a non-pandemic setting.
Treatment options for digital nerve injury: a systematic review and meta-analysis
Authors: Zhang Yi , Hou Nianzong , Zhang Jian , Xie Bing , Liang Jiahui , Chang Xiaohu , Wang Kai , Tang Xin
Published: September 2023

Background

Surgical treatment of finger nerve injury is common for hand trauma. However, there are various surgical options with different functional outcomes. The aims of this study are to compare the outcomes of various finger nerve surgeries and to identify factors associated with the postsurgical outcomes via a systematic review and meta-analysis.

Methods

The literature related to digital nerve repairs were retrieved comprehensively by searching the online databases of PubMed from January 1, 1965, to August 31, 2021. Data extraction, assessment of bias risk and the quality evaluation were then performed. Meta-analysis was performed using the postoperative static 2-point discrimination (S2PD) value, moving 2-point discrimination (M2PD) value, and Semmes–Weinstein monofilament testing (SWMF) good rate, modified Highet classification of nerve recovery good rate. Statistical analysis was performed using the R (V.3.6.3) software. The random effects model was used for the analysis. A systematic review was also performed on the other influencing factors especially the type of injury and postoperative complications of digital nerve repair.

Results

Sixty-six studies with 2446 cases were included in this study. The polyglycolic acid conduit group has the best S2PD value (6.71 mm), while the neurorrhaphy group has the best M2PD value (4.91 mm). End-to-side coaptation has the highest modified Highet’s scoring (98%), and autologous nerve graft has the highest SWMF (91%). Age, the size of the gap, and the type of injury were factors that may affect recovery. The type of injury has an impact on the postoperative outcome of neurorrhaphy. Complications reported in the studies were mainly neuroma, cold sensitivity, paresthesia, postoperative infection, and pain.

Conclusion

Our study demonstrated that the results of surgical treatment of digital nerve injury are generally satisfactory; however, no nerve repair method has absolute advantages. When choosing a surgical approach to repair finger nerve injury, we must comprehensively consider various factors, especially the gap size of the nerve defect, and postoperative complications.

Type of study/level of evidence Therapeutic IV.
Attitude of mental healthcare providers toward tele-psychiatry services and associated factors at public referral hospitals in Addis Ababa city, Ethiopia
Authors: Adem Jibril Bashir , Melaku Mequannent Sharew , Zeleke Tirualem , Tesfaye Muluken , Kitila Firaol Lemessa , Walle Agmasie Damtew
Published: September 2023

Introduction

Health systems around the world are struggling with the massive numbers of people with mental disorders who require professional care. The treatment gap for mental disorders is high all over the world, with between 76 and 85% of people in low- and middle-income countries with severe mental disorders receiving no treatment for their mental health conditions. Tele-psychiatry is used as an alternative solution to the problem of limited mental health services and effective Tele-psychiatry service use may be achievable if mental health providers have a good attitude towards it.

Objective

To assess the attitude of mental healthcare providers toward Tele-psychiatry services and associated factors at public referral hospitals in Addis Ababa city, Ethiopia, 2022.

Method

A Multicenter institution-based cross-sectional study was conducted among 413 mental health professionals working in public referral hospitals in Addis Ababa city, from May 04 to June 10, 2022. Data were collected by using a structured and self-administered questionnaire prepared by reviewing previous related studies. Epi Data version 3.1 and Stata version 14 were used for data entry and analysis respectively. Bivariate and multivariable logistic regression analyses were used to identify factors associated with attitudes toward Tele-psychiatry services. A statistical significance was declared at p-value < 0.05.

Result

A total of 413 Participants were enrolled with a response rate of 91.8%. The majority of respondents 230 (55.69%) were male and the mean age of participants was 29 years (SD + 5.02). In this study the majority (49%) of mental health care professionals had a poor attitude toward Tele-psychiatry. Having electronic health technology experience [AOR 16.79; 95% CI (4.26, 29.3)], lack of training in telemedicine applications [(AOR 0.1; 95% CI (0.01, 0.41)], a good computer uses for daily work activities [AOR 3.65; 95% CI (1.14, 11.60)], availability of e-Health technology awareness program [AOR 0.16; 95% CI (0.03, 0.90)], having a positive perception about the importance of e-Health technologies[AOR 0.041; 95% CI (0.01, 0.29)] and having good knowledge of Tele-psychiatry services [AOR 6.89; 95% CI (1.8, 12.0)] were significantly associated with attitude towards Tele-psychiatry services.

Conclusion

This study found that mental healthcare providers at a public referral hospital in Addis Ababa city generally had poor attitudes regarding Tele-psychiatry services. Considering the significant factors will improve the attitude to use tele-psychiatry services in Ethiopia.
CT-derived extracellular volume and liver volumetry can predict posthepatectomy liver failure in hepatocellular carcinoma
Authors: Peng Yangling , Tang Hao , Huang Yuanying , Yuan Xiaoqian , Wang Xing , Ran Zijuan , Deng Wei , Liu Renwei , Lan Xiaosong , Shen Hesong , Zhang Jiuquan
Published: September 2023

Objectives

Posthepatectomy liver failure (PHLF) is a severe complication of liver resection. We aimed to develop and validate a model based on extracellular volume (ECV) and liver volumetry derived from computed tomography (CT) for preoperative predicting PHLF in resectable hepatocellular carcinoma (HCC) patients.

Methods

A total of 393 resectable HCC patients from two hospitals were enrolled and underwent multiphasic contrast-enhanced CT before surgery. A total of 281 patients from our hospital were randomly divided into a training cohort (n = 181) and an internal validation cohort (n = 100), and 112 patients from another hospital formed the external validation cohort. CT-derived ECV was measured on nonenhanced and equilibrium phase images, and liver volumetry was measured on portal phase images. The model is composed of independent predictors of PHLF. The under the receiver operator characteristic curve (AUC) and calibration curve were used to reflect the predictive performance and calibration of the model. Comparison of AUCs used the DeLong test.

Results

CT-derived ECV, measured future liver remnant (mFLR) ratio, and serum albumin were independent predictors for PHLF in resectable HCC patients. The AUC of the model was significantly higher than that of the ALBI score in the training cohort, internal validation cohort, and external validation cohort (all p < 0.001). The calibration curve of the model showed good consistency in the training cohort and the internal and external validation cohorts.

Conclusions

The novel model contributes to the preoperative prediction of PHLF in resectable HCC patients.

Critical relevance statement

The novel model combined CT–derived extracellular volume, measured future liver remnant ratio, and serum albumin outperforms the albumin–bilirubin score for predicting posthepatectomy liver failure in patients with resectable hepatocellular carcinoma.

Key points

• CT-derived ECV correlated well with the fibrosis stage of the background liver.

• CT-derived ECV and mFLR ratio were independent predictors for PHLF in HCC.

• The AUC of the model was higher than the CT-derived ECV and mFLR ratio.

• The model showed a superior predictive performance than that of the ALBI score.

Graphical Abstract
Injury-experienced satellite cells retain long-term enhanced regenerative capacity
Authors: Morroni Jacopo , Benedetti Anna , Esposito Lorenza , De Bardi Marco , Borsellino Giovanna , Riera Carles Sanchez , Giordani Lorenzo , Bouche Marina , Lozanoska-Ochser Biliana
Published: September 2023

Background

Inflammatory memory or trained immunity is a recently described process in immune and non-immune tissue resident cells, whereby previous exposure to inflammation mediators leads to a faster and stronger responses upon secondary challenge. Whether previous muscle injury is associated with altered responses to subsequent injury by satellite cells (SCs), the muscle stem cells, is not known.

Methods

We used a mouse model of repeated muscle injury, in which intramuscular cardiotoxin (CTX) injections were administered 50 days apart in order to allow for full recovery of the injured muscle before the second injury. The effect of prior injury on the phenotype, proliferation and regenerative potential of satellite cells following a second injury was examined in vitro and in vivo by immunohistochemistry, RT-qPCR and histological analysis.

Results

We show that SCs isolated from muscle at 50 days post-injury (injury-experienced SCs (ieSCs)) enter the cell cycle faster and form bigger myotubes when cultured in vitro, compared to control SCs isolated from uninjured contralateral muscle. Injury-experienced SCs were characterized by the activation of the mTORC 1 signaling pathway, suggesting they are poised to activate sooner following a second injury. Consequently, upon second injury, SCs accumulate in greater numbers in muscle at 3 and 10 days after injury. These changes in SC phenotype and behavior were associated with accelerated muscle regeneration, as evidenced by an earlier appearance of bigger fibers and increased number of myonuclei per fiber at day 10 after the second injury.

Conclusions

Overall, we show that skeletal muscle injury has a lasting effect on SC function priming them to respond faster to a subsequent injury. The ieSCs have long-term enhanced regenerative properties that contribute to accelerated regeneration following a secondary challenge.
A novel recombinant ORF7-siRNA delivered by flexible nano-liposomes inhibits varicella zoster virus infection
Authors: Pei Jiawei , Tian Ye , Ye Wei , Han Jiangfan , Dang Yamei , Cheng Tong , Wang Wei , Zhao Yipu , Ye Weiliang , Huangfu Shuyuan , Li Yu , Zhang Fanglin , Lei Yingfeng , Qian Airong
Published: September 2023

Background

Varicella zoster virus (VZV), which is a human restricted alpha-herpesvirus, causes varicella (chickenpox) and zoster (shingles). The subsequent post-herpetic neuralgia (PHN) due to VZV infection is excruciating for most patients. Thus, developing specific therapeutics against VZV infection is imperative. RNA interference (RNAi) represents an effective approach for alternative antiviral therapy. This study aimed to develop a novel anti-VZV therapeutics based on RNAi.

Results

In this study, we screened and found the open reading frame 7 (ORF7) of the VZV genome was an ideal antiviral target based on RNAi. Therefore, a novel siRNA targeting ORF7 (si-ORF7) was designed to explore the potential of RNAi antiviral treatment strategy toward VZV. We used a bio-engineering approach to manufacture recombinant siRNA agents with high yield in E. coli. Then, the efficacy of recombinant ORF7-siRNA (r/si-ORF7) in inhibiting VZV infection both in cellular level and 3D human epidermal skin model was evaluated. The r/si-ORF7 was proved to inhibit the VZV replication and reduce the virus copy numbers significantly in vitro. Furthermore, flexible nano-liposomes were established to deliver r/si-ORF7 to 3D human epidermal skin model and found r/si-ORF7 also could inhibit the VZV infection, thus maintaining normal skin morphology.

Conclusions

Taken together, our results highlighted that transdermal administration of antiviral r/si-ORF7 was a promising therapeutic strategy for functional cure of VZV infection.
A novel 3D bilayer hydrogel tri-culture system for studying functional motor units
Authors: Lin Yu-Lung , Nhieu Jennifer , Lerdall Thomas , Milbauer Liming , Wei Chin-Wen , Lee Dong Jun , Oh Sang-Hyun , Thayer Stanley , Wei Li-Na
Published: September 2023

Background

A motor unit (MU) is formed by a single alpha motor neuron (MN) and the muscle fibers it innervates. The MU is essential for all voluntary movements. Functional deficits in the MU result in neuromuscular disorders (NMDs). The pathological mechanisms underlying most NMDs remain poorly understood, in part due to the lack of in vitro models that can comprehensively recapitulate multistage intercellular interactions and physiological function of the MU.

Results

We have designed a novel three-dimensional (3D) bilayer hydrogel tri-culture system where architecturally organized MUs can form in vitro. A sequential co-culture procedure using the three cell types of a MU, MN, myoblast, and Schwann cell was designed to construct a co-differentiating tri-culture on a bilayer hydrogel matrix. We utilized a µ-molded hydrogel with an additional Matrigel layer to form the bilayer hydrogel device. The µ-molded hydrogel layer provides the topological cues for myoblast differentiation. The Matrigel layer, with embedded Schwann cells, not only separates the MNs from myoblasts but also provides a proper micro-environment for MU development. The completed model shows key MU features including an organized MU structure, myelinated nerves, aligned myotubes innervated on clustered neuromuscular junctions (NMJs), MN-driven myotube contractions, and increases in cytosolic Ca2+ upon stimulation.

Conclusions

This organized and functional in vitro MU model provides an opportunity to study pathological events involved in NMDs and peripheral neuropathies, and can serve as a platform for physiological and pharmacological studies such as modeling and drug screening. Technically, the rational of this 3D bilayer hydrogel co-culture system exploits multiple distinct properties of hydrogels, facilitating effective and efficient co-culturing of diverse cell types for tissue engineering.
Usefulness of dynamic regression time series models for studying the relationship between antimicrobial consumption and bacterial antimicrobial resistance in hospitals: a systematic review
Authors: Laffont-Lozes Paul , Larcher Romaric , Salipante Florian , Leguelinel-Blache Geraldine , Dunyach-Remy Catherine , Lavigne Jean-Philippe , Sotto Albert , Loubet Paul
Published: September 2023

Backgroung

Antimicrobial resistance (AMR) is on the rise worldwide. Tools such as dynamic regression (DR) models can correlate antimicrobial consumption (AMC) with AMR and predict future trends to help implement antimicrobial stewardship programs (ASPs).

Main body

We carried out a systematic review of the literature up to 2023/05/31, searching in PubMed, ScienceDirect and Web of Science. We screened 641 articles and finally included 28 studies using a DR model to study the correlation between AMC and AMR at a hospital scale, published in English or French. Country, bacterial species, type of sampling, antimicrobials, study duration and correlations between AMC and AMR were collected. The use of β-lactams was correlated with cephalosporin resistance, especially in Pseudomonas aeruginosa and Enterobacterales. Carbapenem consumption was correlated with carbapenem resistance, particularly in Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii. Fluoroquinolone use was correlated with fluoroquinolone resistance in Gram-negative bacilli and methicillin resistance in Staphylococcus aureus. Multivariate DR models highlited that AMC explained from 19 to 96% of AMR variation, with a lag time between AMC and AMR variation of 2 to 4 months. Few studies have investigated the predictive capacity of DR models, which appear to be limited.

Conclusion

Despite their statistical robustness, DR models are not widely used. They confirmed the important role of fluoroquinolones, cephalosporins and carbapenems in the emergence of AMR. However, further studies are needed to assess their predictive capacity and usefulness for ASPs.
Empiric antimicrobial therapy in the intensive care unit based on the risk of multidrug-resistant bacterial infection: a single-centre case‒control study of blood culture results in Japan
Authors: Nanao Taikan , Nishizawa Hideo , Fujimoto Junichi
Published: September 2023

Background

Infections and sepsis are the leading causes of death in intensive care units (ICUs). Antimicrobial agent selection is challenging because the intervention is directly related to the outcome, and the problem of antimicrobial resistance (AMR) must be considered. Therefore, in this study, we aimed to clarify the epidemiological data and examine whether the detection rate of multidrug-resistant (MDR) bacteria differed depending on the presence or absence of the risk of MDR bacterial infections to establish guidance regarding the choice of antimicrobial therapy for ICU patients.

Methods

This retrospective case‒control study was performed in a single ICU in Japan. Patients admitted to the ICU who underwent blood culture (BC) analysis were considered for inclusion in this study; patients were at risk of MDR bacterial infections, and controls were not. The primary outcome measure was the detection rate of MDR bacteria in BCs collected from patients and controls. The secondary outcome measure was the selection rate of anti-Pseudomonas and anti-methicillin-resistant Staphylococcus aureus (MRSA) drugs for patients and controls.

Results

Among the 1,730 patients admitted to the ICU during the study period, BCs were obtained from 186 patients, and 173 samples were finally included in the analysis (n = 129 cases; n = 44 controls). No MDR bacteria or Pseudomonas aeruginosa were detected in the controls (14 (11%) vs. 0 (0%)) (P = 0.014) However, there was no difference in empiric antimicrobials, including anti-MRSA (30 (23%) vs. 12 (27%)) (P = 0.592) and anti-Pseudomonas aeruginosa (61 (47%) vs. 16 (36%)) (P = 0.208) drugs, that were administered to the two groups.

Conclusions

Even in critically ill patients in the ICU, MDR bacteria are unlikely to be detected in patients without the risk of MDR bacterial infections. Therefore, for such patients, a strategy of starting empiric narrow-spectrum antimicrobial therapy rather than empiric broad-spectrum therapy should be considered. This strategy, in conjunction with daily updates of clinical and epidemiological data at each facility, will promote the appropriate use of antimicrobials and reduce the emergence of MDR bacteria in the ICU.

Trial registration: None.
What future for organic farming? Foresight for a smallholder Mediterranean agricultural system
Authors: Moreno-Pérez Olga M. , Blázquez-Soriano Amparo
Published: September 2023

This study aims to foresee the future of organic farming in the smallholder agricultural systems of the Valencian Region (Spain), as well as to identify how different drivers of change may affect such a future. To do so, two qualitative methodologies were combined: The Delphi method and the participatory scenario development. The results estimate an upward trend for organic farming area and sales, which would contribute to a greener and more sustainable economy in the region, a slight drop in organic versus conventional food prices, the entrance of large operators and a “dualisation” of the models of production and consumption of organic food. The key role that the public sector plays for the future of organic farming is underlined by the stakeholders, who suggest that the civil society may counterbalance the lack of public support by way of collective action and an increasing awareness about health and sustainability. This study concludes by highlighting the main findings obtained, both regarding the expected evolution of organic agriculture in the region and the key factors that would influence such evolution, emphasising the applicability of the results to other similar smallholder Mediterranean farming systems.
Association between serum albumin levels and height loss in Japanese workers: a retrospective study
Authors: Shimizu Yuji , Hayakawa Hidenobu , Honda Eiko , Sasaki Nagisa , Takada Midori , Okada Takeo , Ohira Tetsuya , Kiyama Masahiko
Published: September 2023

Background

Height loss starting in middle age was previously shown to be associated with high cardiovascular mortality in later life. However, the factors associated with height loss remain unknown. Since low serum albumin levels are reported to be associated with high mortality caused by cardiovascular disease, they may also contribute to height loss.

Methods

To clarify the association between serum albumin and height loss, we conducted a retrospective study of 7637 Japanese workers who participated in general health check-ups from 2008 to 2019. Height loss was defined as the highest quartile of height loss per year.

Results

Individual with high serum concentration of albumin possess beneficial influence on preventing incidence of height loss. In both men and women, serum albumin level was significantly inversely associated with height loss. After adjustment for known cardiovascular risk factors, the adjusted odd ratio (OR) and 95% confidence interval (CI) for height loss per 1 standard deviation of albumin (0.2 g/dL for both men and women) were 0.92 (0.86, 0.98) in men and 0.86 (0.79, 0.95) in women. Even when the analysis was limited to participants without hypoalbuminemia, essentially same association was observed, with fully adjusted corresponding ORs (95%CI) of 0.92 (0.86, 0.98) in men and 0.86 (0.78, 0.94) in women.

Conclusion

Independent of known cardiovascular risk factors, higher serum albumin levels may prevent height loss among Japanese workers. While several different diseases cause hypoalbuminemia, they may not be the main reasons for the association between serum albumin and height loss. Though further research is necessary, this finding may help clarify the mechanisms underlying the association between height loss and higher mortality in later life.
Cuproptosis-related gene subtypes predict prognosis in patients with head and neck squamous cell carcinoma
Authors: Wang Chi , Zhou Yu
Published: September 2023

Background

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. A novel form of copper-dependent and reactive oxygen species (ROS)-dependent cell death, cuproptosis, has been described in many cancers. The roles and potential mechanisms of cuproptosis-related genes (CRGs) are still unclear in HNSCC.

Method

We downloaded TCGA datasets of HNSCC genomic mutations and clinic data from The Cancer Genome Atlas. Based on the Cuproptosis-related differentially expressed genes in HNSCC, we constructed a prognostic signature.

Results

Eight CRGs have been identified as associated with the prognosis of HNSCC. According to Kaplan–Meier analyses, HNSCC with a high Risk Score had a poor prognosis. Furthermore, the AUC of the Risk Score for the 1-, 3-, and 5- year overall survival was respectively, 0.70, 0.71, and 0.68. TCGA data revealed that T cell functions, such as HLA, cytolytic activity, inflammation regulation, co-inhibition, and co-stimulation, differed significantly between members of the low and high groups. The immune checkpoint genes PD-L1, PD-L1, and CTLA-4 were also expressed differently in the two risk groups.

Conclusions

A CRG signature was defined that is associated with the prognosis of patients with HNSCC.

Graphical Abstract
Artificial coloration of ancient agate beads: a mineralogical study
Authors: Li Xiaoguang , Xue Haozhong , Wu Xinhua , Qin Dahai , Chen Daiming , Yuan Jiangyan , Tang Zihua
Published: September 2023

The process of staining was frequently employed to enhance or alter the color of agate beads in ancient times. One of the key challenges in studying ancient beads is comprehending the intricate techniques employed to color agate stones. An understanding of the staining mechanism from a mineralogical standpoint offers insights into the level of technological advancement in different civilizations. In this study, the mineral structure of eight ancient agate beads from Xinjiang Uygur Autonomous Region, NW China, was analyzed using Micro X-ray fluorescence (µXRF), Raman spectroscopy, Scanning Electron Microscope (SEM), and Fourier Transform Infrared (FTIR) techniques. The color, transparency, mineral phase, and surface roughness of the beads were examined, revealing variations ranging from colorless to light violet to dark violet. Raman and FTIR spectroscopy were employed to determine the SiO2 phase and the changes in optical characteristics of agate beads after artificial staining. The black color of the beads was formed by carbon penetration, while the red color was produced by heating. The coexistence of α-quartz and moganite phases in the red, the dark red, the black, the idiochromatic white and the part translucent zones of the ancient beads was confirmed by the 464 cm−1 peak of α-quartz and the 502 cm−1 peak of moganite phase. The analyzed red, the dark red, the black, the idiochromatic white and the part translucent zones exhibited remarkably similar FTIR spectral features, with two prominent bands at ~ 1097 and ~ 1187 cm−1, as well as two weak bands at 798 and 778 cm−1, indicating the presence of moganite and α-quartz in the unetched ancient beads. In contrast to the idiochromatic white appearance of natural agate, the scattered white coloration in etched beads was generated by an etching reaction. Both Raman and FTIR spectroscopy indicated the absence of moganite in etched beads, indicating that the scattered white color was produced by the loss of moganite and a portion of α-quartz, resulting in a rough surface.
Guided self-help for anxiety among Huntington’s disease gene expansion carriers (GUIDE-HD) compared to treatment as usual: a randomised controlled feasibility trial
Authors: Dale Maria , Eccles Fiona J. R. , Melvin Katie , Khan Zaynah , Jones Lee , Zarotti Nicolò , Kiani Reza , Johnson Jenny , Wells Robert , Simpson Jane
Published: September 2023

Background

Huntington’s disease (HD) is an adult-onset genetic neurodegenerative condition associated with cognitive decline, motor impairments, and emotional difficulties. Anxiety affects up to 71% of HD gene expansion carriers (i.e., those with the version of the gene that causes HD) and can negatively impact quality of life, worsen other HD symptoms, and increase suicide risk. Therefore, helping people with their anxiety should be a clinical priority. A significant evidence base now exists for low-cost talking therapies for anxiety, such as guided self-help, and with people with other neurodegenerative conditions (e.g., Parkinson’s disease). However, this type of intervention has not been specifically assessed with HD gene expansion carriers.

Methods

This protocol describes an exploratory randomised controlled feasibility study of a psychological intervention for anxiety for HD gene expansion carriers. The 10 session guided self-help intervention ('GUIDE-HD') is based on a blend of second and third wave cognitive behavioural models of anxiety (cognitive behaviour therapy [CBT] and acceptance and commitment therapy [ACT]) and is adapted to meet the specific needs of an HD population. This study will compare guided self-help with treatment as usual (TAU), with 15 HD gene expansion carriers randomly allocated to each group. Participants will be recruited across the UK. Quantitative data will be collected pre-intervention, immediately post-intervention, 3-month post-intervention and 6-month post-intervention. Qualitative data will be collected at one month post-intervention from participants, including HD carers. The data will be analysed to assess whether the current intervention and study design are feasible to progress to a larger randomised controlled trial. Feasibility has been defined in terms of recruitment rate, retention rate to both trial arms, intervention adherence, and acceptability of the intervention and measurement tools.

Discussion

Given the lack of evidenced interventions to date to support the wellbeing of people with the expanded Huntington’s gene, this study will assess the feasibility of progressing this particular intervention to a full trial. To try and increase the acceptability of the intervention, a number of stakeholders, including those affected by HD and in caring roles, have been fundamental to the creation of the intervention (e.g., therapy manual, planned therapy process) to date.

Trial registration

Trial ID: ISRCTN47330596.

Date registered: 28/09/2022.

Protocol version and date: Version 2, 09/06/22.

Trial sponsor organisation and contact: Leicestershire Partnership NHS Trust (Dave Clarke).

Role of sponsor: Overall responsibility for the conduct and governance of the trial.

Role of funder: Review of initial research proposal.
Cultural persistence or change? Gender differences in educational expectations of first and second-generation immigrants in Italy
Authors: Autiero Giuseppina , Nese Annamaria
Published: September 2023

This paper analyzes whether cultural heritage determines gender differences in educational expectations to go to university of first- and second-generation immigrants in Italy. The analysis relies on the “Integration of Second-Generation Survey” (INTEG2GEN) carried out by the Italian Institute of Statistics (ISTAT) in 2015. INTEG2GEN is a national representative survey of students living in Italy and attending lower and upper secondary school. Our findings suggest that parents’ cultural background plays a non-negligible role for their daughters’ and sons’ expectations. Nevertheless, there is a gender difference in the way they react to it. Males are more sensitive to cultural orientations towards education. Females are more responsive to gender inequality issues and tend to conform to gender roles deemed appropriate according to their cultural tradition. Nevertheless, females seem more open to changes and opportunities they face in the new country.
Does the systemic rise in serum lactate levels correlate to free flap failure in head and neck reconstructive surgeries—series of cases
Authors: Nikhar Sapna Annaji , Metta Rajasekhar , Nimmagadda Raja , Gopinath R.
Published: September 2023

Background

Head and neck reconstructive surgeries needs free tissue transfer but it fails sometimes. As most of the flap failure occurs in first 24 h. Local rise in lactate level or glucose lactate ratio provides clear indicator of tissue ischemia and further recovery. The question is about systemic rise in lactate levels with failing flap. Hence, we aimed to use systemic lactate levels to indicate free flap failure. To correlate the systemic rise in serum lactate levels to free flap failure in head and neck reconstructive surgeries. The series of cases were targeted undergoing free fibular graft, posted electively for head and reconstructive surgery operated by same surgeon. Record of blood loss, need of blood transfusion and use of microspan was also done. Monitoring of arterial blood gas values mainly lactate and vitals were done.

Results

Out of 15 patients studied, only 2(13.3%) patients had flap re-exploration (group F). Twelve (80%) patients were of ASA class I. Lactate, pH, blood sugars, base deficits and hemoglobin and vitals studied over 24 h in two groups had no statistically significant difference in the two groups. Lactate rise was noted in all cases for first few hours after starting surgery but elevated values were not observed during hours of flap re-exploration.

Conclusions

We could not establish relation between systemic rise in lactate levels and flap re-exploration or flap failure but continuous acidosis can impact outcome. We need to be vigilant and need to have individualized approach for management.
Ensemble Machine Learning Approaches Based on Molecular Descriptors and Graph Convolutional Networks for Predicting the Efflux Activities of MDR1 and BCRP Transporters
Authors: Adachi Asahi , Yamashita Tomoki , Kanaya Shigehiko , Kosugi Yohei
Published: September 2023

Multidrug resistance (MDR1) and breast cancer resistance protein (BCRP) play important roles in drug absorption and distribution. Computational prediction of substrates for both transporters can help reduce time in drug discovery. This study aimed to predict the efflux activity of MDR1 and BCRP using multiple machine learning approaches with molecular descriptors and graph convolutional networks (GCNs). In vitro efflux activity was determined using MDR1- and BCRP-expressing cells. Predictive performance was assessed using an in-house dataset with a chronological split and an external dataset. CatBoost and support vector regression showed the best predictive performance for MDR1 and BCRP efflux activities, respectively, of the 25 descriptor-based machine learning methods based on the coefficient of determination (R2). The single-task GCN showed a slightly lower performance than descriptor-based prediction in the in-house dataset. In both approaches, the percentage of compounds predicted within twofold of the observed values in the external dataset was lower than that in the in-house dataset. Multi-task GCN did not show any improvements, whereas multimodal GCN increased the predictive performance of BCRP efflux activity compared with single-task GCN. Furthermore, the ensemble approach of descriptor-based machine learning and GCN achieved the highest predictive performance with R2 values of 0.706 and 0.587 in MDR1 and BCRP, respectively, in time-split test sets. This result suggests that two different approaches to represent molecular structures complement each other in terms of molecular characteristics. Our study demonstrated that predictive models using advanced machine learning approaches are beneficial for identifying potential substrate liability of both MDR1 and BCRP.

Graphical Abstract
Leucine-rich repeat kinase 2 at a glance
Authors: Zhu Christiane , Herbst Susanne , Lewis Patrick A.
Published: September 2023

Leucine-rich repeat kinase 2 (LRRK2) is a multidomain scaffolding protein with dual guanosine triphosphatase (GTPase) and kinase enzymatic activities, providing this protein with the capacity to regulate a multitude of signalling pathways and act as a key mediator of diverse cellular processes. Much of the interest in LRRK2 derives from mutations in the LRRK2 gene being the most common genetic cause of Parkinson's disease, and from the association of the LRRK2 locus with a number of other human diseases, including inflammatory bowel disease. Therefore, the LRRK2 research field has focused on the link between LRRK2 and pathology, with the aim of uncovering the underlying mechanisms and, ultimately, finding novel therapies and treatments to combat them. From the biochemical and cellular functions of LRRK2, to its relevance to distinct disease mechanisms, this Cell Science at a Glance article and the accompanying poster deliver a snapshot of our current understanding of LRRK2 function, dysfunction and links to disease.