bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemoglobin levels and clinical outcomes after extracorporeal circulation auxiliary to open heart surgery: a retrospective cohort study
Authors: Fan Zhao-kun , Zhang Zhi-rong , Yi Ru-qin , Feng Wen , Li Cheng-en , Chen Wei , Shen Ying-ying
Published: December 2023

Background

Extracorporeal circulation auxiliary to open heart surgery is a common procedure used to treat heart diseases. However, the optimal transfusion strategy for patients undergoing this surgery remains a subject of debate. This study aims to investigate the association between hemoglobin levels and clinical outcomes in patients undergoing extracorporeal circulation auxiliary to open heart surgery, with the ultimate goal of improving surgical success rates and enhancing patients' quality of life.

Methods

A retrospective analysis was conducted on data from the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV 2.2) database, including 4144 patients. The patients were categorized into five groups based on their minimum hemoglobin levels during hospitalization. Baseline characteristics, clinical scores, laboratory results, and clinical outcome data were collected. Statistical analyses utilized descriptive statistics, ANOVA or Kruskal-Wallis tests, Kaplan-Meier method, and Log-rank test.

Results

The results revealed a significant correlation between hemoglobin levels and in-hospital mortality, as well as mortality rates at 30 days, 60 days, and 180 days (p < 0.001). Patients with lower hemoglobin levels exhibited higher mortality rates. However, once hemoglobin levels exceeded 7g/dL, no significant difference in mortality rates was observed (p = 0.557). Additionally, lower hemoglobin levels were associated with prolonged hospital stay, ICU admission time, and mechanical ventilation time (p < 0.001). Furthermore, hemoglobin levels were significantly correlated with complication risk, norepinephrine dosage, and red blood cell transfusion volume (p < 0.001). However, there was no significant difference among the groups in terms of major complications, specifically sepsis (p > 0.05).

Conclusion

The study highlights the importance of managing hemoglobin levels in patients undergoing heart surgery with extracorporeal circulation. Hemoglobin levels can serve as valuable indicators for predicting clinical outcomes and guiding treatment decisions. Physicians should carefully consider hemoglobin levels to optimize transfusion strategies and improve postoperative patient outcomes. Further research and intervention studies are warranted to validate and implement these findings in clinical practice.
Healthcare and community stakeholders’ perceptions of barriers and facilitators to implementing a behavioral activation intervention for people with dementia and depression: a qualitative study using Normalization Process Theory
Authors: Svedin Frida , Blomberg Oscar , Brantnell Anders , Farrand Paul , Åberg Anna Cristina , Woodford Joanne
Published: December 2023

Background

Depression is commonly experienced by people with dementia, and associated with lower quality of life and functional decline. However, access to evidence-based psychological interventions for people with dementia and depression is limited. One potential solution is guided low-intensity behavioral activation. Following the new Medical Research Council Framework, considering factors such as potential barriers and facilitators to implementation is recommended during the development of new interventions. Aims of this study were to: (1) develop an understanding of existing healthcare and community support in the Swedish context for people with dementia and their informal caregivers; and (2) identify barriers and facilitators to intervention uptake informed by Normalization Process Theory.

Methods

Semi-structured interviews and focus groups were held with healthcare (n = 18) and community (n = 7) stakeholders working with people with dementia and/or informal caregivers. Interview questions were informed by Normalization Process Theory. Data was analysed utilizing a two-step deductive analysis approach using the Normalization Process Theory coding manual, with inductive categories applied to data related to the main mechanisms of the theory, but not captured by its sub-constructs.

Results

Ten deductive and three inductive categories related to three Normalization Process Theory primary mechanisms (Coherence, Cognitive Participation, and Collective Action) were identified. Identified barriers to intervention uptake included: (1) additional burden for informal caregivers; (2) lack of appropriate workforce to provide guidance; (3) lack of time and financial resources; (4) people with dementia not recognising their diagnosis of dementia and/or a need for support; and (5) stigma. Identified facilitators to intervention uptake included: (1) intervention has potential to fill a large psychological treatment gap in Sweden; (2) objectives and potential benefits understood and agreed by most stakeholders; and (3) some healthcare professionals recognized their potential role in providing intervention guidance.

Conclusions

Several barriers and facilitators for future implementation, specific to the intervention, individuals and families, as well as professionals, were identified during intervention development. Barriers were mapped into evidence-based implementation strategies, which will be adopted to overcome identified barriers. A feasibility study further examining implementation potential, acceptability and feasibility, alongside clinical, methodological, and procedural uncertainties associated with the intervention will be conducted.

Trial registration

Not applicable.
MedFusionGAN: multimodal medical image fusion using an unsupervised deep generative adversarial network
Authors: Safari Mojtaba , Fatemi Ali , Archambault Louis
Published: December 2023

Purpose

This study proposed an end-to-end unsupervised medical fusion generative adversarial network, MedFusionGAN, to fuse computed tomography (CT) and high-resolution isotropic 3D T1-Gd Magnetic resonance imaging (MRI) image sequences to generate an image with CT bone structure and MRI soft tissue contrast to improve target delineation and to reduce the radiotherapy planning time.

Methods

We used a publicly available multicenter medical dataset (GLIS-RT, 230 patients) from the Cancer Imaging Archive. To improve the models generalization, we consider different imaging protocols and patients with various brain tumor types, including metastases. The proposed MedFusionGAN consisted of one generator network and one discriminator network trained in an adversarial scenario. Content, style, and L1 losses were used for training the generator to preserve the texture and structure information of the MRI and CT images.

Results

The MedFusionGAN successfully generates fused images with MRI soft-tissue and CT bone contrast. The results of the MedFusionGAN were quantitatively and qualitatively compared with seven traditional and eight deep learning (DL) state-of-the-art methods. Qualitatively, our method fused the source images with the highest spatial resolution without adding the image artifacts. We reported nine quantitative metrics to quantify the preservation of structural similarity, contrast, distortion level, and image edges in fused images. Our method outperformed both traditional and DL methods on six out of nine metrics. And it got the second performance rank for three and two quantitative metrics when compared with traditional and DL methods, respectively. To compare soft-tissue contrast, intensity profile along tumor and tumor contours of the fusion methods were evaluated. MedFusionGAN provides a more consistent, better intensity profile, and a better segmentation performance.

Conclusions

The proposed end-to-end unsupervised method successfully fused MRI and CT images. The fused image could improve targets and OARs delineation, which is an important aspect of radiotherapy treatment planning.
Value of the stroke 1-2-0 prehospital stroke education system: the experience of a general practitioner team
Authors: Liu Yang , Wang Daosheng , Chu Min , Yang Zhenzhen , Luo Yunhe , Wang Delong , Zhao Jing
Published: December 2023

Background

Stroke is one of the leading causes of death worldwide, especially in developing countries. In China, there is an urgent need to educate people about stroke awareness and the importance of using emergency medical services (EMS) quickly after a stroke has occurred.

Objective

We sought to explore the effects of the Stroke 1-2-0 Prehospital Stroke Education System based on the experience of a general practitioner team.

Method

We prospectively enrolled 119 community general practitioners to be trained in the procedures advocated by the Stroke 1-2-0 Prehospital Stroke Education System. The training content included early detection of ischemic stroke, first aid for stroke, and intravenous thrombolysis; The effects of the training were later evaluated via a before-and-after comparison. The 119 enrolled physicians formed a Stroke 1-2-0 lecturer group and taught stroke knowledge to community residents. The group remained active for 6 months, during which the medical treatment data of stroke patients (i.e., stroke onset time, prehospital delay, whether an ambulance was called, and whether thrombolytic therapy was performed) in each of 5 jurisdictions were recorded for the month before (January 2021) and that after (August 2021) the 6-month community education program. Finally, the effects of the community education program were evaluated.

Results

The participants’ understanding of intravenous thrombolysis in the treatment of acute ischemic stroke improved significantly after the training as compared with their earlier understanding (96% vs. 78.99%; P < .001), and their understanding of the time window for intravenous thrombolysis increased from 26.05% before to 72% (P < .001) after the training. Most of the participants (90% vs. 67.23%; P < .001) said that they would immediately call the 120 emergency number of China’s emergency phone system if they encountered individuals who appeared to be victims of acute stroke. A total of 82 stroke patients were seen before and 67 after the community education program. As for the use of the emergency call system, more patients with stroke activated that system after the program versus before (21.95% vs. 37.31%; P = .04). The 3-hour arrival rate after the program was nearly three times higher than that before the program (62.69% vs. 19.51%; P < .001). Also, regarding receiving thrombolysis after the occurrence of a stroke, the program triggered a substantial increase compared with the total earlier (19.4% vs. 6.1%; P = .013).

Conclusion

We found that the Stroke 1-2-0 Prehospital Stroke Education System significantly improved community residents’ knowledge regarding stroke.
Promising preclinical patient-derived organoid (PDO) and xenograft (PDX) models in upper gastrointestinal cancers: progress and challenges
Authors: Gao Jing , Lan Jianqiang , Liao Haiyan , Yang Fang , Qiu Pei , Jin Feng , Wang Shubin , Shen Lin , Chao Tengfei , Zhang Cheng , Zhu Yu
Published: December 2023

Gastrointestinal (GI) cancers (gastric cancer, oesophageal cancer, liver cancer, colorectal cancer, etc.) are the most common cancers with the highest morbidity and mortality in the world. The therapy for most GI cancers is difficult and is associated with a poor prognosis. In China, upper GI cancers, mainly gastric cancer (GC) and oesophageal cancer (EC), are very common due to Chinese people’s characteristics, and more than half of patients are diagnosed with distant metastatic or locally advanced disease. Compared to other solid cancers, such as lung cancer and breast cancer, personalized therapies, especially targeted therapy and immunotherapy, in GC and EC are relatively lacking, leading to poor prognosis. For a long time, most studies were carried out by using in vitro cancer cell lines or in vivo cell line-derived xenograft models, which are unable to reproduce the characteristics of tumours derived from patients, leading to the possible misguidance of subsequent clinical validation. The patient-derived models represented by patient-derived organoid (PDO) and xenograft (PDX) models, known for their high preservation of patient tumour features, have emerged as a very popular platform that has been widely used in numerous studies, especially in the research and development of antitumour drugs and personalized medicine. Herein, based on some of the available published literature, we review the research and application status of PDO and PDX models in GC and EC, as well as detail their future challenges and prospects, to promote their use in basic and translational studies or personalized therapy.
The aetiology and burden of myeloproliferative neoplasms in the United Kingdom: the MyelOproliferative neoplasmS: an In-depth case-control (MOSAICC) study protocol
Authors: Abutheraa Nouf , Tarburn Emma-Louise , McShane Charlene M. , Duncombe Andrew , McMullin Mary Frances , Anderson Lesley Ann
Published: December 2023

Background

Myeloproliferative neoplasms (MPNs) are a group of haematological malignancies that affect approximately 8 people in every 100,000 individuals in the UK. Little is known about the aetiology of MPNs, as previous studies have been hampered by small sample sizes, thus it is important to understand the cause of MPNs in a larger study to identify prevention strategies and improve treatment strategies. This study aims to determine environmental, lifestyle, genetic and medical causes of MPNs and to assess the relevance of occupational carcinogen exposures and quality of life impacts.

Methods

A UK-wide case-control study of 610 recently diagnosed MPN patients (within 24 months) receiving clinical care at 21 NHS study sites in Scotland, England, Wales and Northern Ireland and 610 non-blood relative/friend controls is underway. Data on occupational and residential history, medical and environmental factors, and quality of life are being collected from the participants via a structured interview and self-complete questionnaires. Clinical data is being provided by the clinical team. Blood, saliva and toenail samples are also being collected for genetic and elemental analysis. Adjusted odds ratios (ORs) and 95% confidence intervals (95%CI) will be calculated using a p < 0.05 to investigate potential risk factors for the MPN clinical and genetic subtypes, and further analyses will be conducted based on the type of data and outcome of interest at a later stage.

Discussion

The study design is most effective for investigating the aetiology of rare diseases. The study will enable identification of potential causes of MPNs through in-depth assessment of potential risk factors with potential for longer follow-up of a number of outcomes.
Preliminary analysis of predicting the first recurrence in patients with neovascular age-related macular degeneration using deep learning
Authors: Jang Boa , Lee Sang-Yoon , Kim Chaea , Park Un Chul , Kim Young-Gon , Lee Eun Kyoung
Published: December 2023

Background

To predict, using deep learning, the first recurrence in patients with neovascular age-related macular degeneration (nAMD) after three monthly loading injections of intravitreal anti-vascular endothelial growth factor (anti-VEGF).

Methods

Optical coherence tomography (OCT) images were obtained at baseline and after the loading phase. The first recurrence was defined as the initial appearance of a new retinal hemorrhage or intra/subretinal fluid accumulation after the initial resolution of exudative changes after three loading injections. Standard U-Net architecture was used to identify the three retinal fluid compartments, which include pigment epithelial detachment, subretinal fluid, and intraretinal fluid. To predict the first recurrence of nAMD, classification learning was conducted to determine whether the first recurrence occurred within three months after the loading phase. The recurrence classification architecture was built using ResNet50. The model with retinal regions of interest of the entire region and fluid region on OCT at baseline and after the loading phase is presented.

Results

A total of 1,444 eyes of 1,302 patients were included. The mean duration until the first recurrence after the loading phase was 8.20 ± 15.56 months. The recurrence classification system revealed that the model with the fluid region of OCT after the loading phase provided the highest classification performance, with an area under the receiver operating characteristic curve (AUC) of 0.725 ± 0.012. Heatmap analysis revealed that three pathological fluids, subsided choroidal neovascularization lesions, and hyperreflective foci were important areas for the first recurrence.

Conclusions

The deep learning algorithm allowed for the prediction of the first recurrence for three months after the loading phase with adequate feasibility. An automated prediction system may assist in establishing patient-specific treatment plans and the provision of individualized medical care for patients with nAMD.
Gaps in sexual health content of healthcare professional curriculum: a systematic review of educational interventions
Authors: Prize Nikole Bekman Troxman , Kanat Sarit Shimony - , Wruble Anna C. Kienski Woloski
Published: December 2023

Background

Sexual health care, including assessment and patient teaching, is part of comprehensive patient care. Health professional (medical and nursing) students’ education in sexual health lacks uniformity in content and assessment skills.

Objectives

The current systematic review aimed to assess sexual health educational curriculum for health professional students regarding the educational content, duration, and evaluation of these educational interventions.

Methods

This systematic review followed the preferred reporting guidelines for systematic reviews. A comprehensive search was conducted between May–August, 2023 across four databases (PubMed, Scopus, CINAHL, EMBASE), outlining 614 sources. Following the screening process, 36 educational intervention studies were deemed eligible for inclusion. The quality assessment of these studies was conducted using The Effective Public Health Project tool, which was found appropriate for evaluating this type of research.

Results

The studies had a global representation, with most studies conducted in the US. Limited nursing educational interventions were found. Three main categories emerged from the analysis of the educational interventions: one-time interventions, workshops, and semester courses. These categories differed in terms of their duration. Upon evaluating the educational intervention programs, it was found that the majority relied on participant self-reporting, while only a few included objective evaluations.

Conclusions

This review revealed inconsistencies in educational content for healthcare professional students and may impact their clinical skills, particularly in sexual health. The variation in content, duration, and evaluation methods created challenges in assessing the interventions. The lack of standardized sexual health education highlighted a significant gap, raising concerns about students’ ultimate proficiency in this area. Bridging this divide is essential by integrating comprehensive sexual health content and assessment skills into the health professional curriculum.
Clinical features and genetic analysis of a case series of skeletal ciliopathies in a prenatal setting
Authors: Peng Ying , Zhou Lin , Chen Jing , Huang Xiaoliang , Pang Jialun , Liu Jing , Tang Wanglan , Yang Shuting , Liang Changbiao , Xie Wanqin
Published: December 2023

Background

Short-rib polydactyly syndrome (SRPS) refers to a group of lethal skeletal dysplasias that can be difficult to differentiate between subtypes or from other non-lethal skeletal dysplasias such as Ellis-van Creveld syndrome and Jeune syndrome in a prenatal setting. We report the ultrasound and genetic findings of four unrelated fetuses with skeletal dysplasias.

Methods

Systemic prenatal ultrasound examination was performed in the second or third trimester. Genetic tests including GTG-banding, single nucleotide polymorphism (SNP) array and exome sequencing were performed with amniocytes or aborted fetal tissues.

Results

The major and common ultrasound anomalies for the four unrelated fetuses included short long bones of the limbs and narrow thorax. No chromosomal abnormalities and pathogenic copy number variations were detected. Exome sequencing revealed three novel variants in the DYNC2H1 gene, namely NM_001080463.2:c.6809G > A p.(Arg2270Gln), NM_001080463.2:3133C > T p.(Gln1045Ter), and NM_001080463.2:c.337C > T p.(Arg113Trp); one novel variant in the IFT172 gene, NM_015662.3:4540-5 T > A; and one novel variant in the WDR19 gene, NM_025132.4:c.2596G > C p.(Gly866Arg). The genotypes of DYNC2H1, IFT172 and WDR19 and the phenotypes of the fetuses give hints for the diagnosis of short-rib thoracic dysplasia (SRTD) with or without polydactyly 3, 10, and 5, respectively.

Conclusion

Our findings expand the mutation spectrum of DYNC2H1, IFT172 and WDR19 associated with skeletal ciliopathies, and provide useful information for prenatal diagnosis and genetic counseling on rare skeletal disorders.
Identifying tumor cell-released extracellular vesicles as biomarkers for breast cancer diagnosis by a three-dimensional hydrogel-based electrochemical immunosensor
Authors: Zhang Yue , Pan Deng , Ning Zhenqiang , Huang Fang , Wei Yiting , Zhang Mingming , Zhang Yuanjian , Wang Li-xin , Shen Yanfei
Published: December 2023

Tumor cell-released LC3+ extracellular vesicles (LC3+ EVs) participate in immunosuppression during autophagy and contribute to the occurrence and development of breast cancer. In view of the strong association between the LC3+ EVs and breast cancer, developing an effective strategy for the quantitative detection of LC3+ EVs levels with high sensitivity to identify LC3+ EVs as new biomarkers for accurate diagnosis of breast cancer is crucial, but yet not been reported. Herein, an ultrasensitive electrochemical immunosensor is presented for the quantitative determination of LC3+ EVs using a three-dimensional graphene oxide hydrogel-methylene blue composite as a redox probe, showing a low detection limit and a wide linear range. With this immunosensor, the expression levels of LC3+ EVs in various practical sample groups including different cancer cell lines, the peripheral blood of tumor-bearing mice before and after immunotherapy, and the peripheral blood from breast cancer patients with different subtypes and stages were clearly distinguished. This study demonstrated that LC3+ EVs were superior as biomarkers for the accurate diagnosis of breast cancer compared to traditional biomarkers, particularly for cancer subtype discrimination. This work would provide a new noninvasive detection tool for the early diagnosis and prognosis assessment of breast cancer in clinics.
Effect of intravenous low-dose norepinephrine on blood loss in non-tourniquet total knee arthroplasty under general anesthesia: a randomized, double-blind, controlled, single-center trial
Authors: Chen Shijie , Luo Fenqi , Lin Yuan , Yu Guoyu , Luo Jun , Xu Jie
Published: December 2023

Objective

This prospective trial aimed to evaluate the effects of low-dose intravenous norepinephrine (NE) on intraoperative blood loss and bleeding from osteotomy sites during non-tourniquet total knee arthroplasty (TKA) under general anesthesia.

Methods

A total of 120 patients who underwent TKA between December 2020 and May 2022 were enrolled and randomly assigned to the intravenous low-dose NE Group (NE Group) or the control group (C Group). During surgery, NE Group received 0.05–0.1 μg/(kg min) of NE intravenously to raise and maintain the patient's mean arterial pressure (MAP). C Group received the same dose of saline as placebo. Intraoperative blood loss, bleeding score at osteotomy sites, Δlactate levels (Lac), postoperative complications, and transfusion rate during hospitalization were compared between groups.

Results

Intraoperative and osteotomy blood loss was significantly lower in the NE Group than in the C Group (P < 0.001). No significant difference was observed in ΔLac between groups (P > 0.05). There was no significant difference in complications between the groups 3 days after surgery (P > 0.05). In addition, there was no significant difference in blood transfusion rates between the two groups during hospitalization (P > 0.05).

Conclusion

In non-tourniquet TKA under general anesthesia, low-dose intravenous NE safely and effectively reduced intraoperative blood loss and provided a satisfactory osteotomy site while maintaining a higher MAP.
GCLiPP: global crosslinking and protein purification method for constructing high-resolution occupancy maps for RNA binding proteins
Authors: Zhu Wandi S. , Litterman Adam J. , Sekhon Harshaan S. , Kageyama Robin , Arce Maya M. , Taylor Kimberly E. , Zhao Wenxue , Criswell Lindsey A. , Zaitlen Noah , Erle David J. , Ansel K. Mark
Published: December 2023

GCLiPP is a global RNA interactome capture method that detects RNA-binding protein (RBP) occupancy transcriptome-wide. GCLiPP maps RBP-occupied sites at a higher resolution than phase separation-based techniques. GCLiPP sequence tags correspond with known RBP binding sites and are enriched for sites detected by RBP-specific crosslinking immunoprecipitation (CLIP) for abundant cytosolic RBPs. Comparison of human Jurkat T cells and mouse primary T cells uncovers shared peaks of GCLiPP signal across homologous regions of human and mouse 3′ UTRs, including a conserved mRNA-destabilizing cis-regulatory element. GCLiPP signal overlapping with immune-related SNPs uncovers stabilizing cis-regulatory regions in CD5, STAT6, and IKZF1.
The functions of SET domain bifurcated histone lysine methyltransferase 1 (SETDB1) in biological process and disease
Authors: Luo Hanshen , Wu Xingliang , Zhu Xue-Hai , Yi Xin , Du Dunfeng , Jiang Ding-Sheng
Published: December 2023

Histone methyltransferase SETDB1 (SET domain bifurcated histone lysine methyltransferase 1, also known as ESET or KMT1E) is known to be involved in the deposition of the di- and tri-methyl marks on H3K9 (H3K9me2 and H3K9me3), which are associated with transcription repression. SETDB1 exerts an essential role in the silencing of endogenous retroviruses (ERVs) in embryonic stem cells (mESCs) by tri-methylating H3K9 (H3K9me3) and interacting with DNA methyltransferases (DNMTs). Additionally, SETDB1 is engaged in regulating multiple biological processes and diseases, such as ageing, tumors, and inflammatory bowel disease (IBD), by methylating both histones and non-histone proteins. In this review, we provide an overview of the complex biology of SETDB1, review the upstream regulatory mechanisms of SETDB1 and its partners, discuss the functions and molecular mechanisms of SETDB1 in cell fate determination and stem cell, as well as in tumors and other diseases. Finally, we discuss the current challenges and prospects of targeting SETDB1 for the treatment of different diseases, and we also suggest some future research directions in the field of SETDB1 research.
Clinical phenotypes and prognoses of microscopic polyangiitis based on kidney biopsies
Authors: Wang Juan , Li Rui , Zhou Wenyan , Lin Yanwei , Wang Xiaodong , Ye Shuang , Lu Liangjing , Zhang Minfang , Chen Sheng
Published: December 2023

Background

To classify the different clinical phenotypes and compare the distinct prognoses of microscopic polyangiitis (MPA).

Methods

A retrospective analysis of 436 patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) from 2015 to 2022 was conducted in our center, of which 90 patients were diagnosed with MPA and underwent renal biopsy.

Results

Among the 90 MPA patients, 63% were female, and the median age at onset was 63 years (25th–75th percentile: 58–68). The median follow-up time was 26 months (25th–75th percentile: 10–53). We identified four subtypes: renal impairment type (cluster 1, 39%), pure type (cluster 2, 22%), systemic inflammation type (cluster 3, 26%), and rapid progress type (cluster 4, 13%). Cluster 1, characterized by renal dysfunction at onset (80%), demonstrated poor prognoses with only 26% achieved complete remission (CR), 11% dying, and 19% developing renal failure. In contrast, patients in cluster 2, exclusively female, most had only kidney involvement showed the best prognoses with 55% achieving CR and none experiencing death or renal failure within 10 years. Cluster 3 mostly consisted of males; high fever and C-reactive protein levels were the primary characteristics. These cases exhibited moderate prognoses with 53% achieving CR, 9% dying, and 4% developing renal failure. Finally, patients in cluster 4, which was characterized by rapidly progressive glomerulonephritis, had the worst prognoses, with none achieving CR, 8% dying, and 75% developing renal failure despite aggressive treatment.

Conclusions

MPA is classified into four subtypes with distinct clinical manifestations and prognoses.
A cross-sectional study on the prevalence of cardiovascular disease in elderly patients with long-term type 2 diabetes mellitus mainly attended in private clinics in Mexico. The CAPTURE study
Authors: Arenas-León José L. , Morales-Villegas Enrique C. , Cardona-Muñoz Ernesto G. , Alcocer-Gamba Marco A. , Ramirez-Contreras Juan P. , Contreras-Sandoval Aleida Y. , González-Galvez Guillermo
Published: December 2023

Background

To estimate the contemporary prevalence of established cardiovascular disease (CVD) in adults with type 2 diabetes (T2D) in Mexico.

Methods

CAPTURE was a multinational, non-interventional, cross-sectional study across 13 countries from five continents. Standardized demographic and clinical data were collected from adults with T2D attending a single routine healthcare visit in primary or specialized care between December 2018 and September 2019. Data from Mexico are analyzed in this study.

Results

Of the 9,823 patients included in the CAPTURE study, 820 (8.3%) participants were from Mexico, mainly attended in private centers (29.3% in 6 specialized diabetes treatment centers and 70.7% in 26 primary care centers). The median age was 63.0 years, 52.6% were women, the duration of diabetes was 11.8 years and the average HbA1c 7.5%. The weighted prevalence [95% CI] of CVD and atherosclerotic CVD was 36.9% [34.1–39.6] and 29.5% [26.7–32.3], respectively. Additionally, the prevalence of coronary heart disease, heart failure, peripheral arterial disease and cerebrovascular disease was 23.1% [20.6–25-7], 8.4% [6.8–10.0], 5.0% [3.5–6.5] and 3.9% [2.6–5.2], respectively. Glucose lowering drugs were used in 88.5% of patients, being metformin the most commonly drug used (79.4%), followed by sulfonylureas (26.3%). SGLT-2 inhibitors and GLP1 receptor agonists were used in 15.5% and 3.9%, respectively.

Conclusions

In Mexico, nearly four out of ten patients with T2D mainly attended in private centers have CVD, particularly atherosclerotic CVD. Most patients were not taking glucose lowering drugs with proven CV benefit.
An international comparison of gender differences in mental health among higher-education students during the first wave of the COVID-19 pandemic: a multilevel design
Authors: Van de Velde Sarah , De Cuyper Anneleen , De Kort Leen , Jacobs Kimberly , Somogyi Nikoletta , Tholen Robert , Van Eekert Nina , Buffel Veerle
Published: December 2023

Background

Mental health problems are a common phenomenon among higher-education students. How these mental health problems manifest themselves appears to differ between male and female students. While the latter group bears a greater risk of developing internalizing problems, with depression being particularly prevalent, these problems manifest themselves in male students mainly via externalizing disorders, with alcohol abuse being the most prevalent. Available cross-national research on students’ mental health during the COVID-19 pandemic, to date, mainly focused on the prevalence of depressive symptoms, thereby ignoring a possible gendered impact of the pandemic.

Methods

The current study used the COVID-19 International Student Well-Being Study, which collected data on students’ mental health during the first wave of the COVID-19 pandemic in 26 countries, and multilevel modeling was applied.

Results

It finds that, overall, female students reported more depressive feelings, and male students reported more excessive alcohol consumption. The strictness of the governmental containment measures explained a substantial amount of these gender differences in depressive feelings, but not in excessive alcohol consumption.

Conclusions

Our study highlights that the COVID-19 pandemic had a gendered impact on students’ mental health. Studies that ignore the gendered impact of the COVID-19 pandemic are therefore limited in scope.
Exploring near-linearities in price–rate of profit trajectories and the concept of effective rank in input–output matrices
Authors: Tsoulfidis Lefteris
Published: December 2023

In recent years, there has been a resurgence of interest in the controversies surrounding capital theory. At the heart of these debates are the empirically observed near-linearities in the price–rate of profit and wage rate of profit curves. This article posits that these near-linearities can be attributed to the low effective rank property inherent in the economy's system matrices of input–output coefficients. This suggests that a comprehensive representation of how prices evolve in response to changes in income distribution can be achieved with only a few eigenvalues and their respective eigenvectors. Furthermore, this low-dimensional system possesses the capability to capture the majority of distinctive features that characterize the input–output structure of the economy in relation to price movements.
Novel data-driven subtypes and stages of brain atrophy in the ALS–FTD spectrum
Authors: Shen Ting , Vogel Jacob W. , Duda Jeffrey , Phillips Jeffrey S. , Cook Philip A. , Gee James , Elman Lauren , Quinn Colin , Amado Defne A. , Baer Michael , Massimo Lauren , Grossman Murray , Irwin David J. , McMillan Corey T.
Published: December 2023

Background

TDP-43 proteinopathies represent a spectrum of neurological disorders, anchored clinically on either end by amyotrophic lateral sclerosis (ALS) and frontotemporal degeneration (FTD). The ALS–FTD spectrum exhibits a diverse range of clinical presentations with overlapping phenotypes, highlighting its heterogeneity. This study was aimed to use disease progression modeling to identify novel data-driven spatial and temporal subtypes of brain atrophy and its progression in the ALS–FTD spectrum.

Methods

We used a data-driven procedure to identify 13 anatomic clusters of brain volume for 57 behavioral variant FTD (bvFTD; with either autopsy-confirmed TDP-43 or TDP-43 proteinopathy-associated genetic variants), 103 ALS, and 47 ALS–FTD patients with likely TDP-43. A Subtype and Stage Inference (SuStaIn) model was trained to identify subtypes of individuals along the ALS–FTD spectrum with distinct brain atrophy patterns, and we related subtypes and stages to clinical, genetic, and neuropathological features of disease.

Results

SuStaIn identified three novel subtypes: two disease subtypes with predominant brain atrophy in either prefrontal/somatomotor regions or limbic-related regions, and a normal-appearing group without obvious brain atrophy. The limbic-predominant subtype tended to present with more impaired cognition, higher frequencies of pathogenic variants in TBK1 and TARDBP genes, and a higher proportion of TDP-43 types B, E and C. In contrast, the prefrontal/somatomotor-predominant subtype had higher frequencies of pathogenic variants in C9orf72 and GRN genes and higher proportion of TDP-43 type A. The normal-appearing brain group showed higher frequency of ALS relative to ALS–FTD and bvFTD patients, higher cognitive capacity, higher proportion of lower motor neuron onset, milder motor symptoms, and lower frequencies of genetic pathogenic variants. The overall SuStaIn stages also correlated with evidence for clinical progression including longer disease duration, higher King’s stage, and cognitive decline. Additionally, SuStaIn stages differed across clinical phenotypes, genotypes and types of TDP-43 pathology.

Conclusions

Our findings suggest distinct neurodegenerative subtypes of disease along the ALS–FTD spectrum that can be identified in vivo, each with distinct brain atrophy, clinical, genetic and pathological patterns.
A potential transition from a concentrated to a generalized HIV epidemic: the case of Madagascar
Authors: Alonso David , Vallès Xavier
Published: December 2023

Background

HIV expansion is controlled by a range of interrelated factors, including the natural history of HIV infection and socio-economical and structural factors. However, how they dynamically interact in particular contexts to drive a transition from concentrated HIV epidemics in vulnerable groups to generalized epidemics is poorly understood. We aim to explore these mechanisms, using Madagascar as a case-study.

Methods

We developed a compartmental dynamic model using available data from Madagascar, a country with a contrasting concentrated epidemic, to explore the interaction between these factors with special consideration of commercial and transactional sex as HIV-infection drivers.

Results

The model predicts sigmoidal-like prevalence curves with turning points within years 2020–2022, and prevalence reaching stabilization by 2033 within 9 to 24% in the studied (10 out of 11) cities, similar to high-prevalence regions in Southern Africa. The late/slow introduction of HIV and  circumcision, a widespread traditional practice in Madagascar, could have slowed down HIV propagation, but, given the key interplay between risky behaviors associated to young women and acute infections prevalence, mediated by transactional sex, the protective effect of circumcision is currently insufficient to contain the expansion of the disease in Madagascar.

Conclusions

These results suggest that Madagascar may be experiencing a silent transition from a concentrated to a generalized HIV epidemic. This case-study model could help to understand how this HIV epidemic transition occurs.

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The development of the fear of earthquake scale: validity and reliability study in Türkiye after the 2023 earthquake
Authors: Sarı Tuğba , Taşdelen-Karçkay Arzu , Tarcan Şule
Published: December 2023

Background

In 2023, Türkiye experienced a significant earthquake disaster that profoundly impacted 11 provinces. The enduring consequences of these earthquakes on daily life triggered widespread fears and anxieties in society, leading to scholarly investigations in this field.

Objective

The primary objective of this study was to create and evaluate the psychometric properties of the Fear of Earthquake Scale (FES), a modified adaptation of the Fear of COVID-19 Scale (FCV-19 S), tailored to measure earthquake-related experiences in Türkiye.

Methods

A total of 315 Turkish adult participants (106 men, 209 women), with a mean age of 37.71 years, completed the FES, along with the Brief Psychological Resilience Scale (BPRS). Psychometric analyses included confirmatory factor analysis as well as the evaluation of alternative factor structures, internal consistency, convergent validity, and criterion validity with respect to resilience.

Results

The findings indicate that the Turkish version of the Fear of Earthquake Scale has strong psychometric properties in terms of validity and reliability. After assessing various factor structures, it was observed that the two-factor model which represents the emotional and somatic response to fear, exhibited the best-fit values The Cronbach’s alpha coefficients were calculated as 0.89 for the overall FES, 0.84 for the emotional subscale and 0.86 for the somatic subscale, indicating high internal consistency. Additionally, the negative correlation between resilience and the FES supports the criterion validity of the scale, and multi-group confirmatory factor analyses proved that measurement invariance held across genders and whether they experienced an earthquake or not for all groups. Furthermore, the results of the study revealed that women and individuals with prior earthquake experience reported higher levels of fear of earthquakes.

Conclusions

The FES emerged as a reliable and valid tool for assessing earthquake-related fears among the Turkish population.
A step toward autonomy in education: probing into the effects of practicing self-assessment, resilience, and creativity in task supported language learning
Authors: Aldosari Mubarak S. , Alsager Haroon N.
Published: December 2023

Self-assessment (SA) can provide students with opportunities to self-evaluate, or make judgments about their learning process and products of learning. Regarding the importance of SA, this survey pursued to examine the effects of practicing SA on Saudi Arabian EFL learners’ resilience, creativity, and autonomy in task supported language learning. To fulfill these objectives, 60 intermediate EFL learners were chosen and separated accidentally into two groups of control and experimental. They were then pre-tested using three related questionnaires of resilience, creativity, and autonomy. Next, the treatment was practiced on the two groups. Eight lessons of Touchstone Book 3 were taught to the experimental group using SAvia applying different tasks. On the other hand, the lessons were trained to the control group without using SA and tasks. The aforementioned questionnaires were re-administered as the post-tests following the completion of all lessons. Independent and paired samples t-test findings displayed that the control and experimental groups performed differently on the three post-tests. In essence, the results showed that the experimental group's resilience, creativity, and autonomy were all improved by the treatment. The research's implications and conclusions were then outlined. The implications of the research can allow students to evaluate their own progress and skill development critically.
Stimulating creativity in the classroom: examining the impact of sense of place on students’ creativity and the mediating effect of classmate relationships
Authors: Zhang Jianzhen , Yang Yukun , Ge Jiahao , Liang Xiaoyu , An Zhenni
Published: December 2023

Background

Although previous studies have found a close relationship between sense of place and creativity, few studies have been conducted considering the micro-environment of the classroom. The mediating role of classmate relationships in the association between students’ sense of place and creativity remains unclear.

Methods

This study explores classmate relationships as a mediating factor in the relationship between sense of place and creativity. Therefore, we considered a sample of 1555 Chinese high-school students and used a paper-based questionnaire survey. Data analysis was performed using SPSS 24.0, PROCESS 3.2 plugin, and AMOS.

Results

Sense of place in the micro-environment of the classroom has a significant positive predictive effect on creativity. Sense of place also has a significant positive predictive effect on peer relationships. The mediation analysis reveals that peer relationships play a mediating role in the relationship between the sense of place and creativity.

Conclusions

This study revealed the associations between sense of place, classmate relationships, and creativity. Creativity is better expressed in students with a strong sense of place in the classroom. Moreover, a student’s sense of place can enhance their creativity by influencing their peer relationships. These findings enrich the research in educational psychology within the classroom, providing new insights for fostering creativity.
Barriers to social sustainability in urbanisation: a comparative multi-stakeholder perspective
Authors: Sharif Ahlam Ammar
Published: December 2023

Social sustainability is a key pillar of sustainable development that usually receives less focus and emphasis when compared to other environmental or economic aspects. This entails the need to address this gap, should the concept of urban sustainability be comprehensively tackled. Despite such importance, social sustainability is considered a relatively difficult pillar to measure, considering its entanglements with the concerned individuals, communities, and stakeholders. This study aimed to identify the key barriers to achieving social sustainability in the context of Jordan. It relied on the opinions of three groups of experts, including academics, practitioners, and end users to reach a comprehensive account of understanding such barriers within a multi-faceted approach. The methodology relied on the Delphi technique by identifying areas of consensus and variance in provided opinions. The Kruskal–Wallis test was then applied to identify the inter-group differences and explore the key causes for such differences. The study concluded by developing a comprehensive framework of identified barriers weighed according to their relative importance considering the provided cumulative feedback. In so doing, it represents a step towards a comprehensive model that would assist in understanding, and later enabling, the successful achievement of social sustainability in the studied local context.
Comprehensive transcriptomics and metabolomics revealed the antifungal mechanism of Cymbopogon citratus essential oil nanoemulsion against Fusarium solani
Authors: Wen JinRui , Liao HongXin , Nie HongYan , Ling CuiQiong , Zhang LiYan , Xu FuRong , Dong Xian
Published: December 2023

Background

Fusarium solani (F. solani) is the main pathogen causing root rot of Panax notoginseng (Burk.) F. H. Chen (P. notoginseng). Cymbopogon citratus (DC.) Stapf (C. citratus) essential oil (EO) is a mixture of various active ingredients with good antifungal effects and no residue. However, due to its hydrophobicity and oxidation, its bioavailability is low.

Results

In this study, EO was made into a nanoemulsion using Tween-80 and anhydrous ethanol by ultrasonication. The antifungal activity of the traditional emulsion (TEO) and C. citratus nanoemulsion (NEO) was compared by measuring the effects on spores and mycelia and in vivo assays. The components of EO, TEO, and NEO were analyzed by GC‒MS, and the inhibitory mechanism of the emulsion against fungi was revealed by combining transcriptomics and metabolomics. The prepared NEO was a clear and transparent homogeneous liquid with a particle size of 15.86 ± 1.96 nm. It was an oil-in-water nanoemulsion and maintained good stability in different environments. The contents of antifungal components such as citronellal and linalool in NEO were significantly higher than those in TEO. The antifungal effect of NEO against F. solani was increased by 8 times compared with that of TEO. Through transcriptomic and metabolomic analyses, it was found that both NEO and TEO inhibited the fungi by destroying the cell membrane, thereby affecting the ribosome, meiosis and TCA cycle of the fungi, and NEO had a deeper effect than TEO. NEO also inhibited the gene expression of the CYR1 enzyme and decreased the amount of d-trehalose, thus inhibiting the germination of spores and thereby affecting the growth of mycelia.

Conclusions

This study not only solved the problem of EO insoluble in water and low bioavailability but also greatly improved the antifungal activity, revealing the antifungal mechanism and the reason for the enhancement of NEO activity. It provides theoretical research for further development and utilization of EO to produce environmentally friendly pesticides or fertilizers and alleviate root rot of medicinal plants.

Graphical Abstract