bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical features of renal damage associated with Epstein-Barr virus infection in children
Authors: Yang Xiaoqing , Lin Baohua , Shen Tong
Published: March 2023

Objective

To understand the renal damage and clinical features of pediatric patients with acute Epstein-Barr virus (EBV) infection

Methods

In this retrospective observational study, 548 pediatric patients who were admitted to and treated at the Xiamen Women and Children Health Center between January 2017 and December 2021 and who met the criteria of acute EBV infection were selected as participants. The sociodemographic and clinical data of these patients were collected for statistical analysis. The study population was divided into a renal damage group (41 patients) and a non-renal damage group (507 patients), and the characteristics of the two groups were compared.

Results

(1) Of the 548 enrolled patients, 340 and 208 were boys and girls, respectively. Among them, 41 patients showed renal damage (renal damage group), including 26 boys and 15 girls, and the incidence rate of renal damage was 7.48%. (2) The major renal involvements in the 41 pediatric patients with acute EBV infection in the renal damage group manifested as hematuria (56.1%), proteinuria (37.71%), hematuria + proteinuria (12.9%), edema (51.22%), hypertension (17.07%), oliguria (4.88%), and acute renal failure (2.44%). (3) The pediatric patients in the renal damage group had statistically significantly longer fever durations, higher blood EBV-DNA loads, and lower blood CD4+/CD8+ T lymphocyte ratios than those in the non-renal damage group.

Conclusion

In pediatric patients, the incidence rate of acute EBV-induced renal damage is not low. The clinical manifestations are mostly hematuria or proteinuria, with an overall good prognosis, but occasionally severe renal damage such as acute renal failure. The possibility of secondary renal damage is high when pediatric patients with acute EBV have prolonged fever, high blood EBV-DNA loads, and decreased blood CD4+/CD8+ ratios.
Validity of an immersive virtual reality training system for orthognathic surgical education
Authors: Wan Teng , Liu Kai , Li Biao , Wang Xudong
Published: March 2023

Virtual reality (VR) has been proven an important supplement for surgical education in medical students. However, studies on immersive VR (iVR) simulation in orthognathic surgical education are limited. This study aimed to assess the validity of the iVR surgical training system for orthognathic surgery. Participants completed questionnaires at the end of the course to assess the validity of the training system. The questionnaires included questions on the experience of using the iVR system and surgical authenticity. Seven experienced surgeons and seven inexperienced students were recruited in this study to use our self-developed iVR training system for orthognathic surgery. The participants showed strong agreement to the fidelity of our training system (4.35 out of 5), including the virtual environment, instruments, anatomy structures, and surgical procedures. The participants also strongly agreed that the iVR technique was essential in imparting surgical education. However, most of the participants experienced some degree of dizziness or fatigue after 1 h of using the system. The iVR training system is a new method for imparting education about orthognathic surgery. The iVR training system can act as a supplement and potential substitute of the traditional surgical training method.
The incidence and determinants of the meconium-aspiration syndrome among mothers with meconium-stained amniotic fluid after emergency cesarean section: A prospective cross-sectional study in a specialized hospital, south Ethiopia
Authors: Tantu Temesgen , Zewdu Dereje , Degemu Fikretsion , Yehualeshet Tsiyon
Published: March 2023

Background

Meconium aspiration syndrome is respiratory distress diagnosed in neonates delivered with meconium-stained amniotic fluid that is unexplained by other pathologies. It has severe neonatal respiratory complications and a significant impact on the prevalence of neonatal mortality.

Objective

To identify the incidence and determinants associated with meconium aspiration syndrome among mothers with meconium-stained amniotic fluid after emergency cesarean section in Wolkite University specialized hospitals in Ethiopia from September 1, 2021, to August 30, 2022.

Method

An institution-based cross-sectional study was done prospectively through meticulous chart review and interviews with 275 mothers with meconium-stained amniotic fluid who gave birth with an emergency cesarean section. Data were entered using EpiData 7 and analyzed with SPSS 26. The association between independent variables and the meconium-aspiration syndrome was estimated using an odds ratio with 95% confidence intervals. The statistical significance of the association was declared at a p-value of 0.05.

Result

The prevalence of the meconium-aspiration syndrome is 28.7%. The factors associated are: latent phase (AOR: 2.580; 95% CI: 1.126, 5.913), low 1st minute APGAR score (AOR: 2.43; 95% CI: 0.892, 6.625), and thick meconium (AOR: 31.018; 95% CI: 9.982, 96.390). The neonatal death rate associated with meconium aspiration syndrome is 1.8%, and thick meconium contributed to 65% of admissions to the neonatal intensive care unit and all deaths.

Conclusion

The incidence of meconium aspiration syndrome is high, and thick meconium, meconium at early labor, and low APGAR scores all contributed to this. Thick meconium has a substantial effect on neonatal mortality and morbidity. Therefore, an improvement in the quality of obstetric and neonatal care through early intervention in the case of thick meconium and meconium in the early phase of labor is recommended.
Case report: A relatively rare adverse event caused by carbetocin— placenta interception
Authors: Li Jun-Qiang , Zhan Yong-Chi , Wang Xiao-Dong
Published: March 2023

Placenta interception is extremely rare, and herein, we report the case of a 33-year-old woman with placenta interception during cesarean section caused by carbetocin, which was intravenously injected immediately after delivery of the infant to prevent postpartum hemorrhage. There was no sign of placental separation in the third stage of labor. A protuberance with gross subserous blood vessels in the left fundus of the uterus was detected and was misdiagnosed as placental accreta. The patient was transferred to the district referral hospital to manage the protuberance after stitching up the incision. On opening the original incision in the tertiary hospital, the protuberance disappeared, and the placenta was found in the lower segment of the uterus cavity. The intercepted placenta showed a spontaneous resolution from the uterine wall and was removed intact. This case report details the typical presentation of placenta interception to make obstetricians aware of the possibility that carbetocin might lead to this adverse event.
Empagliflozin increases kidney weight due to increased cell size in the proximal tubule S3 segment and the collecting duct
Authors: Sinha Frederick , Federlein Anna , Biesold Annika , Schwarzfischer Magdalena , Krieger Katharina , Schweda Frank , Tauber Philipp
Published: March 2023

The inhibition of renal SGLT2 glucose reabsorption has proven its therapeutic efficacy in chronic kidney disease. SGLT2 inhibitors (SGLTi) have been intensively studied in rodent models to identify the mechanisms of SGLT2i-mediated nephroprotection. So far, the overwhelming effects from clinical trials, could only partially be reproduced in rodent models of renal injury. However, a commonly disregarded observation from these studies, is the increase in kidney weight after SGLT2i administration. Increased kidney mass often relies on tubular growth in response to reabsorption overload during glomerular hyperfiltration. Since SGLT2i suppress hyperfiltration but concomitantly increase renal weight, it seems likely that SGLT2i have a growth promoting effect on the kidney itself, independent of GFR control. This study aimed to investigate the effect of SGLT2i on kidney growth in wildtype animals, to identify enlarged nephron segments and classify the size increase as hypertrophic/hyperplastic growth or cell swelling. SGLT2i empagliflozin increased kidney weight in wildtype mice by 13% compared to controls, while bodyweight and other organs were not affected. The enlarged nephron segments were identified as SGLT2-negative distal segments of proximal tubules and as collecting ducts by histological quantification of tubular cell area. In both segments protein/DNA ratio, a marker for hypertrophic growth, was increased by 6% and 12% respectively, while tubular nuclei number (hyperplasia) was unchanged by empagliflozin. SGLT2-inhibition in early proximal tubules induces a shift of NaCl resorption along the nephron causing compensatory NaCl and H2O reabsorption and presumably cell growth in downstream segments. Consistently, in collecting ducts of empagliflozin-treated mice, mRNA expression of the Na+-channel ENaC and the H2O-channels Aqp-2/Aqp-3 were increased. In addition, the hypoxia marker Hif1α was found increased in intercalated cells of the collecting duct together with evidence for increased proton secretion, as indicated by upregulation of carbonic anhydrases and acidified urine pH in empagliflozin-treated animals. In summary, these data show that SGLT2i induce cell enlargement by hypertrophic growth and possibly cell swelling in healthy kidneys, probably as a result of compensatory glucose, NaCl and H2O hyperreabsorption of SGLT2-negative segments. Particularly affected are the SGLT2-negative proximal tubules (S3) and the collecting duct, areas of low O2 availability.
Lipid-engineered nanotherapeutics for cancer management
Authors: Fernandez-Fernandez Alicia , Manchanda Romila , Kumari Manisha
Published: March 2023

Cancer causes significant mortality and morbidity worldwide, but existing pharmacological treatments are greatly limited by the inherent heterogeneity of cancer as a disease, as well as the unsatisfactory efficacy and specificity of therapeutic drugs. Biopharmaceutical barriers such as low permeability and poor water solubility, along with the absence of active targeting capabilities, often result in suboptimal clinical results. The difficulty of successfully reaching and destroying tumor cells is also often compounded with undesirable impacts on healthy tissue, including off-target effects and high toxicity, which further impair the ability to effectively manage the disease and optimize patient outcomes. However, in the last few decades, the development of nanotherapeutics has allowed for the use of rational design in order to maximize therapeutic success. Advances in the fabrication of nano-sized delivery systems, coupled with a variety of surface engineering strategies to promote customization, have resulted in promising approaches for targeted, site-specific drug delivery with fewer unwanted effects and better therapeutic efficacy. These nano systems have been able to overcome some of the challenges of conventional drug delivery related to pharmacokinetics, biodistribution, and target specificity. In particular, lipid-based nanosystems have been extensively explored due to their high biocompatibility, versatility, and adaptability. Lipid-based approaches to cancer treatment are varied and diverse, including liposomal therapeutics, lipidic nanoemulsions, solid lipid nanoparticles, nanostructured lipidic carriers, lipid-polymer nanohybrids, and supramolecular nanolipidic structures. This review aims to provide an overview of the use of diverse formulations of lipid-engineered nanotherapeutics for cancer and current challenges in the field, as researchers attempt to successfully translate these approaches from bench to clinic.
Development, testing, parameterisation, and calibration of a human PBK model for the plasticiser, di (2-ethylhexyl) adipate (DEHA) using in silico, in vitro and human biomonitoring data
Authors: McNally Kevin , Sams Craig , Loizou George
Published: March 2023

Introduction: A physiologically based biokinetic model for di (2-ethylhexyl) adipate (DEHA) based on a refined model for di-(2-propylheptyl) phthalate (DPHP) was developed to interpret the metabolism and biokinetics of DEHA following a single oral dosage of 50 mg to two male and two female volunteers.

Methods: The model was parameterized using in vitro and in silico methods such as, measured intrinsic hepatic clearance scaled from in vitro to in vivo and algorithmically predicted parameters such as plasma unbound fraction and tissue:blood partition coefficients (PCs). Calibration of the DEHA model was achieved using concentrations of specific downstream metabolites of DEHA excreted in urine. The total fractions of ingested DEHA eliminated as specific metabolites were estimated and were sufficient for interpreting the human biomonitoring data.

Results: The specific metabolites of DEHA, mono-2-ethyl-5-hydroxyhexyl adipate (5OH-MEHA), mono-2-ethyl-5-oxohexyl adipate (5oxo-MEHA), mono-5-carboxy-2-ethylpentyl adipate (5cx-MEPA) only accounted for ∼0.45% of the ingested DEHA. Importantly, the measurements of adipic acid, a non-specific metabolite of DEHA, proved to be important in model calibration.

Discussion: The very prominent trends in the urinary excretion of the metabolites, 5cx-MEPA and 5OH-MEHA allowed the important absorption mechanisms of DEHA to be modelled. The model should be useful for the study of exposure to DEHA of the general human population.
Effects of supplemental fulvic acid on survival, growth performance, digestive ability and immunity of large yellow croaker (Larimichthys crocea) larvae
Authors: Zhang Chenxiang , Liu Yongtao , Yao Chuanwei , Zhang Jianmin , Wang Yuntao , Liu Jiahui , Hong Yucong , Mai Kangsen , Ai Qinghui
Published: March 2023

A 30-day feeding trial was designed to evaluate the effect of supplemental fulvic acid (FA) on survival, growth performance, digestive ability and immunity of large yellow croaker (Larimichthys crocea) larvae (initial body weight 11.33 ± 0.57 mg). Four isonitrogenous and isolipids diets containing 0.00%, 0.01%, 0.02% and 0.04% FA were formulated, respectively. Results showed that the supplementation of 0.04% FA significantly improved survival rate of large yellow croaker larvae. Meanwhile, supplemental FA significantly increased final body weight and specific growth rate. Based on the specific growth rate, the optimal supplementation was 0.0135% FA. Larvae fed the diet with 0.01% FA had significantly higher villus height than the control. The supplementation of 0.01%–0.02% FA significantly increased the muscular thickness of intestine. Moreover, supplementation of FA significantly increased mRNA expression of intestinal epithelial proliferation and barrier genes (pcna, zo-1 and zo-2). Diets supplemented with 0.02%–0.04% FA significantly increased the activity of trypsin in the intestinal segment, while 0.01%–0.02% FA significantly increased the activity of trypsin in the pancreatic segment. Compared with the control, supplementation of FA remarkably increased activities of alkaline phosphatase and leucine aminopeptidase in the brush border membrane of intestine. Larvae fed the diet with 0.01% FA significantly increased activities of lysozyme and total nitric oxide synthase. Furthermore, the supplementation of 0.01% to 0.02% FA significantly decreased the mRNA expression of pro-inflammatory cytokines (tnf-α and il-6). Concurrently, supplemental FA significantly increased anti-inflammatory cytokine (il-10) mRNA expression level. In conclusion, this study indicated that the supplementation of FA could improve the survival rate and growth performance of larvae by promoting intestinal development, digestive enzymes activities and innate immunity.
The biosynthesis of EGCG, theanine and caffeine in response to temperature is mediated by hormone signal transduction factors in tea plant (Camellia sinensis L.)
Authors: Zhu Qiufang , Liu Lijia , Lu Xiaofeng , Du Xinxin , Xiang Ping , Cheng Bosi , Tan Meng , Huang Jiaxin , Wu Lijiao , Kong Weilong , Shi Yutao , Wu Liangyu , Lin Jinke
Published: March 2023

As the main flavor components of tea, the contents of epigallocatechin-3-gallate (EGCG), theanine and caffeine are regulated by ambient temperature. However, whether the biosynthesis of EGCG, theanine and caffeine in response to temperature is regulated by endogenous hormones and its mechanism is still unclear. In this study, tea cuttings cultivated in the phytotron which treated at different temperatures 15℃, 20℃, 25℃ and 30℃, respectively. The UPLC and ESI-HPLC-MS/MS were used to determine the contents of EGCG, theanine, caffeine and the contents of phytohormones in one leaf and a bud. The results showed that indoleacetic acid (IAA), gibberellin 1(GA1) and gibberellin 3 (GA3) were significantly correlated with the content of EGCG; Jasmonic acid (JA), jasmonate-isoleucine (JA-Ile) and methyl jasmonate (MeJA) were strongly correlated with theanine content; IAA, GA1 and gibberellin 4 (GA4) were significantly correlated with caffeine content at different temperatures. In order to explore the internal intricate relationships between the biosynthesis of these three main taste components, endogenous hormones, and structural genes in tea plants, we used multi-omics and multidimensional correlation analysis to speculate the regulatory mechanisms: IAA, GA1 and GA3 up-regulated the expressions of chalcone synthase (CsCHS) and trans-cinnamate 4-monooxygenase (CsC4H) mediated by the signal transduction factors auxin-responsive protein IAA (CsIAA) and DELLA protein (CsDELLA), respectively, which promoted the biosynthesis of EGCG; IAA, GA3 and GA1 up-regulated the expression of CsCHS and anthocyanidin synthase (CsANS) mediated by CsIAA and CsDELLA, respectively, via the transcription factor WRKY DNA-binding protein (CsWRKY), and promoted the biosynthesis of EGCG; JA, JA-Ile and MeJA jointly up-regulated the expression of carbonic anhydrase (CsCA) and down-regulated the expression of glutamate decarboxylase (CsgadB) mediated by the signal transduction factors jasmonate ZIM domain-containing protein (CsJAZ), and promoted the biosynthesis of theanine; JA, JA-Ile and MeJA also jointly inhibited the expression of CsgadB mediated by CsJAZ via the transcription factor CsWRKY and AP2 family protein (CsAP2), which promoted the biosynthesis of theanine; IAA inhibited the expression of adenylosuccinate synthase (CspurA) mediated by CsIAA via the transcription factor CsWRKY; GA1 and gibberellin 4 (GA4) inhibited the expression of CspurA mediated by CsDELLA through the transcription factor CsWRKY, which promoted the biosynthesis of caffeine. In conclusion, we revealed the underlying mechanism of the biosynthesis of the main taste components in tea plant in response to temperature was mediated by hormone signal transduction factors, which provided novel insights into improving the quality of tea.
Potassium fulvic acid alleviates salt stress of citrus by regulating rhizosphere microbial community, osmotic substances and enzyme activities
Authors: Zhang Manman , Li Xiaoya , Wang Xiaoli , Feng Jipeng , Zhu Shiping
Published: March 2023

Salt stress damage to plants has been becoming a global concern for agriculture. The application of potassium fulvic acid (PFA) is a promising strategy to alleviate the damage to plants and improve soil quality. However, the study of PFA on plant growth and rhizosphere microbial community remains limited. In this study, microcosmic experiments were conducted to verify the effect of PFA on citrus. Trifoliate orange (Poncirus trifoliata), the most important citrus rootstock, was used to evaluate the effect of PFA on salt damage. The results showed that PFA significantly increased the contents of chlorophyll a, chlorophyll b and carotenoid by 30.09%, 17.55% and 27.43%, and effectively avoided the yellowing and scorching of leaves under salt stress. Based on the results of two-way ANOVA, the mitigation of salt stress on trifoliate seedlings primarily attributed to the enhancement of protective enzyme activities, K+/Na+ ratio and the contents of soluble sugar, soluble protein and proline. Moreover, PFA enhanced neutral protease (S-NPT), sucrase (S-SC) and urease (S-UE) of rhizosphere soil and improved soil nutrition status. The abundance of Bacillus, a kind of rhizosphere beneficial bacteria, was improved by PFA under salt stress, which was mainly associated with the increased activities of S-NPT, S-SC and S-UE. Overall, the application of PFA showed great potential for the alleviation of salt damage on citrus.
A cross-sectional study of sleep, mood, well-being, motivations, and perceived support in Ukrainian veterans and active-duty military personnel with disability, and their supporters, preparing for a sporting event
Authors: Castle Claire L. , Heinze Nikki , Gomes Renata S. M.
Published: March 2023

Purpose

The benefits of sports and exercise to the lives and rehabilitative journeys of military veterans with disabilities is increasingly well-documented but veteran sporting events remain underexplored. Addressing this topic, the current article seeks to provide insight into the health and well-being of Team Ukraine during a 5-week preparatory camp in the UK before attendance at the 2022 Warrior Games.

Materials and methods

Two surveys were run, one toward the beginning and one toward the end of the camp. Eighteen of the 55 veterans and serving personnel (with disability), support staff, and family members in attendance responded to both surveys. Data on sleep, mood, and competition-related emotions, motivations for participation and perceived support were gathered. Data were analysed descriptively, and sleep, mood, and competition-related emotion responses were categorised to explore improvements, maintenance, or worsening in these areas.

Results and conclusion

Sleep, mood, and competition-related emotions were relatively stable, although sleep duration was low, and there were some increases in daytime dysfunction, anxiety, nervousness, and feeling tense. Family was the most important source of support and representation of one’s country and raising awareness of Ukraine’s circumstances were the most important motivational factors. Findings offer insight into not only the health and well-being experiences associated with participation in this disabled veteran sporting event, but also the important role played by this event in meeting collective goals relating to this unique time in Ukraine’s history.
Positive classroom climate buffers against increases in loneliness arising from shyness, rejection sensitivity and emotional reactivity
Authors: Katulis Gintautas , Kaniušonytė Goda , Laursen Brett
Published: March 2023

Loneliness is detrimental to well-being, particularly during the transition into and early years of adolescence when peer relations are ascendant. Shy and emotionally sensitive youth, who often spend considerable time alone, have known vulnerabilities to loneliness. Studies of young children suggest that a supportive classroom context may mitigate adjustment risks, reducing victimization and improving a sense of belonging. Herein we extend this work to older students, testing the hypothesis that a positive classroom climate protects temperamentally vulnerable children (i.e., those who are shy, emotionally reactive, or sensitive to rejection) from escalating levels of loneliness across the course of a school year. A community sample of 540 (277 boys, 263 girls) Lithuanian students in grades 5–7 (10–14 years old) completed identical surveys twice, 4–5 months apart. Self-reports assessed shyness, emotional reactivity, and rejection sensitivity, as well as perceived positive classroom climate and loneliness. Path analyses indicated that longitudinal associations from shyness, emotional reactivity, and rejection sensitivity to increased loneliness were mitigated by positive classroom climate. In each case, temperamental vulnerability anticipated greater loneliness for youth reporting low but not high positive classroom climate. The results held after accounting for several potential confounding variables. The findings have practical implications, suggesting that scholars and practitioners redouble efforts to improve classroom support, particularly for temperamentally vulnerable children who are at elevated risk for solitude, loneliness, and attendant mental health challenges.
United Against Rabies Forum: The first 2 years
Authors: Tidman Rachel , Fahrion Anna Sophie , Thumbi S. M. , Wallace Ryan M. , De Balogh Katinka , Iwar Vivian , Yale Gowri , Dieuzy-Labaye Isabelle
Published: March 2023

Rabies continues to kill an estimated 59,000 people annually, with up to 99% of human cases transmitted by domestic dogs. The elimination of human deaths from dog-mediated rabies is achievable by applying a One Health approach, and the framework to do this is outlined in Zero by 30: the Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. To build on this global goal, and implement the approaches set out in Zero by 30, the United Against Rabies Forum was launched in 2020. This paper gives a review of the objectives, governance, activities and achievements of the United Against Rabies Forum to date. It also outlines ongoing work, and next steps as the United Against Rabies Forum reviews its first 2 years of activities and identifies priority areas for the coming 12 months.
Impact of environmental interventions based on social programs on physical activity levels: A systematic review
Authors: Hernández Edgar D. , Cobo Elisa A. , Cahalin Lawrence P. , Seron Pamela
Published: March 2023

Background

The design of social programs at the environmental level such as in schools, parks, bicycle paths, or workspaces generates changes in the behavior of individuals and modifies lifestyles by increasing physical activity (PA) levels.

Objective

To determine the effectiveness of environmental interventions based on social programs by changing the population's level of PA.

Methodology

Natural experiment studies that involved environmental intervention programs at a social level were included. The primary outcome was PA levels with consideration of both objective and subjective measurements. An electronic search was carried out in Medline/Pubmed, SCIENCE DIRECT, WEB OF SCIENCE, and CINAHL databases up to January 2022 with two reviewers screening titles and abstracts and selecting studies for full-text reading. Two reviewers also acquired relevant data and evaluated study quality using the ROBINS I tool. A qualitative analysis was performed.

Results

Three thousand eight hundred and sixty-five articles were found in the 4 consulted databases. After eliminating duplication (200), two reviewers screened 3,665 titles and abstracts and excluded 3,566 that did not meet the inclusion criteria, leaving 99 articles to be read in full text. The 99 full texts were reviewed of which 24 papers met the eligibility criteria. All were natural experiments published between 2011 and 2020 and all evaluated environmental social programs revealing that social programs at the environmental level promoted PA in various populations at the community level worldwide.

Conclusion

The 24 reviewed studies suggest innovative proposals for social programs that seek to increase PA and promote healthy lifestyles related to public activity policies developed in the countries in which they were generated. Environmental social programs can positively impact PA levels among children and adults.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=229718, identifier: CRD42021229718.
Association of body roundness index and its trajectories with all-cause and cardiovascular mortality among a Chinese middle-aged and older population: A retrospective cohort study
Authors: Ding Jiacheng , Chen Xuejiao , Shi Zhan , Bai Kaizhi , Shi Songhe
Published: March 2023

Objectives

The body roundness index (BRI) is a novel anthropometric index that is a better indicator for predicting fat distribution than the body mass index (BMI). The longitudinal study can repeatedly collect measured results for the variables to be studied and then consider the potential effects of intraindividual changes in measurement. However, few population-based, longitudinal studies of BRI have been conducted, especially among the Chinese population. The study aimed to investigate the association of BRI and its longitudinal trajectories with all-cause and cardiovascular mortality.

Methods

A total of 71,166 participants with four times BRI measurements between January 2010 and December 2019 were included in this longitudinal study, with a median follow-up was 7.93 years, and 11,538 deaths were recorded, of which 5,892 deaths were due to cardiovascular disease (CVD). A latent class growth mixture modeling (LCGMM) was used to identify BRI trajectories. Cox proportional hazard models were used to estimate associations between BRI trajectories and the risk of all-cause and cardiovascular mortality.

Results

In the restricted cubic spline regression models, a U-shaped relationship between BRI and all-cause and cardiovascular mortality was observed. Three BRI longitudinal trajectories of low-stable (mean BRI = 2.59), moderate-stable (mean BRI = 3.30), and high-stable (mean BRI = 3.65) were identified by LCGMM. After being adjusted for potential confounders, the HRs for all-cause mortality were 1.18 (1.13–1.24) for the moderate-stable group and 1.74 (1.66–1.82) for the high-stable group compared to the low-stable group. The HRs for cardiovascular mortality were 1.12 (1.05–1.18) for the moderate-stable group and 1.64 (1.53–1.75) for the high-stable group compared to the low-stable group.

Conclusion

A nonlinear association of BRI with all-cause and cardiovascular mortality was observed, and participants in the higher BRI longitudinal trajectory group were significantly associated with an increased risk of all-cause and cardiovascular mortality.
Polypharmacy, chronic kidney disease, and mortality among older adults: A prospective study of National Health and nutrition examination survey, 1999–2018
Authors: Wang Xiaowen , Yang Chao , Jiang Jie , Hu Yonghua , Hao Yuantao , Dong Jia-Yi
Published: March 2023

Introduction

Polypharmacy might contribute to a range of adverse outcomes, which could get worse in the elderly with chronic kidney disease (CKD). Evidence on polypharmacy, CKD, and mortality is scarce. We aimed to investigate the prospective association between polypharmacy, CKD and all-cause and cause-specific mortality in adults aged ≥65 years.

Methods

A total of 13,513 adults from the National Health and Nutrition Examination Surveys were included, following up from 1999 to 2018 until December 31, 2019. The simultaneous use of ≥5 medications by one individual was defined as polypharmacy. Survey-weighted Cox proportional hazard models were used to estimate the hazard ratio (HRs) for mortality from all-cause, cardiovascular diseases (CVD), and cancer after adjusting for potential confounding factors.

Results

Among the elderly with CKD, we identified 3,825 total deaths (1,325 CVD and 714 cancer) during a median follow-up of 7.7 years. Participants with polypharmacy had a 27% (HR = 1.27 [1.15, 1.39]) and 39% (HR = 1.39 [1.19, 1.62]) higher risk of all-cause and CVD mortality, respectively, but not for cancer mortality. Compared with the elderly with no polypharmacy and no CKD, the corresponding HRs (95%CIs) for all-cause mortality were 1.04 (0.96, 1.14) for those with no polypharmacy but CKD, 1.24 (1.11, 1.39) for with polypharmacy but no CKD, and 1.34 (1.21, 1.49) for those with both polypharmacy and CKD. A similar pattern was detected for CVD mortality.

Discussion

Polypharmacy was associated with elevated risks of all-cause and CVD mortality among the elderly CKD patients. More evidence-based approaches should be promoted for the appropriate deprescribing in the older adults with CKD.
Estimating 10-year risk of lung and breast cancer by occupation in Switzerland
Authors: van der Linden Bernadette Wilhelmina Antonia , Bovio Nicolas , Arveux Patrick , Bergeron Yvan , Bulliard Jean-Luc , Fournier Evelyne , Germann Simon , Konzelmann Isabelle , Maspoli Manuela , Rapiti Elisabetta , Chiolero Arnaud , Guseva Canu Irina
Published: March 2023

Introduction

Lung and breast cancer are important in the working-age population both in terms of incidence and costs. The study aims were to estimate the 10-year risk of lung and breast cancer by occupation and smoking status and to create easy to use age-, and sex-specific 10-year risk charts.

Methods

New lung and breast cancer cases between 2010 and 2014 from all 5 cancer registries of Western Switzerland, matched with the Swiss National Cohort were used. The 10-year risks of lung and breast cancer by occupational category were estimated. For lung cancer, estimates were additionally stratified by smoking status using data on smoking prevalence from the 2007 Swiss Health Survey.

Results

The risks of lung and breast cancer increased with age and were the highest for current smokers. Men in elementary professions had a higher 10-year risk of developing lung cancer compared to men in intermediate and managerial professions. Women in intermediate professions had a higher 10-year risk of developing lung cancer compared to elementary and managerial professions. However, women in managerial professions had the highest risk of developing breast cancer.

Discussion

The 10-year risk of lung and breast cancer differs substantially between occupational categories. Smoking creates greater changes in 10-year risk than occupation for both sexes. The 10-year risk is interesting for both patients and professionals to inform choices related to cancer risk, such as screening and health behaviors. The risk charts can also be used as public health indicators and to inform policies to protect workers.
Evaluation of COVID-19 pandemic management in Türkiye
Authors: Kartoglu Umit , Pala Kayihan
Published: March 2023

Three years since the first cases were identified and 2 years since an effective vaccine was developed, COVID-19 continues to claim lives and impact people's health and wellbeing, both socially and economically. While the world has been waiting for its leaders to come together to form a collective response to end the pandemic, we still have not seen a multisectoral response, nor any whole-of-society approach. Like many other countries around the globe, Türkiye was caught unprepared by the pandemic. This was exacerbated by the unsuccessful management of the pandemic by the authorities. The reasoning and/or scientific explanations for enforcing or lifting public health measures have never shared with the public. Throughout the pandemic, no epidemiological details have been released on cases and deaths, other than the numbers of these two measures. Civil society organizations, professional associations, and the public in general have been kept out from policy formulation and decision making. As a result, community engagement has never been properly put into practice. In this paper, we analyzed Türkiye's pandemic management response through the continuum of the response cycle to emergencies: prevention, preparedness, readiness, response, and recovery.
A systematic review: Virtual-reality-based techniques for human exercises and health improvement
Authors: Ali Saba Ghazanfar , Wang Xiangning , Li Ping , Jung Younhyun , Bi Lei , Kim Jinman , Chen Yuting , Feng David Dagan , Magnenat Thalmann Nadia , Wang Jihong , Sheng Bin
Published: March 2023

Virtual Reality (VR) has emerged as a new safe and efficient tool for the rehabilitation of many childhood and adulthood illnesses. VR-based therapies have the potential to improve both motor and functional skills in a wide range of age groups through cortical reorganization and the activation of various neuronal connections. Recently, the potential for using serious VR-based games that combine perceptual learning and dichoptic stimulation has been explored for the rehabilitation of ophthalmological and neurological disorders. In ophthalmology, several clinical studies have demonstrated the ability to use VR training to enhance stereopsis, contrast sensitivity, and visual acuity. The use of VR technology provides a significant advantage in training each eye individually without requiring occlusion or penalty. In neurological disorders, the majority of patients undergo recurrent episodes (relapses) of neurological impairment, however, in a few cases (60–80%), the illness progresses over time and becomes chronic, consequential in cumulated motor disability and cognitive deficits. Current research on memory restoration has been spurred by theories about brain plasticity and findings concerning the nervous system's capacity to reconstruct cellular synapses as a result of interaction with enriched environments. Therefore, the use of VR training can play an important role in the improvement of cognitive function and motor disability. Although there are several reviews in the community employing relevant Artificial Intelligence in healthcare, VR has not yet been thoroughly examined in this regard. In this systematic review, we examine the key ideas of VR-based training for prevention and control measurements in ocular diseases such as Myopia, Amblyopia, Presbyopia, and Age-related Macular Degeneration (AMD), and neurological disorders such as Alzheimer, Multiple Sclerosis (MS) Epilepsy and Autism spectrum disorder. This review highlights the fundamentals of VR technologies regarding their clinical research in healthcare. Moreover, these findings will raise community awareness of using VR training and help researchers to learn new techniques to prevent and cure different diseases. We further discuss the current challenges of using VR devices, as well as the future prospects of human training.
Cost analysis of childhood hematopoietic stem cell transplantation in Sichuan, China
Authors: Chen Min , Liu Yantao , Yang Xue , Hong Yu , Ni Jiaqi
Published: March 2023

Objective

To analyze the inpatient cost of hematopoietic stem cell transplantation (HSCT) in children, so as to support clinical decision-making.

Methods

Study population were children who received HSCT in a tertiary children’s hospital (Sichuan, China) between 1st January 2020 and 31st December 2021. The median and interquartile range (IQR) of total cost at 100 days post transplantation were calculated. Subgroup analyses were conducted based on age, gender, transplantation types, and post-transplant complications. The cost differences between subgroups were analyzed to determine whether it had an impact on the total costs.

Results

A total of 142 pediatric patients were included in the study with a total cost of 250721.78 yuan (197019.16–315740.52, 1 yuan equals to around 0.15 US dollars). Drug costs accounted for 51.85% of the total cost, followed by medical service costs (12.57%) and treatment expenses (12.24%). In terms of transplantation types, the cost of autologous transplantation was lower than that of allogeneic transplantation (115722.98 yuan vs. 256043.99 yuan, p < 0.05), and the cost of human leukocyte antigen (HLA) complete matched was lower compared with that of partial matched (213760.88 yuan vs. 294044.84 yuan, p < 0.05). As for post-transplant complications, cases with <3 types of complications cost less than those with ≥3 types (212893.25 yuan vs. 286064.60 yuan, p < 0.05), and those with severity ≤ grade 2 cost less than those > grade 2 (235569.37 yuan vs. 280061.58 yuan, p < 0.05). Age and gender of patients did not lead to statistical differences in the total cost, while the transplantation types and post-transplant complications influenced the total cost.

Conclusion

The total cost at 100 days post transplantation associated with HSCT treatment were substantial for pediatric patients. The HLA compatibility between donors and recipients, and post-transplant complications were important factors affecting the total cost.
Interfacial properties of protein particles at fluid/fluid interfaces and relationship with the stability of foams and emulsions
Authors: Fameau Anne-Laure , Guzmán Eduardo , Ritacco Hernán Alejandro , Saint-Jalmes Arnaud
Published: March 2023

It is now well-known that the assembly of particles at fluid/fluid interfaces, and the resulting dynamical properties of such particle-laden interfaces can provide high stabilization of dispersed systems such as emulsions and foams. Here, we focus on the emerging case of “protein particles,” a novel family of bio particles. We provide an updated perspective about their definition, production, bulk and interface properties, highlighting the most recent results of the obtained bioparticle-laden interfaces, and how such protein particles can stabilize liquid dispersions. The ability of protein particles for undergoing a fast adsorption to fluid/fluid interfaces and for forming viscoelastic layers play a key role on the prevention of drainage, coalescence, or coarsening/ripening, which results in the formation of very stable particle-stabilized foams and emulsions. Therefore, protein particles are an excellent bio-based alternative to synthetic surfactants and other conventional stabilizers for ensuring the stabilization of a broad range of dispersed systems, opening new avenues for the design of new products with interest for cosmetic, food and biomedical industries.
A sustainability analysis of environmental impact, nutritional quality, and price among six popular diets
Authors: Yacoub Bach Lara , Jana Bethany E. , Adaeze Egwatu Chisom Freda , Orndorff Corey Jane , Alanakrih Rinad , Okoro Joy , Gahl Megan K.
Published: March 2023

Introduction

Sustainable diets and their overall impact on the environment and human health have garnered global attention. Environmental impact, human nutrition, and affordability are three relevant dimensions for assessing overall sustainability of diets. Using a relative sustainability score, we compare the Mediterranean, paleo, ketogenic, vegetarian, and vegan diets, along with the World Health Organization dietary guidelines in order to evaluate which diets are most sustainable.

Methods

Environmental, nutrition, and price data on individual food items were collected and used to analyze diets. Using an online meal- prep program, one week's worth of meals standardized at 2,000 kilocalories per day was generated for each diet. Estimates of greenhouse gas emissions, eutrophication, land use, water withdrawals, nutritional quality, and affordability were calculated. Ultimately an overall relative sustainability score based on these metric averages were used to compare diets.

Results

Our model indicates that vegan, Mediterranean, and vegetarian diets are the most sustainable across all metrics while meat-heavy diets, such as the ketogenic diet, have the greatest negative environmental impact. A diet based on the World Health Organization's dietary guidelines performed poorly with regards to affordability, environmental impacts, and nutritional quality. Diets with higher nutritional quality included the vegan, paleo, and Mediterranean diets. Diets that eliminate meat were the cheapest both by total cost and by cost per gram of food.

Discussion

Diets with the highest overall sustainability score share a common characteristic: they all suggest that consumers committed to sustainability should prioritize ‘plant-forward' diets. In contrast, diets rich in meat and animal products perform poorly overall but especially in terms of environmental sustainability.
Identifying research priorities through decision analysis: A case study for cover crops
Authors: Nichols Gina A. , MacKenzie Cameron A.
Published: March 2023

Introduction

In Midwestern maize (Zea-mays L.)-based systems, planting an over-wintering cover crop such as rye (Secale cereale L.) following fall harvests of summer crops maintains continuous soil cover, offering numerous environmental advantages. However, while adoption of cover crops has increased over the past decade, on a landscape-scale it remains low. Identifying where agronomic research could be most impactful in increasing adoption is therefore a useful exercise. Decision analysis (DA) is a tool for clarifying decision trade-offs, quantifying risk, and identifying optimal decisions. Several fields regularly utilize DA frameworks including the military, industrial engineering, business strategy, and economics, but it is not yet widely applied in agriculture.

Methods

Here we apply DA to a maize-soybean [Glycine max (L.) Merr.] rotation using publicly available weather, management, and economic data from central Iowa.

Results

In this region, planting a cover crop following maize (preceding soybean) poses less risk to the producer compared to planting following soybean, meaning it may be a more palatable entry point for producers. Furthermore, the risk of reduced maize yields when planting less than 14 days following rye termination substantially contributes to the overall risk cover crops pose to producers, but also has significant potential to be addressed through agronomic research.

Discussion

In addition to identifying research priorities, DA provided clarity to a complex problem, was performed using publicly available data, and by incorporating risk it better estimated true costs to the producer compared to using input costs alone. We believe DA is a valuable and underutilized tool in agronomy and could aid in increasing adoption of cover crops in the Midwest.
The potential, strategies, and challenges of Monascus pigment for food application
Authors: Egea Mariana Buranelo , Dantas Luciana Arantes , Sousa Tainara Leal de , Lima Alan Gomes , Lemes Ailton Cesar
Published: March 2023

The demand for dyes from natural sources to substitute synthetic dyes for application in the food industry has been continuously increasing due to some synthetic dyes being associated with several problems, including hypersensitivity, carcinogenesis, and negative environmental impacts. Furthermore, dyes from natural sources (like pigments) are generally regarded by the consumer as safer or with fewer side effects—a fact that requires in-depth investigation—, which increases the commercial interest in such products. In this sense, great focus has been given to the biotechnological potential of Monascus sp. to produce red, orange, and yellow pigments using different types of the fermentation process (submerged or in solid-state fermentation), substrates, and process parameters (temperature, pH, agitation, aeration, etc.), aiming at optimizing and reducing costs in pigment production. In general, Monascus pigment has shown stability at neutral and basic pH, at elevated temperatures for a few hours, and to some metallic ions while not showing stability at acidic pH, elevated temperatures for many hours, and in the presence of light. Applications of Monascus pigment with colorant function in foods (candies, bread, yogurt, cheese, beer, and meat products) reported improvement in the color aspect by sensory analysis. The application of Monascus pigment still seems promising and incipient, demonstrating that it needs to be further studied, mainly concerning the stability of the pigment in vivo systems (inside the food) where adverse conditions are combined. Regulatory issues are heterogeneous around the world, which creates difficulties to expand production and commercialization but also demonstrates the need for studies to confirm its safety. In this sense, this mini-review presents the potential, strategies, and challenges of Monascus pigment for food application.