bluuebunny/crossref_metadata_2025 huggingface dataset:
Desmoglein 2 and desmocollin 2 depletions promote malignancy through distinct mechanisms in triple-negative and luminal breast cancer
Authors: Han Ji-Yuan , Che Na , Mo Jing , Zhang Dan-Fang , Liang Xiao-Hui , Dong Xue-Yi , Zhao Xiu-Lan , Sun Bao-Cun
Published: April 2024

Background

Aberrant expressions of desmoglein 2 (Dsg2) and desmocollin 2(Dsc2), the two most widely distributed desmosomal cadherins, have been found to play various roles in cancer in a context-dependent manner. Their specific roles on breast cancer (BC) and the potential mechanisms remain unclear.

Methods

The expressions of Dsg2 and Dsc2 in human BC tissues and cell lines were assessed by using bioinformatics analysis, immunohistochemistry and western blotting assays. Wound-healing and Transwell assays were performed to evaluate the cells’ migration and invasion abilities. Plate colony-forming and MTT assays were used to examine the cells’ capacity of proliferation. Mechanically, Dsg2 and Dsc2 knockdown-induced malignant behaviors were elucidated using western blotting assay as well as three inhibitors including MK2206 for AKT, PD98059 for ERK, and XAV-939 for β-catenin.

Results

We found reduced expressions of Dsg2 and Dsc2 in human BC tissues and cell lines compared to normal counterparts. Furthermore, shRNA-mediated downregulation of Dsg2 and Dsc2 could significantly enhance cell proliferation, migration and invasion in triple-negative MDA-MB-231 and luminal MCF-7 BC cells. Mechanistically, EGFR activity was decreased but downstream AKT and ERK pathways were both activated maybe through other activated protein tyrosine kinases in shDsg2 and shDsc2 MDA-MB-231 cells since protein tyrosine kinases are key drivers of triple-negative BC survival. Additionally, AKT inhibitor treatment displayed much stronger capacity to abolish shDsg2 and shDsc2 induced progression compared to ERK inhibition, which was due to feedback activation of AKT pathway induced by ERK inhibition. In contrast, all of EGFR, AKT and ERK activities were attenuated, whereas β-catenin was accumulated in shDsg2 and shDsc2 MCF-7 cells. These results indicate that EGFR-targeted therapy is not a good choice for BC patients with low Dsg2 or Dsc2 expression. Comparatively, AKT inhibitors may be more helpful to triple-negative BC patients with low Dsg2 or Dsc2 expression, while therapies targeting β-catenin can be considered for luminal BC patients with low Dsg2 or Dsc2 expression.

Conclusion

Our finding demonstrate that single knockdown of Dsg2 or Dsc2 could promote proliferation, motility and invasion in triple-negative MDA-MB-231 and luminal MCF-7 cells. Nevertheless, the underlying mechanisms were cellular context-specific and distinct.
The prevalence of preterm and low birth weight infants among migrant women in the Pearl River Delta region, China: a population-based birth cohort study
Authors: Xie Lulu , Liang Zhijiang , Wang Xionghu , Luo Xianqiong
Published: April 2024

Background

The existing literature evaluating the association between neonatal morbidity and migrant status presents contradictory results. The purpose of this study was to compare the risk of preterm birth (PTB) and low birth weight (LBW) among newborns from local and migrant women in China’s Pearl River Delta (PRD) region.

Methods

In this observational population-based study, we included all live singleton deliveries from PRD region local women and migrant women. Data were sourced from the Guangdong Medical Birth Registry Information System between Jan 1, 2014, and Dec 31, 2020. Women were categorized into three groups by maternal migrant status: local women from PRD region, migrant women from Guangdong province or from other provinces. The outcome variables that were examined included two adverse birth outcomes: PTB and LBW. The association between the risk of PTB and LBW and maternal migrant status was assessed using logistic regression.

Results

During 2014–2020, 5,219,133 single live deliveries were recorded, corresponding 13.22% to local women and the rest to migrant women coming from Guangdong (53.51%) and other provinces (33.26%). PTB prevalence was highest among local women (5.79%), followed by migrant women from Guangdong (5.29%), and the lowest among migrants from other provinces (4.95%). This association did not change after including maternal age, infant sex, delivery mode, and birth season in the models. Compared to local women, migrant women from other provinces had a lower risk of LBW (4.00% vs. 4.98%,P < 0.001). The prevalence of PTB and LBW was higher among local women than migrants. The odds of delivery PTB and LBW were higher for women who were age ≥ 35. Among the three maternal migration groups, the age-LBW association displayed a typical U-shaped pattern, with those in the youngest (16–24 years) and oldest (≥ 35) age categories exhibiting the higher odds of delivering a LBW neonate. With respect to infant sex, the prevalence of PTB was significantly higher in males than females among the three maternal migration groups. An opposite trend was found for LBW, and the prevalence of LBW was higher in females among the three maternal migration groups.

Conclusion

The findings of this study contribute to the understanding of the epidemiology of PTB and LBW among migrant women. Our study suggests that it is the health and robust nature of migrant mothers that predisposes them to better birth outcomes. It is important to recognize that the results of this study, while supportive of the healthy migrant effect, cannot be considered definitive without some exploration of motivation for moving and changes in lifestyle postmigration.
Appropriate use of medication among home care adult cancer patients at end of life: a retrospective observational study
Authors: Mughrabi Amani El , Salmany Sewar S. , Aljarrat Batool , Dabbous Ala’a , Ayyalawwad Haya
Published: April 2024

Background

Medications are commonly used for symptom control in cancer patients at the end of life. This study aimed to evaluate medication utilization among home care palliative patients with cancer at the end of life and assess the appropriateness of these medications.

Method

This retrospective observational study included adult cancer patients who received home care in 2020. Medications taken during the last month of the patient’s life were reviewed and classified into three major categories: potentially avoidable, defined as medications that usually have no place at the end of life because the time to benefit is shorter than life expectancy; medications of uncertain appropriateness, defined as medications that need case-by-case evaluation because they could have a role at the end of life; and potentially appropriate, defined as medications that provide symptomatic relief.

Results

In our study, we enrolled 353 patients, and 2707 medications were analyzed for appropriateness. Among those, 1712 (63.2%) were classified as potentially appropriate, 755 (27.9%) as potentially avoidable, and 240 (8.9%) as medications with uncertain appropriateness. The most common potentially avoidable medications were medications for peptic ulcers and gastroesophageal reflux disease (30.5%), vitamins (14.6%), beta-blockers (9.8%), anticoagulants (7.9%), oral antidiabetics (5.4%) and insulin products (5.3%). Among the potentially appropriate medications, opioid analgesics were the most frequently utilized medications (19.5%), followed by laxatives (19%), nonopioid analgesics (14.4%), gamma-aminobutyric acid analog analgesics (7.7%) and systemic corticosteroids (6%).

Conclusion

In home care cancer patients, approximately one-third of prescribed medications were considered potentially avoidable. Future measures to optimize medication use in this patient population are essential.
Serious game for radiotherapy training
Authors: Kayed Jessika El , Akl Tony , Massoud Chadi , Margossian Christelle , Fayad Hadi , Fares Georges , Felefly Tony , Rihana Sandy
Published: April 2024

Background

Cancer patients are often treated with radiation, therefore increasing their exposure to high energy emissions. In such cases, medical errors may be threatening or fatal, inducing the need to innovate new methods for maximum reduction of irreversible events. Training is an efficient and methodical tool to subject professionals to the real world and heavily educate them on how to perform with minimal errors. An evolving technique for this is Serious Gaming that can fulfill this purpose, especially with the rise of COVID-19 and the shift to the online world, by realistic and visual simulations built to present engaging scenarios. This paper presents the first Serious Game for Lung Cancer Radiotherapy training that embodies Biomedical Engineering principles and clinical experience to create a realistic and precise platform for coherent training.

Methods

To develop the game, thorough 3D modeling, animation, and gaming fundamentals were utilized to represent the whole clinical process of treatment, along with the scores and progress of every player. The model’s goal is to output coherency and organization for students’ ease of use and progress tracking, and to provide a beneficial educational experience supplementary to the users’ training. It aims to also expand their knowledge and use of skills in critical cases where they must perform crucial decision-making and procedures on patients of different cases.

Results

At the end of this research, one of the accomplished goals consists of building a realistic model of the different equipment and tools accompanied with the radiotherapy process received by the patient on Maya 2018, including the true beam table, gantry, X-ray tube, CT Scanner, and so on. The serious game itself was then implemented on Unity Scenes with the built models to create a gamified authentic environment that incorporates the 5 main series of steps; Screening, Contouring, External Beam Planning, Plan Evaluation, Treatment, to simulate the practical workflow of an actual Oncology treatment delivery for lung cancer patients.

Conclusion

This serious game provides an educational and empirical space for training and practice that can be used by students, trainees, and professionals to expand their knowledge and skills in the aim of reducing potential errors.
Flipped Classroom: Improved team performance during resuscitation training through interactive pre-course content – a cluster-randomised controlled study
Authors: Ohlenburg Hendrik , Arnemann Philip-Helge , Hessler Michael , Görlich Dennis , Zarbock Alexander , Friederichs Hendrik
Published: April 2024

Background

Resuscitation is a team effort, and it is increasingly acknowledged that team cooperation requires training. Staff shortages in many healthcare systems worldwide, as well as recent pandemic restrictions, limit opportunities for collaborative team training. To address this challenge, a learner-centred approach known as flipped learning has been successfully implemented. This model comprises self-directed, asynchronous pre-course learning, followed by knowledge application and skill training during in-class sessions. The existing evidence supports the effectiveness of this approach for the acquisition of cognitive skills, but it is uncertain whether the flipped classroom model is suitable for the acquisition of team skills. The objective of this study was to determine if a flipped classroom approach, with an online workshop prior to an instructor-led course could improve team performance and key resuscitation variables during classroom training.

Methods

A single-centre, cluster-randomised, rater-blinded study was conducted on 114 final year medical students at a University Hospital in Germany. The study randomly assigned students to either the intervention or control group using a computer script. Each team, regardless of group, performed two advanced life support (ALS) scenarios on a simulator. The two groups differed in the order in which they completed the flipped e-learning curriculum. The intervention group started with the e-learning component, and the control group started with an ALS scenario.

Simulators were used for recording and analysing resuscitation performance indicators, while professionals assessed team performance as a primary outcome.

Results

The analysis was conducted on the data of 96 participants in 21 teams, comprising of 11 intervention groups and 10 control groups. The intervention teams achieved higher team performance ratings during the first scenario compared to the control teams (Estimated marginal mean of global rating: 7.5 vs 5.6, p < 0.01; performance score: 4.4 vs 3.8, p < 0.05; global score: 4.4 vs 3.7, p < 0.001). However, these differences were not observed in the second scenario, where both study groups had used the e-learning tool.

Conclusion

Flipped classroom approaches using learner-paced e-learning prior to hands-on training can improve team performance.

Trial registration

German Clinical Trials Register (https://drks.de/search/de/trial/DRKS00013096).
Healthcare insurance fraud detection using data mining
Authors: Hamid Zain , Khalique Fatima , Mahmood Saba , Daud Ali , Bukhari Amal , Alshemaimri Bader
Published: April 2024

Background

Healthcare programs and insurance initiatives play a crucial role in ensuring that people have access to medical care. There are many benefits of healthcare insurance programs but fraud in healthcare continues to be a significant challenge in the insurance industry. Healthcare insurance fraud detection faces challenges from evolving and sophisticated fraud schemes that adapt to detection methods. Analyzing extensive healthcare data is hindered by complexity, data quality issues, and the need for real-time detection, while privacy concerns and false positives pose additional hurdles. The lack of standardization in coding and limited resources further complicate efforts to address fraudulent activities effectively.

Methodolgy

In this study, a fraud detection methodology is presented that utilizes association rule mining augmented with unsupervised learning techniques to detect healthcare insurance fraud. Dataset from the Centres for Medicare and Medicaid Services (CMS) 2008-2010 DE-SynPUF is used for analysis. The proposed methodology works in two stages. First, association rule mining is used to extract frequent rules from the transactions based on patient, service and service provider features. Second, the extracted rules are passed to unsupervised classifiers, such as IF, CBLOF, ECOD, and OCSVM, to identify fraudulent activity.

Results

Descriptive analysis shows patterns and trends in the data revealing interesting relationship among diagnosis codes, procedure codes and the physicians. The baseline anomaly detection algorithms generated results in 902.24 seconds. Another experiment retrieved frequent rules using association rule mining with apriori algorithm combined with unsupervised techniques in 868.18 seconds. The silhouette scoring method calculated the efficacy of four different anomaly detection techniques showing CBLOF with highest score of 0.114 followed by isolation forest with the score of 0.103. The ECOD and OCSVM techniques have lower scores of 0.063 and 0.060, respectively.

Conclusion

The proposed methodology enhances healthcare insurance fraud detection by using association rule mining for pattern discovery and unsupervised classifiers for effective anomaly detection.
Knowledge, attitude, practice, needs, and implementation status of intensive care unit staff toward continuous renal replacement therapy: a survey of 66 hospitals in central and South China
Authors: Yu Xiaoyan , Ouyang Lin , Li Jinxiu , Peng Ying , Zhong Dingming , Yang Huan , Zhou Yanyan
Published: April 2024

Background

Continuous renal replacement therapy (CRRT) is a commonly utilized form of renal replacement therapy (RRT) in the intensive care unit (ICU). A specialized CRRT team (SCT, composed of physicians and nurses) engage playing pivotal roles in administering CRRT, but there is paucity of evidence-based research on joint training and management strategies. This study armed to evaluate the knowledge, attitude, and practice (KAP) of ICU staff toward CRRT, and to identify education pathways, needs, and the current status of CRRT implementation.

Methods

This study was performed from February 6 to March 20, 2023. A self-made structured questionnaire was used for data collection. Descriptive statistics, T-tests, Analysis of variance (ANOVA), multiple linear regression, and Pearson correlation coefficient tests (α = 0.05) were employed.

Results

A total of 405 ICU staff from 66 hospitals in Central and South China participated in this study, yielding 395 valid questionnaires. The mean knowledge score was 51.46 ± 5.96 (61.8% scored highly). The mean attitude score was 58.71 ± 2.19 (73.9% scored highly). The mean practice score was 18.15 ± 0.98 (85.1% scored highly). Multiple linear regression analysis indicated that gender, age, years of CRRT practice, ICU category, and CRRT specialist panel membership independently affected the knowledge score; Educational level, years of CRRT practice, and CRRT specialist panel membership independently affected the attitude score; Education level and teaching hospital employment independently affected the practice score. The most effective method for ICU staff to undergo training and daily work experience is within the department.

Conclusion

ICU staff exhibit good knowledge, a positive attitude and appropriately practiced CRRT. Extended CRRT practice time in CRRT, further training in a general ICU or teaching hospital, joining a CRRT specialist panel, and upgraded education can improve CRRT professional level. Considering the convenience of training programs will enhance ICU staff participation. Training should focus on basic CRRT principles, liquid management, and alarm handling.
What’s up doc? Physicians’ reflections on their sustainable employability throughout careers: a narrative inquiry
Authors: van de Voort Iris , Grossmann Irene , Leistikow Ian , Weenink Jan-Willem
Published: April 2024

Background

Physicians have complex and demanding jobs that may negatively affect their sustainable employability (SE) and quality of care. Despite its societal and occupational relevance, empirical research on physicians’ SE is scarce. To further advance our understanding of physicians’ SE, this study explores how physicians perceive their employment context to affect their SE, how physicians self-regulate with the intent to sustain their employability, and how self-regulations affect physicians’ SE and their employment context.

Methods

Twenty Dutch physicians from different specialisms were narratively interviewed between March and September 2021 by a researcher with a similar background (surgeon) to allow participants to speak in their own jargon. The interviews were analyzed collaboratively by the research team in accordance with theory-led thematic analysis.

Results

According to the interviewees, group dynamics, whether positive or negative, and (mis)matches between personal professional standards and group norms on professionalism, affect their SE in the long run. Interviewees self-regulate with the intent to sustain their employability by (I) influencing work; (II) influencing themselves; and (III) influencing others. Interviewees also reflect on long-term, unintended, and dysfunctional consequences of their self-regulations.

Conclusions

We conclude that physicians’ SE develops from the interplay between the employment context in which they function and their self-regulations intended to sustain employability. As self-regulations may unintentionally contribute to dysfunctional work practices in the employment context, there is a potential for a vicious cycle. Insights from this study can be used to understand and appraise how physicians self-regulate to face complex challenges at work and to prevent both dysfunctional work practices that incite self-regulation and dysfunctional consequences resulting from self-regulations.
Health extension service utilization in Ethiopia: systematic review and meta-analysis
Authors: Tiruneh Misganaw Guadie , Fenta Eneyew Talie , Endeshaw Destaw , Delie Amare Mebrat , Adal Ousman , Tareke Abiyu Abadi , Bogale Eyob Ketema , Anagaw Tadele Fentabel
Published: April 2024

Introduction

Ethiopia strives to achieve Universal Health Coverage (UHC) through Primary Health Care (PHC) by expanding access to services and improving the quality and equitable comprehensive health services at all levels. The Health Extension Program (HEP) is an innovative strategy to deliver primary healthcare services in Ethiopia and is designed to provide basic healthcare to approximately 5000 people through a health post (HP) at the grassroots level. Thus, this review aimed to assess the magnitude of health extension service utilization in Ethiopia.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist guideline was used for this review and meta-analysis. The electronic databases (PubMed, Cochrane Library, and African Journals Online) and search engines (Google Scholar and Grey literature) were searched to retrieve articles by using keywords. The Joanna Briggs Institute (JBI) meta-analysis of statistics assessment and review instrument was used to assess the quality of the studies. Heterogeneity was assessed using the I2statistic. The meta-analysis with a 95% confidence interval using STATA 17 software was computed to present the pooled utilization of health extension services. Publication bias was assessed by visually inspecting the funnel plot and statistical tests using Egger’s and Begg’s tests.

Result

22 studies were included in the systematic review with a total of 28,171 participants, and 8 studies were included in the meta-analysis. The overall pooled magnitude of health extension service utilization was 58.5% (95% CI: 40.53, 76.48%). In the sub-group analysis, the highest pooled proportion of health extension service utilization was 60.42% (28.07, 92.77%) in the mixed study design, and in studies published after 2018, 59.38% (36.42, 82.33%). All studies were found to be within the confidence interval of the pooled proportion of health extension service utilization in leave-out sensitivity analysis.

Conclusions

The utilization of health extension services was found to be low compared to the national recommendation. Therefore, policymakers and health planners should come up with a wide variety of health extension service utilization strategies to achieve universal health coverage through the primary health care.
Genetic variability in stroke patients: CYP2C19 polymorphisms unraveled
Authors: Peng Peiyi , Xiao Yingxiu , Peng Xuehong , Chen Jianqiang , Chen Nuan
Published: April 2024

Objective

To study the distribution characteristics of CYP2C19 polymorphisms in patients suffering from stroke in Han Chinese patients.

Method

PCR and DNA microarray chip technology were used to detect the CYP2C19 genotype of 549 patients with stroke, and the genotype, allele frequency and metabolic type of patients with different sexes, ages and types of infarctions and the independent risk factors for clopidogrel resistance were analyzed.

Results

Six genotypes were detected in these 549 patients. A total of 233 (42.44%) patients had the heterozygous allele *1/*2, which was the most prevalent, followed by the homozygous wild-type allele *1/*1 (191, 34.79%). A total of 30 (5.46%) patients possessed the heterozygous allele *1/*3, and 65 (11.84%) patients had the homozygous mutant allele *2/*2. Twenty-nine (5.28%) patients had the compound heterozygous mutant allele *2/*3, and only 1 patient had the homozygous mutant allele *3/*3. The distribution of genotypes, alleles, and metabolic types did not change significantly (P > 0.05) by sex, age, or type of stroke. In addition, no independent risk factors for clopidogrel resistance were found in this analysis.

Conclusion

The distribution of CYP2C19 genotypes, allele frequencies, and metabolic types in patients with stroke in Han Chinese patients were not correlated with sex, age, or infarction type. The possibilities of hyperglycemia, hypercholesterolemia, hypertriglyceridemia, hypo-HDL-cholesterolemia, hyper-LDL-cholesterolemia and high blood pressure were not statistically associated with CYP2C19 genotypes. CYP2C19 gene polymorphism detection is recommended for patients who are available, and during treatment, the CYP2C19 genotype can be used to guide personalized precise medication use in patients with stroke.
REPeated mAgnetic resonance Image-guided stereotactic body Radiotherapy (MRIg-reSBRT) for oligometastatic patients: REPAIR, a mono-institutional retrospective study
Authors: Chiloiro Giuditta , Panza Giulia , Boldrini Luca , Romano Angela , Placidi Lorenzo , Nardini Matteo , Galetto Matteo , Votta Claudio , Campitelli Maura , Cellini Francesco , Massaccesi Mariangela , Gambacorta Maria Antonietta
Published: April 2024

Background

Oligo-progression or further recurrence is an open issue in the multi-integrated management of oligometastatic disease (OMD). Re-irradiation with stereotactic body radiotherapy (re-SBRT) technique could represent a valuable treatment option to improve OMD clinical outcomes. MRI-guided allows real-time visualization of the target volumes and online adaptive radiotherapy (oART). The aim of this retrospective study is to evaluate the efficacy and toxicity profile of MRI-guided repeated SBRT (MRIg-reSBRT) in the OMD setting and propose a re-SBRT classification.

Methods

We retrospectively analyzed patients (pts) with recurrent liver metastases or abdominal metastatic lesions between 1 and 5 centimeters from liver candidate to MRIg-reSBRT showing geometric overlap between the different SBRT courses and assessing whether they were in field (type 1) or not (type 2).

Results

Eighteen pts completed MRIg-reSBRT course for 25 metastatic hepatic/perihepatic lesions from July 2019 to January 2020. A total of 20 SBRT courses: 15 Type 1 re-SBRT (75%) and 5 Type 2 re-SBRT (25%) was delivered. Mean interval between the first SBRT and MRIg-reSBRT was 8,6 months. Mean prescribed dose for the first treatment was 43 Gy (range 24–50 Gy, mean BEDα/β10=93), while 41 Gy (range 16–50 Gy, mean BEDα/β10=92) for MRIg-reSBRT. Average liver dose was 3,9 Gy (range 1–10 Gy) and 3,7 Gy (range 1,6–8 Gy) for the first SBRT and MRIg-reSBRT, respectively. No acute or late toxicities were reported at a median follow-up of 10,7 months. The 1-year OS and PFS was 73,08% and 50%, respectively. Overall Clinical Benefit was 54%.

Conclusions

MRIg-reSBRT could be considered an effective and safe option in the multi-integrated treatment of OMD.
Endocrine disrupting chemicals: gestational diabetes and beyond
Authors: Mitra Tridip , Gulati Richa , Ramachandran Krithika , Rajiv Rohan , Enninga Elizabeth Ann L. , Pierret Chris K , Kumari R Sajeetha , Janardhanan Rajiv
Published: April 2024

Gestational Diabetes Mellitus (GDM) has been on the rise for the last two decades along with the growing incidence of obesity. The ubiquitous use of Endocrine-Disrupting Chemicals (EDCs) worldwide has been associated with this increase in GDM incidence. Epigenetic modifications such as DNA methylation, histone acetylation, and methylation have been associated with prenatal exposure to EDCs. EDC exposure can also drive a sustained disruption of the hypothalamus-pituitary-thyroid axis and various other signaling pathways such as thyroid signaling, PPARγ signaling, PI3K-AKT signaling. This disruption leads to impaired glucose metabolism, insulin resistance as well as β-cell dysfunction, which culminate into GDM. Persistent EDC exposure in pregnant women also increases adipogenesis, which results in gestational weight gain. Importantly, pregnant mothers transfer these EDCs to the fetus via the placenta, thus leading to other pregnancy-associated complications such as intrauterine growth restriction (IUGR), and large for gestational age neonates. Furthermore, this early EDC exposure of the fetus increases the susceptibility of the infant to metabolic diseases in early life. The transgenerational impact of EDCs is also associated with higher vascular tone, cognitive aberrations, and enhanced susceptibility to lifestyle disorders including reproductive health anomalies. The review focuses on the impact of environmental toxins in inducing epigenetic alterations and increasing the susceptibility to metabolic diseases during pregnancy needs to be extensively studied such that interventions can be developed to break this vicious cycle. Furthermore, the use of EDC-associated ExomiRs from the serum of patients can help in the early diagnosis of GDM, thereby leading to triaging of patients based on increasing risk factor of the clinicopathological condition.
The research history of the Middle Triassic fishes of Monte San Giorgio: getting out of the shadow of aquatic reptiles
Authors: Bürgin Toni
Published: April 2024

Around the middle of the nineteenth century, Italian palaeontologists began to investigate fossils of fishes and reptiles from the Middle Triassic outcrops in the vicinity of Monte San Giorgio (Canton Ticino, Switzerland). In 1924, researchers from the University of Zurich started their scientific excavations on the Swiss side. The many fish fossils found since then have often stood in the shadow of the more spectacular and mostly larger fossils of various aquatic reptiles. Beginning around 1980 the fish fossils in the collection of the Palaeontological Institute and Museum of Zurich University have subsequently been brought out of this shadow. The picture presently emerging is that of a species rich fish fauna located in six different fossiliferous beds of Anisian and Ladinian age with a few chondrichthyan, some coelacanth and a wealth of different actinopterygian taxa, many of them well preserved. The ongoing work not only results in taxonomic and systematic novelties, but gives also new insights into their palaeobiology, palaeoecology and palaeobiogeography.
Reconstruction the feedback regulation of amino acid metabolism to develop a non-auxotrophic l-threonine producing Corynebacterium glutamicum
Authors: Liu Jianhang , Liu Jiao , Li Jiajun , Zhao Xiaojia , Sun Guannan , Qiao Qianqian , Shi Tuo , Che Bin , Chen Jiuzhou , Zhuang Qianqian , Wang Yu , Sun Jibin , Zhu Deqiang , Zheng Ping
Published: April 2024

l-Threonine is an important feed additive with the third largest market size among the amino acids produced by microbial fermentation. The GRAS (generally regarded as safe) industrial workhorse Corynebacterium glutamicum is an attractive chassis for l-threonine production. However, the present l-threonine production in C. glutamicum cannot meet the requirement of industrialization due to the relatively low production level of l-threonine and the accumulation of large amounts of by-products (such as l-lysine, l-isoleucine, and glycine). Herein, to enhance the l-threonine biosynthesis in C. glutamicum, releasing the aspartate kinase (LysC) and homoserine dehydrogenase (Hom) from feedback inhibition by l-lysine and l-threonine, respectively, and overexpressing four flux-control genes were performed. Next, to reduce the formation of by-products l-lysine and l-isoleucine without the cause of an auxotrophic phenotype, the feedback regulation of dihydrodipicolinate synthase (DapA) and threonine dehydratase (IlvA) was strengthened by replacing the native enzymes with heterologous analogues with more sensitive feedback inhibition by l-lysine and l-isoleucine, respectively. The resulting strain maintained the capability of synthesizing enough amounts of l-lysine and l-isoleucine for cell biomass formation but exhibited almost no extracellular accumulation of these two amino acids. To further enhance l-threonine production and reduce the by-product glycine, l-threonine exporter and homoserine kinase were overexpressed. Finally, the rationally engineered non-auxotrophic strain ZcglT9 produced 67.63 g/L (17.2% higher) l-threonine with a productivity of 1.20 g/L/h (108.0% higher) in fed-batch fermentation, along with significantly reduced by-product accumulation, representing the record for l-threonine production in C. glutamicum. In this study, we developed a strategy of reconstructing the feedback regulation of amino acid metabolism and successfully applied this strategy to de novo construct a non-auxotrophic l-threonine producing C. glutamicum. The main end by-products including l-lysine, l-isoleucine, and glycine were almost eliminated in fed-batch fermentation of the engineered C. glutamicum strain. This strategy can also be used for engineering producing strains for other amino acids and derivatives.
Existential Analysis as a method of intervention for patients experiencing relational trauma
Authors: Nowakowska Agnieszka , Draczyńska Dorota , Anczewska Marta
Published: April 2024

Analiza egzystencjalna jako podejście osobowo-fenomenologiczne, wspiera poszukiwanie osobistych znaczeń i odpowiedzi na pytania dotyczące ludzkiej egzystencji. Uznając pełne osobliwości życie jednostki, prowadzi do odnajdywania odpowiedzi na cztery fundamentalne pytania: 1) „czy ja mogę tu być?”, 2) „czy ja lubię żyć”, 3) „czy ja mam prawo być takim, jakim jestem?” oraz 4) „po co żyję?”. Podstawę teoretyczną autorskiego treningu akceptacji 4FM jako metody pracy grupowej z osobami hospitalizowanymi psychiatrycznie, z doświadczeniem traumy relacyjnej, spełniającymi kryteria rozpoznania cPTSD wg ICD-11 stanowią cztery fundamentalne motywacje. Trauma relacyjna ogranicza lub powoduje utratę naturalnych dyspozycji jednostki do bycia i działania, czucia i wchodzenia w relacje, pozostawania w harmonii ze sobą i światem zewnętrznym a także nadawaniu celu i sensu życiu. Zakłóca procesy w obrębie wszystkich fundamentalnych motywacji (4FM). Natomiast relacja terapeutyczna uczy doświadczania własnego istnienia, rozumienia siebie, świata i innych w indywidualnym kontekście. Z głęboką troską o człowieka doświadczającego różnych trudności natury psychologicznej, umożliwia badanie złożonej rzeczywistości i poszukiwanie zgody na życie. Celem artykułu jest przegląd założeń analizy egzystencjalnej i czterech fundamentalnych motywacji Alfrieda Längle, ucznia Frankla, stanowiących podstawę teoretyczną treningu Akceptacja 4FM.
Persistence of harmful consequences of childhood trauma in adolescence and adult life: biological mechanisms, psychological effects, clinical examples
Authors: Kalita Lech
Published: April 2024

W niniejszym artykule krótko przedstawię biologiczne mechanizmy oddziaływania traumy psychicznej na mózg dziecka, odnosząc się zwłaszcza do rozwojowych konsekwencji występujących w adolescencji i dorosłości. W odwołaniu do nakreślonego tła neurobiologicznego opiszę wiele problemów psychologicznych: trudności relacyjnych, behawioralnych i emocjonalnych, a także zaburzeń i chorób psychicznych związanych z biologicznymi konsekwencjami traumy. Przytoczę wyniki badań ilościowych prowadzonych w grupach wystarczająco dużych, by uzasadnić pogląd o prawidłowościach występujących w zakresie konsekwencji traumy dziecięcej w adolescencji i dorosłości. Zilustruję główne tezy artykułu za pomocą dwóch przykładów klinicznych — krótkich opisów pochodzących z własnej praktyki psychoterapeutycznej i superwizyjnej. Przykłady kliniczne dotyczą psychoterapii oraz innych oddziaływań prowadzonych na przestrzeni kilkunastu lat, co pozwoli obserwować, jak trauma oddziaływała na losy dziecięcych pacjentów w miarę ich dojrzewania i wchodzenia w dorosłość, ze szczególnym uwzględnieniem roli wczesnych urazów środowiskowych i okresów nasilonego stresu wpisanych w rozwój. Na koniec zaproponuję dwa wnioski dotyczące praktycznej użyteczności rozumienia opisanych prawidłowości oraz uwzględnienia ich w budowaniu koncepcji potraumatycznej rezyliencji.
Decision-making in psychotherapy
Authors: Kuncewicz Dorota K. , Kuncewicz Dariusz S.
Published: April 2024

Celem artykułu było pogłębienie refleksji nad znaczeniem decyzji w psychoterapii. Za punkt wyjścia obraliśmy pogląd klasyków psychoterapii (Eric Berne, Harold Greenwald, Antoni Kępiński), którzy przypisywali decyzjom pacjenta istotny wkład w powstawanie zaburzeń psychicznych oraz ich leczenie. Rozwinięcie i argumentacja niniejszego przekonania zostały podparte wiedzą z zakresu psychologii klinicznej i rozwojowej oraz ilustracjami klinicznymi. W pierwszej części tekstu zarysowaliśmy klasyczne indeterministyczne ujęcie decyzji oraz sposób myślenia o decyzjach, oparty na pojęciu kondycji ludzkiej, który jest możliwy do pogodzenia z determinizmem mechanizmów psychologicznych i użyteczny w psychoterapii. W kolejnych dwóch skupiliśmy się na rozpoznaniu specyfiki i typów decyzji w przebiegu życia pacjenta, które mogą generować lub/i podtrzymywać psychopatologię (adaptacyjne i moralne) oraz tych, które mają swój udział w wyleczeniu (zorientowane na szukanie prawdy i podejmowanie odpowiedzialności). W ostatniej części podjęliśmy próbę wyjaśnienia, na czym polega potencjalny wpływ decyzji terapeuty na kluczowe dla zmiany terapeutycznej decyzje pacjenta oraz sformułowaliśmy kilka postulatów natury metodologicznej i praktycznej.
Arte, espacio, ecología. Dos miradas, veinte entrevistas
Authors: K. Grande John
Published: April 2024

Esta obra recoge una veintena de entrevistas traducidas por primera vez al español realizadas por John K. Grande, una de las figuras más destacadas en el mundo del arte y la ecología, a creadores que, a pesar de sus diferencias en cuanto a formación y métodos empleados, comparten el hecho de producir obras integradas en el medio ambiente o que documentan paisajes en constante cambio. En estas miradas y exploraciones que afloran en distendidas conversaciones se perciben conflictos, perspectivas críticas, modos de hacer creativos y obras fantásticas. De esta manera, podemos, al transitar estos proyectos desde sus entrañas, aprender formas de afrontar situaciones ecológicamente críticas y desarrollar proyectos que inviten a la reflexión y promuevan el cambio, emocional y eficaz, hacia el equilibrio con los entornos.
Współczesne portrety profesorów Uniwersytetu Jagiellońskiego
Authors: Jasińska Anna
Published: April 2024

The professor portrait gallery in possession of the Collegium Maius Museum is the only collection of its kind in Poland and one of the most interesting university collections in Europe. The tradition of portraying the academics of the Krakow Alma Mater continues to this day. The Collegium Maius collection has been the subject of scientific research for many years. In 2010, a monograph titled Nowożytne portrety profesorów Akademii Krakowskiej w zbiorach Collegium Maius (Modern Portraits of Professors of the Krakow Academy in the Collections of Collegium Maius) was published, covering the oldest set of paintings from the 16th to the end of the 18th century. In 2019, another catalog was released, Portrety profesorów Uniwersytetu Jagiellońskiego działających od 1800 do 1945 roku w zbiorach Muzeum Collegium Maius (Portraits of Professors of the Jagiellonian University from 1800 to 1945 in the Collections of the Collegium Maius Museum). This publication is the third and final volume presenting the collection of professor portraits in possession of the Jagiellonian University Museum. It presents works painted after 1945. The created corpus constitutes an iconographic documentation presenting the portraits of distinguished professors while also establishing a narrative about the history of the oldest Polish university – the Krakow Alma Mater.
Desfechos neonatais adversos e fatores associados entre gestantes com diabetes mellitus gestacional e de risco habitual
Authors: Rocha Daniele Marano , Silva Magalhães Camilla Azevedo , Moreira Maria Elisabeth Lopes , Dias Marcos Augusto Bastos
Published: April 2024

Objetivo: Avaliar os desfechos neonatais adversos e fatores associados entre gestantes com diabetes mellitus gestacional e de risco gestacional habitual. Métodos: Estudo transversal, de âmbito nacional e de base hospitalar, conduzido entre fevereiro de 2011 e outubro de 2012. Foram excluídas as mulheres com gestações múltiplas ou natimortos. As informações foram coletadas via questionário padronizado, cartão de pré-natal e/ou prontuário. Resultados: Das 12.712 puérperas avaliadas, 1.915 tinham diabetes mellitus gestacional e 10.797 foram classificadas em risco gestacional habitual. Verificou-se que 74,1% das mulheres com diabetes receberam assistência pré-natal adequada/mais que adequada em relação a 65% das mulheres com risco gestacional habitual. Em contrapartida, o grupo das mulheres com diabetes foi composto em sua maioria por mulheres acima de 35 anos, com hipertensão prévia, excesso de peso pré-gestacional e ganho de peso gestacional excessivo, multíparas, com histórico de cesárea e abortos. Os desfechos “prematuridade” e “nascimento de recém-nascido grande para idade gestacional” foram superiores entre as mulheres com diabetes. Conclusão: As mulheres com diabetes detiveram condições demográficas, antecedentes clínicos/obstétricos e desfechos neonatais mais desfavoráveis em relação às mulheres de risco gestacional habitual. Apesar disso, o pré-natal foi um dos fatores que exerceu extrema importância para que outros desfechos negativos (óbito neonatal e o Apgar<5) não fossem superiores entre as mulheres com diabete sem relação às de risco gestacional habitual. Portanto, reitera-se o papel do pré-natal entre as mulheres brasileiras, sobretudo as de alto risco gestacional.
Avaliação do risco de sarcopenia em pacientes diabéticos tipo 2
Authors: Costa Lima Juliane Ramos , De Lemos Maria Conceição Chaves de Lemos , Lima da Silva Pastich Fabiana Cristina , Hamana Lopes de Brito Laiana
Published: April 2024

Introdução: Diabéticos podem apresentar perda de força e massa muscular de forma acentuada. Assim, as triagens SARC-F e SARC-CALF são úteis na investigação do risco de sarcopenia. Objetivo: Associar o risco de sarcopenia em pacientes diabéticos com as variáveis sociodemográficas, econômicas, clínicas, antropométricas e de estilo de vida. Método: Estudo do tipo série de casos realizado com adultos diabéticos tipo 2, de ambos os sexos, com idade entre 20 e 59 anos. A avaliação do risco de sarcopenia se deu pela aplicação dos questionários SARC-F e SARC-CALF. Para caracterização da amostra e associação com o risco de sarcopenia, foram coletados dados sociodemográficos e econômicos, medidas antropométricas, condições clínicas e estilo de vida. Resultados: A amostra foi composta por 69 pacientes, com média de idade de 53±7,5 anos e maior proporção de mulheres (63,8%; IC95%: 50,7-75,4). A frequência do risco positivo para sarcopenia segundo o SARC-F e o SARC-CALF foi de 43,48% e 46,38%, respectivamente. O SARC-F não mostrou associação significativa com as variáveis estudadas; já o SARC-CALF associou-se com índice de massa corporal (p <0,001), circunferência da cintura (p <0,001) e hábito de fumar (p = 0,027). Conclusão: O risco de sarcopenia foi observado em aproximadamente metade dos pacientes avaliados. O instrumento SARC-CALF apresentou associação com as variáveis antropométricas e o hábito de fumar, podendo ser considerado satisfatório para avaliar o risco de sarcopenia e intervir de forma precoce e efetiva.
Research Roundup
Authors: Pepper Amy , Dening Karen Harrison
Published: April 2024

Amy Pepper and Karen Harrison Dening provide a synopsis and brief review of a selection of recently published research articles that are of interest to neuroscience nurses, highlighting key points to keep you up to date; a full reference is provided for those who wish to read the research in more detail
Supporting best practice in neuroscience nursing
Authors: Weaver Sam , Braine Mary E
Published: April 2024

Sam Weaver and Mary E Braine encourage neuroscience nurses to visit the new British Association of Neuroscience Nurses’ (BANN's) website, consider submitting an abstract for the BANN autumn conference this coming October, and spread news of the new DAISY award for extraordinary neuroscience nurses in partnership with BANN.
Advanced nursing practice: key factors that have shaped its development in the Republic of Ireland
Authors: Lehwaldt Daniela , Stoneman Paul
Published: April 2024

This article explores the development of advanced practice in the Republic of Ireland, highlighting its progressive journey and the key factors that have shaped it. From the initial proposal of advanced roles in nursing and midwifery in 1998 to the establishment of clinical specialist and advanced practice positions, the evolution of advanced practice has been influenced by significant reports, legislative changes, the development of a national educational framework at a MSc advanced nurse practitioner (ANP) level and close collaboration between stakeholders. The article also discusses the distinctions between ANPs and clinical nurse specialists, highlighting the inclusion of medicinal products and ionising radiation prescriptions within the scope of ANPs. Throughout the paper, the regulatory framework and educational standards governing advanced practice in Ireland are highlighted, along with the collaborative efforts of key stakeholders
Exploring the Nexus of Organizational Culture, Digital Capabilities, and Organizational Readiness for Change in Primary School in Digital Transformation: A Quantitative Analysis
Authors: Ly Nguyen Thanh , Huong Nguyen Thi
Published: April 2024

In the context of Vietnam's primary schools undergoing a digital transformation, this research investigates the relationship between organizational culture (OC), digital capabilities (DC), and organizational readiness (OR) for change. This survey, which employs a quantitative methodology, includes 892 teachers and school managers from different elementary schools. Analyses were conducted using SPSS Statistics 26.0. The study shows a favorable relationship between digital skills and organizational readiness, suggesting that more digitally capable institutions are better equipped to handle change. Furthermore, a significant correlation exists between corporate culture, digital skills, and organizational readiness, indicating that schools with a creative and supportive culture are more prone to embrace digital change. These results advance knowledge of the variables affecting organizational change-readiness in Vietnam's primary school digital transformation. These results also have significant implications for educational policymakers, school administrators, and other stakeholders facilitating digital transformation in primary schools. By recognizing the benefits of digital capabilities and organizational culture for organizational change readiness, decision-makers can implement strategies to foster a supportive culture and enhance digital capabilities within educational institutions, ultimately leading to more successful and effective digital transformation initiatives.