bluuebunny/crossref_metadata_2025 huggingface dataset:
Epigenetic effects of herbal medicine
Authors: Wu Yu-Yao , Xu Yan-Ming , Lau Andy T. Y.
Published: May 2023

Epigenetic memory is essential for life that governs the predefined functional features of cells. Recent evidence has indicated that the epigenetic modification provides a potential link to gene expression changes that may be involved in the development of various chronic diseases, and targeting the epigenome becomes a plausible method for treating diseases. Traditional herbal medicine has gradually entered the vision of researchers due to its low toxicity and its effectiveness in treating diseases. As a matter of fact, researchers found that the possessed epigenetic modification capacity of herbal medicine had the ability to combat the progression of the disease, such as various types of cancer, diabetes, inflammation, amnesia, liver fibrosis, asthma, and hypertension-induced renal injury. Studies on the epigenetic effects of herbal medicine will provide valuable insights into the molecular mechanisms of human diseases, which may lead to new therapeutic approaches and diagnoses. Thus, this review summarized the impact of herbal medicine and its bioactive components on disease epigenome as examples of how utilization of epigenetic plasticity could be useful as the basis for the future development of targeted therapies in chronic diseases.
Upregulated expression of Notch1/4 - JAG-1/DLL-1 detected in allergic rhinitis
Authors: Hjalmarsson Eric , Petro Marianne , Georén Susanna Kumlien , Winqvist Ola , Cardell Lars Olaf
Published: May 2023

Background

Allergic rhinitis (AR) is a chronic disease with high prevalence. There are currently many treatments available. However, despite an often good therapeutic response, many patients still report impairment in quality of life (QoL) during the pollen season. A skewed T helper (Th)2 polarization is a well-acknowledged pathologic feature of AR. In animal models, local notch signaling in peripheral tissue seems crucial for Th2 cell differentiation and the development of AR. However, the involvement of Notch signaling in Th2 cell differentiation and the development of AR in humans remains unknown. Hence, the present study investigated the human expression of Notch receptors on CD4+ T-cells in nasal mucosa and blood. Correspondingly Notch ligand expression was assessed on nasal epithelial cells and neutrophils.

Methodology

Nasal brush and blood samples from 18 patients with pollen-induced AR and 22 healthy controls were collected outside the pollen season. Notch 1–4 and Jagged-1,2 and Delta-like ligand 1,3–4 was analyzed using flow cytometry.

Results

The fraction of CD4+Notch1+ and CD4+Notch4+ T-cells was higher in AR patients than in healthy control patients. Further, the expression levels of the Notch ligands JAG-1 and DLL-1 were increased in nasal epithelial cells from AR patients compared to healthy control patients. In addition, AR patients displayed higher expression of JAG-1 on neutrophils both in the nasal mucosa and in peripheral blood.

Conclusion

The present study is the first to demonstrate increased activity in the Notch1/4 - JAG-1/DLL-1 pathways among allergic individuals. Further propagating the importance of Notch signalling in AR and blocking JAG-1 and DLL-1-induced Notch signalling by nasal epithelial cells and Neutrophils are potential targets to reduce allergic airway inflammation.
CT volume analysis in living donor liver transplantation: accuracy of three different approaches
Authors: Kalshabay Yerkezhan , Zholdybay Zhamilya , Di Martino Michele , Medeubekov Ulykbek , Baiguissova Dinara , Ainakulova Akmaral , Doskhanov Maksat , Baimakhanov Bolatbek
Published: May 2023

Objectives

The aim of this retrospective study is to compare and evaluate accuracy of three different approaches of liver volume quantification in living donor transplantations.

Methods

This is a single-center, retrospective study of 60 donors. The total and right lobe liver volumes were analyzed in the portal-venous phase by two independent radiologists who estimated the volumes using manual, semi-automated and automated segmentation methods. The measured right lobe liver volume was compared to the real weight of the graft after back-table examinations.

Results

The mean estimated overall liver volume was 1164.4 ± 137.0 mL for manual, 1277.4 ± 190.4 mL for semi-automated and 1240.1 ± 108.5 mL for automated segmentation. The mean estimated right lobe volume was 762.0 ± 122.4 mL for manual, 792.9 ± 139.9 mL for semi-automated and 765.4 ± 132.7 mL for automated segmentation. The mean graft weight was 711.2 ± 142.9 g. The manual method better correlated with the graft weight (r = 0.730) in comparison with the semi-automated (r = 0.685) and the automated (r = 0.699) methods (p < 0.001). The mean error ratio in volume estimation by each application was 12.7 ± 16.6% for manual, 17.1 ± 17.3% for semi-automated, 14.7 ± 16.8% for automated methods. There was a statistically significant difference between the mean error ratio of the manual and the semi-automated segmentations (p = 0.017), and no statistically significant difference between the manual and the automated applications (p = 0.199).

Conclusion

Volume analysis application better correlates with graft weight, but there is no obvious difference between correlation coefficients of all three methods. All three modalities had an error ratio, of which the semi-automated method showed the highest value.

Critical relevance statement

Volume analysis application was more accurate, but there is no drastic difference between correlation coefficients of all three methods.

Graphical abstract
Magnetic resonance imaging for treatment response evaluation and prognostication of hepatocellular carcinoma after thermal ablation
Authors: Zhang Yun , Wei Hong , Song Bin
Published: May 2023

Hepatocellular carcinoma (HCC) accounts for the vast majority of primary liver cancer and constitutes a major global health challenge. Tumor ablation with either radiofrequency ablation (RFA) or microwave ablation (MWA) is recommended as a curative-intent treatment for early-stage HCC. Given the widespread use of thermal ablation in routine clinical practice, accurate evaluation of treatment response and patient outcomes has become crucial in optimizing individualized management strategies. Noninvasive imaging occupies the central role in the routine management of patients with HCC. Magnetic resonance imaging (MRI) could provide full wealth of information with respect to tumor morphology, hemodynamics, function and metabolism. With accumulation of liver MR imaging data, radiomics analysis has been increasingly applied to capture tumor heterogeneity and provide prognostication by extracting high-throughput quantitative imaging features from digital medical images. Emerging evidence suggests the potential role of several qualitative, quantitative and radiomic MRI features in prediction of treatment response and patient prognosis after ablation of HCC. Understanding the advancements of MRI in the evaluation of ablated HCCs may facilitate optimal patient care and improved outcomes. This review provides an overview of the emerging role of MRI in treatment response evaluation and prognostication of HCC patients undergoing ablation.

Clinical relevance statement

MRI-based parameters can help predict treatment response and patient prognosis after HCC ablation and thus guide treatment planning.

Key points

ECA-MRI provides morphological and hemodynamic assessment of ablated HCC.

EOB-MRI provides more information for tumor response prediction after ablation.

DWI improve the characterization of HCC and optimize treatment decision.

Radiomics analysis enables characterization of tumor heterogeneity guidance of clinical
decision-making.

Further studies with multiple radiologists and sufficient follow-up period are needed.

Graphical abstract
Urinary neutrophil gelatinase-associated lipocalin and plasma IL-6 in discontinuation of continuous venovenous hemodiafiltration for severe acute kidney injury: a multicenter prospective observational study
Authors: Komaru Yohei , Oguchi Moe , Sadahiro Tomohito , Nakada Taka-aki , Hattori Noriyuki , Moriguchi Takeshi , Goto Junko , Shiga Hidetoshi , Kikuchi Yoshihiko , Negi Shigeo , Shigematsu Takashi , Kuriyama Naohide , Nakamura Tomoyuki , Doi Kent
Published: May 2023

Background

Patients with severe acute kidney injury (AKI) who require continuous venovenous hemodiafiltration (CVVHDF) in intensive care unit (ICU) are at high mortality risk. Little is known about clinical biomarkers for risk prediction, optimal initiation, and optimal discontinuation of CVVHDF.

Methods

This prospective observational study was conducted in seven university-affiliated ICUs. For urinary neutrophil gelatinase-associated lipocalin (NGAL) and plasma IL-6 measurements, samples were collected at initiation, 24 h, 48 h after, and CVVHDF discontinuation in adult patients with severe AKI. The outcomes were deaths during CVVHDF and CVVHDF dependence.

Results

A total number of 133 patients were included. Twenty-eight patients died without CVVHDF discontinuation (CVVHDF nonsurvivors). Urinary NGAL and plasma IL-6 at the CVVHDF initiation were significantly higher in CVVHDF nonsurvivors than in survivors. Among 105 CVVHDF survivors, 70 patients were free from renal replacement therapy (RRT) or death in the next 7 days after discontinuation (success group), whereas 35 patients died or needed RRT again (failure group). Urinary NGAL at CVVHDF discontinuation was significantly lower in the success group (93.8 ng/ml vs. 999 ng/ml,p < 0.01), whereas no significant difference was observed in plasma IL-6 between the groups. Temporal elevations of urinary NGAL levels during the first 48 h since CVVHDF initiation were observed in CVVHDF nonsurvivors and those who failed in CVVHDF discontinuation.

Conclusions

Urinary NGAL at CVVHDF initiation and discontinuation was associated with mortality and RRT dependence, respectively. The serial changes of urinary NGAL might also help predict the prognosis of patients with AKI on CVVHDF.

Graphical Abstract
Variational Autoencoders for chord sequence generation conditioned on Western harmonic music complexity
Authors: Comanducci Luca , Gioiosa Davide , Zanoni Massimiliano , Antonacci Fabio , Sarti Augusto
Published: May 2023

In recent years, the adoption of deep learning techniques has allowed to obtain major breakthroughs in the automatic music generation research field, sparking a renewed interest in generative music. A great deal of work has focused on the possibility of conditioning the generation process in order to be able to create music according to human-understandable parameters. In this paper, we propose a technique for generating chord progressions conditioned on harmonic complexity, as grounded in the Western music theory. More specifically, we consider a pre-existing dataset annotated with the related complexity values and we train two variations of Variational Autoencoders (VAE), namely a Conditional-VAE (CVAE) and a Regressor-based VAE (RVAE), in order to condition the latent space depending on the complexity. Through a listening test, we analyze the effectiveness of the proposed techniques.
Factors affecting “employees’ creativity”: the mediating role of intrinsic motivation
Authors: Yesuf Yohannes Mekonnen , Getahun Demis Alamirew , Debas Asemamaw Tilahun
Published: May 2023

This article examines a particular set of influences on the creativity of individual researchers at an Ethiopian agricultural research institute. One set of influences is "work orientations," and the others are "domain-relevant skills" and "creativity-relevant processes." The study posits that another important influence, intrinsic motivation, is a mediating influence between these factors and creativity. The study moves beyond past research by examining the influences together in a structural equation model. The data were collected from 307 researchers working with an agricultural research institute in different centers in Ethiopia. Partial Least Squares (PLS) path modeling, SmartPLS3, was used to empirically test the proposed hypotheses. The findings suggested the significantly positive direct effects of creativity-relevant processes, career orientation, and calling orientation on employees’ creativity. Moreover, the results of mediating effects showed significant indirect effects of domain-relevant skills, creativity-relevant processes, career orientation, and job orientation via intrinsic motivation on enhancing employees’ creativity. However, the results did not confirm the direct effects of domain-relevant skills and job orientation on employees’ creativity. In addition, the results did not confirm the hypothesis that the mediator, intrinsic motivation, had a statistically significant effect on the relationship between job orientation and employees’ creativity. Finally, for managers and decision-makers who prioritize employees’ creativity, these findings will deepen their understanding of the holistic role of intrinsic motivation in nurturing employees’ creativity.
Cuproptosis-Related Ferroptosis genes for Predicting Prognosis in kidney renal clear cell carcinoma
Authors: Luo Gang , Wang Lini , Zheng Ziyu , Gao Baobao , Lei Chong
Published: May 2023

Kidney renal clear cell carcinoma (KIRC) is a main subtype of kidney cancers. Cuproptosis and ferroptosis are correlated with immune infiltration and prognosis in tumors. However, the role of Cuproptosis-related Ferroptosis genes (CRFGs) in KIRC has rarely been fully understood. Therefore, we constructed a prognostic signature based on different expression of CRFGs in KIRC. All raw data of this study were extracted from public TCGA datasets. Cuproptosis and Ferroptosis genes were collected from the previous research. Finally, a total of 36 significantly different CRFGs were identified from TCGA–KIRC cohort. Six-gene signature (TRIB3, SLC2A3, PML, CD44, CDKN2A and MIOX) was identified by LASSO Cox regression based on the significantly different CRFGs. The CRFGs signature was correlated with worse overall survival and the AUC was 0.750. Functional enrichment indicated that CRFGs were mainly enriched in metabolism, drug resistance, tumor immunity pathways. Besides, the IC50 and immune checkpoint differentially expressed between different groups. The proposed 6-CRFGs signature is a promising biomarker to predict clinical outcomes and therapeutic responses for KIRC patient.
Failure Mechanisms and Rehabilitation Scenarios for Concrete Hydroelectric Facilities Affected by Alkali–Aggregate Reaction
Authors: Ftima Mahdi Ben , Yildiz Emre
Published: May 2023

This work focuses on the failure mechanisms of concrete hydroelectric facilities affected by alkali–aggregate reaction (AAR). Identification of potential failure mechanisms is based on an original “top-down approach” using an AAR pushover analysis with multi-physics numerical simulation of a representative hydroelectric facility. Different global rehabilitation scenarios based on slot-cutting and grouting techniques are discussed and compared, using different performance metrics. A new quantitative performance metric, specifically developed for the nonlinear sophisticated analysis tool and considering the volumetric cracking caused by AAR is also suggested. Based on comparison results, a combination of grouting after a partial slot-cutting in the neighborhood of the discontinuities, appears to provide the best compromise in terms of stress relief and extent of cracking. New AAR benchmark problems, issued from the top-down approach, are also suggested for the first time in the literature.
High-risk spatiotemporal patterns of cutaneous leishmaniasis: a nationwide study in Iran from 2011 to 2020
Authors: Firouraghi Neda , Bergquist Robert , Fatima Munazza , Mohammadi Alireza , Hamer Davidson H. , Shirzadi Mohammad Reza , Kiani Behzad
Published: May 2023

Background

Cutaneous leishmaniasis (CL) is a wide-reaching infection of major public health concern. Iran is one of the six most endemic countries in the world. This study aims to provide a spatiotemporal visualization of CL cases in Iran at the county level from 2011 to 2020, detecting high-risk zones, while also noting the movement of high-risk clusters.

Methods

On the basis of clinical observations and parasitological tests, data of 154,378 diagnosed patients were obtained from the Iran Ministry of Health and Medical Education. Utilizing spatial scan statistics, we investigated the disease’s purely temporal, purely spatial, spatial variation in temporal trends and spatiotemporal patterns. AtP = 0.05 level, the null hypothesis was rejected in every instance.

Results

In general, the number of new CL cases decreased over the course of the 9-year research period. From 2011 to 2020, a regular seasonal pattern, with peaks in the fall and troughs in the spring, was found. The period of September–February of 2014–2015 was found to hold the highest risk in terms of CL incidence rate in the whole country [relative risk (RR) = 2.24,P < 0.001)]. In terms of location, six significant high-risk CL clusters covering 40.6% of the total area of the country were observed, with theRRranging from 1.87 to 9.69. In addition, spatial variation in the temporal trend analysis found 11 clusters as potential high-risk areas that highlighted certain regions with an increasing tendency. Finally, five space-time clusters were found. The geographical displacement and spread of the disease followed a moving pattern over the 9-year study period affecting many regions of the country.

Conclusions

Our study has revealed significant regional, temporal, and spatiotemporal patterns of CL distribution in Iran. Over the years, there have been multiple shifts in spatiotemporal clusters, encompassing many different parts of the country from 2011 to 2020. The results reveal the formation of clusters across counties that cover certain parts of provinces, indicating the importance of conducting spatiotemporal analyses at the county level for studies that encompass entire countries. Such analyses, at a finer geographical scale, such as county level, might provide more precise results than analyses at the scale of the province.

Graphical Abstract
The association of care burden with motivation of vaccine acceptance among caregivers of stroke patients during the COVID-19 pandemic: mediating roles of problematic social media use, worry, and fear
Authors: Kukreti Shikha , Strong Carol , Chen Jung-Sheng , Chen Yi-Jung , Griffiths Mark D. , Hsieh Meng-Tsang , Lin Chung-Ying
Published: May 2023

Background

The aim of the present study was to investigate the relationship between care burden and motivation of COVID-19 vaccine acceptance among caregivers of patients who have experienced a stroke and to explore the mediating roles of social media use, fear of COVID-19, and worries about infection in this relationship.

Methods

A cross-sectional survey study with 172 caregivers of patients who had experienced a stroke took part in a Taiwan community hospital. All participants completed the Zarit Burden Interview, Bergen Social Media Addiction Scale, Worry of Infection Scale, Fear of COVID-19 Scale, and Motors of COVID-19 Vaccine Acceptance Scale. Multiple linear regression model was applied to construct and explain the association among the variables. Hayes Process Macro (Models 4 and 6) was used to explain the mediation effects.

Results

The proposed model significantly explained the direct association of care burden with motivation of COVID-19 vaccine acceptance. Despite the increased care burden associated with decreased vaccine acceptance, problematic social media use positively mediated this association. Moreover, problematic social media use had sequential mediating effects together with worry of infection or fear of COVID-19 in the association between care burden and motivation of vaccine acceptance. Care burden was associated with motivation of vaccine acceptance through problematic social media use followed by worry of infection.

Conclusions

Increased care burden among caregivers of patients who have experienced a stroke may lead to lower COVID-19 vaccines acceptance. Moreover, problematic social media use was positively associated with their motivation to get COVID-19 vaccinated. Therefore, health experts and practitioners should actively disseminate accurate and trustworthy factual information regarding COVID-19, while taking care of the psychological problems among caregivers of patients who have experienced a stroke.
The atypical hues of the Santa Cruz blue-and-white cargo: non-invasive analysis of glaze defects and color variations in mid-Ming porcelain
Authors: Hsieh Ellen , Fischer Christian , C. Orillaneda Bobby
Published: May 2023

Color variations and sometimes the frosted appearance of Chinese blue-and-white porcelain produced in folk kilns and recovered in underwater archaeological contexts are usually reported without further investigation. This study focuses on the causes responsible for the appearance of the glaze and blue decorations of late fifteenth-century blue-and-white porcelain from the Santa Cruz, one of the most important mid-Ming shipwrecks discovered in Asian waters. Besides detailed visual observations, chemical composition and colorimetric data were collected on a set of similarly shaped plates showing significant differences in the aspect of the glaze and tones and shades of the blue color. Results from portable X-ray fluorescence (pXRF) analysis confirmed the Jingdezhen origin of the ware and the use of domestic asbolane ores for the Co-based blue pigment. Visual and microstructural analysis has shown that the degree of opacity of the glaze is primarily linked to the crystallization of anorthite, which in some cases has pushed the pigment layer towards the surface, contributing to the development of white-brownish weathering spots. The colorimetric data acquired with fiber optics reflectance spectroscopy (FORS) allowed us to quantify chromaticity parameters and confirm the visual perception of a ‘not-so-blue’ color of the decoration. Without excluding a possible contribution of the underwater environment, the observed variations can be mainly attributed to the ware’s production and more specifically to pigment characteristics, manufacturing processes, and firing conditions even though the connection with these factors is not straightforward and prompts further research and broader discussions. From a historical perspective, it is suggested that the atypical hues are correlated with the progressive switch from foreign to domestic pigment sources during the Chenghua period (1465–87 CE) and the subsequent technological adaptations required by an ever-increasing demand for Chinese blue-and-white porcelain at the turn of the sixteenth century.
The effect of maxillary molar distalization with clear aligner: a 4D finite-element study with staging simulation
Authors: Mao Bochun , Tian Yajing , Xiao Yujia , Li Jing , Zhou Yanheng
Published: May 2023

Introduction

Long-term simulation of tooth movement is crucial for clear aligner (CA) treatment. This study aimed to investigate the effect of maxillary molar distalization with CA via an automatic staging simulation.

Method

A finite-element method (FEM) model of maxillary dentition, periodontal ligaments, attachments, and corresponding CA was established, and a prescribed 2-mm distalization with 0.1 mm each step of the second molar was simulated. The long-term tooth movement under orthodontic force was simulated with an iterative computation method. The morphologic changes of CA during staging were simulated with the thermal expansion method.

Results

Twenty steps of molar distalization were simulated. Significant distal tilting of the second molar was revealed, along with the proclination of anterior teeth, which caused the ‘reversed bow effect’. For the second molar, 4.63°distal tilting at the 20th step was revealed. The intrusion of the incisors and the second molar were 0.43 mm, 0.39 mm, and 0.45 mm, respectively, at step 20. All the anterior teeth showed a proclination of approximately 1.41°–2.01° at the 20th step. The expression rate of the designed distalization of the second molar was relatively low (approximately 68%) compared to the high efficacy of interdental space opening between molars with CA (approximately 89%).

Conclusion

A novel method of simulating long-term molar distalization with CA with FEM was developed. The FEM results suggested distal tilting of the second molar and the proclination of anterior teeth during the molar distalization.
24-h Movement Guidelines and Overweight and Obesity Indicators in Toddlers, Children and Adolescents: A Systematic Review and Meta-Analysis
Authors: Marques Adilson , Ramirez-Campillo Rodrigo , Gouveia Élvio R. , Ferrari Gérson , Tesler Riki , Marconcin Priscila , Loureiro Vânia , Peralta Miguel , Sarmento Hugo
Published: May 2023

Background

Engaging in physical activity increases energy expenditure, reducing total body fat. Time spent in sedentary behaviours is associated with overweight and obesity, and adequate sleep duration is associated with improved body composition. This systematic review aimed to analyse the relationship between compliance with the 24-h movement guidelines and obesity indicators in toddlers, children and adolescents.

Methods

A systematic review and meta-analysis was conducted. PubMed, Web of Science and Scopus were searched from inception to December 2021. Cross-sectional and prospective studies that analysed the relationship between 24-h movement guidelines and overweight and obesity written in English, French, Portuguese or Spanish were included. PROSPERO registration number is CRD42022298316.

Results

The associations between meeting the 24-h movement guidelines and standardised body mass index were null in the two studies for toddlers. Seven studies analysed the relationship between compliance with the 24-h movement guidelines and overweight and obesity among preschool children. Of these seven studies, six found no association between compliance with 24-h movement guidelines and body composition. Among children and adolescents, 15 articles were analysed. Of these 15 studies, in seven, it was found that children and adolescents who meet the 24-h movement guidelines were more likely to have lower risks of overweight and obesity. The meta-analysis yielded a pooled OR = 0.80 (95% CI = 0.68 to 0.95, p = 0.012, I2 = 70.5%) in favour of compliant participants. Regarding participants’ age groups, compliance with 24-h movement guidelines seems to exert greater benefits on overweight and obesity indicators among children-adolescents (OR = 0.62, p = 0.008) compared to participants at preschool (OR = 1.00, p = 0.931) and toddlers (OR = 0.91, p = 0.853).

Conclusion

Most included studies have not observed a significant relationship between compliance with the 24-h movement guidelines and overweight and obesity in toddlers, children and adolescents.
Feasibility and preliminary efficacy of structured programming and a parent intervention to mitigate accelerated summer BMI gain: a pilot study
Authors: Weaver R. G. , Armstrong B. , Adams E. , Beets M. W. , White J. , Flory K. , Wilson D. , McLain A. , Tennie B.
Published: May 2023

Background

This study assessed the initial feasibility and preliminary efficacy of providing children a free summer day camp and a parent intervention to improve self-regulation and mitigate accelerated summer BMI gain.

Methods

This pilot 2x2 factorial randomized control trial used a mixed-methods design to evaluate providing children a free summer day camp (SCV), a parent intervention (PI), and the combination of these two strategies (SCV+PI) to mitigate accelerated summer body mass index (BMI) gain. Progression criteria for feasibility and efficacy were assessed to determine if a full-scale trial was warranted. Feasibility criteria included recruitment capability (≥80 participants recruited) retention (≥70% participants retained), compliance (≥80% of participants attending the summer program with children attending ≥60% of program days, and ≥80% of participants completing goal setting calls with ≥60% of weeks syncing their child’s Fitbit), and treatment fidelity (≥80% of summer program days delivered for ≥9 h/day, and ≥80% of participant texts delivered). Efficacy criteria were assessed via achieving a clinically meaningful impact on zBMI (i.e., ≥0.15). Changes in BMI were estimated using intent-to-treat and post hoc dose-response analyses via multilevel mixed-effects regressions.

Results

For recruitment, capability and retention progression criteria were met with a total of 89 families participating and 24 participants randomized to the PI group, 21 randomized to the SCV group, 23 randomized to the SCV+PI group, and 21 randomized to the control. However, fidelity and compliance progression criteria were not achieved due to COVID-19 and lack of transportation. Progression criteria for efficacy was also not achieved as intent-to-treat analyses did not show changes in BMI gain that were clinically meaningful. Post hoc dose-response analyses showed that for each day (0 to 29) of summer programming children attended they gained −0.009 (95CI= −0.018, −0.001) less in BMIzscore.

Conclusions

Engagement in both the SCV and PI was not ideal due to COVID-19 and lack of transportation. Providing children with structured summer programming to mitigate accelerated summer BMI gain may be an effective strategy. However, because feasibility and efficacy progression criteria were not met, a larger trial is not warranted until further pilot work is completed to ensure children attend the programming.

Trial registration

The trial reported herein was prospectively registered at ClinicalTrials.gov. Trial #: NCT04608188.
Therapeutic roles of thiazides and loop diuretics in blood pressure control and renal protection against chronic kidney disease
Authors: Jo Wonji , Koh Eun Sil , Chung Sungjin
Published: May 2023

Fluid overload secondary to loss of functional nephron mass can elevate blood pressure, which is characteristic of hypertension shown in chronic kidney disease (CKD). Therefore, it is logical to use diuretics at appropriate dose to lower blood pressure in patients with CKD and hypertension. Despite the theoretical background on the use of diuretics in CKD, there have been no definitive data on the effectiveness or safety of diuretics as first-line therapy for the management of hypertension in patients with CKD. Results from some clinical trials have demonstrated that diuretics would not lower blood pressure. They could even worsen electrolyte imbalance and kidney function when they are administered in patients with CKD. Major clinical practice guidelines on management of blood pressure or CKD have stated that evidence for benefits of thiazide diuretics is not conclusive yet in patients with advanced CKD, although loop diuretics are often effective for volume control at lower glomerular filtration rate. Recently, evidence for diuretics as effective blood pressure lowering agents in patients with advanced CKD is increasing. Renoprotective effect of thiazide or loop diuretics might represent a consequence of their influence on blood pressure or their ability to potentiate the effect of renin-angiotensin system blockade by making intraglomerular pressure more renin-angiotensin system-dependent, although their direct benefit on renal function remains controversial. This review summarizes recent data on the possible role of diuretics in lowering blood pressure, slowing the progression of kidney disease, and reducing cardiovascular risk in CKD patients.
International youth mental health case study of peer researchers’ experiences
Authors: Spuerck Inga , Stankovic Milos , Fatima Syeda Zeenat , Yilmas Elmas , Morgan Nicholas , Jacob Jenna , Edbrooke-Childs Julian , Vostanis Panos
Published: May 2023

Background

The involvement of young people as peer researchers, especially with lived experience, is increasingly considered important in youth mental health research. Yet, there is variation in the understanding of the role, and limited evidence on its implementation across different research systems. This case study focusses on the barriers and enablers of implementing peer researcher roles within and across majority world countries contexts.

Methods

Based on an international youth mental health project involving different levels of peer researchers and participants from eight countries, peer researchers and a co-ordinating career researcher reflect on lessons regarding enabling and challenging factors. These reflections are captured and integrated by a systematic insight analysis process.

Results

Building on existing international networks, it was feasible to actively involve peer researchers with lived experience in a multi-country mental health study, who in turn recruited and engaged young participants. Identified challenges include the terminology and definition of the role, cultural differences in mental health concepts, and consistency across countries and sites.

Discussion

Peer researchers’ role could be strengthened and mainstreamed in the future through ongoing international networks, training, sufficient planning, and active influence throughout the research process.

Trial registration: Not applicable.
Knowledge, usability, and impact of wearable fitness devices among community exercisers in Ghana
Authors: Worlanyo Johnson Kwakye , Adams Caleb , Adedugbe Benjamin Oluwole , Lokoyi Ose-Lovet Osita , Moses Monday Omoniyi
Published: May 2023

Background

There has been a rapid evolution of wearable technologies such as wearable fitness devices (WFDs) in recent years globally. The continuous release of upgraded WFDs with diverse qualities presents new opportunities for research into their knowledge, usability, and impact in developed countries. Although few studies have separately examined the knowledge, usability, and impact of WFDs in Sub-Saharan Africa, more information is needed on combined knowledge, usability, and impact of smart WFDs among Ghanaians. The present study (1) assessed the knowledge, usability, and impact of WFDs among healthy community exercisers, and (2) investigated the factors that affect the usage and barriers to the use of WFDs in Ghana.

Methods

The quantitative descriptive design study had 152 healthy community exercisers (mean age = 23.37 ± 5.18 years) as participants. Self-structured questionnaire and System Usability Scale were administered.

Results

There were more non-users of WFDs (73.7%) than users (26.3%). Knowledge on WFDs among participants was high, usability was poor (mean SUS score = 66.87 ± 13.67) among users, and a positively fair impact on users was obtained. Performance expectancy was among the other factors that affected the usage of WFDs and price value was among the significant barriers identified.

Conclusion

There are more non-users of WFDs than users. Knowledge on WFDs among participants was high, usability was poor among users with positively fair impact on users.
Psychotropic medication for problem behaviours in intellectual disability and autism spectrum disorder: the need for caution
Authors: Bertelli Marco O.
Published: May 2023

Many persons with intellectual developmental disorders and/or autism spectrum disorder presenting problem behaviours undergo pharmacotherapy without receiving an appropriate psychiatric assessment and diagnosis. Instead, prescription of psychotropic medication should have specific aims and involve interdisciplinary assessment, personalisation and patient and family participation. Current knowledge about pharmacological management of problem behaviours in this population is limited, necessitating extreme caution in clinical practice and more research into the complex interrelated factors that affect presentation, course and treatment response.
Understanding self-harm and suicidal behaviours in South Asian communities in the UK: systematic review and meta-synthesis
Authors: Özen-Dursun Büşra , Kaptan Safa Kemal , Giles Sally , Husain Nusrat , Panagioti Maria
Published: May 2023

Background

Previous findings have indicated that self-harm and suicide are associated with different rates, and different risk and protective factors in South Asian people compared with White people in the UK. Substantial qualitative research has explored experiences of self-harm and suicide in South Asian people.

Aims

The study aims to review the existing qualitative evidence on self-harm and suicidal behaviours in South Asian communities in the UK.

Method

Systematic searches were conducted on Medline, EMBASE, PsycINFO, CINAHL, Open Dissertations and the British Library Ethos databases. We selected qualitative studies from both journals and grey literature that included South Asian participants who were resident in the UK and presented perceptions or experiences of self-harm and/or suicidal behaviour. Analysis was undertaken based on the meta-ethnographic approach.

Results

Fifteen studies were included in the analysis. Experience of self-harm was discussed based on three aspects: behind self-harm, functions of self-harm and recovery from self-harm. ‘Behind self-harm’ refers to factors associated with self-harm and suicide. ‘Functions of self-harm’ captures the meaning attributed to self-harm and suicide. ‘Recovery from self-harm’ encapsulates personal and professional help, and practical suggestions for the improvement of mental health services.

Conclusions

Although some similarities with the majority White population were present, there were also crucial differences that need consideration when shaping health policies, improving access to health services and developing culturally sensitive psychosocial interventions for self-harm and suicide specific to South Asian communities in the UK.
SARS-CoV-2 susceptibility and COVID-19 illness course and outcome in people with pre-existing neurodegenerative disorders: systematic review with frequentist and Bayesian meta-analyses
Authors: Smadi Muhannad , Kaburis Melina , Schnapper Youval , Reina Gabriel , Molero Patricio , Molendijk Marc L.
Published: May 2023

Background

People with neurodegenerative disease and mild cognitive impairment (MCI) may have an elevated risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may be disproportionally affected by coronavirus disease 2019 (COVID-19) once infected.

Aims

To review all eligible studies and quantify the strength of associations between various pre-existing neurodegenerative disorders and both SARS-CoV-2 susceptibility and COVID-19 illness course and outcome.

Method

Pre-registered systematic review with frequentist and Bayesian meta-analyses. Systematic searches were executed in PubMed, Web of Science and preprint servers. The final search date was 9 January 2023. Odds ratios (ORs) were used as measures of effect.

Results

In total, 136 primary studies (total sample sizen= 97 643 494), reporting on 268 effect-size estimates, met the inclusion criteria. The odds for a positive SARS-CoV-2 test result were increased for people with pre-existing dementia (OR = 1.83, 95% CI 1.16–2.87), Alzheimer's disease (OR = 2.86, 95% CI 1.44–5.66) and Parkinson's disease (OR = 1.65, 95% CI 1.34–2.04). People with pre-existing dementia were more likely to experience a relatively severe COVID-19 course, once infected (OR = 1.43, 95% CI 1.00–2.03). People with pre-existing dementia or Alzheimer's disease were at increased risk for COVID-19-related hospital admission (pooled OR range: 1.60–3.72). Intensive care unit admission rates were relatively low for people with dementia (OR = 0.54, 95% CI 0.40–0.74). All neurodegenerative disorders, including MCI, were at higher risk for COVID-19-related mortality (pooled OR range: 1.56–2.27).

Conclusions

Our findings confirm that, in general, people with neurodegenerative disease and MCI are at a disproportionally high risk of contracting COVID-19 and have a poor outcome once infected.
Management of Advanced Thyroid Cancer: Overview, Advances, and Opportunities
Authors: Agosto Salgado Sarimar , Kaye Erin Rachel , Sargi Zoukaa , Chung Christine H. , Papaleontiou Maria
Published: May 2023

Thyroid cancer is the most common endocrine malignancy with almost one million people living with thyroid cancer in the United States. Although early-stage well-differentiated thyroid cancers account for the majority of thyroid cancers on diagnosis and have excellent survival rates, the incidence of advanced-stage disease has increased over the past few years and confers poorer prognosis. Until recently, patients with advanced thyroid cancer had limited therapeutic options. However, the landscape of thyroid cancer treatment has dramatically changed in the past decade with the current availability of several novel effective therapeutic options, leading to significant advances and improved patient outcomes in the management of advanced disease. In this review, we summarize the current status of advanced thyroid cancer treatment options and discuss recent advances made in targeted therapies that have proven promising to clinically benefit patients with advanced thyroid cancer.
Tbx5 overexpression in embryoid bodies increases TAK1 expression but does not enhance the differentiation of sinoatrial node cardiomyocytes
Authors: Dai Yunkai , Nasehi Fatemeh , Winchester Charles D. , Foley Ann C.
Published: May 2023

Genetic studies place Tbx5 at the apex of the sinoatrial node (SAN) transcriptional program. To understand its role in SAN differentiation, clonal embryonic stem (ES) cell lines were made that conditionally overexpress Tbx5, Tbx3, Tbx18, Shox2, Islet-1, and MAP3k7/TAK1. Cardiac cells differentiated using embryoid bodies (EBs). EBs overexpressing Tbx5, Islet1, and TAK1 beat faster than cardiac cells differentiated from control ES cell lines, suggesting possible roles in SAN differentiation. Tbx5 overexpressing EBs showed increased expression of TAK1, but cardiomyocytes did not differentiate as SAN cells. EBs showed no change in the expression of the SAN transcription factors Shox2 and Islet1 and decreased expression of the SAN channel protein HCN4. EBs constitutively overexpressing TAK1 direct cardiac differentiation to the SAN fate but have reduced phosphorylation of its targets, p38 and Jnk. This opens the possibility that blocking the phosphorylation of TAK1 targets may have the same impact as forced overexpression. To test this, we treated EBs with 5z-7-Oxozeanol (OXO), an inhibitor of TAK1 phosphorylation. Like TAK1 overexpressing cardiac cells, cardiomyocytes differentiated in the presence of OXO beat faster and showed increased expression of SAN genes (Shox2, HCN4, and Islet1). This suggests that activation of the SAN transcriptional network can be accomplished by blocking the phosphorylation of TAK1.
T1 mapping and multimodel diffusion-weighted imaging in the assessment of cervical cancer: a preliminary study
Authors: Li Shujian , Liu Jie , Zhang Wenhua , Lu Huifang , Wang Weijian , Lin Liangjie , Zhang Yong , Cheng Jingliang
Published: May 2023

Objective:

To evaluate the clinical feasibility of T1 mapping and multimodel diffusion-weighted imaging (DWI) for assessing the histological type, grade, and lymphovascular space invasion (LVSI) of cervical cancer.

Methods:

Eighty patients with cervical cancer and 43 patients with a normal cervix underwent T1 mapping and DWI with 11 b-values (0–2000 s/mm2). Monoexponential, biexponential, and kurtosis models were fitted to calculate the apparent diffusion coefficient (ADC), pure molecular diffusion (D), pseudo-diffusion (D*), perfusion fraction (f), mean diffusivity (MD), and mean kurtosis (MK). Native T1 and DWI-derived parameters (ADCmean, ADCmin, Dmean, Dmin, D*, f, MDmean, MDmin, MKmean, and MKmax) were compared based on histological type, grade, and LVSI status.

Results:

Native T1 and DWI-derived parameters differed significantly between cervical cancer and normal cervix (all p < 0.05), except D* (p = 0.637). Native T1 and MKmean varied significantly between squamous cell carcinoma (SCC) and adenocarcinoma (both p < 0.05). ADCmin, Dmin, and MDmin were significantly lower while MKmax was significantly higher in the high-grade SCC group than in the low-grade SCC group (all p < 0.05). LVSI-positive SCC had a significantly higher MKmean than LVSI-negative SCC (p < 0.05).

Conclusion:

Both T1 mapping and multimodel DWI can effectively differentiate cervical cancer from a normal cervix and cervical adenocarcinoma from SCC. Furthermore, multimodel DWI may provide quantitative metrics for non-invasively predicting histological grade and LVSI status in SCC patients.

Advances in knowledge:

Combined use of T1 mapping and multimodel DWI may provide more comprehensive information for non-invasive pre-operative evaluation of cervical cancer.
Clinical efficacy of breathing training combined with core stability training in chronic nonspecific low back pain
Authors: Yu Duoduo , Yu Yaming , Peng Qian , Luo Jingting , He Xu
Published: May 2023

Objective: The study aimed to assess the clinical efficacy of breathing training combined with core stability training in chronic nonspecific low back pain (CNLBP).

Methods: This was a retrospective study. Of 60 included patients with CNLBP admitted by the Sichuan Province Orthopedic Hospital between December 2020 and February 2022. Random number table method was used to divide thirty patients to a control group, and the rest 30 to an observation group. The control group received core stability training, while the observation group underwent breathing training in addition to the exact treatment provided for the control group. To assess the utility of breathing and core stability training for CNLBP treatment, intergroup comparisons were made for clinical outcomes, the VAS, SF‐36, and SCODI scores before treatment and at three and seven weeks post‐treatment, and static and dynamic low‐back muscular endurance before and after treatment.

Results: The observation group had an overall response rate (ORR) of 96.67%, significantly higher than that (73.33%) of the control group (p< 0.05). Following the intervention, the VAS and SCODI scores declined in both groups; The SF‐36 score was elevated in both groups, and likewise. At the end of treatment, both groups exhibited improved static and dynamic muscular endurance of the low back, and the improvement was significantly more distinct in the observation group (p< 0.05).

Conclusion: Compared with core stability training as a sole treatment, breathing training combined with core stability training can yield better outcomes, ameliorate lumbar spine function, relieve pain and enhance low‐back muscular endurance in patients with CNLBP.

doi: https://doi.org/10.12669/pjms.39.4.6918

How to cite this: Yu D, Yu Y, Peng Q, Luo J, He X. Clinical efficacy of breathing training combined with core stability training in chronic nonspecific low back pain. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.6918

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.