bluuebunny/crossref_metadata_2025 huggingface dataset:
ANALISIS RESEP TIDAK TERLAYANI PASIEN RAWAT JALAN DI INSTALASI FARMASI RSU X JAKARTA
Authors: Agustina Ika , Tuahuns Farida , Charles Charles , Adina Arfie Nur
Published: November 2023

Pharmacy service is inseparable from health service system of a hospital. The service of pharmacy unit shall be a priority because an effective and efficient service will affect in the fulfillment of prescriptions. Furthermore, the management on the pharmaceutical stock will influence the revenue of the hospital (part of revenue center). The purpose of this research is to find out the percentage of unfilled prescriptions of outpatients from many different units, its reasons, and Therapeutic Class of unserved drug items. The research applies descriptive method using prospective data i.e. 25,259 R/ sheets of prescriptions obtained by total sampling technique.  The research was conducted in three months from February to April 2021. The result of the research shows that there are unfilled 467 R/ prescriptions due to several factors, such as the drugs are not listed in the formularies, the drugs are out of stock, and the prescribed or patient-requested drugs are not covered by the insurance. Internal medicine unit has the most unfilled prescriptions (160 out of 467). The main reason is the drugs are out of stock (133 out of 467). Medicines for Gastritic, Respiratory, Heart Diseases and Allergicare the top lists in the Therapeutic Class, which is in accordance with data showing that Intenal Medicine, Emergency Department dan General Practisioners, Pulmonary, Dermatology and Venereology, and Obstetrics and Gynecology are the top 5 polyclinics with the number of unserved prescriptions due to out of stock.
POLA PENGGUNAAN DAN ANALISIS EFEKTIVITAS BIAYA OBAT ANTINYERI PADA PASIEN DIABETIK NEUROPATI DI RUMAH SAKIT ISLAM SULTAN AGUNG SEMARANG
Authors: Sari Tri Purma , Perwitasari Dyah Aryani , Supadmi Woro
Published: November 2023

Diabetic neuropathy is gathering symptom clinic which influence system nerves, well single or combination and could happen in a manner suddenly, no detected, with symptom clinic and no specific signs but dangerous. Incidence diabetic neuropathy happen between 60% to 70% on type I and type II DM patients. Methods of data collection carried out prospectively. Data were obtained from outpatient data with a diagnosis of diabetic neuropathy who met the inclusion criteria and received analgetics from September to December 2020. Then a cost-effectiveness analysis was performed by calculating the ACER (Average Cost-Effectiveness Ratio) and ICER (Incremental Cost-Effectiveness Ratio) values. The results showed that the most commonly used analgetics was gabapentin at 65.96%, either alone or in combination with an effectiveness percentage of 83.87%. The use of analgetics with the lowest cost is a single Paracetamol of IDR 73,770. The lowest ACER values were shown in the use of the single analgetics Paracetamol and the combination of Amitriptyline-Paracetamol, namely 737.70 and 805.30.
NP on Logarithmic Space
Authors: Vega Frank
Published: November 2023

$P$ versus $NP$ is considered as one of the most important open problems in computer science. This consists in knowing the answer of the following question: Is $P$ equal to $NP$? It was essentially mentioned in 1955 from a letter written by John Nash to the United States National Security Agency. However, a precise statement of the $P$ versus $NP$ problem was introduced independently by Stephen Cook and Leonid Levin. Since that date, all efforts to find a proof for this problem have failed. Another major complexity classes are $L$ and $NL$. Whether $L = NL$ is another fundamental question that it is as important as it is unresolved. We prove that $NP \subseteq NSPACE(\log^{2} n)$ just using logarithmic space reductions.
Exploring the Bilingual Use of Chinese and English Among Chinese Students in the UK on the Chinese Social Media Platform Xiaohongshu
Authors: Liu Zhihan
Published: November 2023

This study explores the phenomenon of bilingualism among Chinese international students in the United Kingdom and its representation on Xiaohongshu, a popular Chinese social media platform. With the increasing trend of Chinese students studying abroad, bilingualism has become a significant aspect of their identity. This paper examines how these students use both Chinese and English on Xiaohongshu, reflecting their dual identities and cultural adaptation. The research utilizes a combination of quantitative and qualitative methods, analyzing a sample of Xiaohongshu posts related to UK studies. Four key reasons for bilingualism are identified: establishing and demonstrating international student identity; convenience of using certain English terms; linguistic innovation in translanguaging; and leveraging bilingual skills for knowledge profit. The study finds that bilingual posts serve not only as a means of communication but also as a tool for identity formation and cultural exchange. The use of English terms and bilingualism on Xiaohongshu is often a conscious choice to adapt to local customs, facilitate information exchange, and enhance the enjoyment of language learning. The phenomenon of bilingualism is seen as a reflection of the students' identity transformation, where they maintain their native Chinese identity while also adapting to their identity as international students. This duality is further exemplified by their participation in linguistic innovation, showcasing creativity and a blend of cultural knowledge.
Improved catalytic performance and molecular insight for lipoxygenase from Enterovibrio norvegicus via directed evolution
Authors: Zhang Bingjie , Chi Huibing , Shen Juan , Tao Yang , Lu Zhaoxin , Lu Fengxia , Zhu Ping
Published: November 2023

Lipoxygenase (LOX) holds significant promise for food and pharmaceutical industries. However, albeit its application has been hampered by low catalytic activity and suboptimal thermostability. To address the drawbacks, a directed evolution strategy was explored to enhance the catalytic activity and thermostability of LOX from Enterovibrio norvegicus (EnLOX) for the first time. After two rounds of error-prone polymerase chain reaction (error-prone PCR) and one generations of sequential DNA shuffling, all of four different mutants showed a significant increase in the specific activity of EnLOX, ranging from 132.07 ± 9.34 to 330.17 ± 18.54 U/mg. Among these mutants, D95E/T99A/A121H/S142N/N444W/S613G (EAHNWG) exhibited the highest specific activity, which was 8.25-fold higher than the wild-type enzyme (WT). Meanwhile, the catalytic efficiency (Kcat/Km) of EAHNWG was also improved, which was 13.61 ± 1.67 s−1 μM−1, in comparison to that of WT (4.83 ± 0.38 s−1 μM−1). In addition, mutant EAHNWG had a satisfied thermostability with the t1/2,50 °C value of 6.44 ± 0.24 h, which was 0.4 h longer than that of the WT. Furthermore, the molecular dynamics simulation and structural analysis demonstrated that the reduction of hydrogen bonds number, the enhancement of hydrophobic interactions in the catalytic pocket, and the improvement of flexibility of the lid domain facilitated structural stability and the strength of substrate binding capacity for improved thermal stability and catalytic efficiency of mutant LOX after directed evolution. Overall, these results could provide the guidance for further enzymatic modification of LOX with high catalytic performance for industrial application.
Type H vessels: functions in bone development and diseases
Authors: Liu Xiaonan , Zhang Peilin , Gu Yuan , Guo Qiaoyue , Liu Yonggan
Published: November 2023

Type H vessels are specialized blood vessels found in the bone marrow that are closely associated with osteogenic activity. They are characterized by high expression of endomucin and CD31. Type H vessels form in the cancellous bone area during long bone development to provide adequate nutritional support for cells near the growth plate. They also influence the proliferation and differentiation of osteoprogenitors and osteoclasts in a paracrine manner, thereby creating a suitable microenvironment to facilitate new bone formation. Because of the close relationship between type H vessels and osteogenic activity, it has been found that type H vessels play a role in the physiological and pathological processes of bone diseases such as fracture healing, osteoporosis, osteoarthritis, osteonecrosis, and tumor bone metastasis. Moreover, experimental treatments targeting type H vessels can improve the outcomes of these diseases. Here, we reviewed the molecular mechanisms related to type H vessels and their associated osteogenic activities, which are helpful in further understanding the role of type H vessels in bone metabolism and will provide a theoretical basis and ideas for comprehending bone diseases from the vascular perspective.
Gut microbiome dysbiosis in men who have sex with men increases HIV infection risk through immunity homeostasis alteration
Authors: Li Kangjie , Deng Jielian , Zhang Cong , Lai Guichuan , Xie Biao , Zhong Xiaoni
Published: November 2023

Objectives

Recent studies pointed out that gut microbiome dysbiosis in HIV infection was possibly confounded in men who have sex with men (MSM), but there is a lack of evidence. It also remained unclear how MSM-associated gut microbiome dysbiosis affected human health. This study aimed to compare the differences in gut microbiome changes between HIV and MSM and reveal the potential impacts of MSM-associated gut microbiome dysbiosis on the immune system.

Methods

We searched available studies based on the PubMed database, and all gut microbiome changes associated with HIV infection and MSM were extracted from the enrolled studies. The gutMgene database was used to identify the target genes and metabolites of the gut microbiome. Bioinformatic technology and single-cell RNA sequencing data analysis were utilized to explore the impacts of these gut microbiome changes on human immunity.

Results

The results showed significant overlaps between the gut microbiome associated with HIV and that of MSM. Moreover, bioinformatic analysis revealed that gut microbiome dysbiosis in MSM had an impact on several pathways related to immunity, including the IL-17 signaling pathway and Th17 cell differentiation. Additionally, target genes of MSM-associated gut microbiome were found to be highly expressed in monocytes and lymphocytes, suggesting their potential regulatory role in immune cells. Furthermore, we found that MSM-associated gut microbiome could produce acetate and butyrate which were reported to increase the level of inflammatory factors.

Conclusion

In conclusion, this study highlighted that MSM-associated gut microbiome dysbiosis might increase the risk of HIV acquisition by activating the immune system. Further studies are expected to elucidate the mechanism by which gut microbiome dysbiosis in MSM modulates HIV susceptibility.
Dissecting the role of the gut microbiome and fecal microbiota transplantation in radio- and immunotherapy treatment of colorectal cancer
Authors: Van Dingenen Lena , Segers Charlotte , Wouters Shari , Mysara Mohamed , Leys Natalie , Kumar-Singh Samir , Malhotra-Kumar Surbhi , Van Houdt Rob
Published: November 2023

Colorectal cancer (CRC) is one of the most commonly diagnosed cancers and poses a major burden on the human health worldwide. At the moment, treatment of CRC consists of surgery in combination with (neo)adjuvant chemotherapy and/or radiotherapy. More recently, immune checkpoint blockers (ICBs) have also been approved for CRC treatment. In addition, recent studies have shown that radiotherapy and ICBs act synergistically, with radiotherapy stimulating the immune system that is activated by ICBs. However, both treatments are also associated with severe toxicity and efficacy issues, which can lead to temporary or permanent discontinuation of these treatment programs. There's growing evidence pointing to the gut microbiome playing a role in these issues. Some microorganisms seem to contribute to radiotherapy-associated toxicity and hinder ICB efficacy, while others seem to reduce radiotherapy-associated toxicity or enhance ICB efficacy. Consequently, fecal microbiota transplantation (FMT) has been applied to reduce radio- and immunotherapy-related toxicity and enhance their efficacies. Here, we have reviewed the currently available preclinical and clinical data in CRC treatment, with a focus on how the gut microbiome influences radio- and immunotherapy toxicity and efficacy and if these treatments could benefit from FMT.
Research progress of quercetin in cardiovascular disease
Authors: Zhang Weiwei , Zheng Yan , Yan Fang , Dong Mingqing , Ren Yazhou
Published: November 2023

Quercetin is one of the most common flavonoids. More and more studies have found that quercetin has great potential utilization value in cardiovascular diseases (CVD), such as antioxidant, antiplatelet aggregation, antibacterial, cholesterol lowering, endothelial cell protection, etc. However, the medicinal value of quercetin is mostly limited to animal models and preclinical studies. Due to the complexity of the human body and functional structure compared to animals, more research is needed to explore whether quercetin has the same mechanism of action and pharmacological value as animal experiments. In order to systematically understand the clinical application value of quercetin, this article reviews the research progress of quercetin in CVD, including preclinical and clinical studies. We will focus on the relationship between quercetin and common CVD, such as atherosclerosis, myocardial infarction, ischemia reperfusion injury, heart failure, hypertension and arrhythmia, etc. By elaborating on the pathophysiological mechanism and clinical application research progress of quercetin's protective effect on CVD, data support is provided for the transformation of quercetin from laboratory to clinical application.
GPR35 acts a dual role and therapeutic target in inflammation
Authors: Wu Yetian , Zhang Pei , Fan Hongjie , Zhang Caiying , Yu Pengfei , Liang Xinmiao , Chen Yang
Published: November 2023

GPR35 is a G protein-coupled receptor with notable involvement in modulating inflammatory responses. Although the precise role of GPR35 in inflammation is not yet fully understood, studies have suggested that it may have both pro- and anti-inflammatory effects depending on the specific cellular environment. Some studies have shown that GPR35 activation can stimulate the production of pro-inflammatory cytokines and facilitate the movement of immune cells towards inflammatory tissues or infected areas. Conversely, other investigations have suggested that GPR35 may possess anti-inflammatory properties in the gastrointestinal tract, liver and certain other tissues by curbing the generation of inflammatory mediators and endorsing the differentiation of regulatory T cells. The intricate role of GPR35 in inflammation underscores the requirement for more in-depth research to thoroughly comprehend its functional mechanisms and its potential significance as a therapeutic target for inflammatory diseases. The purpose of this review is to concurrently investigate the pro-inflammatory and anti-inflammatory roles of GPR35, thus illuminating both facets of this complex issue.
Knowledge and attitudes of medical students about clinical aspects of congenital cytomegalovirus infection in newborns: A nationwide cross-sectional study in Greece
Authors: Benou Sofia , Hatzidaki Eleftheria , Kalaintzi Anna , Grivea Ioanna , Baltogianni Maria , Giapros Vasileios , Thomaidou Agathi , Sarafidis Kosmas , Tsichla Sofia , Sinopidis Xenophon , Papachatzi Eleni , Karatza Aggeliki , Lagadinou Maria , Dassios Theodore , Dimitriou Gabriel , Papaevangelou Vassiliki , Gkentzi Despoina
Published: November 2023

Introduction

Cytomegalovirus (CMV) is the most frequent cause of congenital infection worldwide causing severe morbidity in newborns, infants, and children. Despite the clinical importance of congenital CMV (cCMV) infection, studies conducted so far indicate that there is limited awareness in the medical community in the field. The aim of this study was to assess Greek medical students’ knowledge on cCMV infection.

Methods

We performed a questionnaire-based nationwide cross-sectional study. A convenience sample of medical students from seven medical schools was enrolled.

Results

Of the 562 respondents, 54,8% considered themselves undereducated on cCMV infection. However, almost half of the participants could correctly recognize some basic principles of cCMV infection including ways of transmission, diagnosis and treatment, while there were aspects of cCMV infection with knowledge deficit. The year of study had a positive impact on the level of knowledge with students of higher years of study being of more sufficient education on the specific topic.

Conclusion

Overall, our study indicates a discrepancy between self-reported awareness and the level of knowledge among medical students in Greece. Further educational opportunities about cCMV should be offered, particularly in areas of the curriculum involving the care of women and children. Establishing medical students’ solid background on the disease burden and educating them about preventative strategies for at-risk populations, should be the main pillars of such efforts in order to promote confidence in managing these cases in their future professional careers.
Successful treatment of nail lichen planus with tofacitinib: a case report and review of the literature
Authors: Huang Jundong , Shi Wei
Published: November 2023

Nail lichen planus (NLP) is a chronic inflammatory disease of unknown etiology and has been recognized as a nail potentially critical disorder, which can be severe and rapidly worsen with irreversible scarring. Currently, the treatment options are limited based on disease progression. High-potency topical or intralesional corticosteroids are commonly considered first-line therapeutic options; however, these therapies are unsuitable for all patients with NLP, especially those with extensive lesions. As a potential therapeutic target for inflammatory skin diseases, Janus kinase (JAK) inhibitors can suppress both type-1 and type-2 cytokines, thereby reducing the immune response and resultant inflammation. Recent studies have suggested benefit in cutaneous lichen planus and lichen planopilaris with oral JAK inhibitors. Here, we report a case of severe NLP that exhibited a favorable response to tofacitinib treatment. A 41-year-old woman presented to our clinic with a 2-year history of nail dystrophy of all fingers of both hands. The NLP was finally confirmed by histopathology and the above clinical features. After the informed consent signature, tofacitinib monotherapy, 5 mg twice a day, was then begun, and after 6 months, the appearance of her nails had a significant improvement.
Fecal microbiota transplantation: a novel strategy for treating Alzheimer’s disease
Authors: Xiang Wu , Xiang Han , Wang Junyu , Jiang Yiqin , Pan Chuanhui , Ji Bingjin , Zhang Anren
Published: November 2023

Alzheimer’s disease is a common neurological disorder, which has become one of the major factors affecting human health due to its serious impact on individuals, families and society. It has been confirmed that gut microbiota can affect the occurrence and development of Alzheimer’s disease. Especially, fecal microbiota transplantation plays a positive role in the treatment of Alzheimer’s disease. The mechanisms for improving Alzheimer’s disease might include anti-inflammation and regulation of amyloid β-protein, synaptic plasticity, short-chain fatty acids, and histone acetylation. In this mini-review, the relationship between fecal microbiota transplantation and Alzheimer’s disease was summarized. It is hoped that fecal microbiota transplantation would play a positive role in the prevention and treatment of Alzheimer’s disease in the future.
Investigating the value of radiomics stemming from DSC quantitative biomarkers in IDH mutation prediction in gliomas
Authors: Ioannidis Georgios S. , Pigott Laura Elin , Iv Michael , Surlan-Popovic Katarina , Wintermark Max , Bisdas Sotirios , Marias Kostas
Published: November 2023

Objective

This study aims to assess the value of biomarker based radiomics to predict IDH mutation in gliomas. The patient cohort consists of 160 patients histopathologicaly proven of primary glioma (WHO grades 2–4) from 3 different centers.

Methods

To quantify the DSC perfusion signal two different mathematical modeling methods were used (Gamma fitting, leakage correction algorithms) considering the assumptions about the compartments contributing in the blood flow between the extra- and intra vascular space.

Results

The Mean slope of increase (MSI) and the K1 parameter of the bidirectional exchange model exhibited the highest performance with (ACC 74.3% AUROC 74.2%) and (ACC 75% AUROC 70.5%) respectively.

Conclusion

The proposed framework on DSC-MRI radiogenomics in gliomas has the potential of becoming a reliable diagnostic support tool exploiting the mathematical modeling of the DSC signal to characterize IDH mutation status through a more reproducible and standardized signal analysis scheme for facilitating clinical translation.
Assessing the factor structure of the Eating Attitude Test-26 among undergraduate students in Malaysia
Authors: Wider Walton , Mutang Jasmine Adela , Chua Bee Seok , Lin Jiaming , Kamu Assis , Pang Nicholas Tze Ping
Published: November 2023

The objective of this study was to assess the factor structure of the 26-item Eating Attitude Test (EAT-26) through confirmatory factor analysis (CFA) among 1,084 undergraduate students in Malaysia. The initial findings indicated a lack of support for the proposed three-factor structure. Model modifications were made due to the inadequate initial fit. The fit of the model was significantly improved by excluding items with factor loadings below 0.40 and integrating residual covariances. In conclusion, it is necessary to make contextual modifications to the EAT-26 in order to effectively utilize it among Malaysian undergraduates. This highlights the significance of cultural adaptations in psychological instruments.
Mitigation of the U.S. agrifood sector’s contribution to human and planetary health: a case study
Authors: Dietz William H. , Fanzo Jessica
Published: November 2023

The relationship of the United States (U.S.) agrifood sector to climate change is bidirectional; cattle production for beef consumption generates methane and nitrous oxide, both of which are potent greenhouse gases (GHGs). These gases contribute to global warming which in turn increase the frequency and strength of adverse catastrophic events, which compromise the food supply. Increased GHGs also affect crop yields and the micronutrient content of crops, which adversely affect the prevalence of food and nutrition insecurity, particularly in low- and middle-income countries. Because the U.S. is a major contributor to global warming, we have a special responsibility to reduce our contribution to the generation of GHGs. The dilemma is that beef is a highly nutritious and desirable food, with excess consumption in the U.S. and under consumption in other parts of the world, but a desirable source of nutrients in low- and middle-income countries (LMICs). Reductions in fossil fuels have been a major focus of concern, and the agrifood system has been largely ignored. Policy changes to reduce beef consumption have been resisted at the highest levels of government. Furthermore, shifts to more plant-based diets have been contentious. Successful reductions in beef consumption will require individual, institutional, municipal, and state initiatives. Building the political will for change will require a compelling communication campaign that emphasizes the unsustainable contribution of beef consumption to climate change and land and water use.
High-sensitive cardiac troponin I (hs-cTnI) concentrations in newborns diagnosed with spinal muscular atrophy
Authors: Johannsen Jessika , Weiss Deike , Driemeyer Joenna , Olfe Jakob , Stute Fridrike , Müller Ferdinand , Schütt Marion , Trollmann Regina , Kölbel Heike , Schara-Schmidt Ulrike , Kirschner Janbernd , Pechmann Astrid , Blaschek Astrid , Horber Veronka , Denecke Jonas
Published: November 2023

Background

Spinal muscular atrophy (SMA) is a genetic neurodegenerative disease leading to muscular weakness and premature death. Three therapeutic options are currently available including gene replacement therapy (GRT), which is potentially cardiotoxic. High-sensitive cardiac troponin I (hs-cTnI) is widely used to monitor potential cardiac contraindications or side effects of GRT, but reference data in healthy newborns are limited and lacking in neonates with SMA. The aim of this study is to determine the range of pre-therapeutic hs-cTnI concentrations in neonates with SMA and to provide guidance for the assessment of these values.

Methods

Hs-cTnI levels, genetic and clinical data of 30 newborns (age range 2–26 days) with SMA were retrospectively collected from 6 German neuromuscular centers. In addition, hs-cTnI levels were measured in 16 neonates without SMA.

Results

The median hs-cTnI concentration in neonates with SMA was 39.5 ng/L (range: 4–1205). In 16 newborns with SMA, hs-cTnI levels were above the test-specific upper reference limit (URL). Exploratory statistical analysis revealed no relevant correlation between hs-cTnI levels and gender, gestational age, mode of delivery, SMN2 copy number, symptoms of SMA or abnormal cardiac findings.

Discussion

Our results suggest higher hs-cTnI plasma levels in newborns with and without SMA compared to assay-specific reference values generated in adults. Given the wide range of hs-cTnI values in neonates with SMA, hs-cTnI levels must be determined before treatment in each patient and post-treatment elevations should be interpreted in the context of the course rather than as individual values.
Intranasal dexmedetomidine improves postoperative sleep quality in older patients with chronic insomnia: a randomized double-blind controlled trial
Authors: Wu Jinghan , Liu Xingyang , Ye Chunyan , Hu Jiajia , Ma Daqing , Wang E.
Published: November 2023

Objective: This study was determined to investigate the impact of intranasal dexmedetomidine (DEX) on postoperative sleep quality in older patients (age over 65) with chronic insomnia during their hospitalization after surgery.

Design: A randomized double-blind controlled trial was conducted to compare the effects of intranasal dexmedetomidine spray with a placebo group.

Setting and Participants: The study was carried out at Xiangya Hospital, Central South University. 110 participants with chronic insomnia were analyzed.

Methods: This trial enrolled older patients who underwent total hip/knee arthroplasty and randomized them to receive intranasal dexmedetomidine (2.0 μg/kg) or saline daily at around 9 p.m. after surgery until discharge. The primary outcomes were subjective sleep quality assessed with the Leeds Sleep Evaluation Questionnaire (LSEQ). The secondary outcomes included the objective sleep quality measured with the Acti-graph, the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI). The other outcomes included the incidence of delirium, levels of inflammatory factors, visual analog scale (VAS) pain scores, postoperative opioid consumption, and treatment-related adverse events.

Results: 174 patients were screened for eligibility, and 110 were recruited and analyzed. The DEX group had significantly higher scores on both the LSEQ-Getting to sleep and LSEQ-Quality of Sleep at each time point compared to the placebo (p < 0.0001), The least squares (LS) mean difference in LSEQ-GTS score at T0 between placebo group and DEX group was 2 (95% CI, −1–6), p = 0.4071 and at T5 was −14 (95% CI, −17 to −10), p < 0.0001; The LS mean difference in the LSEQ-QOS score at T0 was −1 (95% CI, −4 to 1), p = 0.4821 and at T5 was −16 (95% CI, −21 to −10), p < 0.0001. The DEX group exhibited significant improvement in Total Sleep Time (TST), Sleep Onset Latency (SOL), and Sleep Efficiency (SE), at each time point after treatment compared to the placebo group (p < 0.0001). The PSQI and ISI scores in the DEX group were reduced after treatment (p < 0.001). No significant adverse events were reported with the use of dexmedetomidine.

Conclusion and Implications: This study demonstrates that intranasal administration of dexmedetomidine improves postoperative sleep quality in older patients with chronic insomnia who undergo surgery, without increasing the incidence of adverse effects.

Clinical Trial Registration:http://www.chictr.org.cn/, identifier ChiCTR2200057133
Neuroplasticity of the extended amygdala in opioid withdrawal and prolonged opioid abstinence
Authors: Kaplan Gary B. , Thompson Benjamin L.
Published: November 2023

Opioid use disorder is characterized by excessive use of opioids, inability to control its use, a withdrawal syndrome upon discontinuation of opioids, and long-term likelihood of relapse. The behavioral stages of opioid addiction correspond with affective experiences that characterize the opponent process view of motivation. In this framework, active involvement is accompanied by positive affective experiences which gives rise to “reward craving,” whereas the opponent process, abstinence, is associated with the negative affective experiences that produce “relief craving.” Relief craving develops along with a hypersensitization to the negatively reinforcing aspects of withdrawal during abstinence from opioids. These negative affective experiences are hypothesized to stem from neuroadaptations to a network of affective processing called the “extended amygdala.” This negative valence network includes the three core structures of the central nucleus of the amygdala (CeA), the bed nucleus of the stria terminalis (BNST), and the nucleus accumbens shell (NAc shell), in addition to major inputs from the basolateral amygdala (BLA). To better understand the major components of this system, we have reviewed their functions, inputs and outputs, along with the associated neural plasticity in animal models of opioid withdrawal. These models demonstrate the somatic, motivational, affective, and learning related models of opioid withdrawal and abstinence. Neuroadaptations in these stress and motivational systems are accompanied by negative affective and aversive experiences that commonly give rise to relapse. CeA neuroplasticity accounts for many of the aversive and fear-related effects of opioid withdrawal via glutamatergic plasticity and changes to corticotrophin-releasing factor (CRF)-containing neurons. Neuroadaptations in BNST pre-and post-synaptic GABA-containing neurons, as well as their noradrenergic modulation, may be responsible for a variety of aversive affective experiences and maladaptive behaviors. Opioid withdrawal yields a hypodopaminergic and amotivational state and results in neuroadaptive increases in excitability of the NAc shell, both of which are associated with increased vulnerability to relapse. Finally, BLA transmission to hippocampal and cortical regions impacts the perception of conditioned aversive effects of opioid withdrawal by higher executive systems. The prevention or reversal of these varied neuroadaptations in the extended amygdala during opioid withdrawal could lead to promising new interventions for this life-threatening condition.
Architecture, flexibility and performance of a special electron linac dedicated to Flash radiotherapy research: electronFlash with a triode gun of the centro pisano flash radiotherapy (CPFR)
Authors: Di Martino F. , Del Sarto D. , Bass G. , Capaccioli S. , Celentano M. , Coves D. , Douralis A. , Marinelli M. , Marrale M. , Masturzo L. , Milluzzo G. , Montefiori M. , Paiar F. , Pensavalle J. H. , Raffaele L. , Romano F. , Subiel A. , Touzain E. , Verona Rinati G. , Felici G.
Published: November 2023

The FLASH effect is a radiobiological phenomenon that has garnered considerable interest in the clinical field. Pre-clinical experimental studies have highlighted its potential to reduce side effects on healthy tissues while maintaining isoeffectiveness on tumor tissues, thus widening the therapeutic window and enhancing the effectiveness of radiotherapy. The FLASH effect is achieved through the administration of the complete therapeutic radiation dose within a brief time frame, shorter than 200 milliseconds, and, therefore, utilizing remarkably high average dose rates above at least 40 Gy/s. Despite its potential in radiotherapy, the radiobiological mechanisms governing this effect and its quantitative relationship with temporal parameters of the radiation beam, such as dose-rate, dose-per-pulse, and average dose-rate within the pulse, remain inadequately elucidated. A more profound comprehension of these underlying mechanisms is imperative to optimize the clinical application and translation of the FLASH effect into routine practice. Due to the aforementioned factors, the undertaking of quantitative radiobiological investigations becomes imperative, necessitating the utilization of sophisticated and adaptable apparatus capable of generating radiation beams with exceedingly high dose-rates and dose-per-pulse characteristics. This study presents a comprehensive account of the design and operational capabilities of a Linear Accelerator (LINAC) explicitly tailored for FLASH radiotherapy research purposes. Termed the “ElectronFlash” (EF) LINAC, this specialized system employs a low-energy configuration (7 and 9 MeV) and incorporates a triode gun. The EF LINAC is currently operational at the Centro Pisano FLASH Radiotherapy (CPFR) facility located in Pisa, Italy. Lastly, this study presents specific instances exemplifying the LINAC’s adaptability, enabling the execution of hitherto unprecedented experiments. By enabling independent variations of the temporal parameters of the radiation beam implicated in the FLASH effect, these experiments facilitate the acquisition of quantitative data concerning the effect’s dependence on these specific parameters. This novel approach hopefully contributes to a more comprehensive understanding of the FLASH effect, shedding light on its intricate radiobiological behavior and offering valuable insights for optimizing its clinical implementation.
Exploration of the truncated cytosolic Hsp70 in plants - unveiling the diverse T1 lineage and the conserved T2 lineage
Authors: Chen Yi-Jing , Cheng Sou-Yu , Liu Cheng-Han , Tsai Wen-Chieh , Wu Hsin-Hsin , Huang Ming-Der
Published: November 2023

The 70-kDa heat shock proteins (Hsp70s) are chaperone proteins involved in protein folding processes. Truncated Hsp70 (Hsp70T) refers to the variant lacking a conserved C-terminal motif, which is crucial for co-chaperone interactions or protein retention. Despite their significance, the characteristics of Hsp70Ts in plants remain largely unexplored. In this study, we performed a comprehensive genome-wide analysis of 192 sequenced plant and green algae genomes to investigate the distribution and features of Hsp70Ts. Our findings unveil the widespread occurrence of Hsp70Ts across all four Hsp70 forms, including cytosolic, endoplasmic reticulum, mitochondrial, and chloroplast Hsp70s, with cytosolic Hsp70T being the most prevalent and abundant subtype. Cytosolic Hsp70T is characterized by two distinct lineages, referred to as T1 and T2. Among the investigated plant and green algae species, T1 genes were identified in approximately 60% of cases, showcasing a variable gene count ranging from one to several dozens. In contrast, T2 genes were prevalent across the majority of plant genomes, usually occurring in fewer than five gene copies per species. Sequence analysis highlights that the putative T1 proteins exhibit higher similarity to full-length cytosolic Hsp70s in comparison to T2 proteins. Intriguingly, the T2 lineage demonstrates a higher level of conservation within their protein sequences, whereas the T1 lineage presents a diverse range in the C-terminal and SBDα region, leading to categorization into four distinct subtypes. Furthermore, we have observed that T1-rich species characterized by the possession of 15 or more T1 genes exhibit an expansion of T1 genes into tandem gene clusters. The T1 gene clusters identified within the Laurales order display synteny with clusters found in a species of the Chloranthales order and another species within basal angiosperms, suggesting a conserved evolutionary relationship of T1 gene clusters among these plants. Additionally, T2 genes demonstrate distinct expression patterns in seeds and under heat stress, implying their potential roles in seed development and stress response.
Early bruising detection of ‘Korla’ pears by low-cost visible-LED structured-illumination reflectance imaging and feature-based classification models
Authors: Mei Mengwen , Cai Zhonglei , Zhang Xinran , Sun Chanjun , Zhang Junyi , Peng Huijie , Li Jiangbo , Shi Ruiyao , Zhang Wei
Published: November 2023

Introduction

Nondestructive detection of thin-skinned fruit bruising is one of the main challenges in the automated grading of post-harvest fruit. The structured-illumination reflectance imaging (SIRI) is an emerging optical technique with the potential for detection of bruises.

Methods

This study presented the pioneering application of low-cost visible-LED SIRI for detecting early subcutaneous bruises in ‘Korla’ pears. Three types of bruising degrees (mild, moderate and severe) and ten sets of spatial frequencies (50, 100, 150, 200, 250, 300, 350, 400, 450 and 500 cycles m-1) were analyzed. By evaluation of contrast index (CI) values, 150 cycles m-1 was determined as the optimal spatial frequency. The sinusoidal pattern images were demodulated to get the DC, AC, and RT images without any stripe information. Based on AC and RT images, texture features were extracted and the LS-SVM, PLS-DA and KNN classification models combined the optimized features were developed for the detection of ‘Korla’ pears with varying degrees of bruising.

Results and discussion

It was found that RT images consistently outperformed AC images regardless of type of model, and LS-SVM model exhibited the highest detection accuracy and stability. Across mild, moderate, severe and mixed bruises, the LS-SVM model with RT images achieved classification accuracies of 98.6%, 98.9%, 98.5%, and 98.8%, respectively. This study showed that visible-LED SIRI technique could effectively detect early bruising of ‘Korla’ pears, providing a valuable reference for using low-cost visible LED SIRI to detect fruit damage.
Resilience mediates the effect of the COVID-19 pandemic on mental health in a sample of adults in Panama
Authors: Oviedo Diana C. , Tratner Adam E. , Pinzón María Sofía , Rodríguez-Araña Sofía , Pauli-Quirós Elianne , Chavarría Carlos , Rodríguez Camilo Posada , Britton Gabrielle B.
Published: November 2023

Background

The COVID-19 pandemic was characterized by global increases in depression, anxiety, and stress symptoms. Previous studies have shown that resilience mitigates these symptoms, however there is limited research exploring the link between resilience and mental illness during the COVID-19 pandemic in Central America.

Objective

To examine the role of resilience as it relates to the perceived effect of the pandemic on mental health symptoms.

Methods

A sample of 480 adults in Panama were recruited from March to May 2021 to complete an online survey. The online survey consisted of sociodemographic questions and scale measures assessing depression, anxiety and stress symptoms, resilience, and social support.

Results

Results indicated that resilience mediated the relationship between the perceived effect of the COVID-19 pandemic and mental health symptoms; participants who felt more personally affected by the pandemic reported more depression, anxiety, and stress symptoms via decreased resilience. Further analyses revealed that resilience was moderated by sex and social support, showing that the indirect effect of resilience was greater for women and individuals who perceived low social support.

Discussion

These findings contribute to a growing body of research documenting the adverse effects of the COVID-19 pandemic on mental health and reveal potential mechanisms through which pandemic-related distress decreases resilience, thereby increasing symptoms of mental illness.
Cognitive chicken or the emotional egg? How reconceptualizing decision-making by integrating cognition and emotion can improve task psychometrics and clinical utility
Authors: Buelow Melissa T. , Moore Sammy , Kowalsky Jennifer M. , Okdie Bradley M.
Published: November 2023

Decision-making is an executive function, tapping into cognitive, emotional, and personality-based components. This complexity, and the varying operational definitions of the construct, is reflected in the rich array of behavioral decision-making tasks available for use in research and clinical settings. In many cases, these tasks are “subfield-specific,” with tasks developed by cognitive psychologists focusing on cognitive aspects of decision-making and tasks developed by clinical psychologists focusing on interactions between emotional and cognitive aspects. Critically, performance across different tasks does not consistently correlate, obfuscating the ability to compare scores between measures and detect changes over time. Differing theories as to what cognitive and/or emotional aspects affect decision-making likely contribute to this lack of consistency across measures. The low criterion-related validity among decision-making tasks and lack of consistent measurement of the construct presents challenges for emotion and decision-making scholars. In this perspective, we provide several recommendations for the field: (a) assess decision-making as a specific cognitive ability versus a taxonomy of cognitive abilities; (b) a renewed focus on convergent validity across tasks; (c) further assessment of test–retest reliability versus practice effects on tasks; and (d) reimagine future decision-making research to consider the research versus clinical implications. We discuss one example of decision-making research applied to clinical settings, acquired brain injury recovery, to demonstrate how some of these concerns and recommendations can affect the ability to track changes in decision-making across time.
Psychological resilience and work engagement of Chinese nurses: a chain mediating model of career identity and quality of work life
Authors: Meng Zhixing , Zhang Lan , Zan Haijing , Wang Jingru
Published: November 2023

Aim

To investigate how nurses’ psychological resilience affects their work engagement and the resulting pathways, namely, the intermediary effect of career identity and quality of work life.

Background

Psychological resilience is the ability to adapt to new circumstances and overcome difficulties. Work engagement is a positive, perfect emotional and cognitive state in the work process, which has a positive effect on nurses’ physical and mental health and career development. The importance of psychological resilience in nursing is growing in popularity. However, few studies have explored the relationship between psychological resilience and nurses’ work engagement.

Design

This is a cross-sectional study.

Methods

From March to April 2023, 356 nurses in the First Affiliated Hospital of Jinzhou Medical University in China received valid questionnaires. The study was surveyed using the Connor-Davidson, Resilience Scale, the Nursing Career Identity Scale, the Work-Related Quality of Life Scale, and the 15-item Utrecht Work Engagement Scale. Process version 3.5 plug-in SPSS 25 was used to test the mediating effect.

Results

(1) Psychological resilience was significantly and positively correlated with career identity, quality of work life, and work engagement (r = 0.702–0.803, p < 0.001). (2) Career identity and quality of work life partially mediated the relationship between psychological resilience and work engagement, with effect sizes of 0.2382 and 0.0958, respectively. (3) There was a chain mediation model between psychological resilience and work engagement that had a value of 0.1219.

Conclusion

Career identity and quality of work life played a chain-mediating role between psychological resilience and work engagement. Thus, in order to enhance the work engagement of clinical nurses, it is necessary for nursing managers to take measures to enhance not only psychological resilience but also their career identity and the quality of work life.
Innovative solutions for language growth: the impact of problem-based learning via DingTalk on Chinese undergraduates’ business vocabulary amid COVID-19
Authors: Sun Lixuan , Dong Hui , Zhang Xiaotian
Published: November 2023

Amidst the COVID-19, which has necessitated the widespread use of distant learning, there has been a notable increase in the recognition and utilization of inventive pedagogical methods and technological tools in the field of language teaching. The primary objective of this research is to assess the effects of DingTalk-based PBL on the business vocabulary growth of Chinese undergraduates during the pandemic, with a particular focus on remote learning environments. This mixed-methods research employed a sample of 58 participants. The study involved both quantitative vocabulary assessments and qualitative interviews. The quantitative assessments aimed to measure the impact on vocabulary scores, while qualitative interviews were conducted to gather insights into participants’ experiences and perceptions regarding DingTalk-based PBL. The quantitative assessment revealed a significant improvement in business vocabulary scores among the participants who underwent DingTalk-based PBL. This result indicates the platform’s potential to enhance language acquisition. The qualitative interviews provided further insights, with participants expressing positive attitudes toward DingTalk-based PBL. They emphasized its capacity to sustain engagement, foster collaboration, and bridge the gap between remote learning and effective language acquisition. These findings underscore the transformative potential of DingTalk-based PBL in language education, especially in the context of challenges posed by the pandemic. While recognizing the constraints of this study, such as its limited duration and restricted contextual applicability, the research encourages further investigation into sustainable vocabulary expansion, the development of multifaceted language abilities, and the integration of these platforms into emerging hybrid educational frameworks. This study makes a valuable contribution to the ongoing discourse regarding novel technology-based methods in language instruction, providing relevant insights applicable to both present and future educational contexts.