bluuebunny/crossref_metadata_2025 huggingface dataset:
Soluble urokinase plasminogen activator receptor in vaginally collected amniotic fluid predicting fetal inflammatory response syndrome: a prospective cohort study
Authors: Gulbiniene Violeta , Dumalakiene Irena , Balciuniene Greta , Pilypiene Ingrida , Narkeviciute Ieva , Novickij Vitalij , Vysniauskis Gintautas , Ramasauskaite Diana
Published: January 2024

Background

Improving noninvasive antenatal diagnosis of fetal inflammatory response syndrome (FIRS) can assist in the evaluation of prenatal risk and reduce perinatal outcomes. This study aimed to determine whether soluble urokinase-type plasminogen activator receptor (suPAR) in vaginally collected amniotic fluid is significant in identifying FIRS after preterm premature rupture of membranes before 34 weeks of gestation.

Methods

This was a prospective cohort study of 114 pregnant women and their newborns after preterm premature rupture of membranes at 22–34+6 weeks of gestation. SuPAR was evaluated using an enzyme-linked immunosorbent assay in vaginally collected amniotic fluid. Patients were classified according to the presence or absence of FIRS. FIRS was defined by umbilical cord blood interleukin-6 level > 11 pg/mL or histological funisitis. The data were analyzed using the R package (R–4.0.5).

Results

SuPAR was detected in all amniotic fluid samples with a median of 26.23 ng/mL (interquartile range (IQR), 15.19–51.14). The median level of suPAR was higher in the FIRS group than in the non-FIRS group, 32.36 ng/mL (IQR, 17.27–84.16) vs. 20.46 ng/mL (IQR, 11.49–36.63) (P = 0.01), respectively. The presence of histological chorioamnionitis significantly increased the suPAR concentration in the FIRS group (P < 0.001). The areas under the curve for FIRS and FIRS with histological chorioamnionitis were 0.65 and 0.74, respectively, with an optimum cutoff value of 27.60 ng/mL. Controlling for gestational age, the cutoff of suPAR more than 27.60 ng/mL predicted threefold higher odds for FIRS and sixfold higher odds for FIRS with histologic chorioamnionitis.

Conclusion

Soluble urokinase-type plasminogen activator receptor in vaginally obtained amniotic fluid may assist in evaluating prenatal risk of FIRS in patients after preterm premature rupture of membranes before 34 weeks of gestation.
Congenital cytomegalovirus infection in newborns suspected of congenital rubella syndrome in Iran: a cross-sectional study
Authors: Mirsalehi Negar , Yavarian Jila , Ghavami Nastaran , Naseri Maryam , Khodakhah Farshad , Shatizadeh Malekshahi Somayeh , Zadheidar Sevrin , Mokhtari-Azad Talat , Shafiei-Jandaghi Nazanin-Zahra
Published: January 2024

Background

Following rubella virus control, the most important cause of congenital infections is human cytomegalovirus (HCMV). Congenital CMV (cCMV) may happen both in primary and non-primary maternal infections. The present study aimed to screen cCMV in symptomatic newborns suspected of congenital rubella syndrome (CRS) in Iran.

Methods

Out of 1629 collected infants' serum samples suspected of CRS but negative for rubella IgM, 524 samples were selected regarding cCMV complications. These samples were divided into two age groups: 1- one month and younger, 2- older than 1 month up to one year. Anti-HCMV IgM detection was performed on these serums. Then HCMV IgG avidity assay and HCMV DNA detection were carried out on all samples with positive and borderline results in IgM detection.

Results

Herein, 3.67% of symptomatic infants aged one month and younger had positive and borderline HCMV IgM, 12.5% of which had a low avidity index (AI). HCMV IgM detection rate among symptomatic infants older than one month to one year was 14.5%. Identified genotypes in this study were gB-1(63.63%), gB2 (18.18%), and gB3 (18.18%), respectively.

Conclusions

This comprehensive study was performed on serum samples of symptomatic infants clinically suspected of cCMV from all over Iran. There was a good correlation between serology findings and PCR.
Polysubstance mortality trends in White and Black Americans during the opioid epidemic, 1999–2018
Authors: Rawy Marwa , Abdalla Gergis , Look Kevin
Published: January 2024

Background

Psychoactive drug combinations are increasingly contributing to overdose deaths among White and Black Americans. To understand the evolving nature of overdose crisis, inform policies, and develop tailored and equitable interventions, this study provides a comprehensive assessment of polysubstance mortality trends by race and sex during the opioid epidemic.

Methods

We used serial cross-sectional US mortality data for White and Black populations from 1999 through 2018 to calculate annual age-adjusted death rates (AADR) involving any opioid, opioid subtypes, benzodiazepines, cocaine, psychostimulants, or combinations of these drugs, stratified by race and sex. Trend changes in AADR were analyzed using joinpoint regression models and expressed as average annual percent change (AAPC) during each period of the three waves of the opioid epidemic: 1999–2010 (wave 1), 2010–2013 (wave 2), and 2013–2018 (wave 3). Prevalence measures assessed the percent co-involvement of an investigated drug in the overall death from another drug.

Results

Polysubstance mortality has shifted from a modest rise in death rates due to benzodiazepine-opioid overdoses among White persons (wave 1) to a substantial increase in death rates due to illicit drug combinations impacting both White and Black populations (wave 3). Concurrent cocaine-opioid use had the highest polysubstance mortality rates in 2018 among Black (5.28 per 100,000) and White (3.53 per 100,000) persons. The steepest increase in death rates during wave 3 was observed across all psychoactive drugs when combined with synthetic opioids in both racial groups. Since 2013, Black persons have died faster from cocaine-opioid and psychostimulant-opioid overdoses. Between 2013 and 2018, opioids were highly prevalent in cocaine-related deaths, increasing by 33% in White persons compared to 135% in Blacks. By 2018, opioids contributed to approximately half of psychostimulant and 85% of benzodiazepine fatal overdoses in both groups. The magnitude and type of drug combinations with the highest death rates differed by race and sex, with Black men exhibiting the highest overdose burden beginning in 2013.

Conclusions

The current drug crisis should be considered in the context of polysubstance use. Effective measures and policies are needed to curb synthetic opioid-involved deaths and address disparate mortality rates in Black communities.
Mental health self-care during the COVID-19 pandemic: a prospective cohort study in Australia
Authors: Griffiths Daniel , Pradipta Vinsensia Maharani Kanya Dhira , Collie Alex
Published: January 2024

Introduction

Pandemic public health measures have affected mental health for many people. We sought to determine how people were managing their mental health concerns during the pandemic, and to identify worker characteristics where actions were more common.

Methods

A prospective cohort of 1646 Australians, who were in paid employment prior to the pandemic, completed a survey during 27 April– 26 July 2020 on changes in work, health, and actions taken to manage their mental health concerns. Descriptive statistics were calculated to determine actions taken to manage mental health concerns during the prior month, such as lifestyle changes, exercise, use of online resources, and talking to others. Regression models identify worker characteristics where actions were more common.

Results

Lifestyle changes were the most frequently reported action to manage mental health concerns (78%), and were more common for women (OR = 2.33, 95%CI=[1.82, 3.03]), and people experiencing recent work loss (OR = 1.54, 95%CI=[1.04, 2.28]). Overall, mental health self-care was more common for people experiencing psychological distress, or with pre-existing mental conditions. Talking to friends about mental health, and making changes to diet and exercise, was more common for women and those aged 18–24 years. Psychological distress was a significant indicator for consulting with health professionals.

Conclusion

Actions to manage mental health concerns during the pandemic were common, as were conversations with friends or family members. During economic crises, support and services should focus on reducing barriers to formal mental health care, particularly for people who less commonly seek help, and those experiencing moderate to high levels of psychological distress.
Long-term trends of lung cancer incidence and survival in southeastern China, 2011–2020: a population-based study
Authors: Zhou Yan , Xiang Zhisheng , Lin Weikai , Lin Jinghui , Wen Yeying , Wu Linrong , Ma Jingyu , Chen Chuanben
Published: January 2024

Background

Lung cancer is the primary cause of cancer-related deaths in China. This study analysed the incidence and survival trends of lung cancer from 2011 to 2020 in Fujian Province, southeast of China, and provided basis for formulating prevention and treatment strategies.

Methods

The population-based cancer data was used to analyse the incidence of lung cancer between 2011 and 2020, which were stratified by sex, age and histology. The change of incidence trend was analysed using Joinpoint regression. The relative survival of lung cancer with onset in 2011–2014, 2015–2017 and 2018–2020 were calculated using the cohort, complete and period methods, respectively.

Results

There were 23,043 patients diagnosed with lung cancer in seven registries between 2011 and 2020, with an age-standardized incidence rate (ASIR) of 37.7/100,000. The males ASIR increased from 51.1/100,000 to 60.5/100,000 with an annual percentage change (APC) of 1.5%. However, females ASIR increased faster than males, with an APC of 5.7% in 2011–2017 and 21.0% in 2017–2020. Compared with 2011, the average onset age of males and females in 2020 was 1.5 years and 5.9 years earlier, respectively. Moreover, the proportion of adenocarcinoma has increased, while squamous cell carcinoma and small cell carcinoma have decreased over the past decade. The 5-year relative survival of lung cancer increased from 13.8 to 23.7%, with a greater average increase in females than males (8.7% and 2.6%). The 5-year relative survival of adenocarcinoma, squamous cell carcinoma and small cell carcinoma reached 47.1%, 18.3% and 6.9% in 2018–2020, respectively.

Conclusions

The incidence of lung cancer in Fujian Province is on the rise, with a significant rise in adenocarcinoma, a younger age of onset and the possibility of overdiagnosis. Thus, Fujian Province should strengthen the prevention and control of lung cancer, giving more attention to the prevention and treatment of lung cancer in females and young populations.
Measurement properties of cervical joint position error in people with and without neck pain: a systematic review and narrative synthesis
Authors: AlDahas Ahmad , Heneghan Nicola R. , Althobaiti Shouq , Deane Janet A. , Rushton Alison , Falla Deborah
Published: January 2024

Introduction

Proprioception can be impaired in people with neck pain. The cervical joint position sense test, which measures joint position error (JPE), is the most common test used to assess neck proprioception. The aim of this systematic review was to assess the measurement properties of this test for the assessment of people with and without neck pain.

Methods

This systematic review was registered prospectively on Prospero (CRD42020188715). It was designed using the COSMIN guidelines and reported in line with the PRISMA checklist. Two reviewers independently searched Medline, Embase, SportDiscus, and CINAHL Plus databases from inception to the 24th July 2022 with an update of the search conducted until 14th of October 2023. The COSMIN risk of bias checklist was used to assess the risk of bias in each study. The updated criteria for good measurement properties were used to rate individual studies and then the overall pooled results. The level of evidence was rated by two reviewers independently using a modified GRADE approach.

Results

Fifteen studies were included in this review, 13 reporting absolute JPE and 2 reporting constant JPE. The measurement properties assessed were reliability, measurement error, and validity. The measurement of JPE showed sufficient reliability and validity, however, the level of evidence was low/very low for both measurement properties, apart from convergent validity of the constant JPE, which was high.

Conclusion

The measure of cervical JPE showed sufficient reliability and validity but with low/very low levels of evidence. Further studies are required to investigate the reliability and validity of this test as well as the responsiveness of the measure.
Application of robot navigation system for insertion of femoral neck system in the treatment of femoral neck fracture
Authors: Liu Gang , Yang Chengzhi , Wang Renchong , Tang Jingli , Wu Hao , Wei Lu , Hu Juzheng
Published: January 2024

Purpose

To evaluate the short-term clinical efficacy and advantages of surgery robot positioning system for insertion of Femoral Neck System (FNS) in the treatment of femoral neck fractures.

Methods

The clinical data of 52 patients with Femoral neck fracture (FNF) who had been treated with FNS between June 2020 and September 2021 were retrospectively analyzed. Among them, 26 patients were treated with traditional FNS (control group), while 26 additional patients were treated with FNS assisted by an orthopaedic robot positioning system (study group). The operation duration, frequency of key-guide needle placement, intraoperative blood loss, incision length, fracture healing rate, fracture healing time, and the Harris scores at the last follow-up were calculated and compared between the 2 groups.

Results

The study group had shorter operation duration, fewer numbers of placing the key-guide needle, less intraoperative blood loss, and smaller surgical incisions than the control group (all, P < 0.05). There was no significant difference in the rate of fracture healing rate between the 2 groups (P = 0.47), while the fracture healing duration of the study group was shorter than that of the control group (P = 0.03). At the last follow-up, compared with the control group, the Harris score and the number of excellent and good ratings were significantly higher in the study group (all, P < 0.05).

Conclusions

Using orthopaedic surgery robot positioning system-assisted FNS in the treatment of FNFs can effectively improve the efficiency of surgery, shorten operation time, and reduce the number of placing the key-guide needle, intraoperative blood loss, and operative trauma. Simultaneously, it shortens the duration of fracture healing and improves the recovery of hip function.
Prevalence, trend, and associated risk factors for cleft lip with/without cleft palate: a national study on live births from 2016 to 2021
Authors: Heydari Mohammad-Hossein , Sadeghian Ali , Khadivi Gita , Mustafa Hiba J. , Javinani Ali , Nadjmi Nasser , Khojasteh Arash
Published: January 2024

Backgrounds

Cleft lip with or without cleft palate (CL/P) is the most common congenital craniofacial anomaly, including non-syndromic cleft lip with or without cleft palate and cleft palate only. Failure in the fusion of median and lateral nasal processes, the maxillary prominence, and soft tissues around the oral cavity can cause CL/P. Previously, the prevalence has been estimated to be 1 among every 1000 births in 2014 among American neonates and no other reports have been available since. Thus, this study aimed to calculate the prevalence and trend of isolated CL/P among American live births from 2016 to 2021 with its associated risk factors.

Methods and materials

In this cross-sectional population-based retrospective study, we used live birth data provided by the National Center for Health Statistics (NCHS) from the Center for Disease Control and Prevention (CDC). We calculated the prevalence per 10,000 live births of isolated (non-syndromic) CL/P from 2016 to 2021. To examine risk factors for developing isolated CL/P, we used logistic regression modelling.

Results

The total prevalence per 10,000 births from 2016 to 2021 was 4.88 (4.79–4.97), for both sexes, and 5.96 (5.82–6.10) for males, and 3.75 (3.64–3.87) for females. The prevalence did not show any consistent linear decreasing or increasing pattern. We found significant association between increased odds of developing isolated CL/P among cases with 20 to 24 year-old mothers (OR = 1.07, 1.01–1.13, p = 0.013), mothers who smoked 11 to 20 cigarettes per day (OR = 1.46, 1.33–1.60, p <  0.001), mothers with extreme obesity (OR = 1.32, 1.21–1.43, p <  0.001), mothers with grade II obesity (OR = 1.32, 1.23–1.42, p <  0.001), mothers with pre-pregnancy hypertension (OR = 1.17, 1.04–1.31, p = 0.009), mothers with pre-pregnancy diabetes mellitus (OR = 1.96, 1.71–2.25, p <  0.001), and mothers who used assisted reproductive technology (OR = 1.40, 1.18–1.66, p <  0.001).

Conclusions

Our findings suggest a minuscule increase, albeit insignificant, in the trend of CL/P prevalence from 2016 to 2021. Developing CL/P had greater odds among mothers with pre-pregnancy diabetes, smoking, obesity, and pre-pregnancy hypertension mothers along with mothers who used assisted reproductive technology. Isolated CL/P had the highest prevalence in non-Hispanic Whites, American Indian or Alaskan Native and Native Hawaiian and Other Pacific Islanders.
In vitro remineralization of adjacent interproximal enamel carious lesions in primary molars using a bioactive bulk-fill composite
Authors: Phyo Win Myat , Saket Danuthida , da Fonseca Marcio A. , Auychai Prim , Sriarj Wannakorn
Published: January 2024

Background

Surface remineralization is recommended for the management of active non-cavitated interproximal carious lesions in primary teeth. According to the American Academy of Pediatric Dentistry, a recently recognized category of materials called bioactive restorative materials can be used for remineralization. This study aimed to evaluate the release of fluoride (F), calcium (Ca) and phosphate (P) ions from Predicta® Bioactive Bulk-fill composite compared with EQUIA Forte® and Filtek™ Z350 and to determine the remineralization effect of these 3 restorative materials on adjacent initial interproximal enamel carious lesions.

Methods

The release of F, Ca and P ions from 3 groups ((n = 10/group) (Group 1- Predicta®, Group 2- EQUIA Forte® and Group 3- Filtek™ Z350)) was determined at 1st, 4th, 7th and 14th days. After creating artificial carious lesions, human enamel samples were randomly assigned into 3 groups (n = 13/group) which were placed in contact with occluso-proximal restorative materials and exposed to a 14-day pH cycling period. Surface microhardness was determined using a Knoop microhardness assay at baseline, after artificial carious lesions formation and after pH cycling. The difference in the percentage of surface microhardness recovery (%SMHR) among groups was compared. Mineral deposition was analyzed with energy-dispersive x-ray spectroscopy (EDS) and the enamel surface morphology was evaluated with scanning electron microscopy (SEM). Kruskal-Wallis’s test with Dunn’s post hoc test and one-way ANOVA with Tukey’s post hoc test were used for data analysis.

Results

EQUIA Forte® released the highest cumulative amount of F and P ions, followed by Predicta® and Filtek™ Z350. Predicta® released higher amount of Ca ions than EQUIA Forte® and Filtek™ Z350. Predicta® demonstrated the highest %SMHR, followed by EQUIA Forte® and Filtek™ Z350. There was a significant difference in the %SMHR between Predicta® and Filtek™ Z350 (p < 0.05). However, EQUIA Forte® demonstrated the highest fluoride content, followed by Predicta® and Filtek™ Z350. The SEM images of EQUIA Forte® and Predicta® revealed the greater mineral deposition.

Conclusion

Predicta® demonstrated a marked increase in surface microhardness and fluoride content of adjacent initial interproximal enamel carious lesions in primary molars compared with Filtek™ Z350. Predicta® is an alternative restorative material to remineralize adjacent initial interproximal enamel carious lesions in primary molars, especially in high-risk caries patients.
Influence of the coronavirus disease 2019 pandemic on the post-graduate career paths of medical students: a cross-sectional study
Authors: Nishimura Ayumu , Miyoshi Tomoko , Otsuka Fumio , Matsukawa Akihiro
Published: January 2024

Background

The World Health Organization first declared the coronavirus disease 2019 (COVID-19) pandemic in March 2020 and announced the end of the emergency in May 2023. Additionally, the COVID-19 pandemic significantly impacted individuals globally, including medical students. Although the COVID-19 pandemic increased online education, it restricted clinical training, extracurricular activities, and interprovincial travel. Therefore, this study aimed to examine whether the COVID-19 pandemic influenced the choice of training hospitals and career paths among 3rd- to 6th-year medical students in Japan.

Methods

We developed a questionnaire comprising 21 multiple-choice and 1 open-ended questions, which was administered anonymously via online platforms. The survey targeted Japanese medical students to obtain insights into their preferences for training hospitals and career paths during the COVID-19 pandemic. Participants included 4th- to 6th-year medical students from 51 medical schools in Japan. The survey was conducted through student networks from 8 February 2022 to 20 March 2022.

Results

Overall, 507 medical students participated in the survey, with representation from various academic years as follows: 102 (20.1%), 134 (26.4%), 121 (23.9%), and 150 (29.6%) students from the 3rd, 4th, 5th, and 6th year, respectively. Of these, 338 (66.6%) students reported that the COVID-19 pandemic had influenced their choice of training hospitals. The degree of the influence varied based on the university region and the student year. However, most of the students (473, 93.3%) did not change their course for clinical, basic research, or administrative pathways due to the COVID-19 pandemic. Among the clinically oriented students, 391 (77.2%) did not change their preferred speciality.

Conclusions

The COVID-19 pandemic influenced medical students’ choice of training hospitals. Although many students believed that the pandemic would not change their career choices, our results indicate a potential subconscious trend to avoid internal medicine, which is the speciality most directly involved in treating patients with COVID-19.
Design, implementation and evaluation of e-learning program for common diseases to smartphone-based medical students: at a developing university
Authors: niromand Elham , Mansoory Meysam Siyah , Ramezani Ghobad , Khazaei Mohammad Rasool
Published: January 2024

Objective

Mobile-based educational software offers a wealth of resources that can foster the growth of learners and facilitate the creation of an interactive learning environment. This environment encourages both students and instructors to engage in exploration and the examination of various medical issues. The objective of this study is to design, implement, and evaluate an electronic educational program focused on common medical conditions, specifically tailored for medical students and accessible through mobile phones.

Method

The study was conducted following an action research approach, which comprised four key stages: needs assessment, application design, training, and evaluation. This research took place at the Kermanshah University of Medical Sciences’ Medical School. In the needs assessment phase, a formal survey was distributed to the teaching faculty members, requesting them to identify diseases and medical issues of high importance for medical interns’ education that were suitable for virtual teaching. Each faculty member was asked to prioritize a minimum of three and a maximum of seven cases. Subsequently, 10 faculty members from various departments completed the survey, leading to the identification of 47 common diseases after eliminating duplicates. These 47 cases were then presented to 30 medical interns, who were asked to select the 20 most significant cases. The 20 diseases with the highest statistical frequency were selected for further development due to resource constraints. The mobile application was developed for the Android platform using the Java programming language and the Android Studio development environment. To assess the application’s effectiveness from the students’ perspective, a questionnaire was designed, encompassing 25 questions across five domains: satisfaction, performance, learning, usability, and educational effectiveness. The questionnaire employed a Likert scale, with response options ranging from ‘completely disagree’ to ‘completely agree,’ scored from 1 to 5. One hundred medical interns and trainees were invited to participate in the evaluation, with 92 of them completing the questionnaires.

Results

The findings revealed a significant disparity in the average scores between students who underwent traditional teaching methods and those who engaged in mobile-based app-assisted education. This discrepancy was statistically significant across all three examined components.

Conclusion

Mobile-based learning represents a burgeoning educational approach with profound implications for healthcare education and the enhancement of patient care quality. The widespread integration of mobile phones into the educational framework offers a flexible teaching paradigm, fostering the potential for continuous lifelong learning.
Forensic nursing in the emergency department: the distance between nurses’ performed role behaviors and their perception of behaviors’ importance
Authors: Emami Somayeh Zare , Lynch Virginia A. , Banazadeh Marjan
Published: January 2024

Background

Emergency department nurses often deal with victims of violence and trauma. In the emergency department, the main focus is on saving lives and stabilizing patients' conditions. The next important task is to preserve any valuable evidence that could potentially help identify a crime. It is important to describe how nurses currently practice in the emergency department and perceive their role in caring for forensic patients. This study aimed to investigate the frequency of performance and perception of the importance of forensic nursing role behaviors among emergency department nurses as well as the correlation between mean scores of performance and perception.

Methods

This is a cross-sectional correlational descriptive study. This non-observational survey study used a questionnaire to investigate the frequency of performance and perception of the importance of forensic nursing role behaviors among 274 emergency department nurses.

Results

The total mean scores for frequency of performed behaviors and their perceived importance were 2.36±0.65 and 4.23±0.64 respectively. The overall mean scores of importance were significantly higher than frequency. There was a significant correlation between the frequency of performance and perception of the importance of twenty-eight items (twenty-four positive correlations and 4 negative correlations) (p<0.05). The frequency of performed behaviors positively correlated with participants’ type of shift worked and their personal experiences of legal and judicial claims. The female gender of respondents positively correlated with behaviors’ perceived importance.

Conclusion

The study revealed a significant discrepancy between the frequency of forensic nursing role behaviors performed and their perceived importance in the emergency department. This gap emphasizes the pressing requirement for forensic nursing subjects to be incorporated into graduate and undergraduate nursing curricula, as well as ongoing training programs and courses. It is crucial to establish and implement forensic nursing protocols for the care of trauma victims, and to foster collaboration between healthcare systems, law enforcement, and forensic investigators to streamline the process.
Middle-aged and older people’s preference for medical-elderly care integrated institutions in China: a discrete choice experiment study
Authors: Jiang Mao-min , Xiao Mei-fang , Zhang Jia-wen , Yang Mei-fang
Published: January 2024

Background

With the continuing impact of the aging population, medical-elderly care integrated institutions, as a way to bear the pressure of medical and elderly care, effectively ensure the quality of life of the elderly in their later years.

Objectives

To explore the preferences of medical-elderly care integrated institutions among Chinese middle-aged and older people and to provide a reference for establishing elderly-oriented development of medical-elderly care integrated institutions.

Methods

In this study, a discrete choice experiment (DCE) was used to investigate the preferences of people aged 45 years and older in medical-elderly care integrated institutions in China from October 20, 2022, to November 10, 2022. A mixed logit regression model was used to analyze the DCE data. Participants’ willingness to pay for each attribute was also calculated.

Results

Data from 420 participants who provided valid responses were included in the analysis. In terms of the choice preference, moderate service quality (vs. poor service quality: β = 1.707, p < 0.001, 95% CI 1.343 ~ 2.071) and high medical technology level (vs. low medical technology level: β = 1.535, p < 0.001, 95% CI 1.240 ~ 1.830) were the most important attributes to middle-aged and older people, followed by monthly cost, environmental facilities, the convenience of transportation, and entertainment activities. Regarding the willingness to pay, participants were more willing to pay for service quality and medical technology level than for other attributes. They were willing to pay $3156 and $2838 more for “poor service quality” and “low medical technology level,” respectively, to receive “moderate service quality " (p = 0.007, 95% CI 963 ~ 5349) and “high medical technology level” (p = 0.005, 95% CI 852 ~ 4824).

Conclusions

The state should attach great importance to the development of medical-elderly care integrated services industry, actively optimize the model of the medical-elderly care integrated service, improve the facilities, and create a healthy environment. At the same time, give full play to the role of medical insurance, long-term care insurance, and commercial insurance, so as to improve the comprehensive quality of life of the elderly.

Public contribution

The design of the experimental selection was guided by 10 experts in the field, 5 Chinese government officials, and interviews and focus group discussions, without whose participation this study would not have been possible.
Trajectories of health conditions and their associations with the risk of cognitive impairment among older adults: insights from a national prospective cohort study
Authors: Du Min , Tao Liyuan , Liu Min , Liu Jue
Published: January 2024

Background

The associations between trajectories of different health conditions and cognitive impairment among older adults were unknown. Our cohort study aimed to investigate the impact of various trajectories, including sleep disturbances, depressive symptoms, functional limitations, and multimorbidity, on the subsequent risk of cognitive impairment.

Methods

We conducted a prospective cohort study by using eight waves of national data from the Health and Retirement Study (HRS 2002–2018), involving 4319 adults aged 60 years or older in the USA. Sleep disturbances and depressive symptoms were measured using the Jenkins Sleep Scale and the Centers for Epidemiologic Research Depression (CES-D) scale, respectively. Functional limitations were assessed using activities of daily living (ADLs) and instrumental activities of daily living (IADLs), respectively. Multimorbidity status was assessed by self-reporting physician-diagnosed diseases. We identified 8-year trajectories at four examinations from 2002 to 2010 using latent class trajectory modeling. We screened participants for cognitive impairment using the 27-point HRS cognitive scale from 2010 to 2018 across four subsequent waves. We calculated hazard ratios (HR) using Cox proportional hazard models.

Results

During 25,914 person-years, 1230 participants developed cognitive impairment. In the fully adjusted model 3, the trajectories of sleep disturbances and ADLs limitations were not associated with the risk of cognitive impairment. Compared to the low trajectory, we found that the increasing trajectory of depressive symptoms (HR = 1.39; 95% CI = 1.17–1.65), the increasing trajectory of IADLs limitations (HR = 1.88; 95% CI = 1.43–2.46), and the high trajectory of multimorbidity status (HR = 1.48; 95% CI = 1.16–1.88) all posed an elevated risk of cognitive impairment. The increasing trajectory of IADLs limitations was associated with a higher risk of cognitive impairment among older adults living in urban areas (HR = 2.30; 95% CI = 1.65–3.21) and those who smoked (HR = 2.77; 95% CI = 1.91–4.02) (all P for interaction < 0.05).

Conclusions

The results suggest that tracking trajectories of depressive symptoms, instrumental functioning limitations, and multimorbidity status may be a potential and feasible screening method for identifying older adults at risk of cognitive impairment.
Saccharomyces boulardii promoters for control of gene expression in vivo
Authors: Sands Carmen , Hedin Karl Alex , Vazquez-Uribe Ruben , Sommer Morten Otto Alexander
Published: January 2024

Background

Interest in the use of engineered microbes to deliver therapeutic activities has increased in recent years. The probiotic yeast Saccharomyces boulardii has been investigated for production of therapeutics in the gastrointestinal tract. Well-characterised promoters are a prerequisite for robust therapeutic expression in the gut; however, S. boulardii promoters have not yet been thoroughly characterised in vitro and in vivo.

Results

We present a thorough characterisation of the expression activities of 12 S. boulardii promoters in vitro in glucose, fructose, sucrose, inulin and acetate, under both aerobic and anaerobic conditions, as well as in the murine gastrointestinal tract. Green fluorescent protein was used to report on promoter activity. Promoter expression was found to be carbon-source dependent, with inulin emerging as a favourable carbon source. Furthermore, relative promoter expression in vivo was highly correlated with expression in sucrose (R = 0.99).

Conclusions

These findings provide insights into S. boulardii promoter activity and aid in promoter selection in future studies utilising S. boulardii to produce therapeutics in the gut.
Purification and characterization of crude fructooligosaccharides extracted from red onion (Allium cepa var. viviparum) by yeast treatment
Authors: Aisara Jakkrit , Wongsanittayarak Jirat , Leangnim Nalapat , Utama Kraikrit , Sangthong Padchanee , Sriyotai Woraprapa , Mahatheeranont Sugunya , Phongthai Suphat , Unban Kridsada , Lumyong Saisamorn , Khanongnuch Chartchai , Wongputtisin Pairote , Kanpiengjai Apinun
Published: January 2024

Background

Yeast treatment has been used for purification of fructooligosaccharides (FOSs). However, the main drawback of this approach is that yeast can only partially remove sucrose from crude FOSs. The main objective of this research was to screen yeast strains for the capability of selectively consuming unwanted sugars, namely fructose, glucose, and sucrose, in crude FOSs extracted from red onion (Allium cepa var. viviparum) with minimal effect on FOS content.

Results

Among 43 yeast species isolated from Miang, ethnic fermented tea leaves, and Assam tea flowers, Candida orthopsilosis FLA44.2 and Priceomyces melissophilus FLA44.8 exhibited the greatest potential to specifically consume these unwanted sugars. In a shake flask, direct cultivation of C. orthopsilosis FLA44.2 was achieved in the original crude FOSs containing an initial FOSs concentration of 88.3 ± 1.2 g/L and 52.9 ± 1.2 g/L of the total contents of fructose, glucose, and sucrose. This was successful with 93.7% purity and 97.8% recovery after 24 h of cultivation. On the other hand, P. melissophilus FLA48 was limited by initial carbohydrate concentration of crude FOSs in terms of growth and sugar utilization. However, it could directly purify two-fold diluted crude FOSs to 95.2% purity with 92.2% recovery after 72 h of cultivation. Purification of crude FOSs in 1-L fermenter gave similar results to the samples purified in a shake flask. Extracellular β-fructosidase was assumed to play a key role in the effective removal of sucrose. Both Candida orthopsilosis FLA44.2 and P. melissophilus FLA44.8 showed γ-hemolytic activity, while their culture broth had no cytotoxic effect on viability of small intestinal epithelial cells, preliminarily indicating their safety for food processing. The culture broth obtained from yeast treatment was passed through an activated charcoal column for decolorization and deodorization. After being freeze dried, the final purified FOSs appeared as a white granular powder similar to refined sugar and was odorless since the main sulfur-containing volatile compounds, including dimethyl disulfide and dipropyl trisulfide, were almost completely removed.

Conclusion

The present purification process is considered simple and straight forward, and provides new and beneficial insight into utilization of alternative yeast species for purification of FOSs.
Interplay of miRNAs and lncRNAs in STAT3 signaling pathway in colorectal cancer progression
Authors: Rahbar Farzam Omid , Najafi Souzan , Amini Mohammad , Rahimi Zohreh , Dabbaghipour Reza , Zohdi Omid , Asemani Shahgoli Ghazale , Baradaran Behzad , Akbari Bahman
Published: January 2024

In recent decades, colorectal cancer (CRC) has turned into one of the most widespread malignancies, and the incidence of this malignancy is expected to increase. Despite considerable improvements in therapeutic approaches, the prognosis, and the management of CRC face many problems. Likely, the main limitation in the successful treatment of CRC is the lack of appropriate clinical therapeutic targets. As an effective target, the signal transducer and activator of transcription 3 (STAT3) are regulated by a wide range of genes and involved in cellular processes, including cell growth, migration, invasion, immunosuppression, and angiogenesis. Aberrant regulation of STAT3 signaling leads to cellular dysfunction, diseases, and malignancies, including CRC. Consequently, targeting this signaling pathway is considered one of the therapeutic strategies used in CRC treatment. MicroRNAs (miRNAs) and long non-coding RNAs (lncRNAs) are non-coding RNA molecules with partial or no protein-coding activity that participate in gene regulation at epigenetic, transcriptional, and post-transcriptional levels and regulate multiple signaling pathways, including STAT3 signaling (especially JAK/STAT). Therefore, these regulatory molecules are suggested to be very promising targets to present new insights into overcoming the limitations of conventional therapeutic strategies. Therefore, the current review study aimed to summarize the therapeutic and diagnostic significance of miRNAs and lncRNAs and their therapeutic and diagnostic significance related to the expression and activity of STAT3 in CRC.
Immunomodulation of cuproptosis and ferroptosis in liver cancer
Authors: Mo Jia-qian , Zhang Shen-yan , Li Qiang , Chen Mo-xian , Zheng Yue-qing , Xie Xin , Zhang Rongxin , Wang Shan-shan
Published: January 2024

According to statistics, the incidence of liver cancer is increasing yearly, and effective treatment of liver cancer is imminent. For early liver cancer, resection surgery is currently the most effective treatment. However, resection does not treat the disease in advanced patients, so finding a method with a better prognosis is necessary. In recent years, ferroptosis and cuproptosis have been gradually defined, and related studies have proved that they show excellent results in the therapy of liver cancer. Cuproptosis is a new form of cell death, and the use of cuproptosis combined with ferroptosis to inhibit the production of hepatocellular carcinoma cells has good development prospects and is worthy of in-depth discussion by researchers. In this review, we summarize the research progress on cuproptosis combined with ferroptosis in treating liver cancer, analyze the value of cuproptosis and ferroptosis in the immune of liver cancer, and propose potential pathways in oncotherapy with the combination of cuproptosis and ferroptosis, which can provide background knowledge for subsequent related research.
A scoping review of theories, models and frameworks used or proposed to evaluate knowledge mobilization strategies
Authors: Ziam Saliha , Lanoue Sèverine , McSween-Cadieux Esther , Gervais Mathieu-Joël , Lane Julie , Gaid Dina , Chouinard Laura Justine , Dagenais Christian , Ridde Valéry , Jean Emmanuelle , Fleury France Charles , Hong Quan Nha , Prigent Ollivier
Published: January 2024

Background

Evaluating knowledge mobilization strategies (KMb) presents challenges for organizations seeking to understand their impact to improve KMb effectiveness. Moreover, the large number of theories, models, and frameworks (TMFs) available can be confusing for users. Therefore, the purpose of this scoping review was to identify and describe the characteristics of TMFs that have been used or proposed in the literature to evaluate KMb strategies.

Methods

A scoping review methodology was used. Articles were identified through searches in electronic databases, previous reviews and reference lists of included articles. Titles, abstracts and full texts were screened in duplicate. Data were charted using a piloted data charting form. Data extracted included study characteristics, KMb characteristics, and TMFs used or proposed for KMb evaluation. An adapted version of Nilsen (Implement Sci 10:53, 2015) taxonomy and the Expert Recommendations for Implementing Change (ERIC) taxonomy (Powell et al. in Implement Sci 10:21, 2015) guided data synthesis.

Results

Of the 4763 search results, 505 were retrieved, and 88 articles were eligible for review. These consisted of 40 theoretical articles (45.5%), 44 empirical studies (50.0%) and four protocols (4.5%). The majority were published after 2010 (n = 70, 79.5%) and were health related (n = 71, 80.7%). Half of the studied KMb strategies were implemented in only four countries: Canada, Australia, the United States and the United Kingdom (n = 42, 47.7%). One-third used existing TMFs (n = 28, 31.8%). According to the adapted Nilsen taxonomy, process models (n = 34, 38.6%) and evaluation frameworks (n = 28, 31.8%) were the two most frequent types of TMFs used or proposed to evaluate KMb. According to the ERIC taxonomy, activities to “train and educate stakeholders” (n = 46, 52.3%) were the most common, followed by activities to “develop stakeholder interrelationships” (n = 23, 26.1%). Analysis of the TMFs identified revealed relevant factors of interest for the evaluation of KMb strategies, classified into four dimensions: context, process, effects and impacts.

Conclusions

This scoping review provides an overview of the many KMb TMFs used or proposed. The results provide insight into potential dimensions and components to be considered when assessing KMb strategies.
Sex-differences in Mediterranean diet: a key piece to explain sex-related cardiovascular risk in obesity? A cross-sectional study
Authors: Barrea Luigi , Verde Ludovica , Suárez Rosario , Frias-Toral Evelyn , Vásquez Celina Andrade , Colao Annamaria , Savastano Silvia , Muscogiuri Giovanna
Published: January 2024

Background

Mediterranean Diet (MD) has many health benefits, particularly in reducing cardiovascular risk (CVR). However, it is still little known if there are any sex differences in following this nutritional pattern and, thus, the potential sex-related repercussions on CVR in obesity. The study aimed to characterize sex-related adherence to MD and its association with CVR factors in subjects with obesity.

Methods

A total of 968 females (33.81 ± 11.06 years; BMI 34.14 ± 7.43 kg/m2) and 680 males (aged 34.77 ± 11.31years; BMI 33.77 ± 8.13 kg/m2) were included in a cross-sectional observational study. Lifestyle habits, anthropometric parameters, high sensitivity C-reactive protein (hs-CRP), and adherence to MD were evaluated.

Results

Females had significantly higher adherence to MD and lower hs-CRP levels than males (p < 0.001). Additionally, females consumed significantly more vegetables, fruits, legumes, fish/seafood, nuts, and sofrito sauce and less quantity of olive oil, butter, cream, margarine, red/processed meats, soda drinks (p = 0.001), red wine, and commercial sweets and confectionery than their counterparts. A PREDIMED score of ≤ 6 was associated with a significantly increased CVR in both sexes.

Conclusions

Females had higher adherence to MD, lower CVR, and different food preferences than males. Although the same PREDIMED threshold has been identified as a spy of CVR, the sex-related preference of individual foods included in the MD could explain the different impact of this nutritional pattern on CVR in both sexes.

Graphical Abstract
The spike-specific TCRβ repertoire shows distinct features in unvaccinated or vaccinated patients with SARS-CoV-2 infection
Authors: Vecchio Eleonora , Rotundo Salvatore , Veneziano Claudia , Abatino Antonio , Aversa Ilenia , Gallo Raffaella , Giordano Caterina , Serapide Francesca , Fusco Paolo , Viglietto Giuseppe , Cuda Giovanni , Costanzo Francesco , Russo Alessandro , Trecarichi Enrico Maria , Torti Carlo , Palmieri Camillo
Published: January 2024

Background

The evolving variants of SARS-CoV-2 may escape immunity from prior infections or vaccinations. It’s vital to understand how immunity adapts to these changes. Both infection and mRNA vaccination induce T cells that target the Spike protein. These T cells can recognize multiple variants, such as Delta and Omicron, even if neutralizing antibodies are weakened. However, the degree of recognition can vary among people, affecting vaccine efficacy. Previous studies demonstrated the capability of T-cell receptor (TCR) repertoire analysis to identify conserved and immunodominant peptides with cross-reactive potential among variant of concerns. However, there is a need to extend the analysis of the TCR repertoire to different clinical scenarios. The aim of this study was to examine the Spike-specific TCR repertoire profiles in natural infections and those with combined natural and vaccine immunity.

Methods

A T-cell enrichment approach and bioinformatic tools were used to investigate the Spike-specific TCRβ repertoire in peripheral blood mononuclear cells of previously vaccinated (n = 8) or unvaccinated (n = 6) COVID-19 patients.

Results

Diversity and clonality of the TCRβ repertoire showed no significant differences between vaccinated and unvaccinated groups. When comparing the TCRβ data to public databases, 692 unique TCRβ sequences linked to S epitopes were found in the vaccinated group and 670 in the unvaccinated group. TCRβ clonotypes related to spike regions S135-177, S264-276, S319-350, and S448-472 appear notably more prevalent in the vaccinated group. In contrast, the S673-699 epitope, believed to have super antigenic properties, is observed more frequently in the unvaccinated group. In-silico analyses suggest that mutations in epitopes, relative to the main SARS-CoV-2 variants of concern, don’t hinder their cross-reactive recognition by associated TCRβ clonotypes.

Conclusions

Our findings reveal distinct TCRβ signatures in vaccinated and unvaccinated individuals with COVID-19. These differences might be associated with disease severity and could influence clinical outcomes.

Trial registration: FESR/FSE 2014–2020 DDRC n. 585, Action 10.5.12, noCOVID19@UMG.