bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between 14 candidate genes, PM2.5, and affective disorders: a study of the Taiwan Biobank
Authors: Ma Kai-Jie , Lin Yi-Ju , Liu Chiu-Shong , Tseng Pei-Ying , Wang Shi-Heng , Yao Chi-Yu , Wang Jong-Yi
Published: November 2023

Background

Most studies have focused on the risk factors, treatment, and care of affective psychosis, and several have reported a relationship between ambient air quality and this psychosis. Although an association has been reported between psychosis and genes, studies mainly explored the associations between one type of psychosis and one gene; few have identified genes related to affective psychosis. This study investigates the genetic and environmental factors of affective psychosis.

Methods

In this retrospective longitudinal study, 27 604 participants aged 30–70 were selected from Taiwan Biobank. The participants’ propensity scores were calculated based on their demographic information, and propensity score matching was performed to divide the participants into an experimental (i.e., affective psychosis) and control group at a 1:5 ratio. Plink was used to analyze the major and minor types of gene expression related to affective psychosis, and PM2.5 exposure was incorporated into the analyses.

Results

According to the generalized estimating equation analysis results, 8 single nucleotide polymorphisms (SNPs) belonging to the ANK3, BDNF, CACNA1C, and GRID1 genotypes were significantly correlated with depressive disorder (P < .001), with the majority belonging to the ANK3 and CACNA1C. A total of 5 SNPs belonging to the CACNA1C, GRID1, and SIRT1 genotypes were significantly correlated with bipolar disorder (P < .001), with the majority belonging to the CACNA1C. No significant correlation was identified between ambient air pollution and affective psychosis.

Conclusions

CACNA1C and GRID1 are common SNP genotypes for depressive disorder and bipolar disorder and should be considered associated with affective psychosis.
Glycemic variability and time in range among children with type 1 diabetes on insulin pump during the Covid-19 pandemic in Egypt; single center experience
Authors: Maksoud Abeer Ahmed Abdel , Salah Nouran Yousef , Ayoup Safaa Alshraki Alsayed
Published: November 2023

Background

Covid-19 has impacted the lives of individuals worldwide especially those with chronic illnesses. Children with type 1 diabetes (T1DM) are at risk of glycemic deterioration during the Covid-19 pandemic. However, some studies reported glycemic improvement in these children during the pandemic.

Aim

To assess the impact of Covid-19 on glycemic control and acute complications among children with T1DM on insulin pump in Egypt.

Methodology

Forty-two children with T1DM on insulin pump for at least 1 year were assessed during the period from June 2020 to May 2021 for insulin requirements, insulin-pump problems, frequency of diabetic-ketoacidosis (DKA), hypoglycemia and HbA1C. Continuous-glucose monitoring was done using Medtronic i-pro device for 5 days. Data were compared to those obtained from the patients’ medical records 1 year previously.

Result

Upon comparing data during Covid-19 pandemic with previous data from 12–24 months before Covid-19, there was a significant small increase in the mean total daily insulin dose from 0.83 ± 0.28 to 0.88 ± 0.30 U/kg/day with a similar small increase in the mean basal percentage from 51.19 ± 3.46 to 52.74 ± 4.31. Interestingly, the median time in range showed small increase from 53 (IQR 47–61) to 57.0 (IQR 51–73), the mean coefficient of variation showed small decrease from 42.10 ± 9.90 to 38.20 ± 8.12 and the mean HbA1C significantly decreased from 8.8 ± 1.3 (72.31 ± 16.78 mmol/ml) to 7.8 ± 1.2 mg/dl (61.31 ± 16.62 mmol/mol). Twenty-nine children (69%) had insulin-pump problems in the form of skin irritation (31%), skin infection (7.1%) and pump Set/Site occlusion (31%).

Conclusion

No safety issues and overall glycemic improvement were reported among the children with T1DM on insulin pump therapy from this single center during the covid-19 pandemic.
Hard and soft tissue shape variation and changes in Class II division 1 malocclusion during orthodontic treatment: a geometric morphometric analysis
Authors: Chu Chin Sin , Marizan Nor Murshida , Mohamed Alizae Marny , Mohd Hadi Pritam Helmi
Published: November 2023

Background

This study aims to determine the hard and soft tissue shape variation and its changes in Class II division 1 malocclusion before and after orthodontic treatment using Geometric Morphometric Analysis.

Methods

This retrospective study included 141 pre-treatment and near-end treatment lateral cephalometric radiographs of Class II division 1 malocclusion patients aged 16–40 years with a skeletal II pattern (ANB > 4o). 32 landmarks in Cartesian coordinates were created and identified using MorphoJ software to establish a shape analysis.

Results

The vertical dimensions (hypodivergent to hyperdivergent facial profiles) showed the largest variation in the general shape of hard and soft tissue, followed by the anteroposterior dimensions (mild to severe skeletal II patterns). Variations of lip shape (long to short), lip protuberance (everted to inverted), and nasolabial angle (obtuse to acute) were present. Orthodontic treatment affected the shape of the hard and soft tissue significantly (p < 0.0001). T2 showed significant uprighting of upper incisors (17.5o) and lower incisors (3.7o), improved NLA (8o), an increase in upper lip thickness (1.5 mm), and a reduction in lower lip thickness (0.7 mm) (p < 0.05).

Conclusion

Vertical and anteroposterior shape variations were found. Orthodontic treatment had an impact on both hard and soft tissue shapes. Hence, understanding both the hard and soft tissue shape variations and the orthodontic treatment changes is crucial for an accurate diagnosis and treatment plan to achieve a successful outcome and excellent patient satisfaction.
In-bag extraction of tissue through an incision in the posterior vaginal wall in laparoscopic myomectomy: a large retrospective study
Authors: Zhao Xin , Liu Yansong , Shi Yulin , Niu Jumin
Published: November 2023

Background

Our purpose was to describe the outcomes of transvaginal in-bag tissue extraction tissue through an incision in the posterior vaginal wall the middle part incision of posterior vagina in laparoscopic myomectomy.

Methods

This was a retrospective study of patients who received laparoscopic myomectomy and in-bag tissue extraction through an incision in the posterior vaginal wall between January 2016 and December 2022. Patient characteristics, intra- and post-operative complications, and outcomes were collected and analyzed.

Results

A total of 511women were included in the analysis. The mean largest myoma diameter was 8.44 ± 3.56 cm; mean specimen weight was 789.23 ± 276.97 g; mean operative time was 129.01 ± 53.13minutes; and mean blood loss was 175.99 ± 210.96 mL. Within 30-days of surgery, no fever, infection, or vaginal bleeding was noted in any patient, and the vaginal incisions of all patients had healed well. There were no incisional hernias, pelvic infections, and vaginal adhesions noted at follow-up 3 months after the operation. There were 37 cases of vaginal delivery of the patients after surgery, and there were no lacerations of the posterior wall vaginal incision.

Conclusions

Transvaginal in-bag extraction though an incision in the posterior vaginal wall is feasible and safe for removing tissue after laparoscopic myomectomy.
Should AI allocate livers for transplant? Public attitudes and ethical considerations
Authors: Drezga-Kleiminger Max , Demaree-Cotton Joanna , Koplin Julian , Savulescu Julian , Wilkinson Dominic
Published: November 2023

Background

Allocation of scarce organs for transplantation is ethically challenging. Artificial intelligence (AI) has been proposed to assist in liver allocation, however the ethics of this remains unexplored and the view of the public unknown. The aim of this paper was to assess public attitudes on whether AI should be used in liver allocation and how it should be implemented.

Methods

We first introduce some potential ethical issues concerning AI in liver allocation, before analysing a pilot survey including online responses from 172 UK laypeople, recruited through Prolific Academic.

Findings

Most participants found AI in liver allocation acceptable (69.2%) and would not be less likely to donate their organs if AI was used in allocation (72.7%). Respondents thought AI was more likely to be consistent and less biased compared to humans, although were concerned about the “dehumanisation of healthcare” and whether AI could consider important nuances in allocation decisions. Participants valued accuracy, impartiality, and consistency in a decision-maker, more than interpretability and empathy. Respondents were split on whether AI should be trained on previous decisions or programmed with specific objectives. Whether allocation decisions were made by transplant committee or AI, participants valued consideration of urgency, survival likelihood, life years gained, age, future medication compliance, quality of life, future alcohol use and past alcohol use. On the other hand, the majority thought the following factors were not relevant to prioritisation: past crime, future crime, future societal contribution, social disadvantage, and gender.

Conclusions

There are good reasons to use AI in liver allocation, and our sample of participants appeared to support its use. If confirmed, this support would give democratic legitimacy to the use of AI in this context and reduce the risk that donation rates could be affected negatively. Our findings on specific ethical concerns also identify potential expectations and reservations laypeople have regarding AI in this area, which can inform how AI in liver allocation could be best implemented.
Burnout, employee engagement, and changing organizational contexts in VA primary care during the early COVID-19 pandemic
Authors: Apaydin Eric A. , Rose Danielle E. , McClean Michael R. , Mohr David C. , Yano Elizabeth M. , Shekelle Paul G. , Nelson Karin M. , Guo Rong , Yoo Caroline K. , Stockdale Susan E.
Published: November 2023

Background

The COVID-19 pandemic involved a rapid change to the working conditions of all healthcare workers (HCW), including those in primary care. Organizational responses to the pandemic, including a shift to virtual care, changes in staffing, and reassignments to testing-related work, may have shifted more burden to these HCWs, increasing their burnout and turnover intent, despite their engagement to their organization. Our objectives were (1) to examine changes in burnout and intent to leave rates in VA primary care from 2017–2020 (before and during the pandemic), and (2) to analyze how individual protective factors and organizational context affected burnout and turnover intent among VA primary care HCWs during the early months of the pandemic.

Methods

We analyzed individual- and healthcare system-level data from 19,894 primary care HCWs in 139 healthcare systems in 2020. We modeled potential relationships between individual-level burnout and turnover intent as outcomes, and individual-level employee engagement, perceptions of workload, leadership, and workgroups. At healthcare system-level, we assessed prior-year levels of burnout and turnover intent, COVID-19 burden (number of tests and deaths), and the extent of virtual care use as potential determinants. We conducted multivariable analyses using logistic regression with standard errors clustered by healthcare system controlled for individual-level demographics and healthcare system complexity.

Results

In 2020, 37% of primary care HCWs reported burnout, and 31% reported turnover intent. Highly engaged employees were less burned out (OR = 0.57; 95% CI 0.52–0.63) and had lower turnover intent (OR = 0.62; 95% CI 0.57–0.68). Pre-pandemic healthcare system-level burnout was a major predictor of individual-level pandemic burnout (p = 0.014). Perceptions of reasonable workload, trustworthy leadership, and strong workgroups were also related to lower burnout and turnover intent (p < 0.05 for all). COVID-19 burden, virtual care use, and prior year turnover were not associated with either outcome.

Conclusions

Employee engagement was associated with a lower likelihood of primary care HCW burnout and turnover intent during the pandemic, suggesting it may have a protective effect during stressful times. COVID-19 burden and virtual care use were not related to either outcome. Future research should focus on understanding the relationship between engagement and burnout and improving well-being in primary care.
Different mechanisms of X-ray irradiation-induced male and female sterility in Aedes aegypti
Authors: Zhang Heng , Trueman Emma , Hou Xinjun , Chew De Xian , Deng Lu , Liew Jonathan , Chia Tania , Xi Zhiyong , Tan Cheong Huat , Cai Yu
Published: November 2023

Background

Aedes aegypti (Ae. aegypti) is the major vector that transmits many diseases including dengue, Zika, and filariasis in tropical and subtropical regions. Due to the growing resistance to chemical-based insecticides, biological control methods have become an emerging direction to control mosquito populations. The sterile insect technique (SIT) deploys high doses of ionizing radiation to sterilize male mosquitoes before the release. The Wolbachia-based population suppression method of the incompatible insect technique (IIT) involves the release of Wolbachia-infected males to sterilize uninfected field females. Due to the lack of perfect sex separation tools, a low percentage of female contamination is detected in the male population. To prevent the unintentional release of these Wolbachia-infected females which might result in population replacement, a low dose of X-ray irradiation is deployed to sterilize any female escapees. However, it remains unclear whether these irradiation-induced male and female sterilizations share common mechanisms.

Results

In this work, we set out to define the minimum dose of X-ray radiation required for complete female sterilization in Ae. aegypti (NEA-EHI strain). Further results showed that this minimum dose of X-ray irradiation for female sterilization significantly reduced male fertility. Similar results have been reported previously in several operational trials. By addressing the underlying causes of the sterility, our results showed that male sterility is likely due to chromosomal damage in the germ cells induced by irradiation. In contrast, female sterility appears to differ and is likely initiated by the elimination of the somatic supporting cells, which results in the blockage of the ovariole maturation. Building upon these findings, we identified the minimum dose of X-ray irradiation on the Wolbachia-infected NEA-EHI (wAlbB-SG) strain, which is currently being used in the IIT-SIT field trial. Compared to the uninfected parental strain, a lower irradiation dose could fully sterilize wAlbB-SG females. This suggests that Wolbachia-carrying mosquitoes are more sensitive to irradiation, consistent with a previous report showing that a lower irradiation dose fully sterilized Wolbachia-infected Ae. aegypti females (Brazil and Mexican strains) compared to those uninfected controls.

Conclusions

Our findings thus reveal the distinct mechanisms of ionizing X-ray irradiation-induced male or female sterility in Ae. aegypti mosquitoes, which may help the design of X-ray irradiation-based vector control methods.
Radiomic signatures reveal multiscale intratumor heterogeneity associated with tissue tolerance and survival in re-irradiated nasopharyngeal carcinoma: a multicenter study
Authors: Liu Ting , Dong Di , Zhao Xun , Ou Xiao-Min , Yi Jun-Lin , Guan Jian , Zhang Ye , Xiao-Fei Lv , Xie Chuan-Miao , Luo Dong-Hua , Sun Rui , Chen Qiu-Yan , Xing Lv , Guo Shan-Shan , Liu Li-Ting , Lin Da-Feng , Chen Yan-Zhou , Lin Jie-Yi , Luo Mei-Juan , Yan Wen-Bin , He Mei-Lin , Mao Meng-Yuan , Zhu Man-Yi , Chen Wen-Hui , Shen Bo-Wen , Wang Shi-Qian , Li Hai-Lin , Zhong Lian-Zhen , Hu Chao-Su , Wu De-Hua , Mai Hai-Qiang , Tian Jie , Tang Lin-Quan
Published: November 2023

Background

Post-radiation nasopharyngeal necrosis (PRNN) is a severe adverse event following re-radiotherapy for patients with locally recurrent nasopharyngeal carcinoma (LRNPC) and associated with decreased survival. Biological heterogeneity in recurrent tumors contributes to the different risks of PRNN. Radiomics can be used to mine high-throughput non-invasive image features to predict clinical outcomes and capture underlying biological functions. We aimed to develop a radiogenomic signature for the pre-treatment prediction of PRNN to guide re-radiotherapy in patients with LRNPC.

Methods

This multicenter study included 761 re-irradiated patients with LRNPC at four centers in NPC endemic area and divided them into training, internal validation, and external validation cohorts. We built a machine learning (random forest) radiomic signature based on the pre-treatment multiparametric magnetic resonance images for predicting PRNN following re-radiotherapy. We comprehensively assessed the performance of the radiomic signature. Transcriptomic sequencing and gene set enrichment analyses were conducted to identify the associated biological processes.

Results

The radiomic signature showed discrimination of 1-year PRNN in the training, internal validation, and external validation cohorts (area under the curve (AUC) 0.713–0.756). Stratified by a cutoff score of 0.735, patients with high-risk signature had higher incidences of PRNN than patients with low-risk signature (1-year PRNN rates 42.2–62.5% vs. 16.3–18.8%, P < 0.001). The signature significantly outperformed the clinical model (P < 0.05) and was generalizable across different centers, imaging parameters, and patient subgroups. The radiomic signature had prognostic value concerning its correlation with PRNN-related deaths (hazard ratio (HR) 3.07–6.75, P < 0.001) and all causes of deaths (HR 1.53–2.30, P < 0.01). Radiogenomics analyses revealed associations between the radiomic signature and signaling pathways involved in tissue fibrosis and vascularity.

Conclusions

We present a radiomic signature for the individualized risk assessment of PRNN following re-radiotherapy, which may serve as a noninvasive radio-biomarker of radiation injury-associated processes and a useful clinical tool to personalize treatment recommendations for patients with LANPC.
A novel approach to risk exposure and epigenetics—the use of multidimensional context to gain insights into the early origins of cardiometabolic and neurocognitive health
Authors: Ng Jane W. Y. , Felix Janine F. , Olson David M.
Published: November 2023

Background

Each mother–child dyad represents a unique combination of genetic and environmental factors. This constellation of variables impacts the expression of countless genes. Numerous studies have uncovered changes in DNA methylation (DNAm), a form of epigenetic regulation, in offspring related to maternal risk factors. How these changes work together to link maternal-child risks to childhood cardiometabolic and neurocognitive traits remains unknown. This question is a key research priority as such traits predispose to future non-communicable diseases (NCDs). We propose viewing risk and the genome through a multidimensional lens to identify common DNAm patterns shared among diverse risk profiles.

Methods

We identified multifactorial Maternal Risk Profiles (MRPs) generated from population-based data (n = 15,454, Avon Longitudinal Study of Parents and Children (ALSPAC)). Using cord blood HumanMethylation450 BeadChip data, we identified genome-wide patterns of DNAm that co-vary with these MRPs. We tested the prospective relation of these DNAm patterns (n = 914) to future outcomes using decision tree analysis. We then tested the reproducibility of these patterns in (1) DNAm data at age 7 and 17 years within the same cohort (n = 973 and 974, respectively) and (2) cord DNAm in an independent cohort, the Generation R Study (n = 686).

Results

We identified twenty MRP-related DNAm patterns at birth in ALSPAC. Four were prospectively related to cardiometabolic and/or neurocognitive childhood outcomes. These patterns were replicated in DNAm data from blood collected at later ages. Three of these patterns were externally validated in cord DNAm data in Generation R. Compared to previous literature, DNAm patterns exhibited novel spatial distribution across the genome that intersects with chromatin functional and tissue-specific signatures.

Conclusions

To our knowledge, we are the first to leverage multifactorial population-wide data to detect patterns of variability in DNAm. This context-based approach decreases biases stemming from overreliance on specific samples or variables. We discovered molecular patterns demonstrating prospective and replicable relations to complex traits. Moreover, results suggest that patterns harbour a genome-wide organisation specific to chromatin regulation and target tissues. These preliminary findings warrant further investigation to better reflect the reality of human context in molecular studies of NCDs.

Graphical Abstract
Response of rumen fermentation and microbiota to dietary supplementation of sodium selenite and bio-nanostructured selenium in lactating Barki sheep
Authors: Rabee Alaa Emara , Khalil Mayada M. H. , Khadiga Galal Abou , Elmahdy Ahmed , Sabra Ebrahim A. , Zommara Mohsen A. , Khattab Ibrahim M.
Published: November 2023

Dietary selenium (Se) sources affects the structure of the rumen microbial community and rumen fermentation. This study evaluated the effects of sodium selenite (SS) and bio-nanostructured selenium (SeNSM) on rumen fermentation and structure of rumen microbial community of lactating Barki ewes. Twenty one lactating Barki ewes were assigned into three groups based on their body weight and milk yield. The experiment lasted for 50 days, whenever, the control group was fed basal diet; group SS received basal diets plus sodium selenite as inorganic source of Se; and group SeNSM received basal diet plus organic selenium bio-nanostructured. Ruminal pH and volatile Fatty Acids (VFA) was lower (P < 0.05) in SeNSM group compared to control. Principle Coordinate Analysis separated the microbial communities into three clusters based on feeding treatment. The bacterial community was dominated by phylum Bacteroidetes and Firmicutes that were affected (P < 0.05) by Se sources. Specifically Bacteriodetes was higher (P < 0.05) in SS and SeNSM groups; and Firmicutes was higher (P < 0.05) in the control group. Moreover, the predominant bacterial genera were Prevotella, Rikenellaceae RC9 gut group, Unclassified_Bacteroidales, which were higher (P < 0.05) in SeNSM group. The methanogenic community belonged to phylum Euryarchaeota and was significantly decreased (P < 0.05) by Se supplementation. Principal component analysis based on rumen fermentation parameters, and relative abundances of bacteria and methanogens revealed three distinct clusters. These findings suggest that Se supplementation affected the relative abundances of dominant bacterial groups, declined rumen methanogens and SeNSM supplementation showed some positive impacts on some fibrolytic bacteria.
Modular bioengineering of whole-cell catalysis for sialo-oligosaccharide production: coordinated co-expression of CMP-sialic acid synthetase and sialyltransferase
Authors: Schelch Sabine , Eibinger Manuel , Zuson Jasmin , Kuballa Jürgen , Nidetzky Bernd
Published: November 2023

Background

In whole-cell bio-catalysis, the biosystems engineering paradigm shifts from the global reconfiguration of cellular metabolism as in fermentation to a more focused, and more easily modularized, optimization of comparably short cascade reactions. Human milk oligosaccharides (HMO) constitute an important field for the synthetic application of cascade bio-catalysis in resting or non-living cells. Here, we analyzed the central catalytic module for synthesis of HMO-type sialo-oligosaccharides, comprised of CMP-sialic acid synthetase (CSS) and sialyltransferase (SiaT), with the specific aim of coordinated enzyme co-expression in E. coli for reaction flux optimization in whole cell conversions producing 3′-sialyllactose (3SL).

Results

Difference in enzyme specific activity (CSS from Neisseria meningitidis: 36 U/mg; α2,3-SiaT from Pasteurella dagmatis: 5.7 U/mg) was compensated by differential protein co-expression from tailored plasmid constructs, giving balance between the individual activities at a high level of both (α2,3-SiaT: 9.4 × 102 U/g cell dry mass; CSS: 3.4 × 102 U/g cell dry mass). Finally, plasmid selection was guided by kinetic modeling of the coupled CSS-SiaT reactions in combination with comprehensive analytical tracking of the multistep conversion (lactose, N-acetyl neuraminic acid (Neu5Ac), cytidine 5′-triphosphate; each up to 100 mM). The half-life of SiaT in permeabilized cells (≤ 4 h) determined the efficiency of 3SL production at 37 °C. Reaction at 25 °C gave 3SL (40 ± 4 g/L) in ∼ 70% yield within 3 h, reaching a cell dry mass-specific productivity of ∼ 3 g/(g h) and avoiding intermediary CMP-Neu5Ac accumulation.

Conclusions

Collectively, balanced co-expression of CSS and SiaT yields an efficient (high-flux) sialylation module to support flexible development of E. coli whole-cell catalysts for sialo-oligosaccharide production.
Revealing associations between spatial time series trends of COVID-19 incidence and human mobility: an analysis of bidirectionality and spatiotemporal heterogeneity
Authors: Kwon Hoeyun , Koylu Caglar
Published: November 2023

Background

Using human mobility as a proxy for social interaction, previous studies revealed bidirectional associations between COVID-19 incidence and human mobility. For example, while an increase in COVID-19 cases may affect mobility to decrease due to lockdowns or fear, conversely, an increase in mobility can potentially amplify social interactions, thereby contributing to an upsurge in COVID-19 cases. Nevertheless, these bidirectional relationships exhibit variations in their nature, evolve over time, and lack generalizability across different geographical contexts. Consequently, a systematic approach is required to detect functional, spatial, and temporal variations within the intricate relationship between disease incidence and mobility.

Methods

We introduce a spatial time series workflow to investigate the bidirectional associations between human mobility and disease incidence, examining how these associations differ across geographic space and throughout different waves of a pandemic. By utilizing daily COVID-19 cases and mobility flows at the county level during three pandemic waves in the US, we conduct bidirectional Granger causality tests for each county and wave. Furthermore, we employ dynamic time warping to quantify the similarity between the trends of disease incidence and mobility, enabling us to map the spatial distribution of trends that are either similar or dissimilar.

Results

Our analysis reveals significant bidirectional associations between COVID-19 incidence and mobility, and we develop a typology to explain the variations in these associations across waves and counties. Overall, COVID-19 incidence exerts a greater influence on mobility than vice versa, but the correlation between the two variables exhibits a stronger connection during the initial wave and weakens over time. Additionally, the relationship between COVID-19 incidence and mobility undergoes changes in direction and significance for certain counties across different waves. These shifts can be attributed to alterations in disease control measures and the presence of evolving confounding factors that differ both spatially and temporally.

Conclusions

This study provides insights into the spatial and temporal dynamics of the relationship between COVID-19 incidence and human mobility across different waves. Understanding these variations is crucial for informing the development of more targeted and effective healthcare policies and interventions, particularly at the city or county level where such policies must be implemented. Although we study the association between mobility and COVID-19 incidence, our workflow can be applied to investigate the associations between the time series trends of various infectious diseases and relevant contributing factors, which play a role in disease transmission.
Micro electrical fields induced MSC-sEVs attenuate neuronal cell apoptosis by activating autophagy via lncRNA MALAT1/miR-22-3p/SIRT1/AMPK axis in spinal cord injury
Authors: Li Kewei , Liu Zhong , Wu Peipei , Chen Shenyuan , Wang Min , Liu Wenhui , Zhang Leilei , Guo Song , Liu Yanbin , Liu Pengcheng , Zhang Beiting , Tao Lin , Ding Hua , Qian Hui , Fu Qiang
Published: November 2023

Spinal cord injury (SCI) is a traumatic condition of the central nervous system that causes paralysis of the limbs. Micro electric fields (EF) have been implicated in a novel therapeutic approach for nerve injury repair and regeneration, but the effects of human umbilical cord mesenchymal stem cell-derived small extracellular vesicles that are induced by micro electric fields (EF-sEVs) stimulation on SCI remain unknown. The aim of the present study was to investigate whether EF-sEVs have therapeutic effects a rat model of SCI. EF-sEVs and normally conditioned human umbilical cord mesenchymal stem cells-derived small extracellular vesicles (CON-sEVs) were collected and injected intralesionally into SCI model rats to evaluate the therapeutic effects. We detect the expression of candidate long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 (lncRNA-MALAT1) in EF-sEVs and CON-sEVs. The targets and downstream effectors of lncRNA-MALAT1 were investigated using luciferase reporter assays. Using both in vivo and in vitro experiments, we demonstrated that EF-sEVs increased autophagy and decreased apoptosis after SCI, which promoted the recovery of motor function. We further confirmed that the neuroprotective effects of EF-sEVs in vitro and in vivo correlated with the presence of encapsulated lncRNA-MALAT1 in sEVs. lncRNA-MALAT1 targeted miR-22-3p via sponging, reducing miR-22-3p’s suppressive effects on its target, SIRT1, and this translated into AMPK phosphorylation and increased levels of the antiapoptotic protein Bcl-2. Collectively, the present study identified that the lncRNA-MALAT1 in EF-sEVs plays a neuroprotective role via the miRNA-22-3p/SIRT1/AMPK axis and offers a fresh perspective and a potential therapeutic approach using sEVs to improve SCI.
Nurses’ job preferences for working in deprived areas in Tehran: a discrete choice experiment
Authors: Haddadfar Amirmohammad , Emamgholipour Sara , Razani Mohsen , Salehnejad Mohammad Hassan
Published: November 2023

Background

In Iran, the issue of the nursing shortage and unequal distribution exist simultaneously. The shortage of healthcare workers is one of the most important concerns of the health systems. In addition, the disparity in the distribution of healthcare workers between large metropolises and remote or non-capital areas has become a serious concern and a top priority to address. We conducted this study to identify and create a sufficient understanding of the different financial and non-financial preferences of nurses for working in deprived areas.

Methods

This research was carried out in June and April 2022. It was carried out in three major phases. The factors influencing the nurses' job preferences were first discovered using qualitative methods. The second phase was conducting a pilot study and determining the best design for discrete choice experiment scenarios. The last phase involved publishing the questionnaire to gather information. Data were analyzed (discrete choice analysis) using JMP Pro 16 software.

Results

A desirable job for the participants (nurses) in this study would have a higher salary, work in a city, the Rasmi employment contract, a low workload, adequate workplace facilities, an appropriate work schedule, and 1 to 3 years spent on the assigned job to promote to a higher position. Willingness to pay (WTP) and the probability of selecting different attribute levels were also calculated and reported. For example, the highest amount of money that a nurse expected to be paid was for changing the geographical location of the workplace from a city to a deprived area. In this case, a nurse tends to receive 91.87 million IRR more to move from a city to a deprived area to work. This amount of money was by far the most among other WTPs.

Conclusion

The results of this study indicated that nurses are willing to forego net income in exchange for other favorable characteristics of their working environment and conditions. This shows that a variety of actions are accessible to policymakers that can greatly enhance the working conditions for nurses. The WTP and the probability of selecting various attributes may help policymakers plan more effectively.
Characterising support and care assistants in formal hospital settings: a scoping review
Authors: Kagonya Vincent A. , Onyango Onesmus O. , Maina Michuki , Gathara David , English Mike , Imam Abdulazeez
Published: November 2023

Background

A 15 million health workforce shortage is still experienced globally leading to a sub-optimal healthcare worker-to-population ratio in most countries. The use of low-skilled care assistants has been suggested as a cost-saving human resource for health strategy that can significantly reduce the risks of rationed, delayed, or missed care. However, the characterisation, role assignment, regulation, and clinical governance mechanisms for unlicensed assistive workforce remain unclear or inconsistent. The purpose of this study was to map and collate evidence of how care assistants are labelled, utilised, regulated, and managed in formal hospital settings as well as their impact on patient care.

Methods

We conducted a scoping review of literature from PUBMED, CINAHL, PsychINFO, EMBASE, Web of Science, Scopus, and Google Scholar. Searches and eligibility screening were conducted using the Participants–Context–Concepts framework. Thematic content analysis guided the synthesis of the findings.

Results

73 records from a total of 15 countries were included in the final full-text review and synthesis. A majority (78%) of these sources were from high-income countries. Many titles are used to describe care assistants, and these vary within and across countries. On ascribed roles, care assistants perform direct patient care, housekeeping, clerical and documentation, portering, patient flow management, ordering of laboratory tests, emergency response and first aid duties. Additional extended roles that require higher competency levels exist in the United States, Australia, and Canada. There is a mixture of both positive and negative sentiments on their impact on patient care or nurses’ perception and experiences. Clinical and organisational governance mechanisms vary substantially across the 15 countries. Licensure, regulatory mechanisms, and task-shifting policies are largely absent or not reported in these countries.

Conclusions

The nomenclature used to describe care assistants and the tasks they perform vary substantially within countries and across healthcare systems. There is, therefore, a need to review and update the international and national classification of occupations for clarity and more meaningful nomenclature for care assistants. In addition, the association between care assistants and care outcomes or nurses’ experience remains unclear. Furthermore, there is a dearth of empirical evidence on this topic from low- and middle-income countries.
The impact of meaning in life and professional happiness on the turnover intention of health care workers: a cross-sectional study from China
Authors: Huang Yuting , Zhang Huilin , Qin Zuming , Zou Ying , Feng Zhiling , Cheng Jiao
Published: November 2023

Introduction

The turnover and shortage of health care workers (HCWs) have been a worldwide problem for healthcare organizations. The primary aim of this study was to identify the factors influencing the intention of Chinese HCWs to leave their job, especially meaning in life and professional happiness.

Methods

This observational cross-sectional study, conducted among 1125 full-time HCWs, assessed demographic variables, meaning in life, professional happiness, and turnover intention by a survey. The survey was distributed to HCWs in three tertiary hospitals. The data were analyzed by T-tests, ANOVA, Kruskal–Wallis tests and hierarchical linear regression model.

Results

There were statistically significant differences in turnover intention of HCWs by gender, age, role, educational level, years in practice, and number of monthly night shifts. HCWs’ meaning in life and professional happiness were negatively associated with the turnover intention. Furthermore, after controlling for other factors, meaning in life explained 3.7% of the turnover intention and professional happiness explained 13.4%.

Conclusion

In our study, positive psychological factors were related to turnover intentions. Professional happiness was the strongest predictor. Thus, health human resource managers should foster positive psychology among HCWs to reduce their turnover.
Disseminating health research to public health policy-makers and practitioners: a survey of source, message content and delivery modality preferences
Authors: McCrabb Sam , Hall Alix , Milat Andrew , Bauman Adrian , Hodder Rebecca , Mooney Kaitlin , Webb Emily , Barnes Courtney , Yoong Serene , Sutherland Rachel , Wolfenden Luke
Published: November 2023

Background

Understanding the views of policy-makers and practitioners regarding how best to communicate research evidence is important to support research use in their decision-making.

Aim

To quantify and describe public health policy-makers and practitioners’ views regarding the source, content and form of messages describing public health research findings to inform their decision-making. We also sought to examine differences in preferences between public health policy-makers and practitioners.

Methods

A cross sectional, value-weighting survey of policy-makers and practitioners was conducted. Participants were asked to allocate a proportion of 100 points across different (i) sources of research evidence, (ii) message content and (iii) the form in which evidence is presented. Points were allocated based on their rating of influence, usefulness and preference when making decisions about health policy or practice.

Results

A total of 186 survey responses were received from 90 policy-makers and 96 practitioners. Researchers and government department agencies were the most influential source of research evidence based on mean allocation of points, followed by knowledge brokers, professional peers and associations. Mean point allocation for perceived usefulness of message content was highest for simple summary of key findings and implications, and then evidence-based recommendations and data and statistical summaries. Finally, based on mean scores, policy-makers and practitioners preferred to receive research evidence in the form of peer-reviewed publications, reports, evidence briefs and plain language summaries. There were few differences in scores between policy-makers and practitioners across source, message content or form assessments or those with experience in different behavioural areas.

Conclusions

The findings should provide a basis for the future development and optimization of dissemination strategies to this important stakeholder group.
Implementation strategies and outcome measures for advancing learning health systems: a mixed methods systematic review
Authors: Somerville Mari , Cassidy Christine , Curran Janet A. , Johnson Catie , Sinclair Douglas , Elliott Rose Annette
Published: November 2023

Background

Learning health systems strive to continuously integrate data and evidence into practice to improve patient outcomes and ensure value-based healthcare. While the LHS concept is gaining traction, the operationalization of LHSs is underexplored.

Objective

To identify and synthesize the existing evidence on the implementation and evaluation of advancing learning health systems across international health care settings.

Methods

A mixed methods systematic review was conducted. Six databases (CINAHL, Embase, Medline, PAIS, Scopus and Nursing at Allied Health Database) were searched up to July 2022 for terms related to learning health systems, implementation, and evaluation measures. Any study design, health care setting and population were considered for inclusion. No limitations were placed on language or date of publication. Two reviewers independently screened the titles, abstracts, and full texts of identified articles. Data were extracted and synthesized using a convergent integrated approach. Studies were critically appraised using relevant JBI critical appraisal checklists.

Results

Thirty-five studies were included in the review. Most studies were conducted in the United States (n = 21) and published between 2019 and 2022 (n = 24). Digital data capture was the most common LHS characteristic reported across studies, while patient engagement, aligned governance and a culture of rapid learning and improvement were reported least often. We identified 33 unique strategies for implementing LHSs including: change record systems, conduct local consensus discussions and audit & provide feedback. A triangulation of quantitative and qualitative data revealed three integrated findings related to the implementation of LHSs: (1) The digital infrastructure of LHSs optimizes health service delivery; (2) LHSs have a positive impact on patient care and health outcomes; and (3) LHSs can influence health care providers and the health system.

Conclusion

This paper provides a comprehensive overview of the implementation of LHSs in various healthcare settings. While this review identified key implementation strategies, potential outcome measures, and components of functioning LHSs, further research is needed to better understand the impact of LHSs on patient, provider and population outcomes, and health system costs. Health systems researchers should continue to apply the LHS concept in practice, with a stronger focus on evaluation.
Inhibition of Dickkopf-1 enhances the anti-tumor efficacy of sorafenib via inhibition of the PI3K/Akt and Wnt/β-catenin pathways in hepatocellular carcinoma
Authors: Seo Sang Hyun , Cho Kyung Joo , Park Hye Jung , Lee Hye Won , Kim Beom Kyung , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Cheon Jae Hee , Yook Jong In , Kim Man-Deuk , Joo Dong Jin , Kim Seung Up
Published: November 2023

Background

Sorafenib improves the overall survival in patients with advanced hepatocellular carcinoma (HCC). Dickkopf-1 (DKK1) is commonly overexpressed in HCC. In this study, we investigated whether the inhibition of DKK1 enhances the anti-tumor efficacy of sorafenib in HCC.

Methods

HCC cells were treated with sorafenib and WAY-262611, which is an inhibitor of DKK1. Transgenic mouse models were also developed using hydrodynamic tail vein injection. Mice were orally administered with sorafenib (32 mg/kg), WAY-262611 (16 mg/kg), or sorafenib + WAY-262611 for 10 days. Mechanisms of sorafenib and WAY-262611 were explored via western blotting, immunostaining, and RNA sequencing.

Results

DKK1 was significantly overexpressed in patients with HCC than in the healthy controls and patients with liver diseases except HCC (allP < 0.05). Compared with sorafenib alone, sorafenib + WAY-262611 significantly inhibited the cell viability, invasion, migration, and colony formation by promoting apoptosis and altering the cell cycles in HCC cells (allP < 0.05). Moreover, sorafenib + WAY-262611 decreased the p110α, phospho-Akt (allP < 0.05), active β-catenin (allP < 0.05) and phospho-GSK-3β (Ser9) expression levels, while increasing the phospho-GSK-3β (Tyr216) expression levels compared with those in the sorafenib alone in vitro and in vivo. In addition, sorafenib + WAY-262611 inhibited tumor progression by regulating cell proliferation and apoptosis, significantly better than sorafenib alone in mouse models.

Conclusions

Our results indicate that DKK1 inhibition significantly enhances the anti-tumor efficacy of sorafenib by inhibiting the PI3K/Akt and Wnt/β-catenin pathways via regulation of GSK3β activity, suggesting a novel therapeutic strategy for HCC.
Can the bias of self-reported sitting time be corrected? A statistical model validation study based on data from 23 993 adults in the Norwegian HUNT study
Authors: Kongsvold Atle , Flaaten Mats , Logacjov Aleksej , Skarpsno Eivind Schjelderup , Bach Kerstin , Nilsen Tom Ivar Lund , Mork Paul Jarle
Published: November 2023

Background

Despite apparent shortcomings such as measurement error and low precision, self-reported sedentary time is still widely used in surveillance and research. The aim of this study was threefold; (i) to examine the agreement between self-reported and device-measured sitting time in a general adult population; (ii), to examine to what extent demographics, lifestyle factors, long-term health conditions, physical work demands, and educational level is associated with measurement bias; and (iii), to explore whether correcting for factors associated with bias improves the prediction of device-measured sitting time based on self-reported sitting time.

Methods

A statistical validation model study based on data from 23 993 adults in the Trøndelag Health Study (HUNT4), Norway. Participants reported usual sitting time on weekdays using a single-item questionnaire and wore two AX3 tri-axial accelerometers on the thigh and low back for an average of 3.8 (standard deviation [SD] 0.7, range 1–5) weekdays to determine their sitting time. Statistical validation was performed by iteratively adding all possible combinations of factors associated with bias between self-reported and device-measured sitting time in a multivariate linear regression. We randomly selected 2/3 of the data (n = 15 995) for model development and used the remaining 1/3 (n = 7 998) to evaluate the model.

Results

Mean (SD) self-reported and device-measured sitting time were 6.8 (2.9) h/day and 8.6 (2.2) h/day, respectively, corresponding to a mean difference of 1.8 (3.1) h/day. Limits of agreement ranged from − 8.0 h/day to 4.4 h/day. The discrepancy between the measurements was characterized by a proportional bias with participants device-measured to sit less overestimating their sitting time and participants device-measured to sit more underestimating their sitting time. The crude explained variance of device-measured sitting time based on self-reported sitting time was 10%. This improved to 24% when adding age, body mass index and physical work demands to the model. Adding sex, lifestyle factors, educational level, and long-term health conditions to the model did not improve the explained variance.

Conclusions

Self-reported sitting time had low validity and including a range of factors associated with bias in self-reported sitting time only marginally improved the prediction of device-measured sitting time.