bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical analysis of molecular typing of 146 cases of endometrial carcinoma
Authors: Zhang Bo , Zhou Dan , Zhang Shuo , Yan Jinbowen , Meng Qingwei , Lv Qiubo
Published: January 2025

Objective

To investigate the application of TCGA molecular typing in endometrial carcinoma, compare the relationship between molecular typing and clinicopathologic features, and provide a new idea for individual treatment of patients.

Methods

A total of 146 EC patients who underwent surgical treatment and TCGA molecular typing in Beijing Hospital from December 2019 to March 2023 were collected. The clinicopathologic features, immunohistochemistry, and prognosis of the four TCGA molecular types were analyzed retrospectively.

Result

Among the 146 patients with endometrial cancer (EC), 8 patients (5.5%) exhibited the POLE hypermutant type, 29 patients (19.9%) displayed the MSI-H type, 94 patients (64.4%) presented the low copy-number type, and 15 patients (10.3%) manifested the high copy-number type. A comparative analysis of the four TCGA types and age yielded statistically significant results (p = 0.012). Notably, significant associations were observed between menopausal status, the expression of ER, PR, and the four TCGA types. However, no significant difference was observed in CA125 levels before surgery among the four TCGA types (p = 0.587). There were significant differences observed among the four TCGA types and pathological types, pathological grades, FIGO stage, lymph node metastasis, and LVSI. The progression-free survival (PFS) rates of patients with POLE hypermutation, MSI-H type, CNL type, and CNH type were 100%, 100%, 93.62%, and 73.3%, respectively. There was a statistically significant difference between the four groups(p=0.006). POLE mutant and MSI-H type patients have higher PFS, while high copy type patients have the lowest.

Conclusions

TCGA molecular typing has feasibility and application value in the clinical application of endometrial cancer, and has a certain predictive effect on the prognosis of EC patients. It has a certain guiding significance for the individual treatment of patients with endometrial cancer.
Association between transarterial chemoembolization refractoriness and prognosis in Chinese patients with hepatocellular carcinoma: a large retrospective cohort study
Authors: Sun Qinxue , Wu Ziliang , Yin Xi , Li Feng , Liu Ri
Published: January 2025

Background

Hepatocellular carcinoma (HCC) is commonly treated with transarterial chemoembolization (TACE) in intermediate stages. Existing international definitions of TACE refractoriness may not fully suit Chinese patients. The Chinese College of Interventionalists (CCI) proposed a tailored definition, but its impact on HCC prognosis is still limited.

Methods

This study included 844 patients with Barcelona Clinic Liver Cancer (BCLC) stage B HCC from a multicenter dataset. Propensity score matching (PSM) was used to minimize baseline differences between the TACE-Refractoriness (n = 54) and TACE-Non-Refractoriness (n = 108) groups. Kaplan-Meier survival analysis and multivariate Cox regression models were performed to evaluate the association between TACE-Refractoriness and OS. Subgroup analyses were conducted across key clinical and tumor-related characteristics.

Results

Kaplan-Meier survival analysis indicated that patients classified as TACE-Refractory exhibited significantly shorter OS compared to those categorized as TACE-Non-Refractory in both the original and matched cohorts (P < 0.001). Furthermore, multivariate analysis identified TACE refractoriness as a significant predictor of poorer OS, yielding an adjusted hazard ratio (HR) of 5.96 (95% CI: 3.39-10.5, P < 0.001). Subgroup analysis further demonstrated the robustness of these findings across subgroups, except in female patients (HR = 3.0, 95% CI: 0.72–12.52; P=0.131).

Conclusions

CCI-defined TACE refractoriness is associated with reduced OS in patients with BCLC stage B HCC undergoing TACE.
Unveiling the role of SYNGR4 in breast cancer development: a novel target for immunotherapy
Authors: Ma Jie , Wang Hongtao , Gui Zhengwei , Yang Yuanrong
Published: January 2025

Introduction

SYNGR4 is considered to be one of the causative genes for amyotrophic lateral sclerosis, but its role in breast cancer development has not been revealed.

Methods

The expression of SYNGR4 in a variety of malignancies including breast cancer was analyzed using Genotype Tissue Expression (GTEx) and the Cancer Genome Atlas (TCGA) databases and verified by specimens collected from our center. The effect of SYNGR4 on breast cancer prognosis was analyzed using bioinformatics and possible pathways by which this molecule affects breast cancer prognosis were explored. The effect of SYNGR4 on immune infiltration of breast cancer was analyzed using GSVA, and the effects of SYNGR4 on breast cancer proliferation, migration, and tumor-associated macrophage polarization in cancer foci were verified by cellular and animal experiments, respectively.

Results

SYNGR4 is highly expressed in a variety of malignant tumors, including breast cancer, and affects the prognosis of breast cancer patients. This may be a volatile effect through Organelle fission, chromosome segregation, nuclear division, etc. SYNGR4 overexpression affects breast cancer proliferation, migration, and tumor immune infiltration, and promotes breast cancer tumor-associated macrophage polarization toward M2.

Discussion

SYNGR4 overexpression can affect the prognosis of breast cancer patients by promoting M2 polarization of tumor-associated macrophages in breast cancer, and this molecule may be a novel target for breast cancer immunotherapy.
Solitary fibular metastasis from lung adenocarcinoma with gene mutation: a case report
Authors: Chen Jiechen , Alkhatatbeh Ahmad , Lin Yinbing , Lu Xiaolin , Chen Bin , Chen Hongjiang , Lu Xiaohui , Wu Hansheng , Hu Jun
Published: January 2025

Solitary fibular metastasis from lung adenocarcinoma is exceedingly rare, with only five documented cases. This report presents a 40-year-old non-smoking Asian male who initially presented with painful swelling in the right knee. Imaging revealed bony destruction of the right fibular head, and further investigations with chest CT, PET/C, pathologic biopsy and genetic testing identified a primary lung adenocarcinoma with EGFR exon 19 deletion mutation. The patient was treated with Osimertinib, resulting in significant tumor reduction. This was followed by thoracoscopic lobectomy and systematic lymph node dissection, and local radiotherapy for the fibular metastasis. The patient experienced complete pain relief and showed no recurrence or metastasis over a 26-month follow-up. This case highlights the diagnostic challenge posed by atypical presentations of metastasis and underscores the importance of comprehensive evaluation, adherence to treatment guidelines, and a multidisciplinary approach in managing oncological patients. The successful outcome in this young patient emphasizes the effectiveness of personalized treatment strategies in optimizing patient prognosis, offering valuable insights for similar clinical scenarios.
An open window: the crucial role of the gut-brain axis in neurodevelopmental outcomes post-neurocritical illness
Authors: Ronan Victoria
Published: January 2025

Among patients admitted to the pediatric intensive care unit, approximately 10% are discharged with a new functional morbidity. For those who were admitted with a neurocritical illness, the number can be as high as 60%. The most common diagnoses for a neurocritical illness admission include traumatic brain injury, status epilepticus, post-cardiac arrest, hypoxic ischemic encephalopathy, meningo/encephalitis, and stroke. The gut-brain axis is crucial to childhood development, particularly neurodevelopment. Alterations on either side of the bidirectional communication of the gut-brain axis have been shown to alter typical development and have been associated with autism spectrum disorder, anxiety, sleep disturbances, and learning disabilities, among others. For those patients who have experienced a direct neurologic insult, subsequent interventions may contribute to dysbiosis, which could compound injury to the brain. Increasing data suggests the existence of a critical window for both gut microbiome plasticity and neurodevelopment in which interventions could help or could harm and warrant further investigation.
Effects of a therapeutic suit based on myofascial meridians on postural control and balance in children with cerebral palsy: a multiple-baseline, single-subject study
Authors: Cruz Thalita Karla Flores , Souto Deisiane Oliveira , Capuchinho Rafhael Guimarães , Lima Arthur Felipe Barroso de , Nascimento Amanda Aparecida Alves Cunha , Silva Ianara Pereira , Santana Patrícia Aparecida Neves , Criscoullo Lia Constantino , Haase Vitor Geraldi
Published: January 2025

Aim

To investigate the effects of an intervention programme based on the TREINI Exoflex therapeutic suit on balance, postural control, activity, and participation outcomes in children with cerebral palsy (CP).

Method

A multiple-baseline, single-subject A/B research design was used. Balance, postural control, mobility, activities of daily living (ADLs), and goal attainment measures were collected for four children with CP. The intervention was a programme designed for the use of a therapeutic suit, that is, the TREINI Exoflex. The 2-SD band and percentage of non-overlapping data methods were used to compare outcomes between the baseline and intervention phases.

Results

The intervention improved balance and postural control in all four children. The scope of the intervention on activity and participation outcomes varied between children. All children showed improvements in at least one stipulated goal and two in mobility and ADLs. Improvements in goal achievement occurred mainly for balance-related goals, whereas behavioural goals were not achieved.

Conclusion

The results of this study support the use of the TREINI Exoflex suit during functional activities by children with CP. Future research should examine the effects of this approach in children of different ages and at different functional levels.
Role of the very low frequencies of the renal oxygen saturation signal in acute kidney injury in newborns with perinatal asphyxia
Authors: Botero-Rosas Daniel , Agudelo-Pérez Sergio , Troncoso Gloria , Gómez Maria C. , Tuta-Quintero Eduardo
Published: January 2025

Objective

Renal autoregulation, hemodynamic response, and endothelial dysfunction play significant roles in acute kidney injury (AKI) during perinatal asphyxia. A third mechanism of autoregulation, involving very low-frequency oscillations, has been described. This study aimed to evaluate the relationship between the power of the very low-frequency component of the Fast Fourier Transform (FFT) and AKI during therapeutic hypothermia (TH) treatment in neonates with perinatal asphyxia.

Study design

A retrospective longitudinal study was conducted on neonates with moderate and severe perinatal asphyxia. AKI was defined as a decrease of less than 33% in the serum creatinine level by day 3. The power of the very low-frequency component in the FFT was assessed by analyzing renal oxygen saturation using near-infrared spectroscopy (NIRS), focusing on a frequency band of approximately 0.01 Hz. Bivariate analyses were performed to explore the association between the power of the very-low-frequency component and AKI. The predictive ability of this component for AKI was evaluated using a receiver operating characteristic (ROC) curve. Additionally, a generalized estimating equation (GEE) was developed to investigate whether changes in the power of the very-low-frequency component during treatment differed according to the presence of AKI.

Results

A total of 91 patients were included in the study, of whom 15 (16.5%) developed AKI. Neonates with AKI exhibited a significantly lower power of the very low-frequency component on the second day of treatment (p = 0.001). This component demonstrated good predictive ability for AKI (ROC curve 0.77, 95% CI 0.63–0.90).

Conclusion

Among neonates with perinatal asphyxia who developed AKI, a lower power of the very-low-frequency component in FFT (approximately 0.01 Hz) was observed on the second day of therapeutic hypothermia. This finding suggests that alterations in very-low-frequency oscillations may reflect endothelial dysfunction and contribute to the development of AKI, warranting further investigation in larger cohorts.
A review of Psoralea corylifolia L.: a valuable plant with profound biological significance
Authors: Yang Anni , Kong Lingping , You Zhibo , Li Xinyu , Guan Jian , Li Fengjin , Zhong Lingyun , Jiang Hai
Published: January 2025

Psoralea corylifolia L. (PCL) is an annual herb of the genus Psoralea in the family Fabaceae, and its mature fruit can be used medicinally as a precious medicinal herb to tonify muscles and bones. With the deepening of research, its applications to various industries, including food, agriculture, and cosmetics, with products being developed in countries such as Vietnam, India, and Japan. A total of 321 metabolites, including coumarins, flavonoids, meroterpenes, benzofurans, and dimers, were identified in PCL. PCL and related products have demonstrated therapeutic effects, such as antiosteoporosis effects, estrogen-like effects, anti-inflammatory properties, neuroprotection, antitumor activity, and vitiligo treatment. The expression mechanisms of these pharmacological effects are closely related to the regulation of the immune system, the inhibition of oxidative stress, and the induction of apoptosis. This paper summarizes the latest research on the ethnobotany, phytochemistry, processing technology, pharmacology, and hepatotoxicity of PCL. Furthermore, bibliometric analysis was used to systematically analyze the research hotspots and trends in PCL, which have never been addressed in previous reviews of PCL. In the future, it will be necessary to focus on the active metabolites of PCL, analyze its targets and signaling pathway network to address potential toxicity and side effects in clinical applications, and further expand the potential application of PCL in medicine.
Ecological risk assessment of future suitable areas for Piper kadsura under the background of climate change
Authors: Li Shimeng , Li Yuanxin , Hu Mingli , Li Yankun , Yang Mingrong , Wang Shi , Yu Wei , Cheng Chunsong , Cheng Qiqing
Published: January 2025

Introduction

Piper kadsura is a well-known medicinal plant that belongs to woody liana, possessing high therapeutic and economic value. The market demand of P. kadsura is huge, but its wild resources are scarce and artificial cultivation methods have not been established, which leads to a situation with strong contradiction and imbalance between supply and demand.

Methods

In this study, 303 sample of distribution data for P. kadsura in China were collected, 33 environmental variables related to terrain, climate and soil were analyzed and the suitable habitats of P. kadsura during various periods were predicted by MaxEnt model and ArcGIS software, aiming to provide a basis for scientific cultivation and effective utilization of resources.

Results

The results indicated that precipitation and temperature were significant factors in the distribution of P. kadsura. The primary environmental variables influencing the potential distribution of P. kadsura were precipitation during the driest quarter (Bio17), annual precipitation (Bio12), mean diurnal range (Bio2), and annual temperature range (Bio7). Among them, precipitation of driest quarter (Bio17) was the most influential environmental variable for the distribution of P. kadsura with the range between 100.68 and 274.48 mm. The current distribution of P. kadsura is mainly located in the coastal areas of eastern and southern China, especially Guangxi, Guangdong, Zhejiang and Fujian, with a total area of 51.74 × 104 km2. Future climate change of global warming will lead to a reduction in the total suitable areas and high suitable areas under various climate scenarios. Especially in the SSP585 scenario, the total suitable area and the highly suitable area will be significantly reduced by 89.26% and 87.95% compared with the present during the 2090s.

Discussion

Overall, these findings can provide useful references for the suitable areas’ determination of wild resources, optimization of artificial cultivation and scientific selection of high quality medicinal materials on P. kadsura.
Identification and functional characterization of the RPP13 gene family in potato (Solanum tuberosum L.) for disease resistance
Authors: Yuan Baoqi , Li Chuang , Wang Qingfeng , Yao Qi , Guo Xiaowei , Zhang Yuhang , Wang Zhongwei
Published: January 2025

Potato (Solanum tuberosum L.), as the world’s fourth largest food crop, plays a crucial role in ensuring food security through its disease resistance. The RPP13 gene family is known to play a pivotal role in plant disease resistance responses; however, its specific functions in potato remain unclear. In this study, we conducted the first comprehensive identification and analysis of 28 RPP13 gene family members in potato, examining their gene structures, chromosomal locations, expression patterns, and functional characteristics. Gene structure analysis revealed that most members contain the typical CC-NBS-LRR domains, with exon numbers ranging from 1 to 6. Phylogenetic analysis grouped these genes into four evolutionary clades, indicating a high level of conservation. Cis-regulatory element analysis identified that the promoter region of StRPP13-26 is enriched with pathogen-responsive elements such as the WUN-motif and MYC, suggesting its potential role in disease defense. Expression pattern analysis showed that StRPP13-8, StRPP13-10, and StRPP13-23 are highly expressed in various tissues, indicating their involvement in basic physiological functions, whereas StRPP13-6 and StRPP13-25 are mainly induced under specific pathogen infection conditions. Transcriptome and qRT-PCR analyses further revealed functional divergence of the RPP13 gene family in response to potato scab disease. Notably, StRPP13-11 was significantly downregulated in both resistant and susceptible cultivars, suggesting its crucial role in the early stages of pathogen recognition. Subcellular localization experiments showed that the StRPP13-11 protein is localized in the chloroplast. Combined with transcriptome-based functional enrichment analysis, this finding implies that StRPP13-11 may participate in disease defense by regulating photosynthesis-related genes and the dynamic balance of reactive oxygen species within the chloroplast. This study provides new insights into the potential functions of the RPP13 gene family in potato disease resistance mechanisms, offering valuable genetic resources and theoretical support for future disease-resistant breeding programs.
Positive impacts of typical desert photovoltaic scenarios in China on the growth and physiology of sand-adapted plants
Authors: Meng Ruibing , Meng Zhongju , Ren Xiaomeng , Cai Jiale , Tong Xufang
Published: January 2025

Desert regions are characterized by complex terrain, frequent wind–sand activities, and extreme environmental conditions making vegetation recovery after disturbances difficult. The construction of large-scale photovoltaic (PV) power stations presents a significant challenge in balancing with vegetation protection. This study focused on a large PV site in the Hobq Desert examining the growth characteristics of Astragalus adsurgens at different positions within fixed PV arrays. It also analyzed changes in chlorophyll (Chl), soluble sugar (SS), soluble protein (SP), enzyme activity, and other physiological indicators to evaluate the plant’s adaptive mechanisms to the presence of PV panels. The results showed that A. adsurgens near the PV panels exhibited significant growth advantages, with plant height, leaf length, and stem–leaf nutrient content greater than the those of the control (CK) showing an adaptive trend of elongation, thinning, and enlargement. During the growing season, A. adsurgens located before, behind, and under the panels increased Chl with environmental changes. The plants also adjusted their SS, SP, and other internal substance levels depending on their location relative to the panels. Notably, superoxide dismutase (SOD) and peroxidase (POD) activities were higher in all treated plants compared to those of CK, effectively removing O2− and providing H2O2 protection, thereby delaying plant senescence and demonstrating strong adaptability. Through membership function analysis, the plant’s tolerance levels at various positions around the PV panels ranked under panels > before panels > behind panels > CK. In conclusion, A. adsurgens demonstrated adaptability to environmental changes at PV power stations by modifying its growth characteristics and physiological traits. These findings provide scientific evidence for the ecological industrial use of PV power stations in desert regions and offer practical guidance for vegetation restoration and ecological construction around such stations.
Genome skimming provides evidence to accept two new genera (Apiaceae) separated from the Peucedanum s.l.
Authors: Song Bo-Ni , Liu Chang-Kun , Deng Jiao-Jiao , Tan Wei-Yan , Zhou Song-Dong , He Xing-Jin
Published: January 2025

Background

The Peucedanum s.l. genus, the backbone member of subfamily Apioideae, includes many medically and economically important plants. Although previous studies have proved that the genus was not a natural taxonomic unit and taxonomists also conducted several taxonomic revisions for taxa of this genus, classifications of numerous taxa of the genus still have not been satisfactorily resolved, especially for those endemic to China. Therefore, we conducted a comprehensive taxonomic revision of taxa within the polyphyletic Peucedanum s.l. genus in this study.

Methods

We used two molecular datasets (103 plastomes and 43 nrDNA sequences) generated by genome skimming to reconstructed a reliable phylogenetic framework with high support and resolution. In addition, we also investigated the divergence time of core clade of endemic taxa.

Results and Discussion

Both analyses failed to recover Peucedanum s.l. as a monophyletic group and robustly supported that P. morisonii, the representative of Peucedanum s.s., was distantly related to other Peucedanum s.l. members, which implied that these Peucedanum s.l. taxa were not “truly Peucedanum plants”. Among these Peucedanum s.l. members, plastid-based phylogenies recognized two monophyletic clades, clade A (four species) and clade B (10 taxa). Meanwhile, obvious recognized features for morphology, plastome, and chromosome number for each clade were detected: dorsally compressed and glabrous mericarps with filiform dorsal ribs, winged lateral ribs, numerous vittae in commissure and each furrow, IRa/LSC border falling into rpl23 gene, an overall plastome size of 152,288-154,686 bp, and chromosome numbers of 2n=20 were found in clade A; whereas dorsally compressed and pubescent mericarps with filiform dorsal ribs, winged lateral ribs, numerous vittae in commissure and each furrow, IRa/LSC border falling into the ycf2 gene, an overall plastome size of 146,718-147,592 bp, and chromosome numbers of 2n=22 were discovered in clade B. Therefore, we established two new genera (Shanopeucedanum gen. nov. and Sinopeucedanum gen. nov.) to respectively accommodate the taxa of clades A and B. Furthermore, molecular dating analysis showed that the diversification of clades A and B occurred in the early Pleistocene and late Pliocene, respectively, which may have been driven by the complex geological and climate shifts of these periods. In summary, our study impelled a revision of Peucedanum s.l. members and improved the taxonomic system of the Apiaceae family.
Comprehensive identification, characterization and expression analyses of the class III POD gene family in water lily (Nymphaea colorata)
Authors: Khan Wasi Ullah , Khan Latif Ullah , Khan Noor Muhammad , Zhang Ji , Wenquan Wang , Chen Fei
Published: January 2025

Class III peroxidases are plant-specific glycoproteins and widely distributed among plant species, that play a crucial role in plant resistance to different stresses, such as salt, heat, cold and metal toxicity. The present study is the first comprehensive and systematic report to characterize the NcPOD gene family in water lily (Nymphaea colorata). In this study, 94 NcPOD genes in water lily were identified, each possessing a conserved POD domain, which are dispersed unevenly across the genome. Through comparative maximum-likelihood phylogenetic analysis, these genes were categorized into 10 groups, along with two other species, Arabidopsis thaliana and Nymphaea thermarum. Notably, the largest group, group-c, comprised 32 distinct types of NcPOD proteins. These genes exhibited uneven distribution on 11 of the 14 chromosomes of water lily. Exon-intron and motif analyses exhibited the structural and functional diversity among the sub-groups. The Examination of duplication patterns suggests that tandem duplication has contributed to the expansion of NcPOD genes. The analysis of promoter cis-acting elements indicated the presence of regulatory elements associated with various responses such as ABA, MeJA, light responsiveness, anaerobic conditions, and drought inducibility. Finally, the RT-qPCR based expression and enzymes activity of ten NcPOD genes depicted the dynamically differential response to NaCl, heat, cold, and heavy metals (CuSO4 and CdCl2) stresses. These findings provide valuable insights for future exploration of NcPOD functions in water lily growth and stress tolerance, laying a foundation for further comparative genomics and functional studies of this important class of antioxidant genes.
Factors of suicide-related behaviors based on stress-vulnerability model and prevention strategies among nurses: a scoping review
Authors: Yang Xiaoyu , Hu Deying , Li Lecheng , Rezak Rezvanguli
Published: January 2025

Objective

The objective of this scoping review was to explore, appraise and synthesize the current literature regarding the incidence, factors influencing, and prevention strategies related to suicide risk among nurses.

Methods

An extensive literature search was conducted using databases such as PubMed, Web of Science, Medline, and Embase from its formation to June 20, 2024, specifically focusing on the suicide-related behaviors of nurses written in Chinese or English. Two researchers independently screened the literature, and disagreements were debated until a consensus was reached. Data extraction was conducted for the studies that were included. The process of data synthesis was carried out using narrative analysis.

Results

The study encompassed 40 papers from 15 different countries. This study found that nurses’ suicide ideation ranged from 4.3 to 44.58%, while suicide attempts ranged from 2.9 to 12.6%. Based on the stress-vulnerability model, factors influencing nurses’ suicide-related behaviors include vulnerability (personality traits, coping styles), stressors (mental disorders, workplace bullying, etc.) and protective factors (social support, resilience, etc.). The strategies for preventing nurse suicide encompass primary prevention (for all nurses), secondary prevention (for nurses at risk of suicide), and tertiary prevention (for nurses who have attempted suicide).

Conclusion

The suicide rate among nurses exceeds that of the general population. Mental disorders and workplace bullying are significant stressors that contribute to nurse suicide. Suicide-related behaviors among nurses can be effectively prevented and managed through the implementation of the tertiary prevention strategies. Primary prevention is essential in reducing suicide. Cognitive exercises and schedule shifts reasonably are primary preventive measures tailored for nurses. This study addresses the gaps in influencing factors about suicide-related behaviors among nurses and the strategies for preventing suicide, and provides a complete review of the current situation of nurses’ suicide-related behaviors, providing references for the safe management of nurses’ suicide.
Blended digital health intervention for adolescents at high risk with digital media use disorders: protocol for a randomised controlled trial within the Res@t-Consortium
Authors: Labrenz Oliver , Waedel Lucie , Kölch Michael , Lezius Susanne , Wacker Christina , Fröhlich Antonia , Paschke Kerstin , Thomasius Rainer , Reis Olaf
Published: January 2025

Background

Digital media use disorder (DMUD) is a prevalent problem among young people, which can result in adverse consequences and functional impairments across multiple domains of life due to a persistent inability to regulate one’s use, which can lead to the development of psychological problems. In particular, children and adolescents who live in families that are part of the child and youth welfare system and receive support services are considered to be at high risk of developing mental disorders. It is less likely that these families will choose a therapeutic setting for the treatment of DMUD. The objective is to reduce DMUD-related symptoms and improve media use behaviour through the implementation of an app-based training programme.

Methods

The efficacy of Res@t digital, initially conceived as an adjunct to child and adolescent psychiatric treatment, is to be evaluated for n= 32 children and adolescents with a media use disorder or at risk of developing this disorder, and their families enrolled in child and youth welfare services. The efficacy of the app will be evaluated in a randomised controlled trial with a waitlist control group. The primary outcome is the reduction of DMUD symptoms over a 20-week period following the onset of app training. Secondary outcomes include EEG measurements and changes in standardised psychopathological variables.

Discussion

Should the Res@t app prove efficacious when compared to a waitlist control group, it would constitute an evidence-based intervention for the treatment of DMUD in children and adolescents. For high-risk families, the app could serve as a motivational tool to prompt action regarding potential DMUD and facilitates access to therapeutic facilities.

Clinical trial registration

https://drks.de, identifier DRKS00033379.
A mixed-methods systematic review of mental health activities among urban left-behind children in mainland China
Authors: Long Siyu , Madon Zainal Bin , Norowi Noris Mohd , Ang Mei Foong
Published: January 2025

Introduction

The mental health of left-behind children has garnered attention from Chinese scholars in recent years. Although several interventions have been implemented to address these children’s mental health in urban areas, a gap remains in understanding the types of interventions, their effectiveness, and the factors that act as barriers or facilitators during the implementation process.

Methods

A mixed methods systematic review informed by JBI methodology. Researchers conducted a comprehensive search of databases in both English and Chinese, covering the years 2005 to 2023. The initial search took place in January 2024 and was updated in March 2024. This study includes all studies results available up to December 31, 2023. The protocol has been registered on PROSPERO (CRD42023384078) and includes 14 studies in the review.

Results

The activity categories included group psychological activities, individual family activities and multiple formats services. Three barriers to implementation emerged: social workers, activities and parents. The facilitators were parents and activity design.

Conclusion

This review revealed that some studies suffered from poor data collection methods and data quality. Studies on services for mental health in urban left-behind children requires methodologically robust study designs for broader dissemination and rigorous evaluation.

Systematic review registration

PROSPERO, CRD42023384078, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023384078.
Factors influencing reselection of village doctors in rural-oriented tuition-waived medical education program in Shanghai, China: a cross-sectional study
Authors: Gao Jing , Zhang Juhua , Shi Chenlei , Fan Aiqin , Zhang Peng
Published: January 2025

Background

In order to actively cultivate a new generation of village doctors (NGVDs) who possess a high level of education, provide high-quality healthcare services, Shanghai Municipal Health Bureau, together with the Municipal Education Commission, Municipal Finance Bureau, and Municipal Agriculture Commission initiated Rural-oriented Tuition-waived Medical Education (RTME) in 2006. This study aims to identify the factors that influence the reselection intention and perceptions of NGVDs of RTME program in Shanghai.

Methods

In 2023, a questionnaire survey was conducted among a sample of NGVDs enrolled in the RTME program in 8 districts of Shanghai. The research focused on five aspects, including demographic characteristics, job characteristics, reasons for choosing RTME, career identity and job satisfaction. The participants were asked questions related to their experiences, opinions, and perceptions. Analysis of variance (ANOVA), chi-square tests and logistic regression analysis was conducted.

Results

A total of 419 questionnaires were collected. The majority (64.44%) indicated they would reselect this career, while 35.56% expressed either no preference or indifference. Factors influencing reselection included “Volunteering to serve the grassroots people” (odds ratio [OR], 2.29 [95% confidence interval {CI}, 1.22–4.30]), “Enjoying the medical profession” (OR, 2.64 [95%CI, 1.33–5.27]), not fulfilling family wishes (OR, 0.47 [95%CI, 0.24–0.88]), Satisfied with the current salary (OR, 2.39 [95%CI, 1.27–4.49]). NGVDs who think village doctors can leverage their professional ability with “okay” (OR, 32.87 [95%CI, 3.69–293.64]) and “yes” (OR, 120.03 [95%CI, 12.78- > 999.99]) and who think NGVDs were “important” (OR, 3.74 [95%CI, 1.21–11.55]) were more inclinatively to reselect to be NGVD.

Conclusion

Reasons for choosing RTME, understanding of the government’s policy, career identity, and job satisfaction were all influence the reselection of RTME. This research can contribute to the improvement and development of similar programs in the future, benefiting both the students and the healthcare system as a whole.
Health information orientation and health literacy as determinants of health promotion behaviors in adolescents: a cross-sectional study
Authors: You Mi-Ae , Ahn Jeong-Ah
Published: January 2025

Introduction

This cross-sectional study aimed to identify the impact of health information orientation and health literacy on adolescents’ health-promoting behaviors.

Methods

We enrolled 149 middle school students from an urban city in South Korea through convenience sampling. The data was collected in October 2022 using a self-reported questionnaire. Health information orientation was measured using the Health Information Orientation Instrument (Cronbach’s α = 0.86). Health literacy was assessed with the Korean Adolescent Health Literacy Scale (KR-20 = 0.66), and health promotion behaviors were evaluated using the Adolescent Health Promotion Scale-Short Form (Cronbach’s α = 0.89). Analysis methods included independent t-tests, one-way ANOVA, and multiple regression.

Results

Results indicated significant differences in health promotion behaviors based on perceived health status, economic status, primary health-related information provider, and health literacy. Health information orientation showed a strong positive correlation with health promotion behaviors. The factors that influenced health promotion behaviors were health information orientation, primary information provider, economic status, and health literacy.

Discussion

Findings suggest that school and community health promotion programs should engage adolescents and parents to enhance health literacy and proactive information-seeking behaviors for improving the health outcomes of adolescents.
Factors affecting life satisfaction among retired older adults
Authors: Gu Minkyung , Yu Jakyung , Sok Sohyune
Published: January 2025

Background

The population of older adult people is rapidly increasing in South Korea. Consequently, older adult people’s life satisfaction, especially the retired older adult, is emerging as a social issue and not just an individual problem.

Objective

This study aimed to examine and identify the factors affecting the life satisfaction of the retired older adult.

Methods

A cross-sectional descriptive design was employed. The sample included 149 retired older adults living in Gyeonggi or Seoul, South Korea. The data included the general characteristics of study participants and the level of their life satisfaction, health conservation, self-efficacy, and social activity. The data was collected from January to February 2020 and analyzed using SPSS PC+ version 23.0.

Results

The factors affecting life satisfaction in retired older adults were health conservation (β = 0.28, p < 0.001), self-efficacy (β = 0.26, p = 0.001), marital status (β = 0.24, p = 0.001), social activity (β = 0.18, p = 0.018), and family relationships (β = −0.15, p = 0.048). The explanatory power of the final regression model was 59%.

Conclusion

The study suggests that to improve the life satisfaction of retired older adults, their health conservation, self-efficacy, social activity, and family relationships should be increased, and married status with spouse needs to be considered. Most importantly, health professionals need to pay attention to the factors that improve the life satisfaction of retired older adults in community fields.
Parent-implemented early intervention design for improving speech and language skills among Mandarin-speaking infants and toddlers with cleft lip and/or palate
Authors: Lai Sha , Lu Li , Zhou Zhongliang , Shen Chi , Yang Binting , Ren Zhanping , Ma Siwei
Published: January 2025

Background

Cleft lip and/or palate (CL/P) speech is a significant communication disorder with notable and enduring consequences. This study focused on developing an intervention mapping (IM)-based and parent-implemented early intervention to improve speech and language skills among infants and toddlers with CL/P in China.

Methods

An IM procedure was used to develop a parent-implemented early intervention. First, parent–child interaction problems affecting language development in infants and toddlers were identified through 132 questionnaires completed by parents of children with CL/P and 30 family videos of parent–child interactions. Second, according to the problem diagnosis, the logical model of parent–child interaction behavior change was constructed. Finally, the health outcomes were transformed into intervention goals at three levels (i.e., infants and toddlers with CL/P, parents and environment), and a set of early intervention programs were designed by integrating various intervention techniques.

Results

The diagnosis of parent–child interaction problems showed that 40.91% of parents and children often use electronic media together; in parent–child interaction, 41.67% of parents presented ‘lack of waiting’, 29.55% overcorrected pronunciation errors. Video analysis revealed issues in parent–child interaction, such as inadequate parental skills, ineffective interactions, and an unsuitable environment. A parent-implemented early intervention was developed, including the following specific steps: health education within the hospital, 9 days of an online reading program in WeChat groups, face-to-face standardized training workshops, and individualized video feedback therapy.

Conclusion

We have devised a parent-implemented early intervention to enhance speech and language abilities in Mandarin-speaking infants and toddlers with CL/P, overcoming the shortage of speech therapy services in China.
Generational trends in education and marriage norms in rural India: evidence from the Pune Maternal Nutrition Study
Authors: Marphatia Akanksha A. , Wells Jonathan C. K. , Reid Alice M. , Poullas Marios , Bhalerao Aboli , Yajnik Pallavi , Yajnik Chittaranjan S.
Published: January 2025

Introduction

Globally in 2024, 1 in 5 women aged 20–24 years worldwide had been married before the age of 18 years. One reason for this persistent prevalence of underage marriage may be the slow change in social norms relating to education levels and women's marriage age. However, we know little about how norms change, and whether they vary by socio-demographic characteristics. We aimed to investigate changes in social norms across generations in rural Maharashtra, India.

Methods

To understand the status quo, we identified education levels and marriage ages typical of contemporary young adults in rural Maharashtra using the National Family Health Survey. To see if norms have shifted across generations, we analysed data on education and marriage age in 659 parent-adolescent dyads from the Pune Maternal Nutrition Study (PMNS) in rural Maharashtra. To ascertain if norms might shift in the future, we investigated adolescents' aspirations for their future hypothetical children's education and marriage, and classified adolescents as wanting (a) their children to decide themselves, (b) more education and later marriage age, or (c) the status quo. We assessed whether these aspirations differed by socio-demographic characteristics.

Results

Compared to the status quo and PMNS adults, PMNS adolescents had substantially more education, and girls were marrying slightly later. About 70% of the adolescents wanted their children to themselves decide their schooling. The remainder of both sexes wanted their children to have the same education as them (15 years). Only 10% of adolescent girls and 14% of boys wanted their child to decide their own marriage age. Most adolescents wanted a later marriage age for their children than their own experience. Lower educated and early married girls aspired for greater education for their children. More educated boys aspired for later marriage for their children.

Discussion

Education norms have changed by a larger magnitude than marriage age norms. Adolescents are already attaining their education aspirations, but aspire for later marriage of their children, more so for their hypothetical sons than daughters. Since senior household members remain influential in marriage decisions, it may take time before adolescents' aspirations for their children become a new norm.
From perceptions by beneficiaries, can homelessness be reduced through self-help housing in the central region of South Africa?
Authors: Qumbisa Nolwazi , Emuze Fidelis , Smallwood John
Published: January 2025

As an alternative housing approach, self-help housing has been implemented for many years, particularly in developing nations. This study aimed to evaluate the potential of self-help housing as a mitigation strategy for reducing homelessness in South Africa. The focus was on the perception that housing is commonly regarded as a fundamental necessity the government provides, even though beneficiaries ultimately construct their own homes. A qualitative study was conducted using semi-structured interviews with 25 key informants involved in five projects located in the central region of South Africa. The objective was to assess the effectiveness of self-help housing in addressing homelessness, understand beneficiary perceptions, and identify the challenges associated with conventional and non-conventional housing delivery methods. The key findings revealed that while both methods present challenges, beneficiaries preferred self-help housing due to their involvement in the projects, the larger housing units they received, and their overall satisfaction with the outcomes. The study concluded that there is a need to reform self-help housing policies in South Africa to efficiently regulate and support incremental housing initiatives across the country.
Exploring perceived barriers to palliative and end of life care provision in South-West England: bringing together the perspectives of professionals, patients, and families
Authors: Hodge Gary , Kallis Gina , Oh Tomasina M. , Wheat Hannah , Pearce Susie
Published: January 2025

Introduction

Palliative and End of Life care (PEoLC) in the United Kingdom (UK) is increasingly being reported as inadequate. This is occurring amidst a wider backdrop of health and social care systems facing unprecedented pressure, particularly as they recover from the long-term impact of the COVID-19 pandemic. This study aimed to explore the barriers to PEoLC faced by those providing and receiving care in South-West England (UK). This region of the UK brings its own set of unique challenges due to its rural and coastal location, an aging population, and a historical lack of research.

Methods

An exploratory study was conducted which involved patients, families, and professionals who were providing and receiving PEoLC. A total of 13 qualitative focus groups were held with a total of 63 participants; 45 were health and care professionals and 18 were people toward the end of their life, family/carers and people who were bereaved.

Results

A range of barriers were identified for those providing and receiving PEoLC services. These were a lack of specialist palliative and EoL care resources (particularly in out-of-hours care); poor communication, collaboration and co-ordination across providers; inequalities in the access and provision of care; the impact of the COVID-19 pandemic; and a reluctance to have conversations about death and dying.

Conclusion

This study brings together the voices of patients, family, and professionals from different settings in a geographical area of the UK. Understanding their experiences and perceived barriers to care is key to being able to develop and transform care. Ultimately, there is a need for a collaborative and co-ordinated approach across both practice and research, working toward what is important to those providing, and most importantly, those receiving care at the end of their lives.
Technical and cost efficiency analysis of irrigated onion production insight from smallholders irrigated onion farmers in north East Amhara National Regional State, Ethiopia
Authors: Ayen Kindye , Kidane Tariku , Wubet Adane
Published: January 2025

Introduction

Onions are an imperative root crop that can be grown both under irrigation and rain-fed conditions. It is considered a complementary product to tomatoes and is a globally commercial crop. Onions are a popular crop in Ethiopia for human consumption and export.

Methods

For this study, 150 smallholder producers were surveyed to collect cross-sectional data. A single-step Cobb–Douglas stochastic frontier model was used to estimate both the technical and cost efficiency of irrigated onion production.

Results

The results from the maximum likelihood stochastic frontier model result indicated that the technical efficiency in onions was influenced by the age of the household head, slope of the land, number of extension contacts with development agents, distance from the sampled respondent’s residence to the office of the kebele agriculture office, and the number of oxen owned by the sampled households. Cost efficiency, on the other hand, was determined by the age and educational status of the household head, family size in man equivalent, and the size of irrigated land owned by the onion farmer. The study found that the average technical efficiency score for irrigated onions in the study area was 87%, while the average cost efficiency score was 84%.

Discussion

This indicates that, on average, onion farmers in the study area could potentially increase their technical efficiency by 13% and their cost efficiency by 16% with existing inputs, technologies, and current environmental conditions. Thus, the study suggests institutional interventions such as providing extension services to farmers who are far from agriculture offices, advising on fertility reclamation measures, facilitating young farmers in onion production, and assisting in asset building, particularly in acquiring oxen, to maximize technical and cost efficiency in the study area.