bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer resection patients: a systematic review and meta-analysis
Authors: Wang Jun , Deng Na , Qi Fang , Li Qingbo , Jin Xuegang , Hu Huiling
Published: July 2023

Background

The main aim of this systematic review was to determine the effectiveness of postoperative rehabilitation interventions that include breathing exercises as a component to prevent atelectasis in lung cancer resection patients.

Methods

In this review, we systematically and comprehensively searched the Cochrane Library, PubMed, EMBASE, and Web of Science in English and CNKI and Wanfang in Chinese from 2012 to 2022. The review included any randomized controlled trials focusing on the effectiveness of postoperative rehabilitation interventions that include breathing exercises to prevent pulmonary atelectasis in lung cancer patients. Participants who underwent anatomic pulmonary resection and received postoperative rehabilitation interventions that included breathing exercises as a component were included in this review. The study quality and risks of bias were measured with the GRADE and Cochrane Collaboration tools, and statistical analysis was performed utilizing RevMan 5.3 software.

Results

The incidence of atelectasis was significantly lower in the postoperative rehabilitation intervention group (OR = 0.35; 95% CI, 0.18 to 0.67; I2 = 0%; P = 0.67) than in the control group. The patients who underwent the postoperative rehabilitation program that included breathing exercises (intervention group) had higher forced vital capacity (FVC) scores (MD = 0.24; 95% CI, 0.07 to 0.41; I2 = 73%; P = 0.02), forced expiratory volume in one second (FEV1) scores (MD = 0.31; 95% CI, 0.03 to 0.60; I2 = 98%; P < 0.01) and FEV1/FVC ratios (MD = 9.09; 95% CI, 1.50 to 16.67; I2 = 94%; P < 0.01).

Conclusion

Postoperative rehabilitation interventions that included breathing exercises decreased the incidence rate of atelectasis and improved lung function by increasing the FVC, FEV1, and FEV1/FVC ratio.
Retrospective analysis of pulmonary cryptococcosis and extrapulmonary cryptococcosis in a chinese tertiary hospital
Authors: Shi Jiejun , Chen Jianhua , Hu Liqing , Ma Ada Hoi Yan , Hu Haoxuan , Wang Chuwen , Huang Jiajia , Song Qifa , Qian Guoqing
Published: July 2023

Cryptococcosis is an invasive fungal disease with increased morbidity in China over the past two decades. Cryptococci can infect immunocompromised hosts as well as immunocompetent ones. In this study, we reviewed data of 71 inpatients with cryptococcosis at Ningbo First Hospital from May 2010 to May 2020 and compared the clinical profiles of pulmonary cryptococcosis (PC) and extrapulmonary cryptococcosis (EPC). Of 71 patients (38 males, 33 females), 70 were non-HIV. The annual inpatient population increased dramatically, especially in the PC group. PC was confirmed in 77.46% (55/71) of cases by pathology. The rest were EPC including intracranial infection (15.49%, 11/71) and cryptococcemia (7.04%, 5/71). Compared with PC, a larger proportion of EPC patients were found to have immunocompromised conditions judged by predisposing factors (p < 0.01), or detectable humoral or cellular immunodeficiency. Fever and headache were more common in EPC patients (p < 0.001). Patients with EPC had lower serum sodium level (p = 0.041), lower monocyte counts (p = 0.025) and higher C-reactive protein (p = 0.012). In our study, the sensitivity of cryptococcus antigen detection for EPC was 100% regardless of sample type, while serum lateral flow assay (LFA) tested negative in 25% (5/20) of PC. Immunocompromised hosts are more likely to suffer from EPC than PC.
Fatty infiltration of the cervical multifidus musculature and its clinical correlation to cervical spondylosis
Authors: Li Zhifei , Liang Qinqiu , Li He , Lin Xiaocheng , Meng Jiwen , Yang Daishui , Li Chengwei , Liang Yuanyao , Yang Yin , Lin Yuanfang , Liang Ziyang
Published: July 2023

Purpose

Fat infiltration (FI) of the deep neck extensor muscles has been shown to be associated with poor outcomes in cervical injury, mechanical neck pain, and axial symptoms after cervical spine surgery. However, information is scarce on the severity of FI in cervical extensors associated with different clinical syndromes in patients with cervical spondylosis.

Objective

To investigate the relationship between the severity of FI in the cervical multifidus musculature and its clinical correlates in the syndromes and sagittal alignment of patients with cervical spondylosis.

Methods

This study was conducted as a retrospective study of twenty-eight healthy volunteers (HV) together with sixty-six patients who underwent cervical radiculopathy (CR), degenerative myelopathy (DM), and axial joint pain (AJP) from January 2020 to March 2022. MRI was used to measure the fat cross-sectional area (FCSA), functional muscle cross-sectional area (FMCSA), total muscle cross-sectional area (TMCSA), FI ratio of the cervical multifidus musculature at each cervical level from the C3 to C6 segments and the cervical lordosis angle in the included subjects.

Results

The difference in the FCSA and FI ratio in patient groups with cervical spondylosis was significantly greater than that of the HV group (P < 0.05), and the Cobb angle of the DM group, AJP group and HV group was significantly greater than that of the CR group (P < 0.05). The FI ratio comparison showed no significant difference by sex, and the comparison of FCSA, FMCSA, TMCSA and FI ratio showed no significant difference by age range from 35 to 69 in the included subjects. The FCSA and TMCSA in patients with cervical spondylosis were positively related to the Cobb angle (rs= 0.336, P = 0.006, rs =0.319, P = 0.009, respectively), and the FI ratio was inversely correlated with the Cobb angle (rs= -0.285, P = 0.020) and positively correlated with age (rs =0.261, P = 0.034). In the HV group, FMCSA was inversely correlated with age (rs= -0.400, P = 0.035), while the FI ratio had a positive correlation with age (rs= -0.423, P = 0.025).

Conclusion

Compared with healthy subjects, a more severe degree of FI in the multifidus musculature and sagittal imbalance were found in patients with cervical spondylosis. These two imaging features are considered to be important concomitant phenomena of cervical spondylosis, and the more severe FI is, the worse the sagittal imbalance. However, each syndrome had no obvious difference in FI in the multifidus musculature.
Visual Thinking Strategies in medical education: a systematic review
Authors: Cerqueira Ana Rita , Alves Ana Sofia , Monteiro-Soares Matilde , Hailey Dabney , Loureiro Domingos , Baptista Sofia
Published: July 2023

Background

Arts-based pedagogical tools have been increasingly incorporated into medical education. Visual Thinking Strategies (VTS) is a research-based, constructivist teaching methodology that aims to improve visual literacy, critical thinking, and communication skills through the process of investigating works of art. Harvard Medical School pioneered the application of VTS within medical education in 2004. While there are several studies investigating the use of VTS, there is a need to systematically assess the different programs that exist for medical education and their efficacy in improving relevant clinical skills. This systematic review aims to critically analyse the available evidence of the effectiveness of VTS in medical education to guide future research and provide a framework to adapt medical curricula.

Methods

A systematic search of PubMed, PsycINFO, and Cochrane CENTRAL databases (through November 2022) was conducted to identify studies of VTS-based interventions in undergraduate and postgraduate medical education. Two reviewers independently screened citations for inclusion criteria, extracted data, and assessed risk of bias. The extracted data was then narratively synthesized.

Results

Of 5759 unique citations, 10 studies met the inclusion criteria. After reference review, one additional study was included. Therefore, 11 studies were included in our review. Of these, eight reported VTS-based interventions for undergraduate medical students and three reported interventions in residency training, specifically in dermatology and ophthalmology. The main goal of most studies was to increase observational or visual diagnostic skills. Three of the studies in undergraduate medical education and two in postgraduate achieved a statistically significant improvement in observational skills in post-course evaluations. Some studies reported increased tolerance for ambiguity and empathy.

Conclusions

Although the studies varied considerably in study design, learning objectives, and outcomes, findings consistently indicate that the VTS approach can serve as a vehicle to develop crucial clinical competencies, encouraging more in-depth visual analysis that could be applied when observing a patient. Despite some limitations of the included studies (lack of control groups, self-selection bias, or non-standard outcome measures), the results of this review provide support for greater inclusion of VTS training in the medical curriculum.
Patients’ experiences of using a mobile application-based rehabilitation programme after total hip or knee arthroplasty: a qualitative descriptive study
Authors: Wang Qingling , Lee Regina Lai-Tong , Hunter Sharyn , Chan Sally Wai-Chi
Published: July 2023

Background

An increasing number of patients are discharged from a total hip or knee arthroplasty with a short length of hospital stay. Technologies, such as mobile applications, are used to provide remote support to patients’ postoperative rehabilitation. Patients’ experiences of receiving mobile application-based rehabilitation after total hip or knee arthroplasty have not been investigated extensively.

Methods

This was a qualitative descriptive study. Twenty-five participants who had completed a mobile application-based rehabilitation programme for total hip or knee arthroplasty were recruited. Semi-structured interviews were conducted via telephone between July 2021 and January 2022 regarding the participants’ experiences using the programme. All interviews were audio-recorded and verbatim transcribed. Data were analysed using inductive content analysis. The reporting of this study followed the Consolidated Criteria for Reporting Qualitative Research.

Results

Data analysis revealed five categories: (a) improved access to health care, (b) encouraged postoperative recovery, (c) established supportive relationships, (d) facilitated learning, and (e) future directions.

Conclusion

The theory-underpinned mobile application-based rehabilitation programme demonstrated potential value in supporting patients’ rehabilitation after arthroplasty. Nurses can consider using mobile technologies to expand their role in arthroplasty rehabilitation and improve the quality of rehabilitation care.
Assessing the effects of organizational support, psychological capital, organizational identification on job performance among nurses: a structural equation modeling approach
Authors: Ma Huijuan , Zhu Xiaoli , Huang Jinyu , Zhang Suofei , Tan Jing , Luo Yu
Published: July 2023

Background

The job performance of individual employees determines the overall performance of an organization, and organizational support is known as an important resource at the organizational level to enhance job performance. Although nursing scholars have confirmed the crucial role of organizational support in enhancing job performance, there are no studies on whether psychological capital and organizational identification mediate the association between organizational support and job performance. The purpose of this study is to investigate the influence of organizational support, psychological capital, and organizational identification on nurses’ job performance.

Methods

A cross-sectional survey was conducted among 455 nurses from 21 public hospitals in China. Instruments were perceived organizational support scale, task performance scale, contextual performance scale, Nurse Psychological Capital Questionnaire, and Organizational Identification Questionnaire. Survey data were analyzed using SPSS and AMOS, and hypotheses were tested using path model analysis.

Results

Nurses’ perceived organizational support, psychological capital, organizational identification, and task/contextual performance were positively correlated in every two variables. Psychological capital played an important mediating role in perceived organizational support and task/contextual performance, as well as organizational identification. The multi-mediating effect of psychological capital and organizational identification on the relationship between organizational support and task/contextual performance were 0.14 and 0.25, respectively.

Conclusions

There was a positive correlation between organizational support and job performance among nurses. Psychological support, organizational identification and contextual performance played a chain mediation role in the relationship between organizational support on task performance in nurses. Nursing managers should pay more attention to enhancing nurses’ psychological capital and organizational identification through effective interventions to improve nurses’ job performance.
Models of integration of TB and HIV services and factors associated with perceived quality of TB-HIV integrated service delivery in O. R Tambo District, South Africa
Authors: Dlatu Ntandazo , Longo-Mbenza Benjamin , Apalata Teke
Published: July 2023

Background

Tuberculosis is the leading infectious cause of death among people living with HIV. Reducing morbidity and mortality from HIV-associated TB requires strong collaboration between TB and HIV services at all levels with fully integrated, people-centered models of care.

Methods

This is a qualitative study design using principles of ethnography and the application of aggregate complexity theory. A total of 54 individual interviews with healthcare workers and patients took place in five primary healthcare facilities in the O.R. Tambo district. The participants were purposively selected until the data reached saturation point, and all interviews were tape-recorded. Quantitative analysis of qualitative data was used after coding ethnographic data, looking for emerging patterns, and counting the number of times a qualitative code occurred. A Likert scale was used to assess the perceived quality of TB/HIV integration. Regression models and canonical discriminant analyses were used to explore the associations between the perceived quality of TB and HIV integrated service delivery and independent predictors of interest using SPSS® version 23.0 (Chicago, IL) considering a type I error of 0.05.

Results

Of the 54 participants, 39 (72.2%) reported that TB and HIV services were partially integrated while 15 (27.8%) participants reported that TB/HIV services were fully integrated. Using the Likert scale gradient, 23 (42.6%) participants perceived the quality of integrated TB/HIV services as poor while 13 (24.1%) and 18 (33.3%) perceived the quality of TB/HIV integrated services as moderate and excellent, respectively. Multiple linear regression analysis showed that access to healthcare services was significantly and independently associated with the perceived quality of integrated TB/HIV services following the equation: Y = 3.72–0.06X (adjusted R2 = 23%, p-value = 0.001). Canonical discriminant analysis (CDA) showed that in all 5 municipal facilities, long distances to healthcare facilities leading to reduced access to services were significantly more likely to be the most impeding factor, which is negatively influencing the perceived quality of integrated TB/HIV services, with functions’ coefficients ranging from 9.175 in Mhlontlo to 16.514 in KSD (Wilk’s Lambda = 0.750, p = 0.043).

Conclusion

HIV and TB integration is inadequate with limited access to healthcare services. Full integration (one-stop-shop services) is recommended.
Risk of hip fracture in meat-eaters, pescatarians, and vegetarians: a prospective cohort study of 413,914 UK Biobank participants
Authors: Webster James , Greenwood Darren C. , Cade Janet E.
Published: July 2023

Background

Meat-free diets may be associated with a higher risk of hip fracture, but prospective evidence is limited. We aimed to investigate the risk of hip fracture in occasional meat-eaters, pescatarians, and vegetarians compared to regular meat-eaters in the UK Biobank, and to explore the role of potential mediators of any observed risk differences.

Methods

Middle-aged UK adults were classified as regular meat-eaters (n = 258,765), occasional meat-eaters (n = 137,954), pescatarians (n = 9557), or vegetarians (n = 7638) based on dietary and lifestyle information at recruitment (2006–2010). Incident hip fractures were identified by record linkage to Hospital Episode Statistics up to September 2021. Multivariable Cox regression models were used to estimate associations between each diet group and hip fracture risk, with regular meat-eaters as the reference group, over a median follow-up time of 12.5 years.

Results

Among 413,914 women, 3503 hip fractures were observed. After adjustment for confounders, vegetarians (HR (95% CI): 1.50 (1.18, 1.91)) but not occasional meat-eaters (0.99 (0.93, 1.07)) or pescatarians (1.08 (0.86, 1.35)) had a greater risk of hip fracture than regular meat-eaters. This is equivalent to an adjusted absolute risk difference of 3.2 (1.2, 5.8) more hip fractures per 1000 people over 10 years in vegetarians. There was limited evidence of effect modification by BMI on hip fracture risk across diet groups (pinteraction = 0.08), and no clear evidence of effect modification by age or sex (pinteraction = 0.9 and 0.3, respectively). Mediation analyses suggest that BMI explained 28% of the observed risk difference between vegetarians and regular meat-eaters (95% CI: 1.1%, 69.8%).

Discussion

Vegetarian men and women had a higher risk of hip fracture than regular meat-eaters, and this was partly explained by their lower BMI. Ensuring adequate nutrient intake and weight management are therefore particularly important in vegetarians in the context of hip fracture prevention.

Trial registration

NCT05554549, registered retrospectively.
Estimating the full health and economic benefits of current and future influenza vaccines
Authors: Lafond K. E. , Gharpure R. , Dugan V. G. , Azziz-Baumgartner E.
Published: July 2023

In the dynamic landscape of respiratory virus vaccines, it is crucial to assess the value of novel mRNA and combination influenza/COVID-19 vaccines in low- and middle-income countries. Modeling studies, such as the one conducted by Waterlow et al., provide vital information about the cost–benefit potential of these products compared to currently licensed vaccines. However, this approach only accounts for directly measured medically attended influenza-associated illnesses and has two major limitations. First, this method fails to capture the full disease burden of influenza (including non-respiratory and non-medically attended influenza illnesses), which are particularly important drivers of disease burden in infants and older adults. Second, the model does not describe the ancillary benefits of influenza vaccination such as the attenuation of severe disease, prevention of severe non-respiratory outcomes (e.g., myocardial infarctions), or reduced antibiotic use. To obtain a comprehensive understanding of the benefits of influenza vaccines, we must strive to improve the inputs for future modeling-based evaluations.
“Treated like a Human Being”: perspectives of people who inject drugs attending low-threshold HCV treatment at a syringe service program in New York City
Authors: Kapadia Shashi N. , Aponte-Melendez Yesenia , Rodriguez Alicia , Pai Melinda , Eckhardt Benjamin J. , Marks Kristen M. , Fong Chunki , Mateu-Gelabert Pedro
Published: July 2023

Background

Hepatitis C virus (HCV) treatment can effectively cure HCV among people who inject drugs (PWID). Perspectives of PWID treated in innovative models can reveal program features that address barriers to treatment, and guide implementation of similar models.

Methods

We interviewed 29 participants in the intervention arm of a randomized trial. The trial enrolled PWID with HCV in New York City from 2017 to 2020 and tested the effectiveness of a low-threshold HCV treatment model at a syringe services program. Participants were purposively sampled and interviewed in English or Spanish. The interview guide focused on prior experiences with HCV testing and treatment, and experiences during the trial. Interviews were inductively coded and analyzed using thematic analysis.

Results

Before enrollment, participants reported being tested for HCV in settings such as prison, drug treatment, and emergency rooms. Treatment was delayed because of not being seen as urgent by providers. Participants reported low self-efficacy, competing priorities, and systemic barriers to treatment such as insurance, waiting lists, and criminal-legal interactions. Stigma was a major factor. Treatment during the trial was facilitated through respect from staff, which overcame stigma. The flexible care model (allowing walk-ins and missed appointments) helped mitigate logistical barriers. The willingness of the staff to address social determinants of health was highly valued.

Conclusion

Our findings highlight the need for low-threshold programs with nonjudgmental behavior from program staff, and flexibility to adapt to participants’ needs. Social determinants of health remain a significant barrier, but programs’ efforts to address these factors can engender trust and facilitate treatment.

Trial registration NCT03214679.
The prevalence of osteoporotic fractures in the elderly in China: a systematic review and meta-analysis
Authors: Meng Shilong , Tong Minghao , Yu Yang , Cao Yanguang , Tang Binbin , Shi Xiaolin , Liu Kang
Published: July 2023

Background

Prevalence information is the first step in developing preventive procedures or health services. This study was conducted to systematically evaluate the epidemiology of osteoporotic fractures in Chinese elderly aged ≥ 60 years and to provide evidence-based evidence for the prevention and treatment of osteoporotic fractures.

Methods

We identified relevant studies by searching the literature published in PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang Data, and VIP databases from the establishment of the database until August 2022. We used a random-effects model to obtain prevalence estimates and identified sources of heterogeneity and comparisons of prevalence among different groups through subgroup analysis and sensitivity analysis.

Results

A total of 29 articles were included in this study, and the prevalence of osteoporosis fractures in elderly Chinese was high (18.9%). The prevalence has increased significantly over the past decade (from 13.2% in 2000–2010 to 22.7% in 2012–2022). The prevalence of osteoporosis is higher in women than in men (18.5% vs 14.3%) and increases with age. The northern region was higher than the southern region (20.3% vs 18.9%), and the spine, hip, and distal forearm were the most common sites of fracture.

Conclusion

The prevalence of osteoporotic fractures in the Chinese elderly is 18.9%, and timely prevention and treatment are necessary.
European Achondroplasia Forum guiding principles for the detection and management of foramen magnum stenosis
Authors: Irving Melita , AlSayed Moeenaldeen , Arundel Paul , Baujat Geneviève , Ben-Omran Tawfeg , Boero Silvio , Cormier-Daire Valérie , Fredwall Svein , Guillen-Navarro Encarna , Hoyer-Kuhn Heike , Kunkel Philip , Lampe Christian , Maghnie Mohamad , Mohnike Klaus , Mortier Geert , Sousa Sérgio B.
Published: July 2023

Foramen magnum stenosis is a serious, and potentially life-threatening complication of achondroplasia. The foramen magnum is smaller in infants with achondroplasia, compared with the general population, and both restricted growth in the first 2 years and premature closure of skull plate synchondroses can contribute to narrowing. Narrowing of the foramen magnum can lead to compression of the brainstem and spinal cord, and result in sleep apnoea and sudden death. There is a lack of clarity in the literature on the timing of regular monitoring for foramen magnum stenosis, which assessments should be carried out and when regular screening should be ceased. The European Achondroplasia Forum (EAF) is a group of clinicians and patient advocates, representative of the achondroplasia community. Members of the EAF Steering Committee were invited to submit suggestions for guiding principles for the detection and management of foramen magnum stenosis, which were collated and discussed at an open workshop. Each principle was scrutinised for content and wording, and anonymous voting held to pass the principle and vote on the level of agreement. A total of six guiding principles were developed which incorporate routine clinical monitoring of infants and young children, timing of routine MRI screening, referral of suspected foramen magnum stenosis to a neurosurgeon, the combination of assessments to inform the decision to decompress the foramen magnum, joint decision making to proceed with decompression, and management of older children in whom previously undetected foramen magnum stenosis is identified. All principles achieved the ≥ 75% majority needed to pass (range 89–100%), with high levels of agreement (range 7.6–8.9). By developing guiding principles for the detection and management of foramen magnum stenosis, the EAF aim to enable infants and young children to receive optimal monitoring for this potentially life-threatening complication.
Sexual function assessment in patients with SAPHO syndrome: a cross-sectional study
Authors: Li Chen , Jiang Haixu , Zhang Yunan , Huang Guangrui
Published: July 2023

Introduction

SAPHO syndrome is a group of special syndromes characterized by synovitis, acne, pustulosis, hyperostosis and osteitis. Skin lesions and joint damage are the main clinical manifestations. Among them, females mostly present with palm toe pustulosis, while males have severe acne as the main external manifestation. The bone and joint damage characterized by bone hypertrophy and osteitis is the core manifestation of SAPHO and affects all parts of the body. SAPHO syndrome causes great physical and mental suffering to patients, and it also brings a huge financial burden to the family. The purpose of this study is to explore the impact of SAPHO on the quality of sexual life of patients.

Methods

We screened and included 249 SAPHO patients (169 women and 80 men) from Peking Union Medical College Hospital (Beijing, China). First, we recorded the basic situation of the patient through questionnaires (including gender, age, SAPHO duration, BMI, smoking, drinking, marital status, educational level, occupational status and work status.). Then, the patient needed to fill in the Short Form-36 quality of life questionnaire (SF-36 QoL) to record the quality of life. For Sexual dysfunction (SD), female patients needed to fill in the Female Sexual Function Index (FSFI) to assess the quality of sexual life; while the International Index of Erectile Function (IIEF) was used to assess the SD of male patients. At the same time, we used self-esteem and relationship questionnaire (SEAR) to analyze the psychological state of SAPHO patients. Finally, we performed statistical analysis on the data obtained, and then explored the connection between SAPHO and SD.

Results

In this cross-sectional study, a total of 249 patients completed the questionnaire and constituted the study population. We found that among 169 female patients, 124 patients had FSD (73.4%); while 45 patients did not have FSD (26.6%); and among 80 male patients, 45 (56.3%) had ED; However, 35 patients did not have ED (43.7%). The results of the quality of life and mental state assessment showed that female patients with SD showed lower scores in terms of mental state. Among all male participants, we found no significant difference in quality of life and mental state among participants with or without SD. In addition, there was no significant difference in the duration of SAPHO between female and male participants with or without SD.

Conclusion

This study is the first to evaluate the SD of SAPHO patients. The incidence of SD in female SAPHO patients is higher than that in male patients; the cause of female SD may be mainly psychological factors. These results prove that it is particularly important to focus on regulating their psychological state while diagnosing and treating SAPHO patients in clinical practice.
Hyperhomocysteinemia potentiates megakaryocyte differentiation and thrombopoiesis via GH-PI3K-Akt axis
Authors: Lei Wenjing , Liu Zhuoliang , Su Zhiyuan , Meng Panpan , Zhou Chun , Chen Xiaomei , Hu Zheng , Xiao An , Zhou Miaomiao , Huang Liping , Zhang Yiyue , Qin Xianhui , Wang Junping , Zhu Fengxin , Nie Jing
Published: July 2023

Hyperhomocysteinemia (HHcy) is closely associated with thrombotic diseases such as myocardial infarction and stroke. Enhanced platelet activation was observed in animals and humans with HHcy. However, the influence of HHcy on thrombopoiesis remains largely unknown. Here, we reported increased platelet count (PLT) in mice and zebrafish with HHcy. In hypertensive patients (n = 11,189), higher serum level of total Hcy was observed in participants with PLT ≥ 291 × 109/L (full adjusted β, 0.59; 95% CI 0.14, 1.04). We used single-cell RNA sequencing (scRNA-seq) to characterize the impact of Hcy on transcriptome, cellular heterogeneity, and developmental trajectories of megakaryopoiesis from human umbilical cord blood (hUCB) CD34+ cells. Together with in vitro and in vivo analysis, we demonstrated that Hcy promoted megakaryocytes (MKs) differentiation via growth hormone (GH)-PI3K-Akt axis. Moreover, the effect of Hcy on thrombopoiesis is independent of thrombopoietin (TPO) because administration of Hcy also led to a significant increase of PLT in homozygous TPO receptor (Mpl) mutant mice and zebrafish. Administration of melatonin effectively reversed Hcy-induced thrombopoiesis in mice. ScRNA-seq showed that melatonin abolished Hcy-facilitated MK differentiation and maturation, inhibited the activation of GH-PI3K-Akt signaling. Our work reveals a previously unrecognized role of HHcy in thrombopoiesis and provides new insight into the mechanisms by which HHcy confers an increased thrombotic risk.

Trial Registration clinicaltrials.gov Identifier: NCT00794885.
IPSC derived cardiac fibroblasts of DMD patients show compromised actin microfilaments, metabolic shift and pro-fibrotic phenotype
Authors: Soussi Salwa , Savchenko Lesia , Rovina Davide , Iacovoni Jason S. , Gottinger Andrea , Vialettes Maxime , Pioner Josè-Manuel , Farini Andrea , Mallia Sara , Rabino Martina , Pompilio Giulio , Parini Angelo , Lairez Olivier , Gowran Aoife , Pizzinat Nathalie
Published: July 2023

Duchenne muscular dystrophy (DMD) is a severe form of muscular dystrophy caused by mutations in the dystrophin gene. We characterized which isoforms of dystrophin were expressed by human induced pluripotent stem cell (hiPSC)-derived cardiac fibroblasts obtained from control and DMD patients. Distinct dystrophin isoforms were observed; however, highest molecular weight isoform was absent in DMD patients carrying exon deletions or mutations in the dystrophin gene. The loss of the full-length dystrophin isoform in hiPSC-derived cardiac fibroblasts from DMD patients resulted in deficient formation of actin microfilaments and a metabolic switch from mitochondrial oxidation to glycolysis. The DMD hiPSC-derived cardiac fibroblasts exhibited a dysregulated mitochondria network and reduced mitochondrial respiration, with enhanced compensatory glycolysis to sustain cellular ATP production. This metabolic remodeling was associated with an exacerbated myofibroblast phenotype and increased fibroblast activation in response to pro fibrotic challenges. As cardiac fibrosis is a critical pathological feature of the DMD heart, the myofibroblast phenotype induced by the absence of dystrophin may contribute to deterioration in cardiac function. Our study highlights the relationship between cytoskeletal dynamics, metabolism of the cell and myofibroblast differentiation and provides a new mechanism by which inactivation of dystrophin in non-cardiomyocyte cells may increase the severity of cardiopathy.
Comparing conventional treatment, single-target rTMS, or dual-target rTMS for the treatment of post-stroke cognitive impairment — clinical effects and neuroscientific insights: study protocol for a randomized controlled trial
Authors: Xu Bingshan , Lin Chunrong , Guo Cailian , Wang Hong
Published: July 2023

Background

Although increasing evidence suggests that repetitive transcranial magnetic stimulation may help improve cognitive impairment after stroke, its clinical efficacy is still limited. This limitation may be due to the fact that the left dorsolateral prefrontal cortex (DLPFC) is only one of several brain areas involved in post-stroke cognitive impairment (PSCI). The aim of the present study is to reveal whether dual-target stimulation is superior to single-target stimulation and usual care in the treatment of PSCI.

Methods

A single-center, single-blind, randomized controlled trial will be conducted, and fifty-seven PSCI patients will be recruited and randomly assigned to one of three groups based on the stimulating site. The primary outcome is cognitive function, measured using the Montreal Cognitive Assessment Beijing Version (MoCA-BJ) and Mini-Mental Status Examination (MMSE). The secondary outcomes are the modified Barthel Index (MBI), Trail-Making Test (TMT), and digital span test (DST). Furthermore, changes in brain activity are assessed using transcranial Doppler sonography (TCD) examination and serum levels of brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) closely related to nerve and vascular repair after brain injury. All outcomes will be measured at baseline and 4 weeks after treatment.

Discussion

If dual-target rTMS in significant improvements in cognitive function, this method could be considered as a first-line clinical treatment for PSCI. This proposed study has the potential to identify a new, evidence-based intervention that can enhance cognition and independent living in patients with cognitive impairment after stroke.

Trial registration

Chinese Clinical Trial Registry ChiCTR2200066184. It was registered on 26 November 2022.
Upregulation of Hox genes leading to caste-specific morphogenesis in a termite
Authors: Oguchi Kohei , Miura Toru
Published: July 2023

Background

In social insects, interactions among colony members trigger caste differentiation with morphological modifications. In termite caste differentiation, caste-specific morphologies (such as mandibles in soldiers, genital organs in reproductives or wings in alates) are well developed during post-embryonic development under endocrine controls (e.g., juvenile hormone and ecdysone). Since body part-specific morphogenesis in caste differentiation is hormonally regulated by global factors circulated throughout the body, positional information should be required for the caste-specific and also body part-specific morphogenesis. To identify factors providing the positional information, expression and functional analyses of eight Hox genes were carried out during the three types of caste differentiation (i.e., soldier, neotenic and alate differentiation) in a termite, Hodotermopsis sjostedti.

Results

Spatio-temporal patterns of Hox gene expression during caste differentiation were elucidated by real-time qPCR, showing the caste-specific upregulations of Hox genes during the differentiation processes. Among eight Hox genes, Deformed (Dfd) was upregulated specifically in mandibles in soldier differentiation, abdominal-A (abd-A) and Abdominal-B (Abd-B) were upregulated in the abdomen in neotenic differentiation, while Sex-comb reduced (Scr) and Antennapedia (Antp) were upregulated during alate differentiation. Furthermore, RNAi knockdown of Dfd in soldier differentiation and of abd-A and Abd-B in neotenic differentiation distorted the modifications of caste-specific morphologies.

Conclusions

Gene expression and functional analyses in this study revealed that, in the caste differentiation in termites, upregulation of Hox genes provide positional identities of body segments, resulting in the caste-specific morphogenesis. The acquisition of such developmental modifications would have enabled the evolution of sophisticated caste systems in termites.
Association Between Availability of Molecular Genotyping Results and Overall Survival in Patients With Advanced Nonsquamous Non–Small-Cell Lung Cancer
Authors: Aggarwal Charu , Marmarelis Melina E. , Hwang Wei-Ting , Scholes Dylan G. , McWilliams Tara L. , Singh Aditi P. , Sun Lova , Kosteva John , Costello Michael R. , Cohen Roger B. , Langer Corey J. , Doucette Abigail , Gabriel Peter N. , Shulman Lawrence N. , Rendle Katharine A. , Thompson Jeffrey C. , Bekelman Justin E. , Carpenter Erica L.
Published: July 2023

PURPOSE

Current guidelines recommend molecular genotyping for patients newly diagnosed with metastatic nonsquamous (mNSq) non–small-cell lung cancer (NSCLC). The association between availability of molecular genotyping before first line (1L) therapy and overall survival (OS) is not known.

METHODS

We conducted a real-world cohort study using electronic health records in patients newly diagnosed with mNSq NSCLC. Cox proportional-hazards multivariable regression models were constructed to examine the association between OS and test result availability before 1L therapy, adjusting for covariates. Additional analyses were conducted to assess the consistency and strength of the relationship. Multivariable logistic regression models were used to examine the association between concurrent tissue and plasma testing ( v tissue alone) and result availability.

RESULTS

Three hundred twenty-six patients were included, 80% (261/326) with results available before 1L (available testing group), and 20% (65/326) without results available (unavailable testing group). With 14.2-month median follow-up, patients in the available testing group had significantly longer OS relative to the unavailable testing group (adjusted hazard ratio, 0.43; 95% CI, 0.30 to 0.62; P < .0001). The adjusted odds of availability of results before 1L therapy was higher with concurrent tissue and plasma testing ( v tissue testing alone; adjusted odds ratio, 2.06; 95% CI, 1.09 to 3.90; P = .026).

CONCLUSION

Among patients with mNSq NSCLC in a real-world cohort, availability of molecular genotyping results before 1L therapy was associated with significantly better OS. Concurrent tissue and plasma testing was associated with a higher odds of availability of results before 1L therapy. These findings warrant renewed attention to the completion of molecular genotyping before 1L therapy.
Creatures of Empire in Le Fanu'sUncle Silas
Authors: Braun Gretchen
Published: July 2023

The interim between Darwin's first publication of the theory of natural selection (The Origin of Species, 1859) and his extended application of it to human development (The Descent of Man, 1871) corresponds with the reign of sensation fiction, a genre built upon older gothic tropes but imbricated with cultural and scientific modernization. Joseph Sheridan Le Fanu's Uncle Silas, a novel that straddles generic and national literature categories, typifies the sensation era's uneasy awareness of not only similarity but interdependence across boundaries. While eschewing typical sensation engagement with technology such as trains and telegrams, Uncle Silas reflects theories of species transmutation and particularly Darwin's Origin, which posited a malleability of seemingly distinct categories through species interaction and environmental influence. The plot of Uncle Silas centers on dislocation and efforts to fortify self-identity and reestablish security. Le Fanu's narrator-protagonist, the orphaned English or Anglo-Irish heiress Maud Ruthyn, practices bodily self-regulation and careful discernment to shore up boundaries of nationality and class that sustain her hereditary privilege. She stabilizes her class, national, and gender identity through rational revulsion from her French governess and implicitly Irish cousin. Narrator-protagonist Maud resolutely positions Englishness against foreignness and humanity against animality, but these categorical divisions, which she enforces as a character in the novel's imagined world, are exposed as false by her narration. Uncle Silas presents unregulated animal appetites as threatening to rational community governance, but it also implies that our bestial shared capacity for pain, which crosses boundaries of nationality, class, and even species, enables ethical response.
The Impacts of Politicization on Public Health Workers: The COVID-19 Pandemic in Oregon and Montana
Authors: Barsky Christina , Camarillo Earlene
Published: July 2023

Context: The contributions from the field of public health to human society are numerous and are often taken for granted. The COVID-19 pandemic thrust the largely invisible public health workforce into the public eye. Like other career civil servants at the intersection of the citizen-state encounter, reports of uncooperative, hostile, and even violent confrontations between public health workers and those they serve are on the rise. This study explores the attitudes of public health professionals in two states in the American West.

Methods: The authors conducted an anonymous web-based survey of public health professionals in Montana and Oregon one year into the COVID-19 pandemic.

Findings: Public health workers who responded to the survey reported beliefs that the COVID-19 pandemic was politicized by actors in the government, both major political parties, the media, and the public broadly. This politicization affected workers' abilities to do their jobs, with respondents in Montana experiencing more negative impacts than those in Oregon.

Conclusions: Public health workers face growing antagonism from the public and pressure from political leaders, which poses a significant concern for the public health workforce and for communities as they prepare to address and overcome future public health challenges.
State Efforts to Regulate Provider Networks and Directories: Lessons for the Future
Authors: Haeder Simon F. , Xu Wendy Y. , Elton Thomas , Pitcher Ariana
Published: July 2023

Managed care arrangements are the dominant form of insurance coverage in the United States today. These arrangements rely on a network of contracted providers to deliver services to their enrollees. After the managed care backlash, governments moved to ensure consumer access by issuing a number of requirements for carriers related to the composition and size of their networks and how this information is shared with consumers. The authors provide a comprehensive review of these state-based efforts to regulate provider network adequacy and provider directory accuracy for commercial insurance markets. In addition to common measures of adequacy, they also include requirements specifically targeted to underserved populations. Their assessment comes on the heels of recent empirical work that has raised significant questions about whether these efforts are effective, particularly considering the limited nature of enforcement. They also provide a brief overview and assessment of recent federal government efforts that replicate these state regulations with a focus on lessons learned from state regulations that may help improve their federal counterparts. Furthermore, they outline a future research agenda focused on a more comprehensive evaluation of efforts to ensure consumer access.
“Skin of the Earth”
Authors: Tam Mankei
Published: July 2023

This article explores soil and the multiple pathways it has provided for the coconstitution of forms of life that might be possible following the Fukushima nuclear fallout. In Iitate, a former evacuation zone where radiation still lingers, farmers and concerned citizens deploy a coproduction framework that involves experts in making their own science. Incorporating tactile knowledge of the environment, they make life-strengthening claims on the future amid state promises of revival and progress. Soil becomes alive in madei, which emerges from the processes of separating radiocesium from topsoil, growing rice, and other improvisations for relating to soils that cascade to regenerate a livable world. This article discusses how the Japanese state utilizes temporal scales that orient its citizenry to a future associated with accelerated and intensified productivity as a sign of progress, incorporating decontamination technologies to assert control over organic lives and inorganic matter to make them productive for humans. Through madei, this article addresses how soil guides human attention to the rediscovery of interspecies temporalities, paces, and rhythms, reconfiguring radioactivity to create what I conceptualize as a regenerative time to underscore how actors reanimate the future(s) in the here and now.
Practicing for Death in the Anthropocene
Authors: Becker-Lindenthal Hjördis , Kotva Simone
Published: July 2023

This article analyzes the theme of practicing for death as it has emerged in recent environmental discourse. In the first part, it situates Roy Scranton’s Learning to Die in the Anthropocene (2015) in the context of new critical approaches to death and asceticism, especially Peter Sloterdijk’s You Must Change Your Life: On Anthropotechnics (2013). In the second part, it offers an environmental reading of the “remembrance of death” as it appears in John Climacus’s influential seventh-century manual, The Ladder of Divine Ascent. Here, the authors build on Sloterdijk’s remarks on Climacus while developing Sloterdijk’s analysis substantially, drawing (in part three) on ecotheological readings of Byzantine asceticism to elucidate Climacus’s environmental practice. The authors argue that what is at stake in the remembrance of death is the death not of the self but of a perception of the self that valorizes the self-possessed subject. In the final part, they compare the death of specific self-images in Christian asceticism to the death of the human qua self-possessed subject in the posthumanist ethics of Rosi Braidotti. At the same time, the authors see Climacus as deepening positions sketched out in Braidotti’s posthumanism and providing a critical perspective on the idea of resigning from care.
Axon guidance genes control hepatic artery development
Authors: Gannoun Lila , De Schrevel Catalina , Belle Morgane , Dauguet Nicolas , Achouri Younes , Loriot Axelle , Vanderaa Christophe , Cordi Sabine , Dili Alexandra , Heremans Yves , Rooman Ilse , Leclercq Isabelle A. , Jacquemin Patrick , Gatto Laurent , Lemaigre Frédéric P.
Published: July 2023

Earlier data on liver development demonstrated that morphogenesis of the bile duct, portal mesenchyme and hepatic artery is interdependent, yet how this interdependency is orchestrated remains unknown. Here, using 2D and 3D imaging, we first describe how portal mesenchymal cells become organised to form hepatic arteries. Next, we examined intercellular signalling active during portal area development and found that axon guidance genes are dynamically expressed in developing bile ducts and portal mesenchyme. Using tissue-specific gene inactivation in mice, we show that the repulsive guidance molecule BMP co-receptor A (RGMA)/neogenin (NEO1) receptor/ligand pair is dispensable for portal area development, but that deficient roundabout 2 (ROBO2)/SLIT2 signalling in the portal mesenchyme causes reduced maturation of the vascular smooth muscle cells that form the tunica media of the hepatic artery. This arterial anomaly does not impact liver function in homeostatic conditions, but is associated with significant tissular damage following partial hepatectomy. In conclusion, our work identifies new players in development of the liver vasculature in health and liver regeneration.