bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation on the natural smoke exhaust performance by vertical shaft in tunnel fires under different ambient pressures
Authors: Gao Zihe , Cai Jiajun , Jiang Lin , Mensah Rhoda Afriyie , Fan Chuangang
Published: April 2024

In high-altitude tunnels, due to the ambient pressure and density of air being different from those under normal pressure, the convection and heat radiation in tunnels are also different when fires occur. As a result, the smoke exhaust capacity varies under different pressures. This work aimed to numerically explore the impact of ambient pressure on the smoke exhaust efficiency at high-altitude shallow tunnels with natural ventilation by shaft. The numerical results demonstrated that the smoke exhaust capacity is enhanced with increasing ambient pressure. This is because of the increase in the air entrainment coefficient and air density, and it causes plug-holing more easily to occur under higher ambient pressures. Once the plug-holing has taken place, the fresh air can be directly exhausted through the shaft, which results in a poor smoke exhaust capacity. By accounting for the factors of the smoke layer thickness, ambient pressure, the exhausted smoke temperature and heat release rate, the Richardson number was introduced as the criterion for determining whether plug-holing occurs. As ambient pressure was increased, the critical Richardson number for plug-holing was observed to decrease, a finding supported by existing research.
Management of groin hernia repair in Sweden: A register-based comparative analysis of public and private healthcare providers
Authors: Hemberg Anders , Landén Jakob , Montgomery Agneta , Holmberg Henrik , Nordin Pär
Published: April 2024

Background:

Swedish healthcare is in a period of transition with an expanding private sector. This study compares quality of outcome after groin hernia repair performed in a public or private healthcare setting.

Methods:

A cohort study based on data from the Swedish National Hernia Register combined with Patient-Reported Outcome Measures (PROMs) 1 year after groin hernia repair. Between September 2012 and December 2018, a questionnaire was sent to all patients registered in the hernia register 1 year after surgery. Endpoints were reoperation for recurrence, chronic pain, and patient satisfaction.

Results:

From a total of 87,650 patients with unilateral groin hernia repair, 61,337 PROM answers (70%) were received from 71 public and 28 private healthcare providers. More females, acute and recurrent cases, and patients with high American Society of Anesthesiology (ASA) scores were operated under the national healthcare system. The private sector had more experience surgeons with higher annual volume per surgeon, shorter time on waiting lists, and shorter operation times. No difference was seen in patient satisfaction. Groin hernia repair performed in a private clinic was associated with less postoperative chronic pain (OR 0.85, 95% CI 0.8–0.91) but a higher recurrence rate (HR 1.41; 95% CI 1.26–1.59) in a multivariable logistic regression analysis.

Conclusion:

Despite private clinics having a higher proportion of experienced surgeons and fewer complex cases, the recurrence rate was higher, whereas the risk for chronic postoperative pain was higher among patients treated in the public sector.
Transmission tower bolt-loosening time–frequency analysis and localization method considering time-varying characteristics
Authors: Zhao Long , Wen Guanru , Wang Jingyao , Liu Zhicheng , Huang Xinbo
Published: April 2024

To address the issues of high concealment and difficult positioning of loose bolts in transmission towers, this paper proposes a new method for locating loose bolts in transmission towers. In this method, we divide the vibration response of the transmission tower into low-frequency signals of 2–25 Hz and high-frequency signals of 25–75 Hz. For the low-frequency signals, the single signal component is obtained by adaptive Chirp mode decomposition and uses the general demodulation transformation to deeply denoise the non-modal information. Since frequency characteristics themselves do not contain time information, considering the importance of time information for positioning, we propose a low-frequency time-varying frequency feature that preserves time characteristics based on synchronous wavelet transform and peak search. For the high-frequency signals, we use singular value decomposition to remove signal outliers caused by pulse excitation and eliminate forced vibrations through wavelet packet transform. Without altering its inherent characteristics, this method enables high-frequency time-domain signals to better represent the nonlinear characteristics of transmission towers. Furthermore, based on the powerful capabilities of Timesnet and Transformer in dealing with time series data, we propose a fault diagnosis model, which ultimately achieves the positioning of loose bolts in transmission towers. The bolt node model proves that this approach can better represent the loose bolt characteristics, and the transmission tower model verifies the effectiveness of this approach in locating loose bolts in transmission towers. Finally, bolt-loosening tests were conducted on a 110 kV transmission tower, and the accuracy of the positioning results reached 92.8%, demonstrating the effectiveness and efficiency of this method in practical positioning applications.
The Impact of Air Pollution on Game Outcome
Authors: Xu Yiwen , Wang Ying , Yang Yang
Published: April 2024

Although air pollution is an important practical and theoretical issue, the impact of air pollution on game outcomes has not yet been comprehensively investigated. Therefore, by using data from the Chinese Football Association Super League, this study examined the impact of the Air Quality Index and six major air pollutants on game outcomes. Results show that air pollution is negatively and significantly related to game outcomes and is heterogeneous between home teams and away teams. The results extend the knowledge of air pollution studies and sports studies and provide insights into both environmental regulations and sports markets.
Different Splice Isoforms of Peripheral Triggering Receptor Expressed on Myeloid Cells 2 mRNA Expressions are Associated With Cognitive Decline in Mild Dementia Due to Alzheimer’s Disease and Reflect Central Neuroinflammation
Authors: Chiang Yi-Kuan , Lin Yung-Shuan , Chen Chun-Yu , Lirng Jiing-Feng , Yang Yu-Hsiu , Lee Wei-Ju , Fuh Jong-Ling
Published: April 2024

Triggering receptor expressed on myeloid cells 2 (TREM2) is upregulated in activated microglia and may be related to cognitive decline in patients with Alzheimer’s disease (AD). There is conflicting evidence regarding the association of peripheral TREM2 mRNA expression/soluble TREM2 (the extracellular domain of TREM2) with cognitive function/neuroinflammation in patients with AD. Herein, we studied the TREM2 and TREM2alt mRNA expression and their association with the cognitive performance in subjects with mild dementia due to AD and healthy controls. In a subgroup of patients with AD, magnetic resonance spectroscopy was used to measure the myo-inositol level in the posterior cingulate cortex, a surrogate marker for neuroinflammation. The results showed that increased TREM2 and TREM2alt mRNA expression is associated with AD pathogenesis at the mild dementia stage, thereby serving as a potential biomarker for early symptomatic stage of AD. TREM2 may exert protective effects on both cognition and central neuroinflammation.
High-resolution ultrasound of thyroglossal cysts with special emphasis on the detection of cystic portions above the hyoid within the tongue base
Authors: Podzimek Jiri , Fruth Kai , Jecker Peter
Published: April 2024

Background:

Thyroglossal duct cysts (TGDCs) within the tongue base represent a challenge for the surgeon and are often the cause of recurrence.

Purpose:

This study aimed to evaluate diagnostic performance of high-resolution ultrasound in TGDCs within the tongue base, compared to intraoperative findings. Furthermore, accuracy with which the detection of thyroid tissue in parts of the thyroglossal duct cyst was possible was investigated.

Methods:

A total of 50 patients with TGDCs were examined by high-resolution ultrasound. Every thyroglossal cystic lesion was examined for the presence of solid thyroid tissue with colour-coded duplex sonography and evaluated according to American Thyroid Association (ATA) guidelines. Ultimately, 45 of the 50 patients underwent surgery (Sistrunk procedure).

Results:

In 38/50 patients (76%), TGDCs were seen in their typical distal location inferior to the hyoid. Four patients (8%) had the thyroglossal duct cyst superior and inferior to the hyoid. The TGDC remnants only in the tongue base were recognised in 16% of cases (8 patients). Histological specimens revealed thyroid tissue within the TGDCs in 23 of the 45 patients (49%). Thyroid tissue was diagnosed preoperatively in 15 patients (65%) X2(1, N = 23) = 2.13, p = 0.144. One patient exhibited suspicious features for thyroid cancer, which was confirmed histologically as papillary thyroid carcinoma.

Conclusion:

High-resolution ultrasound represents quick, safe and reliable imaging for TGDCs on both sides of the hyoid bone (inferior and superior) with an impact on surgical planning. Furthermore, thyroid tissue within TGDCs can be revealed preoperatively and assessed for suspicious features.
Public fear or public sphere? A content analysis of user comments on Egyptian newspaper Facebook pages
Authors: Elmasry Mohamad Hamas , el-Nawawy Mohammed
Published: April 2024

This content analysis examined posts and user comments on four of the most followed Egyptian newspaper Facebook pages: Al-Masry Al-Youm, Al-Youm Al-Saba’, Al-Shorouk and Al-Ahram. The purpose of the analysis was to assess the extent to which Egyptians are able to navigate ongoing government authoritarianism to self-express online. Contrary to expectations, the results indicate that Facebook page size appears to be a much more important factor in dictating the conditions of Egyptian news spheres than editorial policies and ownership structures. Overall, this suggests that current authoritarian conditions in Egypt have rendered editorial lines relatively unimportant.
Benchmarking Relevance for Hospital Design and Planning: An International Web-Based Survey
Authors: Silja Viergutz Hannah-Kathrin , Cambra-Rufino Laura , Apple Michael , Heithoff Abigail , Lindahl Goran , Capolongo Stefano , Brambilla Andrea
Published: April 2024

Objective:

The study aims to investigate what design practitioners and healthcare facility managers deem as important benchmarking metrics worldwide, investigating country differences in benchmarking usage and which metrics are prioritized.

Background:

Benchmarking is a regular practice in the healthcare sector, both for clinical and managerial aspects to compare, measure, and improve standardized processes. However, limited knowledge is available about benchmarking procedures in hospital planning, design, and construction.

Methods:

A web-based survey was designed, revised, and pilot-tested in five countries; it was adjusted according to local experts’ suggestions and submitted globally via SoSci multilingual platform to persons involved in hospital design, research, construction, and facility management. It was composed of closed questions on 5-point Likert-type scale ranking frequency or importance and open-ended questions divided into six sections. Two hundred and eighty full responses have been collected. Statistical analysis was performed via PowerBI and R-Studio, while qualitative analysis was performed via MAXQDA.

Results:

The findings reported allow for both specific insights per each country or category as well as enabling general considerations of a practice that is becoming always more international with 30%–50% of respondents working in the international context. The evaluation of the survey highlights the most important benchmarks, among others. For example, for respondents from the top five countries (Sweden, Spain, Germany, Italy, and the United States), the most important metric for benchmark comparability is whether the project was new construction, new construction attached to an existing hospital, or interior renovation. Construction date, client type (public vs. private), and country of location were also generally rated as the most important metrics by respondents. Other metrics that were consistently rated as important globally included inpatient unit layout, walking distances, number of floors, and whether all patient rooms are private. Space-related metrics are considered very important elements in the design and planning of healthcare facilities worldwide. Regarding cost-related metrics, all countries consider the ratio construction cost per building gross area as the most important.

Conclusions:

Benchmarking emerges as a relevant tool for hospital design and planning as it can support efficiency, standardization, and confidence; currently, benchmarking is still underutilized due to the challenge of international comparison, access to data outside each specific company, and variation design metrics nationally. Benchmarking strategies should be further investigated to support knowledge exchange and to ensure reliable and comparable information globally.
Feasibility and usability of remote monitoring in Alzheimer's disease
Authors: Muurling Marijn , de Boer Casper , Hinds Chris , Atreya Alankar , Doherty Aiden , Alepopoulos Vasilis , Curcic Jelena , Brem Anna-Katharine , Conde Pauline , Kuruppu Sajini , Morató Xavier , Saletti Valentina , Galluzzi Samantha , Vilarino Luis Estefania , Cardoso Sandra , Stukelj Tina , Kramberger Milica Gregorič , Roik Dora , Koychev Ivan , Hopøy Ann-Cecilie , Schwertner Emilia , Gkioka Mara , Aarsland Dag , Visser Pieter Jelle ,   the RADAR-AD consortium
Published: April 2024

Introduction

Remote monitoring technologies (RMTs) can measure cognitive and functional decline objectively at-home, and offer opportunities to measure passively and continuously, possibly improving sensitivity and reducing participant burden in clinical trials. However, there is skepticism that age and cognitive or functional impairment may render participants unable or unwilling to comply with complex RMT protocols. We therefore assessed the feasibility and usability of a complex RMT protocol in all syndromic stages of Alzheimer's disease and in healthy control participants.

Methods

For 8 weeks, participants (N = 229) used two activity trackers, two interactive apps with either daily or weekly cognitive tasks, and optionally a wearable camera. A subset of participants participated in a 4-week sub-study (N = 45) using fixed at-home sensors, a wearable EEG sleep headband and a driving performance device. Feasibility was assessed by evaluating compliance and drop-out rates. Usability was assessed by problem rates (e.g., understanding instructions, discomfort, forgetting to use the RMT or technical problems) as discussed during bi-weekly semi-structured interviews.

Results

Most problems were found for the active apps and EEG sleep headband. Problem rates increased and compliance rates decreased with disease severity, but the study remained feasible.

Conclusions

This study shows that a highly complex RMT protocol is feasible, even in a mild-to-moderate AD population, encouraging other researchers to use RMTs in their study designs. We recommend evaluating the design of individual devices carefully before finalizing study protocols, considering RMTs which allow for real-time compliance monitoring, and engaging the partners of study participants in the research.
Internal Marketing, Faculty Engagement, and Innovative Behavior: An Empirical Study in Higher Education
Authors: Sarangal Rajani Kumari , Nargotra Meenakshi , Singh Rabinder , Singh Gurmeet
Published: April 2024

The current research study investigated the significance of internal marketing (IM) to enhance faculty innovative behavior (FIB) and faculty engagement (FE) in higher education (HE). Furthermore, the mediation of FE in the association between IM and FIB has been investigated. Three hundred teachers from three major public sector universities in union territory (Jammu and Kashmir) in India have been contacted to gather responses. The study contributes in numerous ways to the literature—dimensions of IM have a significant and positive impact on FIB in the HE sector. FE significantly mediated the effect of IM and its dimensions on FIB. This study also enlarged the scope of social exchange theory by using it from faculty perspectives in HE. Furthermore, the study has made an attempt to modify the scale to measure constructs for making them suitable in the HE sectors. Research findings offer numerous suggestions for administrators in HE institutions.
Systemic sclerosis and anorectal dysfunction: The Leeds experience
Authors: Suresh Nikhil , Karanth Ranjitha , Cheah Ramsah , Casey John , Jayne David G , Del Galdo Francesco
Published: April 2024

Systemic sclerosis is an autoimmune disorder which frequently affects the gastrointestinal tract. Anorectal dysfunction is common in systemic sclerosis and is manifested mainly by atrophy of internal anal sphincter. Faecal incontinence is the result of internal anal sphincter atrophy secondary to systemic sclerosis. In this study, we aimed to assess the internal anal sphincter in 17 patients with faecal incontinence and systemic sclerosis using anorectal manometry and endoanal ultrasound and compare them with an age and gender-matched control group without systemic sclerosis. Most patients have limited cutaneous systemic sclerosis. Majority of the patients with systemic sclerosis and faecal incontinence presented with symptoms of faecal leakage and urgency. Systemic sclerosis patients had low basal sphincter pressures. The mean thickness of internal anal sphincter in systemic sclerosis group was significantly lower than the control group (p < 0.001). Rectal sensation is preserved in systemic sclerosis. There was no difference in the mean thickness of the external anal sphincter between the two groups. To conclude internal anal sphincter is atrophic in systemic sclerosis resulting in decreased resting sphincter pressures and passive faecal leakage. Further investigations and studies are needed to determine the natural course of faecal incontinence in systemic sclerosis, associated risk factors and efficacy of therapeutic interventions.
Anatomic Medial Ulnar Collateral Ligament Reconstruction With Internal Brace Augmentation in Throwing Athletes
Authors: Camp Christopher L. , Jurgensmeier Kevin , Boos Alexander , Dines Joshua S.
Published: April 2024

Background:

Injury to the medial ulnar collateral ligament (MUCL) is a common setback experienced by many throwing athletes often requiring reconstruction with 12 to 18 months of rehabilitation. Current reconstructive techniques fail to anatomically restore the MUCL. This presentation demonstrates the “anatomic technique” for reconstruction of the MUCL supplemented by internal brace augmentation.

Indications:

Initial injuries of the MUCL can often be managed conservatively; however, many complete tears and those failing nonoperative management are frequently treated with MUCL reconstruction.

Technique Description:

After graft harvest, a 6-cm incision is created over the medial epicondyle to expose the sublime tubercle and medial epicondyle. Sutures are placed through the torn ligament which are used to formally repair the native ligament. A 4-mm socket is drilled in the MUCL origin of the medial epicondyle, and two 2-mm penetrating sockets are drilled toward the base of the 4-mm socket. The sutures in the native ligament are passed through the sockets and later tied over the bone bridge to complete the native ligament repair. A tight rope is shuttled through the medial epicondyle socket and assembled. The palmaris longus autograft and a suture tape are loaded onto the tightrope and reduced into the humeral socket. On the ulna, soft suture anchors are placed on either side of the sublime tubercle. The distal end of the graft is then sutured utilizing a FiberWire. The graft is secured to the sublime tubercle by tying down the previously placed suture anchors. The suture tapes and internal brace are loaded into a SwiveLock suture anchor, which is fixed distally along the sublime tubercle ridge creating an anatomic reconstruction. Then, the native ligament sutures and tight rope are re-tensioned and tied across the humeral bone bridge for final fixation.

Results:

In our cohort of 26 professional and amateur throwers, >90% returned to play at the same level at a mean of 9.9 months postoperatively.

Discussion/Conclusion:

Anatomic reconstruction of the MUCL with internal bracing is a viable option for MUCL injuries and may allow expedited return to sport for most athletes.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Long-term treatment with selective PI3Kδ inhibitor leniolisib in adults with activated PI3Kδ syndrome
Authors: Rao V. Koneti , Kulm Elaine , Grossman Jennifer , Buchbinder David , Chong Hey , Bradt Jason , Webster Sharon , Šedivá Anna , Dalm Virgil A. , Uzel Gulbu
Published: April 2024

Activated phosphoinositide 3-kinase delta (PI3Kδ) syndrome (APDS) is an inborn error of immunity that manifests as immune deficiency and dysregulation; symptoms include frequent infections and lymphoproliferation. In our dose-finding and phase 3 placebo-controlled trials, treatment with the selective PI3Kδ inhibitor leniolisib reduced lymphoproliferation and normalized lymphocyte subsets. Here, we present 6 years of follow-up from the 6 adult patients in the original dose-finding trial receiving leniolisib. We used data from the ongoing open-label extension study, which was supplemented at later time points by investigators, including health-related quality of life (HRQoL) assessed through a clinician-reported questionnaire. We observed improvements in HRQoL: 5 of 6 patients experienced an increase in physical capabilities and socialization, and a decrease in prescribed medications. Immune subsets improved in all patients: mean transitional B-cell levels decreased from 38.17% to 2.47% and the CD4:CD8 T-cell ratio normalized to 1.11. Manifestations seen before and within the first year of leniolisib exposure, such as infections and gastrointestinal conditions, attenuated after year 2, with few new conditions emerging out to year 6. Thrombocytopenia or lymphopenia remained present in half of patients at year 6. Of 83 adverse events through year 5, 90.36% were grade 1; none were grade 4/5 nor deemed leniolisib related. Collectively, we saw an enhancement in HRQoL as well as durable changes in lymphocyte subsets and clinical manifestations, further supporting the use of leniolisib as a long-term therapeutic option for the treatment of APDS. This trial was registered at www.ClinicalTrials.gov as #NCT02859727.
Transcriptome exploration of ferroptosis-related genes in TGFβ- induced lens epithelial to mesenchymal transition during posterior capsular opacification development
Authors: Fan Cong , Wang Chao , Wang Yan , Jiang Jian
Published: April 2024

Background

Posterior capsular opacification (PCO) is the main reason affecting the long-term postoperative result of cataract patient, and it is well accepted that fibrotic PCO is driven by transforming growth factor beta (TGFβ) signaling. Ferroptosis, closely related to various ocular diseases, but has not been explored in PCO.

Methods

RNA sequencing (RNA-seq) was performed on both TGF-β2 treated and untreated primary lens epithelial cells (pLECs). Differentially expressed genes (DEGs) associated with ferroptosis were analyzed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) to investigate their biological function. Additionally, protein-to-protein interactions among selected ferroptosis-related genes by PPI network and the top 10 genes with the highest score (MCC algorithm) were selected as the hub genes. The top 20 genes with significant fold change values were validated using quantitative real-time polymerase chain reaction (qRT-PCR).

Results

Our analysis revealed 1253 DEGs between TGF-β2 treated and untreated pLECs, uncovering 38 ferroptosis-related genes between two groups. Among these 38 ferroptosis-related genes,the most prominent GO enrichment analysis process involved in the response to oxidative stress (BPs), apical part of cell (CCs),antioxidant activity (MFs). KEGG were mainly concentrated in fluid shear stress and atherosclerosis, IL-17 and TNF signaling pathways, and validation of top 20 genes with significant fold change value were consistent with RNA-seq.

Conclusions

Our RNA-Seq data identified 38 ferroptosis-related genes in TGF-β2 treated and untreated pLECs, which is the first observation of ferroptosis related genes in primary human lens epithelial cells under TGF-β2 stimulation.

Graphical Abstract

Our study initially observed ferroptosis related genes in primary human lens epithelial cells stimulated by TGF-β2. These findings may improve the understanding of the molecular mechanisms of PCO and provide a new direction for exploring the potential mechanisms of PCO
General practitioners’ well-being in Belgium: results from the cross-sectional PRICOV-19 study
Authors: Cholewa Joanna , Ponsar Cecile , de Rouffignac Ségolène , Pétré Benoit , Van Poel Esther , Willems Sara , De Jonghe Michel
Published: April 2024

Background

The mental health and well-being of GPs is a critical issue as they play a vital role in providing healthcare services to individuals and communities. Research has shown that GPs often face high levels of stress, burnout, and mental health problems due to their demanding work environment. During the COVID-19 pandemic, GPs faced additional challenges which further impacted their mental health and well-being. This study aims to investigate the impact of systemic work-related stressors on the level of well-being of GPs in Belgium during the pandemic, with a particular emphasis on identifying regional variations between Flanders, Wallonia, and Brussels-Capital.

Methods

Data were collected with a self-reported online questionnaire from 479 GPs Belgian practices between December 2020 and August 2021 as part of the international PRICOV-19 study that explored the organization of general practices during COVID-19 in 38 countries to guarantee safe, effective, patient-centered, and equitable care. Well-being was evaluated by the Mayo Clinic's expanded 9-item well-being index.

Results

The findings of this study reveal notable regional discrepancies in the degree of well-being experienced by Belgian GPs, with the Walloon region displaying the lowest level of well-being (37%) in a population highly susceptible to professional distress (57%). Among the key stressors contributing to such distress, financial difficulties among patients (p < 0.011), the fee-for-service payment system (p = 0.013), a lack of work-related purpose (p = 0.047), and inadequate work-life balance (p < 0.001) were identified as significant factors. When examining the influence of regional disparities, it was found that the sole significant interaction between work-related stressors and region regarding the probability of experiencing distress was related to the possibility of workload sharing among practice personnel.

Conclusion

The findings from this study underscore the imperative for more comprehensive research aimed at scrutinizing the differences in well-being across the three regions in Belgium and identifying the systemic factors that influence the practice environment, as opposed to exclusively concentrating on enhancing individual resilience.
Management of diabetic ocular complications: from cellular insights to community strategies
Authors: Rani Padmaja Kumari
Published: April 2024

The editorial outlines an integrated approach to managing diabetic ocular complications, combining advanced scientific research with practical public health strategies to improve the prevention, diagnosis, and treatment of diabetic retinopathy and macular edema globally.
A meta-analysis for prevalence of infectious laryngotracheitis in chickens in mainland China in 1981–2022
Authors: Hong Xingping , Zhang Huiling , Zhang Xiaorong , Zhang Xue Ping , Zhang Tangjie
Published: April 2024

Background

Infectious laryngotracheitis (ILT) is a highly infectious upper respiratory tract disease of chickens caused by infectious laryngotracheitis virus or Gallid herpesvirus 1 (GaHV-1). ILT is an important respiratory disease of chickens and annually causes significant economic losses in the chicken industry. Although numerous relevant studies have been published, the overall prevalence of ILT infection among chicken in mainland China is still unknown, and associated risk factors need to be evaluated to establish preventive measures.

Results

The present study reviewed the literature on the prevalence of ILT in chickens in China as of December 20, 2022, retrieved from six databases—CNKI, Wanfang, VIP, PubMed, Web of Science, and ScienceDirect—were used to retrieve relevant studies published between January 1, 1981 and December 20, 2022. The literature quality of studies was assessed, and 20 studies with a total of 108,587 samples were included in the meta-analysis. Results of the meta-analysis showed that the overall prevalence of ILT was 10% (95% confidence interval: 8 –12%) through the random-effects model, which showed high heterogeneity, I2 = 99.4%. Further subgroup analyses showed that the prevalence of ILT decreased over time; furthermore, the prevalence in Northwest China was slightly lower than that in North China and South China, and the prevalence estimated using the diagnostic technique AGP was higher than that reported using other diagnostic techniques.

Conclusions

ILT is prevalent to some extent in mainland China. Given that the ILT attenuated live vaccine has a certain level of virulence and the prevalence differences between regions, we recommend controlling breeding density, improving immunization programs and continuously monitoring viruses and to prevent ILT prevailing in mainland China.
Associations between digital literacy, health literacy, and digital health behaviors among rural residents: evidence from Zhejiang, China
Authors: Ji Hao , Dong Junqiang , Pan Weiguang , Yu Yingying
Published: April 2024

Objective

Within the digital society, the limited proficiency in digital health behaviors among rural residents has emerged as a significant factor intensifying health disparities between urban and rural areas. Addressing this issue, enhancing the digital literacy and health literacy of rural residents stands out as a crucial strategy. This study aims to investigate the relationship between digital literacy, health literacy, and the digital health behaviors of rural residents.

Methods

Initially, we developed measurement instruments aimed at assessing the levels of digital literacy and health literacy among rural residents. Subsequently, leveraging micro survey data, we conducted assessments on the digital literacy and health literacy of 968 residents in five administrative villages in Zhejiang Province, China. Building upon this foundation, we employed Probit and Poisson models to empirically scrutinize the influence of digital literacy, health literacy, and their interaction on the manifestation of digital health behaviors within the rural population. This analysis was conducted from a dual perspective, evaluating the participation of digital health behaviors among rural residents and the diversity to which they participate in such behaviors.

Results

Digital literacy exhibited a notably positive influence on both the participation and diversity of digital health behaviors among rural residents. While health literacy did not emerge as a predictor for the occurrence of digital health behavior, it exerted a substantial positive impact on the diversity of digital health behaviors in the rural population. There were significant interaction effects between digital literacy and health literacy concerning the participation and diversity of digital health behaviors among rural residents. These findings remained robust even after implementing the instrumental variable method to address endogeneity issues. Furthermore, the outcomes of robust analysis and heterogeneity analysis further fortify the steadfastness of the aforementioned conclusions.

Conclusion

The findings suggest that policymakers should implement targeted measures aimed at enhancing digital literacy and health literacy among rural residents. This approach is crucial for improving rural residents' access to digital health services, thereby mitigating urban–rural health inequality.
Liposomes, transfersomes and niosomes: production methods and their applications in the vaccinal field
Authors: Riccardi Domenico , Baldino Lucia , Reverchon Ernesto
Published: April 2024

One of the most effective strategies to fight viruses and handle health diseases is vaccination. Recent studies and current applications are moving on antigen, DNA and RNA-based vaccines to overcome the limitations related to the conventional vaccination strategies, such as low safety, necessity of multiple injection, and side effects. However, due to the instability of pristine antigen, RNA and DNA molecules, the use of nanocarriers is required. Among the different nanocarriers proposed for vaccinal applications, three types of nanovesicles were selected and analysed in this review: liposomes, transfersomes and niosomes. PubMed, Scopus and Google Scholar databases were used for searching recent papers on the most frequently used conventional and innovative methods of production of these nanovesicles. Weaknesses and limitations of conventional methods (i.e., multiple post-processing, solvent residue, batch-mode processes) can be overcome using innovative methods, in particular, the ones assisted by supercritical carbon dioxide. SuperSomes process emerged as a promising production technique of solvent-free nanovesicles, since it can be easily scaled-up, works in continuous-mode, and does not require further post-processing steps to obtain the desired products. As a result of the literature analysis, supercritical carbon dioxide assisted methods attracted a lot of interest for nanovesicles production in the vaccinal field. However, despite their numerous advantages, supercritical processes require further studies for the production of liposomes, transfersomes and niosomes with the aim of reaching well-defined technologies suitable for industrial applications and mass production of vaccines.
Plasma glial fibrillary acidic protein and tau: predictors of neurological outcome after cardiac arrest
Authors: Arctaedius Isabelle , Levin Helena , Thorgeirsdóttir Bergthóra , Moseby-Knappe Marion , Cronberg Tobias , Annborn Martin , Nielsen Niklas , Zetterberg Henrik , Blennow Kaj , Ashton Nicholas J. , Frigyesi Attila , Friberg Hans , Lybeck Anna , Mattsson-Carlgren Niklas
Published: April 2024

Background

The purpose was to evaluate glial fibrillary acidic protein (GFAP) and total-tau in plasma as predictors of poor neurological outcome after out-of-hospital (OHCA) and in-hospital cardiac arrest (IHCA), including comparisons with neurofilament light (NFL) and neuron-specific enolase (NSE).

Methods

Retrospective multicentre observational study of patients admitted to an intensive care unit (ICU) in three hospitals in Sweden 2014–2018. Blood samples were collected at ICU admission, 12 h, and 48 h post-cardiac arrest. Poor neurological outcome was defined as Cerebral Performance Category 3–5 at 2–6 months after cardiac arrest. Plasma samples were retrospectively analysed for GFAP, tau, and NFL. Serum NSE was analysed in clinical care. Prognostic performances were tested with the area under the receiver operating characteristics curve (AUC).

Results

Of the 428 included patients, 328 were OHCA, and 100 were IHCA. At ICU admission, 12 h and 48 h post-cardiac arrest, GFAP predicted neurological outcome after OHCA with AUC (95% CI) 0.76 (0.70–0.82), 0.86 (0.81–0.90) and 0.91 (0.87–0.96), and after IHCA with AUC (95% CI) 0.77 (0.66–0.87), 0.83 (0.74–0.92) and 0.83 (0.71–0.95). At the same time points, tau predicted outcome after OHCA with AUC (95% CI) 0.72 (0.66–0.79), 0.75 (0.69–0.81), and 0.93 (0.89–0.96) and after IHCA with AUC (95% CI) 0.61 (0.49–0.74), 0.68 (0.56–0.79), and 0.77 (0.65–0.90). Adding the change in biomarker levels between time points did not improve predictive accuracy compared to the last time point. In a subset of patients, GFAP at 12 h and 48 h, as well as tau at 48 h, offered similar predictive value as NSE at 48 h (the earliest time point NSE is recommended in guidelines) after both OHCA and IHCA. The predictive performance of NFL was similar or superior to GFAP and tau at all time points after OHCA and IHCA.

Conclusion

GFAP and tau are promising biomarkers for neuroprognostication, with the highest predictive performance at 48 h after OHCA, but not superior to NFL. The predictive ability of GFAP may be sufficiently high for clinical use at 12 h after cardiac arrest.
Associations between cognitive function and lifestyle in community-living older people: a correlational study
Authors: Zarringhadam Maryam , Hasanvand Shirin , Birjandi Mehdi , Beiranvand Afsaneh
Published: April 2024

Background

Previous studies have examined relationship between cognitive function and lifestyle; however, the nature of this relationship is expected to vary in diverse cultural and low-income setting where lifestyle practices differ from those in high-income countries.

Aim

This study aims to investigate the correlation between lifestyle factors and cognitive function among individuals aged 60 years and older in 2021.

Methods

This cross-sectional, Community-based study involved 300 older adults from comprehensive urban health centers in Khorramabad, Iran, selected through stratified cluster sampling. Data were collected using the demographic information questionnaire, Mini-Mental State Examination, and Lifestyle Questionnaire. Data management and analysis were performed using SPSS (version 22) and independent t-tests, Pearson's correlation coefficient, ANOVA, and multiple linear regression analysis were used. A p value < 0.05 was considered significant.

Results

The study included 156 males (52%) and 144 females (48%). Findings revealed a significant correlation between cognitive function and lifestyle (P < 0.001). Multiple linear regression analysis indicated that physical health, environmental health, exercise, accident prevention, and avoidance of medication exerted the most significant positive effect on cognitive function. Conversely, social health exhibited a notable negative influence on cognitive function. (P < 0.001).

Conclusion

The results suggest that specific aspects of lifestyle, such as physical health, accident prevention, and avoidance of medication are associated with cognitive function in older adults. Consequently, lifestyle promotion programs may enhance cognitive function and improve the quality of life among older adults.
Essential right heart physiology for the perioperative practitioner POQI IX: current perspectives on the right heart in the perioperative period
Authors: McEvoy Matthew D. , Heerdt Paul M. , Morton Vicki , Bartz Raquel R. , Miller Timothy E. ,   POQI IX Collaborators, Ibekwe Stephanie , Deschamps Jean , Grocott Michael , Liang Yafen , Perry Tjorvi , Shaw Andrew , Arora Rakesh , Brown Jessica , Tong Mike , Chatterjee Subha , Gan T. J. , Singh Gurmeet
Published: April 2024

As patients continue to live longer from diseases that predispose them to right ventricular (RV) dysfunction or failure, many more patients will require surgery for acute or chronic health issues. Because RV dysfunction results in significant perioperative morbidity if not adequately assessed or managed, understanding appropriate assessment and treatments is important in preventing subsequent morbidity and mortality in the perioperative period. In light of the epidemiology of right heart disease, a working knowledge of right heart anatomy and physiology and an understanding of the implications of right-sided heart function for perioperative care are essential for perioperative practitioners. However, a significant knowledge gap exists concerning this topic. This manuscript is one part of a collection of papers from the PeriOperative Quality Initiative (POQI) IX Conference focusing on “Current Perspectives on the Right Heart in the Perioperative Period.” This review aims to provide perioperative clinicians with an essential understanding of right heart physiology by answering five key questions on this topic and providing an explanation of seven fundamental concepts concerning right heart physiology.
The direct and indirect effects of the COVID-19 pandemic on the mental health of confined youth
Authors: Liu Lin
Published: April 2024

The COVID-19 pandemic posed an unprecedented threat to the mental health of youth due to its attendant, drastic changes in everyday life brought about by restrictions such as social distancing and the cancelation of in-person classes. Although numerous articles have discussed the impact of the pandemic on youths’ mental health, most of them have been opinion pieces. This study used state-wide empirical data to quantify the direct and indirect effect of the pandemic on the mental health of confined youth, a vulnerable social group that is rarely represented in school survey data. Group comparisons of youth who entered juvenile justice facilities during pandemic and non-pandemic times were also conducted. Findings revealed that youth who entered residential facilities during the pandemic due to criminal offenses had higher rates of prior mental health problems and victimization. With major confounders controlled, multivariate regression results showed that the impact of the pandemic on confined youths’ mental health is indirect: it conditioned the effect of underage drinking on the youths’ mental health. Youth who were admitted into facilities during the pandemic were more likely to experience mental health problems than their peers who entered facilities during non-pandemic times. Implications for policymaking are discussed.
Two cases of gastric cancer with elevated serum levels of KL-6
Authors: Yanagisawa Naoe , Koide Naohiko , Fukai Harunari , Koyama Yoshinori , Ogihara Yuu , Ohya Maki
Published: April 2024

Background

The serum level of Krebs von den Lungen-6 (sKL-6) is a biomarker of interstitial pneumonia and has been reported to be elevated in patients with cancers. However, there have been few cases of gastric cancer (GC) with elevated sKL-6 that were treated by chemotherapy. We herein report two cases of GC with elevated sKL-6 that were treated with oxaliplatin plus S-1 (SOX) chemotherapy and discussed the resulting changes in sKL-6.

Case presentation

The first patient was a 79-year-old woman complaining of loss of appetite. Esophagogastroduodenoscopy (EGD) showed a type-3 tumor in the gastric antrum and biopsy specimens showed adenocarcinoma. Computed tomography (CT) showed multiple liver metastases. sKL-6 was elevated to 1,292 U/ml, but a CT revealed no obvious lesions of the lungs, including interstitial pneumonia. The tumor was diagnosed as GC with liver metastases and elevated sKL-6. Respiratory function data were normal. SOX therapy using oxaliplatin and S-1 was performed. After 3 courses of SOX therapy, CT showed reductions of the liver metastases as well as the primary tumor, and sKL-6 was decreased to 201 U/ml. After the 44 courses, sKL-6 was slightly elevated. Chest CT showed interstitial pneumonia and chemotherapy was stopped. The patient is still alive without any metastasis 72 months later. The second patient was a 69-year-old woman complaining of upper abdominal pain. EGD revealed a type-3 tumor in the gastric antrum showing adenocarcinoma with HER2-positive pathology. CT showed multiple node metastases around the abdominal aorta. sKL-6 was elevated to 2,239 U/ml, but a respiratory function test showed no abnormalities, and CT of the lungs showed no obvious lesions. The tumor was diagnosed as GC with distant node metastases and elevated sKL-6. The patient received SOX therapy combined with trastuzumab. After 6 courses, the size of the primary tumor and multiple node metastases were reduced, and sKL-6 was decreased to 284 U/ml.

Conclusions

These two cases suggest that sKL-6 may be important not only as an indicator of interstitial pneumonia in chemotherapeutic courses, but also as a tumor marker in GC patients with multiple metastases.
Exploring the effects of fitbit incentive on treatment outcomes in veterans undergoing intensive pain rehabilitation program
Authors: Toor Tiffany , Palyo Sarah , Schopmeyer Kathryn , Simmons Alan N. , Strigo Irina A.
Published: April 2024

Objective

This study compares clinical pain outcomes between patients in a pain treatment program that received a Fitbit, to patients that did not. We also explored: (1) cognitive, emotional, and psychological factors that may have impacted the decision to opt in to receiving a Fitbit; and (2) whether the choice to receive a Fitbit impacted changes in cognitive, emotional, and psychological factors following treatment.

Methods

Among 58 patients in a multidisciplinary pain treatment program at a Veterans Affairs Healthcare System hospital, 31 patients opted to receive a Fitbit as adjunct treatment, while 27 did not. This study utilized patient-reported and practitioner-collected data from the pain treatment program.

Results

Compared to the non-Fitbit group, the Fitbit group displayed a significant decrease in average pain intensity, however showed no correlation between Fitbit activity and average pain intensity. Additionally, treatment satisfaction was the only predictor of treatment group, when modeling pre- and post-treatment outcomes changes.

Conclusion

The implementation of a Fitbit may lead to improved pain intensity. Initial evidence suggests that opting to receive a Fitbit during a pain treatment program indicates treatment engagement leading to greater treatment satisfaction. Future work is needed to verify and expand upon this potential mechanism.