bluuebunny/crossref_metadata_2025 huggingface dataset:
Lung function in young adulthood in relation to moderate-to-late preterm birth
Authors: Lundberg Björn , Merid Simon Kebede , Um-Bergström Petra , Wang Gang , Bergström Anna , Ekström Sandra , Kull Inger , Melén Erik , Hallberg Jenny
Published: December 2023

Background

Moderate-to-late preterm birth (32 to <37 weeks of gestation) has been associated with impaired lung function in adolescence, but data in adulthood and physiological phenotyping beyond spirometry are scarce. We aimed to investigate lung function development from adolescence into young adulthood and to provide physiological phenotyping in individuals born moderate-to-late preterm.

Methods

Lung function data from individuals born moderate-to-late preterm (n=110) and term (37 to <42 weeks of gestation, n=1895) in the Swedish birth cohort BAMSE were used for analysis and included dynamic spirometry, fractional exhaled nitric oxide and multiple breath nitrogen wash-out. Data from 16- and 24-year follow-ups were analysed using regression models stratified on sex and adjusted for smoking. Data-driven latent class analysis was used to phenotype moderate-to-late preterm individuals at 24 years, and groups were related to background factors.

Results

Males born moderate-to-late preterm had lower forced expiratory volume in 1 s (FEV1) at 24 years of age (−0.28 z-score, p=0.045), compared to males born term. In females, no difference was seen at 24 years, partly explained by a significant catch up in FEV1between 16 and 24 years (0.18 z-score, p=0.01). Lung function phenotypes described as “asthma-like”, “dysanapsis-like” and “preterm reference” were identified within the preterm group. Maternal overweight in early pregnancy was associated with “asthma-like” group membership (OR 3.59, p=0.02).

Conclusion

Our results show impaired FEV1at peak lung function in males born moderate-to-late preterm, while females born moderate-to-late preterm had significant catch up between the ages of 16 and 24 years. Several phenotypes of lung function impairment exist in individuals born moderate-to-late preterm.
Clinical relevance of lung function trajectory clusters in middle-aged and older adults
Authors: Bertels Xander , Ross James C. , Faner Rosa , Cho Michael H. , Ikram M. Arfan , Brusselle Guy G. , Lahousse Lies
Published: December 2023

Background

The determinants and health outcomes of lung function trajectories in adults among the general population are poorly understood. We aimed to identify and characterise clusters of lung function trajectories in adults aged ≥45 years.

Methods

Gaussian finite-mixture modelling was applied to baseline and annualised change of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio z-scores in participants of the Rotterdam Study, a prospective population-based cohort study, with repeated spirometry (n=3884; mean±sdage 64.7±8.9 years). Longitudinal outcomes were all-cause mortality, respiratory outcomes (symptoms, COPD (FEV1/FVC <0.7 in absence of asthma), preserved ratio impaired spirometry (PRISm; FEV1/FVC ≥0.7 and FEV1or FVC <80%)), smoking cessation and weight changes. Independent risk factors, including genetics, were identified by multiple logistic regression.

Results

We identified eight trajectory clusters, with the reference group having persistently normal spirometry (prevalence 42.8%). Three clusters showed higher mortality, adjusted for confounders: 1) the persistently low FEV1cluster (prevalence 6.8%, hazard ratio (HR) 1.71, 95% CI 1.37–2.13); 2) rapid FEV1decliners (prevalence 4.6%, HR 1.48, 95% CI 1.10–1.99); and 3) FVC decliners (prevalence 3.7%, HR 1.49, 95% CI 1.09–2.03). In contrast, FVC improvers (prevalence 6.7%, HR 0.61, 95% CI 0.41–0.90) and persistently high FEV1(prevalence 29.2%, HR 0.82, 95% CI 0.69–0.98) were protective trajectory clusters. Clusters were characterised by differences in genetic predisposition (polygenic scores of FEV1and FEV1/FVC), demographics, cigarette smoking, respiratory symptoms (chronic cough, wheezing and dyspnoea), cardiovascular factors (body mass index, hypertension and heart failure) and serum C-reactive protein levels. Frailty, weight changes and the development of respiratory symptoms, COPD and PRISm were significantly associated with trajectory clusters.

Conclusions

This study reveals clinically relevant lung function trajectory clusters in older adults of the general population.
A review on selenium and gold nanoparticles combined photodynamic and photothermal prostate cancer tumors ablation
Authors: Omiyale Olumakinde Charles , Musa Mariama , Otuyalo Adewunmi Ifeoluwa , Gbayisomore Tolulope Judah , Onikeku Damilola Zainab , George Solomon Damilare , Popoola Possible Okikiola , Olofin Olabimpe Oluwatoyin , Umunnam Kelechi Franklin , Nneji Patricia Okwuchi , Adnan Musa , Ogunjobi Taiwo Temitope
Published: December 2023

The acceptance of nanoparticle technology in the quest for cancer treatment is due to its many potentials and possibilities of filling in the gaps in the limitations of the current treatment modalities. Insights into the possibilities of getting even more from this technology, as well as the synergistic properties of photothermal therapy (PTT) and photodynamic therapy (PDT)—the use of reactive oxygen species (ROS)—can also be exploited in the ablation of prostate cancer tumors. Therefore, the combination of gold and selenium photoactive nanoparticles as platforms for drug delivery via PTT/PDT in prostate cancer therapy, with a specific emphasis on the 'micro-carrier' based approach, was discussed and explored in this review under relevant subtopics ranging from understanding the complex chemistry and biology of the pharmacologically active Se/Au-containing agents to giving a thorough knowledge of these therapeutic agents' potential as a targeted and successful treatment strategy for prostate cancer by investigating the complex mechanisms behind their delivery, activation, and synergistic effects. Furthermore, this article presents a comprehensive overview of the current research environment, problems encountered, and future perspectives in the continuous war against prostate cancer.
Attention-based neural networks for clinical prediction modelling on electronic health records
Authors: Fridgeirsson Egill A. , Sontag David , Rijnbeek Peter
Published: December 2023

Background

Deep learning models have had a lot of success in various fields. However, on structured data they have struggled. Here we apply four state-of-the-art supervised deep learning models using the attention mechanism and compare against logistic regression and XGBoost using discrimination, calibration and clinical utility.

Methods

We develop the models using a general practitioners database. We implement a recurrent neural network, a transformer with and without reverse distillation and a graph neural network. We measure discrimination using the area under the receiver operating characteristic curve (AUC) and the area under the precision recall curve (AUPRC). We assess smooth calibration using restricted cubic splines and clinical utility with decision curve analysis.

Results

Our results show that deep learning approaches can improve discrimination up to 2.5% points AUC and 7.4% points AUPRC. However, on average the baselines are competitive. Most models are similarly calibrated as the baselines except for the graph neural network. The transformer using reverse distillation shows the best performance in clinical utility on two out of three prediction problems over most of the prediction thresholds.

Conclusion

In this study, we evaluated various approaches in supervised learning using neural networks and attention. Here we do a rigorous comparison, not only looking at discrimination but also calibration and clinical utility. There is value in using deep learning models on electronic health record data since it can improve discrimination and clinical utility while providing good calibration. However, good baseline methods are still competitive.
Trigeminal neuralgia caused by a persistent primitive trigeminal artery variant passing through Meckel’s cavity: a case report
Authors: Zhu Zhengyan , Zhang Zhenpan , Liang Risheng
Published: December 2023

Background

Persistent primitive trigeminal artery variant (PPTAv) is a rare remnant of the primitive intracranial embryonic anastomotic arteries, and its persistence has an unknown etiology. Trigeminal neuralgia attributed to a PPTAv passing through Meckel’s cavity is extremely uncommon.

Case presentation

A 73-year-old woman presented with right-sided facial pain for 10 years that had failed to respond to medication. Magnetic resonance angiography suggested the presence of a PPTAv compressing the trigeminal nerve, as the abnormal artery originated from the right internal carotid artery. During microvascular decompression (MVD), the offending vessel was inferred to be a PPTAv, as it continued to become the anterior inferior cerebellar artery after passing through Meckel’s cavity. Postoperative computed tomography angiography showed the PPTAv continuing posteriorly as the anterior inferior cerebellar artery and supplying the cerebellar hemisphere, which confirmed the intraoperative judgment. The pain resolved after MVD and has not recurred in 12 months of follow-up.

Conclusion

MVD is the best surgical choice for trigeminal neuralgia combined with a PPTAv. For patients with neurovascular conflicts, particularly those with suspected vascular variations, preoperative imaging examinations play a critical role in meticulously evaluating the anatomical locations of the nerves and blood vessels. Semilunar puncture (for radiofrequency ablation or percutaneous balloon compression) is contraindicated in patients with a PPTAv.
How co-locating public mental health interventions in community settings impacts mental health and health inequalities: a multi-site realist evaluation
Authors: Baskin Cleo , Duncan Fiona , Adams Emma A. , Oliver Emily J. , Samuel Gillian , Gnani Shamini
Published: December 2023

Background

Public mental health interventions are non-clinical services that aim to promote wellbeing and prevent mental ill health at the population level. In England, the health, social and community system is characterised by complex and fragmented inter-sectoral relationships. To overcome this, there has been an expansion in co-locating public mental health services within clinical settings, the focus of prior research. This study evaluates how co-location in community-based settings can support adult mental health and reduce health inequalities.

Methods

A qualitative multi-site case study design using a realist evaluation approach was employed. Data collection took place in three phases: theory gleaning, parallel testing and refining of theories, and theory consolidation. We collected data from service users (n = 32), service providers (n = 32), funders, commissioners, and policy makers (n = 11), and members of the public (n = 10). We conducted in-depth interviews (n = 65) and four focus group discussions (n = 20) at six case study sites across England, UK, and two online multi-stakeholder workshops (n = 20). Interview guides followed realist-informed open-ended questions, adapted for each phase. The realist analysis used an iterative, inductive, and deductive data analysis approach to identify the underlying mechanisms for how community co-location affects public mental health outcomes, who this works best for, and understand the contexts in which co-location operates.

Results

Five overarching co-location theories were elicited and supported. Co-located services: (1) improved provision of holistic and person-centred support; (2) reduced stigma by creating non-judgemental environments that were not associated with clinical or mental health services; (3) delivered services in psychologically safe environments by creating a culture of empathy, friendliness and trust where people felt they were being treated with dignity and respect; (4) helped to overcome barriers to accessibility by making service access less costly and more time efficient, and (5) enhance the sustainability of services through better pooling of resources.

Conclusion

Co-locating public mental health services within communities impacts multiple social determinants of poor mental health. It has a role in reducing mental health inequalities by helping those least likely to access services. Operating practices that engender inter-service trust and resource-sharing are likely to support sustainability.
Individual and community level factors associated with modern contraceptive utilization among married women in the emerging region of Ethiopia: a multilevel mixed effects analysis of the 2019 Ethiopia Mini-Demographic and health survey
Authors: Kebede Natnael , Kefale Bereket , Yigezu Muluken , Bogale Eyob Ketema , Zewdie Amare , Wasihun Yitbarek , Adane Metadel
Published: December 2023

Background

A demonstrated technique to enhance reproductive health and economic progress is through ensuring that family planning services are accessible universally. Those studies that used Ethiopia Demographic and Health Survey (EDHS) data did not assess individual and community-level factors in contraceptive utilization. Thus, the study employs a multilevel mixed effects analysis approach, which allows for the examination of individual and community-level factors that influence contraceptive utilization.

Methods

This study analyzed the 2019 Ethiopia Min Demographic and Health Survey datasets. A total of 1916 married women in the 2019 surveys were included in the analysis. The data were analyzed using Stata version 17.0. The data were analyzed using Multi-level mixed-effect logistic regression to identify the individual and community-level factors associated with modern contraceptive utilization. An adjusted odds ratio with a 95% confidence interval was used to.

Show the strength and direction of the association and statistical significance was declared at a P value less than 0.05.

Results

Factors significantly associated with modern contraceptive utilization were; Muslim and protestant followers [AOR = 0.31, 95% CI: (0.134, 0.714)] and [AOR = 0.35, 95% CI: (0.173, 0.691)] respectively, women with no education (OR = 0.46; 95% CI: 0.293, 0.710), those women who belong to the poor and middle wealth of household [AOR = 0.35, 95% CI: (0.237, 0.527)] and [AOR = 0.56, 95% CI: (0.347, 0.919)] respectively, women who had one to five and greater than or equal to six living children [AOR = 11.36, 95% CI:(2.119, 60.918)] and [AOR = 7.44, 95% CI:(1.437, 38.547)]respectively, Women in clusters poor wealth status [AOR = 0.40, 95% CI: (0.183, 0.875)] and women who belong to the Somali region [AOR = 0.20, 95% CI: (0.0.070, 0.506)].

Conclusion

The study revealed that both individual and community-level factors determined modern contraceptive utilization. At the individual level, the religion of women, educational status, the wealth of the household, and the total number of living children were significantly associated with modern contraceptive utilization. At community-level factors, community wealth status and belonging to the Somali region were significantly associated with modern contraceptive utilization. The findings suggest that interventions aimed at increasing modern contraceptive utilization should target women with lower levels of education, those living in households with lower wealth, and those with larger families. Additionally, efforts should be made to improve access to modern contraceptives in communities with lower wealth status and in regions where traditional beliefs may hinder their use.
Lost in the loop - a qualitative study on patient experiences of care in standardized cancer patient pathways
Authors: Solberg Monica , Berg Geir Vegard , Andreassen Hege Kristin
Published: December 2023

Background

The Norwegian health authorities introduced standardized cancer patient pathways (CPPs) in 2015, aiming to reduce practice variations across hospitals and regions, and improve the continuity, coordination and overall quality of the health care service provided to cancer patients. There has been few studies investigating this change, and that have looked into the organisational and economic benefits of standardized pathways, however the element of care and the patient perspective has been especially neglected. This study explored the care element in cancer patient pathways through an in-depth study of patient experiences.

Methods

The patients were enrolled approximately three years after the introduction of standardized CPPs in Norway. Through a qualitative design with in-depth interviews, a total of 21 interviews were conducted with seven patients between 2018 and 2020. The first interview took place after the diagnosis was established and before treatment, the second interview during treatment, and the final interview approximately one year after the completion of active treatment. The empirical catchment area was eastern Norway. Data were analysed using a theoretical thematic analysis.

Results

This study sheds light on the complex challenges patients’ faces, while navigating CPPs, including the need for better transition support, improved coordination and continuity in care, and a more holistic approach that encompasses emotional well-being and family support. Three overarching themes were identified: [1] Navigating CPPs: patient care and transition challenges, [2] Fragmented cancer care: challenges in coordination and continuity [3] Unmet needs and overlooked opportunities in CPPs.

Conclusions

Patients experience that cancer patient pathways offer good medical treatment, but that the care element deserves more attention. Current CPPs are trapped in a logic of choice, preventing room for the element of care to receive the attention it requires for the patient to truly experience holistic person-centred care and continuous, well-coordinated services. Based in our study we argue there is a need to look into the missed opportunities for using the CPPs as points of departure for more holistic collaborative models for cancer care.
Tumor-targeting hydroxyapatite nanoparticles for remodeling tumor immune microenvironment (TIME) by activating mitoDNA-pyroptosis pathway in cancer
Authors: Yang Yuxuan , Yang Jia , Zhu Nan , Qiu Haosen , Feng Wenxiang , Chen Ying , Chen Xinhua , Chen Yuehong , Zheng Wenbo , Liang Min , Lin Tian , Yu Jiang , Guo Zhaoze
Published: December 2023

In recent years, immunotherapy has emerged as a promising strategy for treating solid tumors, although its efficacy remains limited to a subset of patients. Transforming non-responsive “cold” tumor types into immuno-responsive “hot” ones is critical to enhance the efficacy of immune-based cancer treatments. Pyroptosis, a programmed cell death mechanism, not only effectively eliminates tumor cells but also triggers a potent inflammatory response to initiate anti-tumor immune activities. This sheds light on the potential of pyroptosis to sensitize tumors to immune therapy. Hence, it is urgent to explore and develop novel treatments (e.g., nanomedicines) which are capable of inducing pyroptosis. In this study, we constructed tumor-targeting nanoparticles (CS-HAP@ATO NPs) by loading atorvastatin (ATO) onto chondroitin sulfate (CS) modified hydroxyapatite (HAP) nanoparticles (CS-HAP). CS was strategically employed to target tumor cells, while HAP exhibited the capacity to release calcium ions (Ca2+) in response to the tumor microenvironment. Moreover, ATO disrupted the mitochondrial function, leading to intracellular energy depletion and consequential changes in mitochondrial membrane permeability, followed by the influx of Ca2+ into the cytoplasm and mitochondria. CS and HAP synergetically augmented mitochondrial calcium overload, inciting the production of substantial amount of reactive oxygen species (ROS) and the subsequent liberation of oxidized mitochondrial DNA (OX-mitoDNA). This intricate activation process promoted the assembly of inflammasomes, most notably the NLRP3 inflammasome, followed by triggering caspase-1 activation. The activated caspase-1 was able to induce gasderminD (GSDMD) protein cleavage and present the GSDM-N domain, which interacted with phospholipids in the cell membrane. Then, the cell membrane permeability was raised, cellular swelling was observed, and abundant cell contents and inflammatory mediators were released. Ultimately, this orchestrated sequence of events served to enhance the anti-tumor immunoresponse within the organism.
Effectiveness of a digital rehabilitation program based on computer vision and augmented reality for isolated meniscus injury: protocol for a prospective randomized controlled trial
Authors: Wang Li , Chen Xi , Deng Qian , You MingKe , Xu Yang , Liu Di , Lin Ye , Li PengCheng , Li Jian
Published: December 2023

Background

The lack of access to physical therapists in developing countries and rural areas poses a significant challenge in supervising postsurgical rehabilitation, potentially impeding desirable outcomes following surgical interventions. For this reason, this study aims to evaluate the feasibility, safety, and effectiveness of utilizing a digital rehabilitation program based on computer vision and augmented reality in comparison with traditional care for patients who will undergo isolated meniscus repair, since to date, there is no literature on this topic.

Methods

This study intends to enroll two groups of participants, each to be provided with informed consent before undergoing randomization into either the experimental or control group. The experimental group will undergo a digital rehabilitation program utilizing computer vision and augmented reality (AR) technology following their surgical procedure, while the control group will receive conventional care, involving in-clinic physical therapy sessions weekly. Both groups will adhere to a standardized rehabilitation protocol over a six-month duration. Follow-up assessments will be conducted at various intervals, including preoperatively, and at 2 weeks, 6 weeks, 12 weeks, and 24 weeks postoperatively. Imaging assessments and return-to-play evaluations will be conducted during the final follow-up. Clinical functionality will be assessed based on improvements in International Knee Documentation Committee (IKDC) and Visual Analog Scale (VAS) scores.

Registration number

ChiCTR2300070582.
The impact of land cover change on the carbon stock of moist afromontane forests in the Majang Forest Biosphere Reserve
Authors: Tadese Semegnew , Soromessa Teshome , Aneseye Abreham Berta , Gebeyehu Getaneh , Noszczyk Tomasz , Kindu Mengistie
Published: December 2023

Backgorund

Forest plays an important role in the global carbon cycle by sequestering carbon dioxide and thereby mitigating climate change. In this study, an attempt was made to investigate the effects of land use/land cover (LULC) change (1989–2017) on carbon stock and its economic values in tropical moist Afromontane forests of the Majang Forest Biosphere Reserve (MFBR), south-west Ethiopia. Systematic sampling was conducted to collect biomass and soil data from 140 plots in MFBR. The soil data were collected from grassland and farmland. InVEST modelling was employed to investigate the spatial and temporal distribution of carbon stocks. Global Voluntary Market Price (GVMP) and Tropical Economics of Ecosystems and Biodiversity (TEEB) analysis was performed to estimate economic values (EV) of carbon stock dynamics. Correlation and regression analyses were also employed to identify the relationship between environmental and anthropogenic impacts on carbon stocks.

Results

The results indicated that the above-ground carbon and soil organic carbon stocks were higher than the other remaining carbon pools in MFBR. The mean carbon stock (32.59 M tonne) in 2017 was lower than in 1989 (34.76 Mt) of MFBR. Similarly, the EV of carbon stock in 2017 was lower than in 1989. Elevation, slope, and harvesting index are important environmental and disturbance factors resulting in major differences in carbon stock among study sites in MFBR.

Conclusions

Therefore, the gradual reduction of carbon stocks in connection with LULC change calls for urgent attention to implement successful conservation and sustainable use of forest resources in biosphere reserves.
Development and validation of chemometric-assisted spectrophotometric models for efficient quantitation of a binary mixture of supportive treatments in COVID-19 in the presence of its toxic impurities: a comparative study for eco-friendly assessment
Authors: Abd El-Hadi Heidi R. , Eissa Maya S. , Zaazaa Hala E. , Eltanany Basma M.
Published: December 2023

The use of sustainable solvents has increased significantly in recent years due to advancements in green analytical methods. The number of impurities in the drug substance determines how safe the finished product is. Therefore, during the whole medication planning process, contaminants need to be closely watched. Using chemometric models, the concentrations of hyoscine N-butyl bromide (HYO) and paracetamol (PAR) were determined in the presence of three PAR impurities [P-nitrophenol (PNP), P-aminophenol (PAP), and P-chloroacetanilide (PCA), as well as DL-tropic acid (TRO) as a HYO impurity]. It was possible to isolate and measure these dangerous impurities. Fever and spasms associated with COVID-19 are reported to be considerably reduced when PAR and HYO are taken together. Artificial neural networks, principal component regression, multivariate curve resolution-alternating least squares, and partial least squares are the four chemometric-assisted spectrophotometric models that were created and verified. All of the proposed methods’ quantitative analytical potency was assessed using recoveries%, root mean square error of prediction, and standard error of prediction. For PAR, HYO, PNP, PCA, TRO, and PAP, respectively, the indicated approaches were used in the ranges of 4.00–8.00, 16.00–24.00, 1.00–5.00, 0.40–0.80, 4.00–12.00, and 2.00–6.00 µg/mL. They are able to get around difficulties like collinearity and spectral overlaps. After statistical testing, there was no discernible difference between the recommended methods and the published one. The degree of greenness of the established models was evaluated using three different green assessment methods. In the presence of their harmful impurities, PAR and HYO could be identified using the recommended methods.
Novel analytical method based on chemometric models applied to UV–Vis spectrophotometric data for simultaneous determination of Etoricoxib and Paracetamol in presence of Paracetamol impurities
Authors: Rahman Mona A. Abdel , Elghobashy Mohamed R. , Zaazaa Hala E. , El-Mosallamy Sally S.
Published: December 2023

The multivariate models that are used for spectral data analysis have many beneficial applications, and one of the important applications is the analysis of drugs and their impurities. Three Chemometrically-assisted spectrophotometric models have been proposed and validated. The proposed models are Partial Least Squares (PLS), Artificial Neural Networks (ANN), and Multivariate Curve Resolution-Alternating Least Squares (MCR-ALS). The advanced chemometric models were applied to resolve the significantly overlapping spectra of Etoricoxib (ETO) and Paracetamol (PCM), along with impurities of PCM namely; P-aminophenol (PAP) and P-hydroxy acetophenone (PHA). The proposed models succeeded in simultaneously analyzing the mixture of ETO and PCM along with the impurities of PCM. So, the proposed techniques can be used without requiring a separation step in the analysis of pharmaceutical formulation. Moreover, no significant differences were found when the results of the suggested and published chemometric models were compared statistically with the reported HPLC method.
Efficient delivery of the lncRNA LEF1-AS1 through the antibody LAIR-1 (CD305)-modified Zn-Adenine targets articular inflammation to enhance the treatment of rheumatoid arthritis
Authors: Zhang Xiaonan , He Xiaoyu , Zhang Ming , Wu Tianyu , Liu Xiaojie , Zhang Yan , Xie Zhuobei , Liu Saisai , Xia Tian , Wang Yuanyuan , Wei Fang , Wang Hongtao , Xie Changhao
Published: December 2023

Backgrounds

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by synovial hyperplasia. Maintaining a balance between the proliferation and apoptosis of rheumatoid arthritis synovial fibroblasts (RASFs) is crucial for preventing the erosion of bone and cartilage and, ultimately, mitigating the progression of RA. We found that the lncRNA LEF1-AS1 was expressed at low levels in the RASFs and inhibited their abnormal proliferation by targeting PIK3R2 protein and regulating the PI3K/AKT signal pathway through its interaction with miR-30-5p. In this study, we fabricated a nano-drug delivery system for LEF1-AS1 using Zn-Adenine nanoparticles (NPs) as a novel therapeutic strategy against RA.

Methods

The expression levels of LEF1-AS1, miR-30-5p, PIK3R2, p-PI3K, and p-AKT were detected in the primary RASFs and a human fibroblast-like synovial cell line (HFLS). Zn-Adenine nanoparticles (NPs) were functionalized with anti-CD305 antibody to construct (Zn-Adenine)@Ab. These NPs were then loaded with LEF1-AS1 to form (Zn-Adenine)@Ab@lncRNA LEF1-AS1. Finally, the (Zn-Adenine)@Ab@lncRNA LEF1-AS1 NPs were locally injected into a rat model with collagen-induced arthritis (CIA). The arthritic injuries in each group were evaluated by HE staining and other methods.

Results

LEF1-AS1 was expressed at low levels in the primary RASFs. High expression levels of LEF1-AS1 were detected in the HFLS cells, which corresponded to a significant downregulation of miR-30-5p. In addition, the expression level of PIK3R2 was significantly increased, and that of p-PI3K and p-AKT were significantly downregulated in these cells. The (Zn-Adenine)@Ab@lncRNA LEF1-AS1 NPs significantly inhibited the proliferation of RASFs and decreased the production of inflammatory cytokines (IL-1β, IL-6, TNF-α). Intra-articular injection (IAI) of (Zn-Adenine)@Ab@lncRNA LEF1-AS1 NPs significantly alleviated cartilage destruction and joint injury in the CIA-modeled rats.

Conclusions

LEF1-AS1 interacts with miR-30-5p to inhibit the abnormal proliferation of RASFs by regulating the PI3K/AKT signal pathway. The (Zn-Adenine)@Ab NPs achieved targeted delivery of the loaded LEF1-AS1 into the RASFs, which improved the cellular internalization rate and therapeutic effects. Thus, LEF1-AS1 is a potential target for the treatment of RA.
Silver nanoparticles synthesized by probiotic bacteria and antibacterial role in resistant bacteria
Authors: Khalifa Eman , Abdel Rafea Mohamed , Mustapha Nazir , Sultan Rania , Hafez ElSayed
Published: December 2023

Many dangerous bacteria have become highly resistant to traditional antibiotics, which is a huge public health concern. This study investigated the use of silver nanoparticles biosynthesized in a culture filtrate of Lactobacillus acidophilus as antimicrobials. UV–visual spectrophotometry, Fourier-transform-infrared spectroscopy, X-ray power diffraction, and scanning electron microscopy have all validated the findings. The biosynthesized nanoparticles ranged in size from 33 to 90 nm. The cytotoxicity of the nanosilver generated was then investigated using nine 200 g BW rats separated into three groups. When compared to the control group, the treated rats showed little signs of toxicity; parameters of physiological function, including alanine transaminase, aspartate aminotransferase, albumin, creatinine, and urea were significantly different in treated and non-treated animals. Moreover, the antibacterial role of the generated silver nanoparticles was examined in multi-drug resistant (MDR) pathogenic bacteria, Proteus vulgaris, Escherichia coli, Staphylococcus aureus, and Klebsiella pneumoniae, revealing high antibacterial activity against the examined bacteria. For more demonstration of the effect of the nanosilver on transcription and gene regulation of treated and non-treated bacteria differential display droplet digital-PCR was used, and the results revealed that several genes were up- and down-regulated. Some genes were selected for DNA sequencing and according to the sequence analysis, these genes were mecA, beta-lactam, and unidentified protein genes, and these have been deposited in the GenBank Database with the following accession numbers: Staphylococcus MZ748472 and Klebsiella MZ748473. We conclude that silver nanoparticles biosynthesized by L. acidophilus are environmentally friendly and have antibacterial activities against MDR pathogenic bacteria.
The public’s intention to vote for continued use of woody biomass for energy in Denmark: a cognitive hierarchy perspective
Authors: Ugarte Lucas Paula , Lund Thomas Bøker , Gamborg Christian
Published: December 2023

Background

To be socially robust, renewable energy policies aiming at achieving a low-carbon society require public support. Woody biomass is an important renewable energy source. It accounts for a large share of the renewable energy consumption in several EU countries. However, its sustainability credentials are contested. Little is known as yet about how the public perceives woody biomass. This paper aims to examine the public’s intention to vote for continued use of woody biomass, and to find out whether this voting intention can be explained using the cognitive hierarchy model. This model posits that values, attitudes and beliefs predict higher order cognitions like intention. We extend the model by including an additional variable (perceived benefit). Although the model is widely used in connection with natural resource management issues, it has not yet been applied to the case of increasingly contested energy sources like woody biomass. We use Denmark as a case study given that woody biomass makes up the largest share of the renewable energy mix in the country.

Results

Results of a nationwide questionnaire-based survey of the general public show that a large proportion of Danes are undecided about their attitudes towards, and their intention to vote for, woody biomass. Structural equation modeling results show that belief in the mitigation potential of woody biomass has a significant positive effect on both attitudes and voting intention. Altruistic and egoistic values have a significant positive effect on attitudes, which in turn have a significant positive influence on voting intention. We also confirm the mediating role of attitudes.

Conclusions

Understanding public opinion-making processes can help to promote environmental decision-making that takes due account of public perceptions of the ways in which energy transitions come about. The cognitive hierarchy model is an apt framework with which to predict voting intention in the context of contested energy sources.
‘Helper’ or ‘punisher’? A qualitative study exploring staff experiences of treating severe and complex eating disorder presentations in inpatient settings
Authors: Bommen Sienna , Nicholls Helen , Billings Jo
Published: December 2023

Background

Eating disorders have been described as challenging to treat, with the most severe cases requiring inpatient admission. Previous studies have explored staff’s perspectives on eating disorders and service provision. However, little is currently known about how staff experience working with severe and complex eating disorder presentations in inpatient settings and how they may be impacted by their work.

Aims

This study aimed to explore the experiences of staff who contribute towards the treatment of severe and complex eating disorder presentations in inpatient settings.

Methods

Participants were recruited purposively via clinical contacts and a private hospital group in the UK. Semi-structured interviews were conducted, recorded, transcribed verbatim, and analysed guided by the principles of reflexive thematic analysis.

Results

Interviews were completed with twelve staff members, including frontline nursing staff and multidisciplinary team (MDT) staff, from both private and public specialist settings. Participants expressed uncertainty about the treatment approach for service-users with severe and complex presentations. As service-users often resisted treatment, participants felt positioned as a ‘punisher’ rather than a ‘helper’ in initial treatment stages. Many had experienced physically and emotionally impactful events at work, including violence and aggression, as well as serious incidents of self-harm and suicide attempts. Participants generally found support in their colleagues, however considered organisational support insufficient.

Conclusions

This research highlights an urgent need to consider the wellbeing of staff who works in eating disorder inpatient settings, as well as their support needs. Retention and recruitment strategies should be reviewed to reduce staff turnover and improve patient care. Further research should investigate whether specialist inpatient staff are impacted by symptoms of vicarious or direct trauma, moral injury and compassion fatigue.
The effects of cognitive behavioral therapy on health-related quality of life, anxiety, depression, illness perception, and in atrial fibrillation patients: a six-month longitudinal study
Authors: Minjie Zheng , Zhijuan Xie , Xinxin Shi , Xinzhu Bai , Shan Qu
Published: December 2023

Background

Atrial fibrillation (AF) often leads to an impaired Health-Related Quality of Life (HRQoL) in many patients. Moreover, psychological factors such as depression, anxiety, and illness perception have been found to significantly correlate with HRQoL. This study aims to evaluate the long-term effectiveness of Cognitive Behavioral Therapy (CBT) in enhancing HRQoL and mitigating psychological distress among AF patients.

Methods

Employing a prospective, open design with pseudo-randomization, this study encompassed pre-tests, post-treatment evaluations, and a 6-month follow-up. A total of 102 consecutive patients diagnosed with paroxysmal AF were initially enrolled. Out of these, 90 were assigned to two groups; one to receive a 10-week CBT treatment specifically focusing on anxiety, and the other to receive standard care. Outcome measures were evaluated using tools such as the Item Short Form Health Survey (SF-12), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), University of Toronto Atrial Fibrillation Severity Scale (AFSS), and Brief Illness Perception Questionnaire (BIPQ). These assessments were conducted at pre-treatment, post-treatment, and at the 6-month follow-up mark. We explored the effectiveness of CBT using Generalized Estimating Equations (GEE).

Results

Our analysis revealed a notable improvement in the CBT group relative to the control group. All metrics displayed consistent improvement across a 6-month duration. At the 6-month checkpoint, the CBT group exhibited a more favorable SF-12 Mental Component Score (MCS) (50.261 ± 0.758 vs. 45.208 ± 0.887, p < 0.001), reduced GAD-7 (4.150 ± 0.347 vs. 8.022 ± 0.423, p < 0.001), BIPQ (34.700 ± 0.432 vs. 38.026 ± 0.318, p < 0.001), and AFSS (9.890 ± 0.217 vs. 10.928 ± 0.218, p = 0.001) scores when compared to the TAU group. Conversely, the SF-12 PCS (44.212 ± 0.816 vs. 47.489 ± 0.960, p = 0.139) and PHQ-9 scores (8.419 ± 0.713 vs. 10.409 ± 0.741, p = 0.794) manifested no significant difference between the two groups.

Conclusion

The findings suggest that CBT is effective in improving HRQoL and reducing psychological distress among patients with AF at 6 month follow-up. This highlights the potential benefits of integrating CBT into the therapeutic regimen for AF patients.

Trial Registration

Retrospectively registered with ClinicalTrials.gov (NCT05716828). The date of registration : 5 June 2023.
Reappraisal of volcanic seismicity at the Kirishima volcano using machine learning
Authors: Yukutake Yohei , Kim Ahyi , Ohminato Takao
Published: December 2023

Volcanic earthquakes provide essential information for evaluating volcanic activity. Because volcanic earthquakes are often characterized by swarm-like features, conventional methods using manual picking require considerable time to construct seismic catalogs. In this study, using a machine learning framework and a trained model from a volcanic earthquake catalog, we obtained a detailed picture of volcanic earthquakes during the past 12 years at the Kirishima volcano, southwestern Japan. We detected ~ 6.2 times as many earthquakes as a conventional seismic catalog and obtained a high-resolution hypocenter distribution through waveform correlation analysis. Earthquake clusters were estimated below the craters, where magmatic or phreatic eruptions occurred in recent years. Increases in seismic activities, b values, and the number low-frequency earthquakes were detected before the eruptions. The process can be conducted in real time, and monitoring volcanic earthquakes through machine learning methods contributes to understanding the changes in volcanic activity and improving eruption predictions.

Graphical Abstract
Does posterior tibial slope laterality exist? A matched cohort study between ACL‐injured and non‐injured knees
Authors: Tensho Keiji , Kumaki Daiki , Yoshida Kazushige , Shimodaira Hiroki , Horiuchi Hiroshi , Takahashi Jun
Published: December 2023

Purpose

The purpose of this study is to examine 1) the degree and frequency of laterality in posterior tibial slope (PTS) with control and anterior cruciate ligament (ACL) injury groups and 2) the laterality of PTS between sides of injury and dominant legs in patients with primary ACL injuries.

Methods

A total of 187 consecutive patients with clinically diagnosed noncontact ACL injuries and an age‐ and sex‐matched 1:1 control group were identified. PTS was measured using three different methods (aPTS = anterior PTS, mPTS = middle PTS, pPTS = posterior PTS) on a lateral knee radiograph. PTS of the left and right sides were compared between the patients in the control and ACL‐injured groups, and between the injured and non‐injured and dominant and non‐dominant legs among the patients in the ACL‐injured group. The patients with a difference in PTS of ≥ 3° in mPTS were selected. The percentages were compared between left and right between and among both groups, and between the injured and non‐injured, and non‐dominant and dominant leg, for the ACL group. Multiple regression analysis was performed to analyze the factors influencing the degree of mPTS.

Results

Both control (Right vs Left: aPTS; 9.0 ± 2.5 vs 10.5 ± 3.0, mPTS; 6.6 ± 2.3 vs 8.1 ± 2.7, pPTS; 4.0 ± 2.4 vs 5.6 ± 2.8, respectively, p < 0.01) and ACL injury groups (Right vs Left: aPTS; 10.6 ± 3.0 vs 12.6 ± 2.9, mPTS; 7.6 ± 2.6 vs 9.5 ± 2.6, pPTS; 5.9 ± 3.0 vs 8.0 ± 3.0, respectively, p < 0.01) had a significantly greater PTS on the left than on the right side, and the ACL group had a significantly greater PTS than the control group on both the left and right sides. In the ACL group, PTS was greater on the injured and the non‐dominant leg than on the non‐injured and the dominant leg. The percentage of patients with a PTS difference of ≥ 3° was significantly greater on the left, injured, and non‐dominant leg (95.3% vs 4.7%, 73.8% vs 26.2%, 86.1% vs 13.9%, respectively, p < 0.01). Only the left leg had a significant influence on PTS in the multivariate analysis.

Conclusion

There was laterality in PTS within control and ACL injury groups, and this information is of benefit for effective treatment of ACL injuries.

Level of evidence

Level III.
Differential cardiomyocyte transcriptomic remodeling during in vitro Trypanosoma cruzi infection using laboratory strains provides implications on pathogenic host responses
Authors: Candray-Medina Katherine-Sofia , Nakagama Yu , Ito Masamichi , Nakagama Shun , Tshibangu-Kabamba Evariste , Takeda Norihiko , Sugiura Yuki , Nitahara Yuko , Michimuko-Nagahara Yu , Kaku Natsuko , Onizuka Yoko , Arias Carmen-Elena , Mejia Maricela , Alas Karla , Peña Susana , Maejima Yasuhiro , Komuro Issei , Nakajima-Shimada Junko , Kido Yasutoshi
Published: December 2023

Background

Chagas disease can lead to life-threatening cardiac manifestations. Regional factors, including genetic characteristics of circulatingTrypanosoma cruzi (T. cruzi), have attracted attention as likely determinants of Chagas disease phenotypic expression and Chagas cardiomyopathy (CCM) progression. Our objective was to elucidate the differential transcriptomic signatures of cardiomyocytes resulting from infection with genetically discreteT. cruzistrains and explore their relationships with CCM pathogenesis and progression.

Methods

HL-1 rodent cardiomyocytes were infected withT. cruzitrypomastigotes of the Colombian, Y, or Tulahuen strain. RNA was serially isolated post-infection for microarray analysis. Enrichment analyses of differentially expressed genes (fold-change ≥ 2 or ≤ 0.5) highlighted over-represented biological pathways. Intracellular levels of reactive oxygen species (ROS) were compared betweenT. cruzi-infected and non-infected HL-1 cardiomyocytes.

Results

We found that oxidative stress-related gene ontology terms (GO terms), ‘Hypertrophy model’, ‘Apoptosis’, and ‘MAPK signaling’ pathways (all withP < 0.01) were upregulated. ‘Glutathione and one-carbon metabolism’ pathway, and ‘Cellular nitrogen compound metabolic process’ GO term (all withP < 0.001) were upregulated exclusively in the cardiomyocytes infected with the Colombian/Y strains. Mean intracellular levels of ROS were significantly higher in theT. cruzi-infected cardiomyocytes compared to the non-infected (P < 0.0001).

Conclusions

The upregulation of oxidative stress-related and hypertrophic pathways constitutes the universal hallmarks of the cardiomyocyte response elicited byT. cruziinfection. Nitrogen metabolism upregulation and glutathione metabolism imbalance may implicate a relationship between nitrosative stress and poor oxygen radicals scavenging in the unique pathophysiology of Chagas cardiomyopathy.
Vascular access modalities in a pediatric intensive care unit in tertiary hospital indications and outcomes: a single-center cross-sectional study
Authors: Aziz Miriam Magdy , Bazaraa Hafez , Aboulmakarem Aly Sayed , Helal Dalia
Published: December 2023

Background

Vascular access is a mainstay of pediatric critical care. The selection of the route of access and equipment used will depend on patient- and provider-specific factors, which constantly need revision to achieve more effective assessment and management.

Objective

To evaluate the use, indication, and outcome of different vascular access modalities in critically ill children in the Emergency Pediatric Intensive Care Unit (ER-PICU) of a tertiary university hospital.

Patients and methods

This cross-sectional descriptive study was based on data collected by reviewing all modes of vascular access used for 168 consecutive patients admitted to ER-PICU during a 6-month period from May to October 2020.

Results

Among the study group (n = 168), there were 92 males (54.8%) and 76 females (45.2%). The median age of cases was 18 months. 333 vascular access devices were observed: 219 peripheral (65.8%) and 114 central catheters (34.2%). Catheters lasted a total of 1920 catheter days. Central venous catheters lasted significantly more than peripheral lines (P < 0.001); median of 8.5 and 3 days, respectively. The incidence of peripheral line complications (35.2%) was found significantly higher compared to central venous catheters (22.8%) (P. = 0.021). Longer dwell time of central access was associated with a higher incidence of catheter-related bloodstream infection. The incidence of catheter-related bloodstream infection was 9.05 per 1000 catheter days. Mortality rate was 24.4%.

Conclusions

Despite having lower incidence of complications than peripheral lines, central venous catheters’ complications are considered more serious. Dwell time of central venous catheters (CVC) should be revised daily to avoid the occurrence of infection.