bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of major adverse cardiac and cerebrovascular events after percutaneous coronary intervention in older adults: a systematic review and meta-analysis
Authors: Jalali Arash , Hassanzadeh Ali , Najafi Mohammad Sadeq , Nayebirad Sepehr , Dashtkoohi Mohadese , Karimi Zahra , Shafiee Akbar
Published: April 2024

Aim

We systematically reviewed and meta-analyzed the predictors of major adverse cardiac and cerebrovascular events (MACE/MACCE) in older adults who underwent PCI.

Methods

Three databases, PubMed, Embase, and Scopus, were searched for observational studies considering the out-of-hospital MACE/MACCE in adults ≥ 60 years old with coronary artery disease (acute or chronic) who underwent PCI. Studies were eligible if they had determined at least two statistically significant predictors of MACE/MACCE by multivariable analysis. We used the QUIPS tool to evaluate the risk of bias in the studies. Random-effects meta-analysis was utilized to pool the hazard ratios (HRs) of the most reported predictors.

Results

A total of 34 studies were included in the review. Older age (HR = 1.04, 95% Confidence Interval (CI): 1.03–1.06, P-value < 0.001), diabetes (HR = 1.36, 95% CI: 1.22–1.53, P < 0.001), history of myocardial infarction (MI) (HR = 1.88, 95% CI: 1.37–2.57, P < 0.001), ST-elevation MI (STEMI) at presentation (HR = 1.72, 95% CI: 1.37–2.18, P < 0.001), reduced left ventricular ejection fraction (LVEF) (HR = 2.01, 95% CI: 1.52–2.65, P < 0.001), successful PCI (HR = 0.35, 95% CI: 0.27–0.47, P < 0.001), eGFR (HR = 0.99, 95% CI: 0.97-1.00; P-value = 0.04) and left main coronary artery (LMCA) disease (HR = 2.07, 95% CI: 1.52–2.84, P < 0.001) were identified as predictors of MACE.

Conclusion

We identified older age, diabetes, history of MI, STEMI presentation, lower LVEF, and LMCA disease increased the risk of MACE/MACCE after PCI in older adults. Meanwhile, higher eGFR and successful PCI predicted lower adverse events risk. Future studies should focus on a more robust methodology and a precise definition of MACE.

Registration

PROSPERO (CRD42023480332).
The effect of participation in support groups on retirement syndrome in older adults
Authors: Qorbani Sakineh , Majdabadi Zahra Amrollah , Nikpeyma Nasrin , Haghani Shima , Shahrestanaki Sahar Keyvanloo , Poortaghi Sarieh
Published: April 2024

Background

Retirement and aging are phenomena that often occur simultaneously and lead to various physical and psychological changes in older adults. Retirement syndrome consists of symptoms such as feelings of emptiness, loneliness, uselessness, lack of clear understanding of future conditions and dissatisfaction with one’s performance after retirement. This phenomenon requires interventions to adapt to these changes. Considering the supportive role of nurses, the formation of support groups as an effective intervention in adapting to transitional stages is emphasized.

Aims

This study aims to investigate the effect of older adults’ participation in support groups on retirement syndrome.

Methods

This Quasi-experimental study recruited a total of 80 retired older adults meeting the inclusion criteria from three Retirement Associations (Retirement centers for social security retirees are among the institutions that have been set up by the government and this organization to provide face-to-face and offline services to social security retirees, as well as providing some facilities to this segment of the society). in Iran, Research samples were randomly assigned to two intervention and control groups. The demographic questionnaire and retirement syndrome questionnaire were completed by both groups at the beginning of the study. Then, four support group sessions lasting 60 to 90 min were held twice a week for the support group, and eight weeks after the end of the intervention, the questionnaires were completed for both groups. The data were analyzed using statistical tests in SPSS version 16. The significance level was set at p < 0.05 for all tests.

Results

The results of the covariance analysis showed that after the intervention, the feelings of helplessness and failure (p < 0.001), feelings of older and idleness (p = 0.027), and feelings of confusion and conflict (p = 0.002) were significantly less in the support group compared to the control group. In addition, the Feeling of trying and new direction (p < 0.001) was higher after the intervention. The paired t-test results showed that in the support group, the feelings of helplessness and failure (p < 0.001), feelings of older and idleness (p = 0.004), and feelings of confusion and conflict (p < 0.001) significantly decreased after the intervention compared to before it, while the feelings of trying and new direction (p = 0.004) significantly increased. Therefore, the results showed that after the intervention, there was a statistically significant difference between the two groups in all components of the retirement syndrome.

Conclusion

The results of this study show that participation of retired older adults in support groups can significantly improve all components of retirement syndrome, leading to an improvement in their quality of life and satisfaction.
Predictors of quality of life of TB/HIV co-infected patients in the Northern region of Ghana
Authors: Nabei Jacob Nignan , Bonful Harriet Affran , Afari Edwin Andrews , Mohammed Abdul Gafaru , Anum Adote
Published: April 2024

Background

Tuberculosis (TB) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) co-morbidity continues to be a serious worldwide health issue, particularly in Sub-Saharan Africa. Studies on the quality of life (QOL) of TB/HIV co-infected patients guide stakeholders on the delivery of patient-centred healthcare. This study evaluated QOL of TB/HIV co-infected individuals and its contributing factors.

Methods

We conducted a cross-sectional study among TB/HIV co-infected patients, receiving treatment at clinics in the Northern Region of Ghana. Simple random sampling technique was used to select 213 patients from 32 clinics. We gathered information on patients’ QOL using the World Health Organization QOL-HIV BREF assessment tool. At a 5% level of significance, multiple logistic regression analyses were carried out to find correlates of QOL among the patients.

Results

The mean age of the patients was (38.99 ± 14.00) years with most, 33.3% (71/213) aged 30–39 years. Males constituted 54.9% (117/213). About 30.0% (64/213) of the patients reported a good QOL. Being employed (aOR = 5.23, 95% CI: 1.87 – 14.60), and adhering to treatment (aOR = 6.36, 95% CI: 1.51 – 26.65) were significantly associated with a good QOL. Being depressed (aOR = 0.02, 95% CI: 0.03 – 0.29), stigmatized (aOR = 0.31, 95% CI : 0.11 – 0.84), and not exercising (aOR = 0.28, 95% CI: 0.12 – 0.67) were negatively associated with a good QOL.

Conclusion

Less than one-third of TB/HIV co-infected patients in the region have good QOL. To guarantee good QOL, modifiable predictors such as patients’ physical activity and medication adherence should be targeted by the National AIDS and TB Control Programs.
Beyond prediction: unveiling the prognostic power of μ-opioid and cannabinoid receptors, alongside immune mediators, in assessing the severity of SARS-CoV-2 infection
Authors: Tavakoli-Yaraki Masoumeh , Abbasi Aida , Pishkenari Fatemeh Nejat , Baranipour Saeed , Jahangirifard Alireza , Mirtajani Seyed Bashir , Mejareh Zahra Noorani , Vaezi Mohammad Amin , Yavarian Jila , Abdollahi Bahare , Mokhtari-Azad Talat , Salimi Vahid
Published: April 2024

Background

This study aims to explore the potential of utilizing the expression levels of cannabinoid receptor 2 (CB2), μ-opioid receptor (MOR), MCP-1, IL-17, IFN-γ, and osteopontin as predictors for the severity of SARS-CoV-2 infection. The overarching goal is to delineate the pathogenic mechanisms associated with SARS-CoV-2.

Methods

Using quantitative Real-time PCR, we analyzed the gene expression levels of CB2 and MOR in nasopharynx specimens obtained from patients diagnosed with SARS-CoV-2 infection, with 46 individuals classified as having severe symptoms and 46 as non-severe. Additionally, we measured the circulating levels of MCP-1, IL-17, IFN-γ, and osteopontin using an ELISA assay. We examined the predictive capabilities of these variables and explored their correlations across all patient groups.

Results

Our results demonstrated a significant increase in MOR gene expression in the epithelium of patients with severe infection. The expression of CB2 receptor was also elevated in both male and female patients with severe symptoms. Furthermore, we observed concurrent rises in MCP-1, IL-17, IFN-γ, and osteopontin levels in patients, which were linked to disease severity. CB2, MOR, MCP-1, IL-17, IFN-γ, and osteopontin showed strong predictive abilities in distinguishing between patients with varying degrees of SARS-CoV-2 severity. Moreover, we identified a significant correlation between CB2 expression and the levels of MOR, MCP-1, osteopontin, and IFN-γ.

Conclusions

These results underline the interconnected nature of molecular mediators in a sequential manner, suggesting that their overexpression may play a role in the development of SARS-CoV-2 infections.

Graphical Abstract
Neonatal outcomes according to different glucose threshold values in gestational diabetes: a register-based study
Authors: Kariniemi Kaisa , Vääräsmäki Marja , Männistö Tuija , Mustaniemi Sanna , Kajantie Eero , Eteläinen Sanna , Keikkala Elina ,   the Finnish Gestational Diabetes [FinnGeDi] study group, Pouta Anneli , Kaaja Risto , Eriksson Johan G , Laivuori Hannele , Gissler Mika
Published: April 2024

Background

Mild hyperglycaemia is associated with increased birth weight but association with other neonatal outcomes is controversial. We aimed to study neonatal outcomes in untreated mild hyperglycaemia using different oral glucose tolerance test (OGTT) thresholds.

Methods

This register-based study included all (n = 4,939) singleton pregnant women participating a 75 g 2-h OGTT in six delivery hospitals in Finland in 2009. Finnish diagnostic cut-offs for GDM were fasting ≥ 5.3, 1 h ≥ 10.0 or 2-h glucose ≥ 8.6 mmol/L. Women who did not meet these criteria but met the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria (fasting 5.1–5.2 mmol/L and/or 2-h glucose 8.5 mmol/L, n = 509) or the National Institute for Health and Clinical Excellence (NICE) criteria (2-h glucose 7.8–8.5 mmol/L, n = 166) were considered as mild untreated hyperglycaemia. Women who met both the Finnish criteria and the IADPSG or the NICE criteria were considered as treated GDM groups (n = 1292 and n = 612, respectively). Controls were normoglycaemic according to all criteria (fasting glucose < 5.1 mmol/L, 1-h glucose < 10.0 mmol/L and 2-h glucose < 8.5 mmol/L, n = 3031). Untreated mild hyperglycemia groups were compared to controls and treated GDM groups. The primary outcome – a composite of adverse neonatal outcomes, including neonatal hypoglycaemia, hyperbilirubinaemia, birth trauma or perinatal mortality – was analysed using multivariate logistic regression.

Results

The risk for the adverse neonatal outcome in untreated mild hyperglycemia was not increased compared to controls (adjusted odds ratio [aOR]: 1.01, 95% confidence interval [CI]: 0.71–1.44, using the IADPSG criteria; aOR: 1.05, 95% CI: 0.60–1.85, using the NICE criteria). The risk was lower compared to the treated IADPSG (aOR 0.38, 95% CI 0.27–0.53) or the treated NICE group (aOR 0.32, 95% CI 0.18–0.57).

Discussion

The risk of adverse neonatal outcomes was not increased in mild untreated hyperglycaemia compared to normoglycaemic controls and was lower than in the treated GDM groups. The OGTT cut-offs of 5.3 mmol/L at fasting and 8.6 mmol/L at 2 h seem to sufficiently identify clinically relevant GDM, without excluding neonates with a risk of adverse outcomes.
The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000–2020
Authors: Waddell Oliver , Pearson John , McCombie Andrew , Marshall Harriet , Purcell Rachel , Keenan Jacqueline , Glyn Tamara , Frizelle Frank
Published: April 2024

Background

The incidence of early-onset colorectal cancer (EOCRC), diagnosed before age 50, has been rising in many countries in the past few decades. This study aims to evaluate this trend in Aotearoa New Zealand and assess its impact on Māori.

Methods

Crude incidence and age-standardized incidence of colorectal cancer (CRC) was analyzed from all new cases from the Aotearoa New Zealand national cancer registry for the period 2000–2020. Trends were estimated by sex, ethnicity, age group and location of cancer and projections made to 2040.

Results

Between 2000 and 2020, there were a total of 56,761 cases of CRC diagnosed in Aotearoa New Zealand, 3,702 of these being EOCRC, with age-standardized incidence decreasing significantly (P = 8.2 × 10− 80) from 61.0 to 47.3 cases per 100,000. EOCRC incidence increased on average by 26% per decade (incidence rate ratio (IRR) 1.26,p = < 0.0001) at all sites (proximal colon, distal colon and rectum), while the incidence in those aged 50–79 years decreased on average by 18% per decade (IRR 0.82,p = < 0.0005), again across all sites. There was no significant average change in CRC incidence in those over 80 years. In Māori, there was no significant change in age-standardized incidence. There was however a significant increase in crude incidence rates (IRR 1.28,p = < 0.0005) driven by significant increases in EOCRC (IRR1.36,p = < 0.0005). By 2040, we predict the incidence of EOCRC will have risen from 8.00 to 14.9 per 100,000 (6.33 to 10.00 per 100,000 in Māori). However, due to the aging population an estimated 43.0% of all CRC cases will be diagnosed in those over 80 years of age (45.9% over 70 years of age in Māori).

Conclusion

The age-standardized incidence of CRC from 2000 to 2020 decreased in Aotearoa New Zealand, but not for Māori. The incidence of EOCRC over the same period continues to rise, and at a faster rate in Māori. However, with the ageing of the population in Aotearoa New Zealand, and for Māori, CRC in the elderly will continue to dominate case numbers.
A cross-sectional study on personal values of medical students: the differences from their instructors, their associations with mental wellbeing, and the influences of gender
Authors: Chiencharoenthanakij Romteera , Charoenthamruksa Chatchavan , Nisu Sansanee , Anuroj Krittisak
Published: April 2024

Background

Personal values of Thai medical students have been observed to be diverging from those of their seniors, but the differences remain uncharacterized. Despite its potential association with mental wellbeing, the issue remain unexplored in the population. This study aimed to explore (1) the difference in personal values between medical students and instructors and (2) the association between student’s value adherence to mental well-being and the interaction by gender.

Methods

An online survey was performed in 2022. Participants rated their adherence to five groups of values, namely, Self-Direction, Hedonism, Achievement & Power, Universalism & Benevolence, and Tradition. Participants also rated their mental wellbeing. Comparisons were made between the personal values of students and instructors. The association between the personal values of students and their mental wellbeing and the interaction between values and gender were analyzed in linear regression.

Results

Compared to instructors, students rated higher on Universalism & Benevolence, marginally higher on Hedonism, and lower on Tradition. Students’ ratings on Self-Direction, Universalism & Benevolence, and Tradition predicted better mental wellbeing. Their rating on Hedonism predicted poorer mental wellbeing, the effect of which was marginally stronger in males. Ratings on Achievement & Power marginally predicted poorer mental wellbeing in females.

Conclusion

Difference in personal values between medical students and instructors have been observed. Some of these values hold potentials over student’s mental wellbeing. Curricular and medical school environmental accommodation for the changes in the characters of learners may be necessary to mitigate the adverse effects on their mental wellbeing and foster development of desirable professional characteristics.
Common mental disorders and associated factors among mothers of children attending severe acute malnutrition treatment in Gedio Zone, Southern Ethiopia, 2022: a cross-sectional study
Authors: Girma Bekahegn , Bimer Kirubel , Kassaw Chalachew , Mengistu Nebiyu , Zewdie Ashenafi , Sewalem Jerusalem , Madoro Derebe
Published: April 2024

Background

Common mental disorders describe the physical, mental, and social disturbances that are more prevalent in low and middle-income countries. Mothers are among the more vulnerable groups especially mothers having children with under-nutrition. However, there are limited studies about the magnitude of common mental disorders among mothers of undernourished children in Ethiopia. Therefore, we aimed to assess the magnitude of common mental disorders and associated factors among mothers of children attending severe acute malnutrition treatment in Gedio Zone, Southern Ethiopia.

Methods

A cross-sectional study was employed on 405 systematically selected participants. The outcome variable was assessed by a self-reporting questionnaire (SRQ-20) which was applicable and validated in Ethiopia. Data were entered and analyzed by EPi data version 5 software and SPSS version 25 respectively. Model fitness was checked by Hosmer Lemeshow’s test. Logistic regression was employed to identify significant determinants. A p-value < 0.05 was used to declare association and expressed by odds ratio with a 95% CI.

Result

In this study, the magnitude of common mental disorders was 33.16% (95% CI [28.5–38])). In multivariable analysis, six factors poor social support [AOR: 14.0, 95% CI (5.45, 35.9)], educational status [AOR: 1.95, 95% CI (1.07. 3.55)], cigarette smoking [AOR: 10.9, 95% CI (1.78, 67.01)], mother of a child with another chronic disease [AOR: 3.19, 95% CI (1.13, 8.99)], sexual violence [AOR: 4.14, 95% CI (1.38, 12.4)] and mothers with chronic disease [AOR: 3.44, 95% CI (1.72, 6.86)] were significantly associated with common mental disorders.

Conclusion

The magnitude of common mental disorders was high. Six factors were significantly associated with common mental disorders; social support, sexual violence, maternal chronic illness, educational status, smoking, and mother of child with other chronic disease. Community awareness regarding the effect of violence, substance use, and social support on mental health should be created by the local stakeholders.
Hearing health survey of the population in Bangkok
Authors: Ruencharoen Suwimol , Lertsukprasert Krisna , Suvanich Ravin , Seesangnom Jirapat , Chockboondee Mondnath , Aekplakorn Wichai , Jariengprasert Chanchai , Kiatthanabumrung Sivaporn , Wisupagan Tosapohn
Published: April 2024

In this cross-sectional random survey among Thai adults living in Bangkok, we aimed to identify the prevalence of hearing problems and examine their relationship with individual factors. We administered a self-report questionnaire and performed pure-tone air conduction threshold audiometry. A total of 2463 participants (1728 female individuals) aged 15–96 years were included. The hearing loss prevalence was 53.02% and increased with age. The prevalence of a moderate or greater degree of hearing impairment was 2.8%. Participants aged 65 years and over had 8.56 and 6.79 times greater hearing loss and hearing impairment than younger participants, respectively. Male participants were twice as likely to have hearing loss and hearing impairment as female individuals. Participants with higher education levels showed less likelihood of having hearing loss and hearing impairment than those with no or a primary school education. Participants who ever worked under conditions with loud noise for > 8 h per day had 1.56 times greater hearing loss than those without such exposure. An inconsistent correlation was found between hearing loss, hearing impairment and noncommunicable diseases (diabetes, hypertension, and obesity). Although most participants had mild hearing loss, appropriate care and monitoring are necessary to prevent further loss in such individuals. The questionnaire-based survey found only people with hearing problems that affect daily communication.
Evaluation of the population-level impacts of the LiveLighter® obesity prevention campaign from 2012 to 2019 based on serial cross-sectional surveys
Authors: Humphreys Lauren , Morley Belinda , Nuss Tegan , Dixon Helen , Ambrosini Gina L. , O’Flaherty Ciara , Ledger Melissa , Sartori Ainslie , Wakefield Melanie
Published: April 2024

Background

Halting and reversing the upward trend in obesity requires sustained implementation of comprehensive, evidence-based strategies at the population-level. The LiveLighter® program targets adults using a range of public education strategies, including mass media campaigns, to support healthy lifestyle changes to attain or maintain a healthy weight and reduce the risk of chronic disease. LiveLighter® has been implemented in Western Australia (WA) since 2012 and, to our knowledge, includes the longest running adult-targeted mass media campaign for healthy weight and lifestyle promotion and education globally. This evaluation assessed the impact of LiveLighter® on WA adults’ knowledge, intentions and behaviours as they relate to healthy eating and body weight from 2012 to 2019.

Methods

LiveLighter® mass media campaigns, which are TV-led and aired statewide, depict genuine, graphic imagery of visceral fat around internal organs to raise awareness about the link between excess body weight and chronic diseases; demonstrate how unhealthy food and drink consumption can contribute to unhealthy weight gain; and recommend healthy alternatives. Cross-sectional telephone surveys were conducted at baseline and following each campaign phase with an independent, randomly selected sample of WA adults aged 25 to 49 years (n = 501 to n = 1504 per survey) to assess their knowledge of the link between excess body weight and chronic diseases, and their intentions and behaviours related to healthy eating and weight. Multivariable logistic regression models were undertaken to assess differences in responses between baseline and each post-campaign survey.

Results

Compared to baseline, there were significant increases in the proportion of respondents reporting knowledge of excess body weight as a risk factor for certain cancers and type 2 diabetes, intentions to eat more fruit and vegetables and drink less sugar sweetened beverages (SSBs) in the next seven days, and the proportion of respondents who reported meeting guidelines for daily vegetable intake. Reported consumption of SSBs significantly decreased.

Conclusions

LiveLighter® is associated with improvements in knowledge of the health risks associated with excess body mass, increased vegetable intake and reduced SSB consumption in WA adults. These findings support the use of sustained, well-designed healthy lifestyle promotion and education programs as part of a comprehensive obesity prevention strategy.
Cigarette smoking and cardiovascular disease incidence and all-cause mortality: the modifying role of diet quality
Authors: Norouzzadeh Mostafa , Teymoori Farshad , Farhadnejad Hossein , Moslehi Nazanin , Mirmiran Parvin , Rahideh Seyedeh Tayebeh , Azizi Fereidoun
Published: April 2024

Background

This study examines the potential long-term joint association between smoking and diet quality as modifiable risk factors concerning cardiovascular diseases (CVDs) incidence and all-cause mortality among current and former smokers.

Methods

The study followed 955 smokers from the third and fourth examinations of the Tehran Lipid and Glucose Study to March 2018. Dietary data was collected using a food frequency questionnaire. Three diet quality indices (DQIs) were computed at baseline: DQI-international (DQI-I), DQI-revised (DQI-R), and Mediterranean-DQI (Med-DQI). Cox proportional hazards regression models were used to determine the HR (95% CI) of the joint association between smoking and diet quality among heavy and light smokers, based on the number of cigarettes per day and pack-years, as well as between current and former smokers based on smoking habits.

Results

Over a follow-up period of almost eight years, 94 cases of CVDs (9.80%) and 40 cases of mortality (4.20%) were documented. The lower diet quality based on the Med-DQI was associated with a higher risk of mortality among current smokers (HR:3.45; 95%CI:1.12, 10.57). Light smokers with good diet quality, compared to heavy smokers with poor diet quality, had a lower risk of CVDs incident (HR:0.35; 95%CI: 0.15, 0.83) and all-cause mortality (HR:0.20; 95%CI:0.05, 0.77). Current smokers with good DQI had a lower risk of mortality compared to current smokers with poor DQI (HR:0.26; 95%CI:0.08, 0.80). However, this lower risk was more significant in former smokers with good DQI (HR:0.10; 95%CI:0.02, 0.45).

Conclusions

Light and former smokers had a lower risk of developing CVDs and experiencing mortality. However, when coupled with a high-quality diet, this protective effect is even more pronounced.
From womb to world: mapping gut microbiota-related health literacy among Italian mothers, a cross-sectional study
Authors: Consales Alessandra , Toscano Letizia , Ceriotti Chiara , Tiraferri Valentina , Castaldi Silvana , Giannì Maria Lorella
Published: April 2024

Background

The gut microbiota is a key determinant of long-term health. Promoting maternal health literacy may enhance children well-being. Aim of the present study was to assess gut microbiota-related health literacy of Italian women and identify potential gaps in awareness.

Methods

A cross-sectional survey study was conducted using an online questionnaire (17 questions) on determinants and long-term impact of infant gut microbiota. The survey targeted Italian pregnant women and mothers of children under 2 years old, and was distributed through various social media channels between September 28th and November 15th, 2022. A total score was calculated as the sum of positive answers. Data on demographics, pregnancy status, and pre-existing knowledge of the infant gut microbiota were also collected. Descriptive and inferential statistics were applied.

Results

The questionnaire was completed by 1076 women. Median total score was 9 [7–11]. The 81.7% of respondents declared prior knowledge of the gut microbiota. The internet was among the most commonly cited primary sources of information. Independent predictors of total score were having a university degree (B = 0.656, p = 0.002) and prior knowledge (B = 2.246, p < 0.001). Conversely, older age was associated with lower total scores (B = -0.092, p < 0.001). The least known determinants of infant gut microbiota were gestational BMI, prematurity, mode of delivery and NICU stay. Pregnant women failed to recognize the role of breastfeeding in the development of infant gut microbiota more frequently than non-pregnant women. The 97.5% of participants reported increased interest in the gut microbiota, with heightened interest associated with prior knowledge.

Conclusions

Our study revealed a moderate level of knowledge about infant gut microbiota among respondents, emphasizing the positive impact of prior knowledge on understanding and interest. Targeted educational interventions are needed to address awareness gaps, especially concerning the influence of breastfeeding on infant gut microbiota. Healthcare providers have the potential to enhance women's knowledge and awareness of this topic.
Building public engagement and access to palliative care and advance care planning: a qualitative study
Authors: Black Rachel , Hasson Felicity , Slater Paul , Beck Esther , McIlfatrick Sonja
Published: April 2024

Background

Research evidence suggests that a lack of engagement with palliative care and advance care planning could be attributed to a lack of knowledge, presence of misconceptions and stigma within the general public. However, the importance of how death, dying and bereavement are viewed and experienced has been highlighted as an important aspect in enabling public health approaches to palliative care. Therefore, research which explores the public views on strategies to facilitate engagement with palliative care and advance care planning is required.

Methods

Exploratory, qualitative design, utilising purposive random sampling from a database of participants involved in a larger mixed methods study. Online semi-structured interviews were conducted (n = 28) and analysed using reflexive thematic analysis. Thematic findings were mapped to the social-ecological model framework to provide a holistic understanding of public behaviours in relation to palliative care and advance care planning engagement.

Results

Three themes were generated from the data: “Visibility and relatability”; “Embedding opportunities for engagement into everyday life”; “Societal and cultural barriers to open discussion”. Evidence of interaction across all five social ecological model levels was identified across the themes, suggesting a multi-level public health approach incorporating individual, social, structural and cultural aspects is required for effective public engagement.

Conclusions

Public views around potential strategies for effective engagement in palliative care and advance care planning services were found to be multifaceted. Participants suggested an increase in visibility within the public domain to be a significant area of consideration. Additionally, enhancing opportunities for the public to engage in palliative care and advance care planning within everyday life, such as education within schools, is suggested to improve death literacy and reduce stigma. For effective communication, socio-cultural aspects need to be explored when developing strategies for engagement with all members of society.
Ganoderma spore lipid ameliorates docetaxel, cisplatin, and 5-fluorouracil chemotherapy-induced damage to bone marrow mesenchymal stem cells and hematopoiesis
Authors: Lin Haohui , Chung Manhon , Sun Jingchun , Yang Yi , Zhang Li , Pan Xiaohua , Wei Minghui , Cai Sa , Pan Yu
Published: April 2024

Background

A triplet chemotherapy regimen of docetaxel, cisplatin, and 5-fluorouracil (TPF) is used to treat head and neck squamous cell carcinoma; however, it is toxic to bone marrow mesenchymal stem cells (BMSCs). We previously demonstrated that Ganoderma spore lipid (GSL) protect BMSCs against cyclophosphamide toxicity. In this study, we investigated the protective effects of GSL against TPF-induced BMSCs and hematopoietic damage.

Methods

BMSCs and C57BL/6 mice were divided into control, TPF, co-treatment (simultaneously treated with GSL and TPF for 2 days), and pre-treatment (treated with GSL for 7 days before 2 days of TPF treatment) groups. In vitro, morphology, phenotype, proliferation, senescence, apoptosis, reactive oxygen species (ROS), and differentiation of BMSCs were evaluated. In vivo, peripheral platelets (PLTs) and white blood cells (WBCs) from mouse venous blood were quantified. Bone marrow cells were isolated for hematopoietic colony-forming examination.

Results

In vitro, GSL significantly alleviated TPF-induced damage to BMSCs compared with the TPF group, recovering their morphology, phenotype, proliferation, and differentiation capacity (p < 0.05). Annexin V/PI and senescence-associated β-galactosidase staining showed that GSL inhibited apoptosis and delayed senescence in TPF-treated BMSCs (p < 0.05). GSL downregulated the expression of caspase-3 and reduced ROS formation (p < 0.05). In vivo, GSL restored the number of peripheral PLTs and WBCs and protected the colony-forming capacity of bone marrow cells (p < 0.05).

Conclusions

GSL efficiently protected BMSCs from damage caused by TPF and recovered hematopoiesis.
Potential role of Citrus bergamia flower essential oil against oral pathogens
Authors: Aziz Muhammad Imran , Hasan Muhammad Mohtasheemul , Ullah Riaz , Bari Ahmed , Khan Mohsin Abbas , Hasnain Syed Zia Ul , Baloch Rabia , Akram Muhammad , obaid Aqsa , Ullah Aziz , Abbas Khizar , Amin Adnan
Published: April 2024

Background

Oral bacterial infections are difficult to treat due to emergence of resistance against antibiotic therapy. Essential oils are considered emerging alternate therapy against bacterial infections and biofilms. We investigated Citrus bergemia flower essential oil against oral pathogens.

Methods

The essential oil was analsyed using Gas Chromatography(GC–MS), in silico investigations, antioxidant, antimicrobial, antibiofilm and antiquorum sensing assays.

Results

Gas Chromatography analysis confirmed presence of 17 compounds including 1,6-Octadien-3-ol,3,7-dimethyl, 48.17%), l-limonene (22.03%) and p-menth-1-ol, 8-ol (7.31%) as major components. In silico analysis showed compliance of all tested major components with Lipinski’s rule, Bioavailability and antimicrobial activity using PASS (prediction of activity spectrum of substances). Molecular docking with transcriptional regulators 3QP5, 5OE3, 4B2O and 3Q3D revealed strong interaction of all tested compounds except 1,6-Octadien-3-ol,3,7-dimethyl. All tested compounds presented significant inhibition of DPPH (2,2-diphenyl-1-picrylhydrazyl) (IC50 0.65 mg/mL), H2O2 (hydrogen peroxide) (63.5%) and high FRAP (ferrous reducing antioxidant power) value (239.01 µg). In antimicrobial screening a significant activity (MIC 0.125 mg/mL) against Bacillus paramycoides and Bacillus chungangensis was observed. Likewise a strong antibiofilm (52.1 – 69.5%) and anti-QS (quorum sensing) (4–16 mm) activity was recorded in a dose dependent manner.

Conclusion

It was therefore concluded that C. bergemia essential oil posess strong antioxidant, antimicrobial and antibiofilm activities against tested oral pathogens.
Perceptions and experiences of undergraduate medical students regarding social accountability: a cross-sectional study at a Subsaharan African medical school
Authors: Oriokot Lorraine , Munabi Ian Guyton , Kiguli Sarah , Mubuuke Aloysius Gonzaga
Published: April 2024

Background

Medical schools are called to be socially accountable by medical education and healthcare system stakeholders. Social accountability is a feature of excellent medical education. Medical students are essential to the development of socially accountable medical schools. Therefore, understanding the perceptions and experiences of medical students regarding social accountability is critical for efforts to improve social accountability practices and outcomes.

Methods

This cross-sectional online questionnaire-based survey used Google Forms and involved medical students in their fourth and fifth years of study at the Makerere University School of Medicine. The survey was conducted between September 2022 and October 2023. We used a study questionnaire and a validated toolkit designed by students as part of The Training for Health Equity Collaborative to gauge a school’s progress towards social accountability in medical schools to collect data on demographics, perceptions and experiences and evaluate social accountability.

Results

Out of 555 eligible medical students, 426 responded to the online questionnaire. The response rate was 77%. The mean age of the students was 25.24 ± 4.4 years. Almost three fourths of the students were male (71.3%), and slightly less than two thirds were in their fourth year of study (65%). Almost half of the students (48.1%%) evaluated the school as doing well with regard to social accountability. The evaluation items referring to community-based research and positive impact on the community had the highest mean scores. Only 6 (3.6%) students who reported hearing of social accountability had a clear understanding of social accountability. Students receiving career guidance in secondary school was associated with evaluating social accountability in the medical school as strong (p-0.003).

Conclusions

Medical students evaluated the medical school favorably forsocial accountability despite lacking a clear understanding of social accountability. Receiving career guidance in secondary school was significantly associated with a positive evaluation of social accountability.
Outpatient geriatric health care in the German federal state of Mecklenburg-Western Pomerania: a population-based spatial analysis of claims data
Authors: Pfeuffer Nils , Radicke Franziska , Leiz Maren , Moon Kilson , Hoffmann Wolfgang , van den Berg Neeltje
Published: April 2024

Background

Due to unidentified geriatric needs, elderly patients have a higher risk for developing chronic conditions and acute medical complications. Early geriatric screenings and assessments help to identify geriatric needs. Holistic and coordinated therapeutic approaches addressing those needs maintain the independence of elderly patients and avoid adverse effects. General practitioners are important for the timely identification of geriatric needs. The aims of this study are to examine the spatial distribution of the utilization of outpatient geriatric services in the very rural Federal State of Mecklenburg-Western Pomerania in the Northeast of Germany and to identify regional disparities.

Methods

Geographical analysis and cartographic visualization of the spatial distribution of outpatient geriatric services of patients who are eligible to receive basic geriatric care (BGC) or specialized geriatric care (SGC) were carried out. Claims data of the Association of Statutory Health Insurance Physicians in Mecklenburg-Western Pomerania were analysed on the level of postcode areas for the quarter periods between 01/2014 and 04/2017. A Moran’s I analysis was carried out to identify clusters of utilization rates.

Results

Of all patients who were eligible for BGC in 2017, 58.3% (n = 129,283/221,654) received at least one BCG service. 77.2% (n = 73,442/95,171) of the patients who were eligible for SGC, received any geriatric service (BGC or SGC). 0.4% (n = 414/95,171) of the patients eligible for SGC, received SGC services. Among the postcode areas in the study region, the proportion of patients who received a basic geriatric assessment ranged from 3.4 to 86.7%. Several regions with statistically significant Clusters of utilization rates were identified.

Conclusions

The widely varying utilization rates and the local segregation of high and low rates indicate that the provision of outpatient geriatric care may depend to a large extent on local structures (e.g., multiprofessional, integrated networks or innovative projects or initiatives). The great overall variation in the provision of BGC services implicates that the identification of geriatric needs in GPs’ practices should be more standardized. In order to reduce regional disparities in the provision of BGC and SGC services, innovative solutions and a promotion of specialized geriatric networks or healthcare providers are necessary.
A cilia-bound unconventional secretory pathway for Drosophila odorant receptors
Authors: Dzaki Najat , Alenius Mattias
Published: April 2024

Background

Post-translational transport is a vital process which ensures that each protein reaches its site of function. Though most do so via an ordered ER-to-Golgi route, an increasing number of proteins are now shown to bypass this conventional secretory pathway.

Results

In the Drosophila olfactory sensory neurons (OSNs), odorant receptors (ORs) are trafficked from the ER towards the cilia. Here, we show that Or22a, a receptor of various esters and alcoholic compounds, reaches the cilia partially through unconventional means. Or22a frequently present as puncta at the somatic cell body exit and within the dendrite prior to the cilia base. These rarely coincide with markers of either the intermediary ER-Golgi-intermediate-compartment (ERGIC) or Golgi structures. ERGIC and Golgi also displayed axonal localization biases, a further indication that at least some measure of OR transport may occur independently of their involvement. Additionally, neither the loss of several COPII genes involved in anterograde trafficking nor ERGIC itself affected puncta formation or Or22a transport to the cilium. Instead, we observed the consistent colocalization of Or22a puncta with Grasp65, the sole Drosophila homolog of mammalian GRASP55/Grh1, a marker of the unconventional pathway. The numbers of both Or22a and Grasp65-positive puncta were furthermore increased upon nutritional starvation, a condition known to enhance Golgi-bypassing secretory activity.

Conclusions

Our results demonstrate an alternative route of Or22a transport, thus expanding the repertoire of unconventional secretion mechanisms in neurons.
Targeting of REST with rationally-designed small molecule compounds exhibits synergetic therapeutic potential in human glioblastoma cells
Authors: Panina Svetlana B. , Schweer Joshua V. , Zhang Qian , Raina Gaurav , Hardtke Haley A. , Kim Seungjin , Yang Wanjie , Siegel Dionicio , Zhang Y. Jessie
Published: April 2024

Background

Glioblastoma (GBM) is an aggressive brain cancer associated with poor prognosis, intrinsic heterogeneity, plasticity, and therapy resistance. In some GBMs, cell proliferation is fueled by a transcriptional regulator, repressor element-1 silencing transcription factor (REST).

Results

Using CRISPR/Cas9, we identified GBM cell lines dependent on REST activity. We developed new small molecule inhibitory compounds targeting small C-terminal domain phosphatase 1 (SCP1) to reduce REST protein level and transcriptional activity in glioblastoma cells. Top leads of the series like GR-28 exhibit potent cytotoxicity, reduce REST protein level, and suppress its transcriptional activity. Upon the loss of REST protein, GBM cells can potentially compensate by rewiring fatty acid metabolism, enabling continued proliferation. Combining REST inhibition with the blockade of this compensatory adaptation using long-chain acyl-CoA synthetase inhibitor Triacsin C demonstrated substantial synergetic potential without inducing hepatotoxicity.

Conclusions

Our results highlight the efficacy and selectivity of targeting REST alone or in combination as a therapeutic strategy to combat high-REST GBM.
Nuclear lamina component KAKU4 regulates chromatin states and transcriptional regulation in the Arabidopsis genome
Authors: Cao Yaxin , Yan Hengyu , Sheng Minghao , Liu Yue , Yu Xinyue , Li Zhongqiu , Xu Wenying , Su Zhen
Published: April 2024

Background

The nuclear lamina links the nuclear membrane to chromosomes and plays a crucial role in regulating chromatin states and gene expression. However, current knowledge of nuclear lamina in plants is limited compared to animals and humans.

Results

This study mainly focused on elucidating the mechanism through which the putative nuclear lamina component protein KAKU4 regulates chromatin states and gene expression in Arabidopsis leaves. Thus, we constructed a network using the association proteins of lamin-like proteins, revealing that KAKU4 is strongly associated with chromatin or epigenetic modifiers. Then, we conducted ChIP-seq technology to generate global epigenomic profiles of H3K4me3, H3K27me3, and H3K9me2 in Arabidopsis leaves for mutant (kaku4-2) and wild-type (WT) plants alongside RNA-seq method to generate gene expression profiles. The comprehensive chromatin state-based analyses indicate that the knockdown of KAKU4 has the strongest effect on H3K27me3, followed by H3K9me2, and the least impact on H3K4me3, leading to significant changes in chromatin states in the Arabidopsis genome. We discovered that the knockdown of the KAKU4 gene caused a transition between two types of repressive epigenetics marks, H3K9me2 and H3K27me3, in some specific PLAD regions. The combination analyses of epigenomic and transcriptomic data between the kaku4-2 mutant and WT suggested that KAKU4 may regulate key biological processes, such as programmed cell death and hormone signaling pathways, by affecting H3K27me3 modification in Arabidopsis leaves.

Conclusions

In summary, our results indicated that KAKU4 is directly and/or indirectly associated with chromatin/epigenetic modifiers and demonstrated the essential roles of KAKU4 in regulating chromatin states, transcriptional regulation, and diverse biological processes in Arabidopsis.
The effects of telehealth-delivered mindfulness meditation, cognitive therapy, and behavioral activation for chronic low back pain: a randomized clinical trial
Authors: Day Melissa A. , Ciol Marcia A. , Mendoza M. Elena , Borckardt Jeffrey , Ehde Dawn M. , Newman Andrea K. , Chan Joy F. , Drever Sydney A. , Friedly Janna L. , Burns John , Thorn Beverly E. , Jensen Mark P.
Published: April 2024

Background

Chronic low back pain (CLBP) is a significant problem affecting millions of people worldwide. Three widely implemented psychological techniques used for CLBP management are cognitive therapy (CT), mindfulness meditation (MM), and behavioral activation (BA). This study aimed to evaluate the relative immediate (pre- to post-treatment) and longer term (pre-treatment to 3- and 6-month follow-ups) effects of group, videoconference-delivered CT, BA, and MM for CLBP.

Methods

This is a secondary analysis of a three-arm, randomized clinical trial comparing the effects of three active treatments—CT, BA, and MM—with no inert control condition. Participants were N = 302 adults with CLBP, who were randomized to condition. The primary outcome was pain interference, and other secondary outcomes were also examined. The primary study end-point was post-treatment. Intent-to-treat analyses were undertaken for each time point, with the means of the changes in outcomes compared among the three groups using an analysis of variance (ANOVA). Effect sizes and confidence intervals are also reported.

Results

Medium-to-large effect size reductions in pain interference were found within BA, CT, and MM (ds from − .71 to − 1.00), with gains maintained at both follow-up time points. Effect sizes were generally small to medium for secondary outcomes for all three conditions (ds from − .20 to − .71). No significant between-group differences in means or changes in outcomes were found at any time point, except for change in sleep disturbance from pre- to post-treatment, improving more in BA than MM (d =  − .49).

Conclusions

The findings from this trial, one of the largest telehealth trials of psychological treatments to date, critically determined that group, videoconference-delivered CT, BA, and MM are effective for CLBP and can be implemented in clinical practice to improve treatment access. The pattern of results demonstrated similar improvements across treatments and outcome domains, with effect sizes consistent with those observed in prior research testing in-person delivered and multi-modal psychological pain treatments. Thus, internet treatment delivery represents a tool to scale up access to evidence-based chronic pain treatments and to overcome widespread disparities in healthcare.

Trial registration

Clinicaltrials.gov, NCT03687762.
New frontiers in salivary extracellular vesicles: transforming diagnostics, monitoring, and therapeutics in oral and systemic diseases
Authors: Cui Li , Zheng Jiarong , Lu Ye , Lin Pei , Lin Yunfan , Zheng Yucheng , Xu Rongwei , Mai Zizhao , Guo Bing , Zhao Xinyuan
Published: April 2024

Salivary extracellular vesicles (EVs) have emerged as key tools for non-invasive diagnostics, playing a crucial role in the early detection and monitoring of diseases. These EVs surpass whole saliva in biomarker detection due to their enhanced stability, which minimizes contamination and enzymatic degradation. The review comprehensively discusses methods for isolating, enriching, quantifying, and characterizing salivary EVs. It highlights their importance as biomarkers in oral diseases like periodontitis and oral cancer, and underscores their potential in monitoring systemic conditions. Furthermore, the review explores the therapeutic possibilities of salivary EVs, particularly in personalized medicine through engineered EVs for targeted drug delivery. The discussion also covers the current challenges and future prospects in the field, emphasizing the potential of salivary EVs in advancing clinical practice and disease management.