bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitreous inflammatory and angiogenic factors on patients with proliferative diabetic retinopathy or diabetic macular edema: the role of Lipocalin2
Authors: Batsos Georgios , Christodoulou Eleni , Christou Evita Evangelia , Galanis Petros , Katsanos Andreas , Limberis Loren , Stefaniotou Maria
Published: December 2022

Purpose

Quantitative analysis of vitreous inflammatory and angiogenic factors from patients with proliferative diabetic retinopathy (PDR) or diabetic macular edema (DME).

Materials and methods

Collection of undiluted vitreous samples from 20 diabetic patients: 13 with proliferative diabetic retinopathy (PDR) and 7 with diabetic macular edema (DME). DME patients had suboptimal response to anti-VEGF treatment. Samples from 11 control patients, with vitreomacular interface pathology such as idiopathic epiretinal membrane (iERM) (n = 4), vitreomacular traction syndrome (VMT) (n = 3) and full thickness macular hole (FTMH) (n = 3), were also collected. The levels of IL1b, IL6, IL8, IL27, TNFα, ICAM-1, VCAM, MCP-1, VEGFA and LCN2 were measured using cytometry flow analysis. Median values were compared with Mann–Whitney test since the distributions were skewed. Statistical analysis was performed with the Statistical Package for Social Sciences software (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.).

Results

The median concentration of LCN2, IL6, IL8, IL1b, IL27, ICAM, VCAM-1, MCP-1, TNFa and VEGFA was higher in PDR patients than in controls. Similarly, the median concentration of LCN2, IL6, IL8, IL27, ICAM, VCAM-1, TNFa and VEGFA was higher in DME patients than in controls. In particular, median LCN2 concentration in diabetic patients was 5,711 pg/ml (interquartile range [IR] = 2,534), while in controls was 2,586 pg/ml (IR = 2,345). Moreover, median LCN2 was 6,534 pg/ml in the DME group (IR = 6,850) and 4,785 pg/ml in the PDR group (IR = 2,608), (p = 0.025).

Conclusion

Various inflammatory and angiogenic factors are involved in the pathophysiology of PDR and DME. Elevated vitreous levels of LCN2 in PDR and especially in DME patients reveal a potential pathogenic association. More extended studies could verify LCN2 as an alternative therapeutic target.
Stress symptoms and associated factors among adolescents in Dhaka, Bangladesh: findings from a cross-sectional study
Authors: Anjum Afifa , Hossain Sahadat , Hasan M. Tasdik , Christopher Enryka , Uddin Md. Elias , Sikder Md. Tajuddin
Published: December 2022

Background

Stress affects adolescents’ daily lives by disrupting their working capacity and begets comorbidity. This study aimed to estimate the prevalence of stress symptoms and the factors associated with these symptoms among secondary school-going adolescents in Bangladesh.

Methods

A cross-sectional study using two-stage cluster sampling was conducted. A self-administered questionnaire was given to 2355 adolescents from nine secondary schools in Dhaka, Bangladesh. Of the respondents, 2313 completed the 10-item Perceived Stress Scale (PSS-10). Sociodemographic information, self-reported body image, a modified Leisure Time Exercise Questionnaire (LTEQ), and the WHO Global Physical Activity Questionnaire (GPAQ) were used to determine the sociodemographic and lifestyle factors associated with stress symptoms among adolescents.

Results

Findings suggest that about 65% of adolescents experienced moderate stress symptoms, and about 9% experienced high-stress symptoms. Females (58.7%) suffered more from stress compared to males (41.3%). Age, grade, and residential setting were significantly associated with stress. Logistic regression estimates show that level of physical activity (AOR: 1.52; 95% CI:1.26–1.84), sleep dissatisfaction (AOR: 1.33; 95% CI: 1.07–1.65), and perception of self as overweight/obese (AOR: 1.46; 95% CI: 1.13–1.89) were significantly associated with stress symptoms among adolescents.

Conclusions

Stress symptoms are highly prevalent among secondary school adolescents in Bangladesh. Further exploratory investigations are needed on possible intervention strategies to reduce the burden of stress among adolescents.
Psychological stress and psychological support of Chinese nurses during severe public health events
Authors: Zhou Yufang , Wang Youtian , Huang Meilian , Wang Chen , Pan Yuanxin , Ye Junrong , Wu Shengwei , Wu Chenxin , Wang Haoyun , Wang Ting , Xiao Aixiang , Yu Lin
Published: December 2022

The domestic health care system has been facing a difficult task, especially in medical care, and Chinese nurses are under tremendous psychological pressure. Psychological support is a protective factor to relieve stress. This study examined the stress level and characteristics of Chinese nurses with different psychological support-seeking behaviours. Data from online questionnaires for this cross-sectional study were collected between January 2020 and February 2020 and yielded 2248 valid questionnaires for analysis with a response rate of 99.8%. General information of the respondents was also collected. The nurses’ stress levels were assessed using the Perceived Stress Scale (PSS-10). T tests, chi-square tests, and linear regression were used to examine the relationships among the factors. The results of this survey showed that between January and February 2020, 26.9% of nurses received psychological counselling, and the proportion was higher among men and nurses with lower education. The PSS-10 was related to gender, age group, provincial severity, and confidence in the control of the epidemic. The results showed that psychological support can effectively improve the confidence of domestic nurses in the face of arduous work and effectively relieve the psychological pressure caused by a heavy workload.
Association of anticipated HIV testing stigma and provider mistrust on preference for HIV self-testing among cisgender men who have sex with men in the Philippines
Authors: Sison Olivia T. , Baja Emmanuel S. , Bermudez Amiel Nazer C. , Quilantang Ma. Irene N. , Dalmacion Godofreda V. , Guevara Ernest Genesis , Garces-Bacsal Rhoda Myra , Hemingway Charlotte , Taegtmeyer Miriam , Operario Don , Biello Katie B.
Published: December 2022

Background

New HIV infections in the Philippines are increasing at an alarming rate. However, over three quarters of men who have sex with men (MSM) have never been tested for HIV. HIV self-testing (HIVST) may increase overall testing rates by removing barriers, particularly fear of stigmatization and mistrust of providers. This study aimed to determine if these factors are associated with preference for HIVST among Filipino cisgender MSM (cis-MSM), and whether there is an interaction between anticipated HIV testing stigma and provider mistrust on preference for HIVST.

Methods

We conducted secondary analysis of a one-time survey of 803 cis-MSM who were recruited using purposive sampling from online MSM dating sites and MSM-themed bar locations in Metro Manila, Philippines. Summary statistics were computed to describe participant characteristics. Multivariable modified Poisson regression analyses were conducted to determine if anticipated HIV testing stigma and provider mistrust were associated with preference for HIVST among cis-MSM. Other variables such as age, education, monthly income, relationship status, HIV serostatus, and knowing where to get HIV testing were the minimal sufficient adjustment set in the analyses.

Results

Average age of participants was 28.6 years (SD = 8.0); most had received college degrees (73%) and were employed (80%). Most respondents (81%) preferred facility-based testing, while 19% preferred HIVST. A high percentage of participants reported anticipated HIV testing stigma (66%) and provider mistrust (44%). Anticipated HIV testing stigma (aPR = 1.51; 95% CI = 1.01–2.25, p = 0.046) and provider mistrust (aPR = 1.49; 95% CI = 1.07–2.09, p = 0.020) were independently associated with a preference for HIVST. There was a positive, additive interaction between provider mistrust and anticipated HIV testing stigma on preference for HIVST (RERI = 1.13, 95% CI: 0.20–2.06; p = 0.017), indicating that the association between anticipated HIV testing stigma and preference for HIVST is greater among those with provider mistrust compared to those without provider mistrust.

Conclusions

HIVST should be offered as a supplement to traditional facility-based HIV testing services in the Philippines to expand testing and reach individuals who may not undergo testing due to anticipated HIV testing stigma and provider mistrust.
Pitfalls in the Diagnosis of Primary Hyperparathyroidism in a Sudanese Adolescent Boy; a case disguised as rickets
Authors: Gafar Sara MohammedAhmed , Fadlalbari Ghassan Faisal , Abdalla Asmahan T. , Mohammed Sawsan Abdel Rahim , Alrasheed Mohammed Khalid , Taha Isam Ahmed , Abdullah Mohamed Ahmed
Published: December 2022

Background

Juvenile primary hyperparathyroidism (PHPT) is a rare endocrine disease. Its diagnosis might be masked by clinical, biochemical, and radiological features of rickets.

Case presentation

A 12-year-old Sudanese boy presented with progressive lower limbs deformity and difficulty in walking for six months. It was associated with fatigability, poor appetite, and generalized bone pain. On examination, he was thin, disproportionately short and pubertal, and had bilateral genu valgum deformity. X-rays showed osteopenia and signs of rickets. Biochemical workup revealed mildly elevated serum calcium, low phosphate, high alkaline phosphatase, and high parathyroid hormone with low 25-hydroxy vitamin D3. Celiac screening, liver function test and renal profile were normal. Serum calcium rose dramatically after vitamin D therapy. Genetic testing was negative for CYP2R1 and MEN1 genes. Ultrasound neck showed left inferior parathyroid adenoma which was surgically excised. Histopathology confirmed the diagnosis of parathyroid adenoma. Postoperatively, he had hypocalcemia which was treated with calcium and alfacalcidol. Corrective surgery is planned for the genu valgum deformity which markedly improved after parathyroidectomy.

Conclusion

Although PHPT is extremely rare in the young population, it should be considered in patients with rickets and elevated serum calcium at baseline or after initiating vitamin D therapy.
Upfront surgery in patients with epithelial ovarian cancer and enlarged supradiaphragmatic lymph nodes associated with comparable to neoadjuvant chemotherapy
Authors: Weitzner Omer , Yagur Yael , Kadan Yfat , Fishman Ami , Zissin Rivka , Ben-Ezry Emilie , Helpman Limor , Beiner Mario E.
Published: December 2022

Background

There is little data regarding the optimal approach to advanced epithelial ovarian cancer (EOC) with isolated extra-peritoneal disease in the cardiophrenic lymph nodes. This study assessed whether the prognosis and surgical outcomes are affected by the treatment approach among these patients.

Material and methods

This retrospective cohort study included patients with advanced EOC, who were treated 2012–2020. Computed tomography scans were reviewed for disease extent and the presence of enlarged supradiaphragmatic nodes (SDLN). Demographic, clinical and oncologic data were recorded. Characteristics and outcomes of patients with and without enlarged SDLN were evaluated, and outcomes of patients with enlarged SDLN who underwent upfront surgery and neoadjuvant chemotherapy were compared.

Results

Among 71 women, 47 (66%) had enlarged supradiaphragmatic lymph nodes. Groups had similar baseline characteristics. Among 47 women who had enlarged SDLN. There was no significant difference in progression free survival among patients who had upfront cytoreduction compared to those who received neoadjuvant chemotherapy. Only one asymptomatic chest recurrence was observed.

Conclusion

Patients with enlarged SDLN have comparable outcomes with either upfront surgery or neoadjuvant chemotherapy. Moreover, the frequency of chest recurrences in patients presenting with enlarged SDLN is exceedingly low.
A mixed-methods study of the effectiveness and perceptions of a course design institute for health science educators
Authors: Speer Julie , Conley Quincy , Thurber Derek , Williams Brittany , Wasden Mitzi , Jackson Brenda
Published: December 2022

Background

Most health care professionals get their start in academics without formal teaching training. As such, institutions encourage participation in opportunities to address gaps in faculty’s knowledge of pedagogy and learning theory in order to promote both successful student and patient outcomes. This study aimed to examine the reception of a faculty development program focused on teaching participants the basics of course design.

Methods

Applying a mixed-method approach, this retrospective study used pre/post-tests, assignment grades, self-assessment questionnaires, and focus groups to elucidate the impact of the faculty development intervention on course design. The participants (n = 12) were health educators from a private all-graduate level university with campus locations across the United States, including in the Southwest and Midwest. In the Course Design Institute (CDI), the participating faculty learned evidence-based instructional approaches and techniques to implement contemporary teaching practices.

Results

The data from the pre/post-tests and focus groups suggest that participants learned about topics including instructional alignment, learning goals and objectives, instructional strategies, assessment planning, feedback approaches, communicating expectations, and adult learning theories by participating in this course. The final deliverable scores indicate that the CDI graduates were able to apply a backward design process to plan their own instruction. Data from both the survey and the focus groups suggest that participants were satisfied with the experience and particularly appreciated that the course was relevant to them as educators in the health sciences.

Conclusions

The results of this study indicate that the CDI was influential in developing the faculty’s knowledge of the course design process, promoted the application of course design and pedagogy skills amongst CDI graduates, and positively impacted self-reported attitudes about their teaching abilities. In addition, feedback from participants indicates that they recognized the value of this program in their own development and they believed it should be a required course for all educators at the institution.
Association between sociodemographic characteristics and level of knowledge about oral cancer among Mexican dental health professionals: a cross-sectional online survey
Authors: Gijón-Soriano Ana Lilia , Argueta-Figueroa Liliana , Pérez-Cervera Yobana , Acevedo-Mascarúa Alfonso Enrique , González-Arratia-López-Fuentes Norma Ivonne , Torres-Muñoz Martha Adelina , Moyaho-Bernal María de los Angeles , Torres-Rosas Rafael
Published: December 2022

Background

A good level of knowledge in dentists is crucial for an early diagnosis of oral cancer (OC). In Latin America there are a few studies of OC knowledge among dentist, those has been performed in Brazil, Colombia, and Chile, and their results showed low level of OC knowledge. On the other hand, there is no publication in which the level of knowledge of dentists in Mexico has been addressed. Therefore, this study aimed to assess knowledge of OC and to determine the association of the level of knowledge with sociodemographic characteristics among dentists in Mexico.

Methods

A cross-sectional online survey was designed to obtain information via questionnaire. The questionnaire was developed in the Spanish language, and the content validity was determined. The study was conducted among Mexican dentists with a 23-item questionnaire that was designed to be anonymous. The sample size was calculated using the finite population formula. Based on the responses, the level of knowledge of OC was categorized as very low, low, regular, good, or excellent. Additionally, the association between sociodemographic characteristics and the level of knowledge about OC was evaluated.

Results

This research was conducted on a sample of 387 dentists. Most of the respondents were general dentists and worked in urban zones. The majority of dentists lacked a specialty (76.7%). Additionally, most of the respondents were students (44.2%). The level of knowledge of the participants was between regular and good (77.8%). On the other hand, concerning self-evaluation, most of the participants considered their knowledge of OC to be regular (50.6%). In addition, there was no association between sociodemographic characteristics and knowledge about OC.

Conclusions

This research identified some weaknesses in most Mexican dentists’ knowledge of OC.
Knowledge, attitude and dispensing practice of the pharmacists related to complementary alternative medicines in the Riyadh region of Saudi Arabia: a cross-sectional descriptive study
Authors: Al-Yousef Hanan M. , Alghadir Ahmad H. , Iqbal Amir
Published: December 2022

Background

The use of complementary alternative medicines (CAMs) has risen globally in recent times. Such medications are exclusively and readily available in the Riyadh region of Saudi Arabia through community pharmacies and other retail outlets, exposing the consumers to various risks like harmful drug interactions. These situations take pharmacists to a responsible position where they should provide evidence-based information to help consumers make safe consumption. The consumption of CAMs can be ensured safe if pharmacists have appropriate knowledge and training about their use, dosing, side effects, etc. This study aimed to investigate and evaluate the pharmacist's factual knowledge, perception and dispensing practice related to various aspects of CAMs based on gender and experience.

Methods

The study followed a structured self-administered questionnaire-based cross-sectional survey design. Out of 200, with a response rate of 89.5%, 179 pharmacists (115 males; 64 females) from the Riyadh region of Saudi Arabia participated in this study. The knowledge scores of male and female pharmacists were compared using an unpaired t-test. The correlation between pharmacists’ knowledge and their work experience was determined using Pearson's correlation coefficient test, keeping the significance value atp < 0.05.

Results

Almost all the respondents (99%) reported that they had never attended any lecture or course related to CAMs. Results show low knowledge scores, indicating poor respondents' knowledge concerning the use of CAMs. No significant difference was observed in knowledge scores based on gender, and no significant correlation between pharmacists' knowledge scores and their work experiences.

Conclusion

Therefore, the study concluded that both male and female pharmacists possess equal knowledge concerning the use of CAMs, and their work experience doesn’t differentiate in their knowledge. Various factors like lack of time, etc., prevented respondents from interacting with patients. Regular organization of mandatory continuing education programs about the safe use of CAMs that can improve their knowledge is recommended. In addition, establishing a pharmacy connection network system can enhance patient monitoring and CAMs vigilance. This study lays a foundation for further work to assess pharmacists’ knowledge and practice patterns in Saudi Arabia.

Trial registration

Not applicable.
Impact of different mosquito collection methods on indicators of Anopheles malaria vectors in Uganda
Authors: Mawejje Henry Ddumba , Asiimwe Jackson R. , Kyagamba Patrick , Kamya Moses R. , Rosenthal Philip J. , Lines Jo , Dorsey Grant , Staedke Sarah G.
Published: December 2022

Background

Methods used to sample mosquitoes are important to consider when estimating entomologic metrics. Human landing catches (HLCs) are considered the gold standard for collecting malaria vectors. However, HLCs are labour intensive, can expose collectors to transmission risk, and are difficult to implement at scale. This study compared alternative methods to HLCs for collecting Anopheles mosquitoes in eastern Uganda.

Methods

Between June and November 2021, mosquitoes were collected from randomly selected households in three parishes in Tororo and Busia districts. Mosquitoes were collected indoors and outdoors using HLCs in 16 households every 4 weeks. Additional collections were done indoors with prokopack aspirators, and outdoors with pit traps, in these 16 households every 2 weeks. CDC light trap collections were done indoors in 80 households every 4 weeks. Female Anopheles mosquitoes were identified morphologically and Anopheles gambiae sensu lato were speciated using PCR. Plasmodium falciparum sporozoite testing was done with ELISA.

Results

Overall, 4,891 female Anopheles were collected, including 3,318 indoors and 1,573 outdoors. Compared to indoor HLCs, vector density (mosquitoes per unit collection) was lower using CDC light traps (4.24 vs 2.96, density ratio [DR] 0.70, 95% CIs 0.63–0.77, p < 0.001) and prokopacks (4.24 vs 1.82, DR 0.43, 95% CIs 0.37–0.49, p < 0.001). Sporozoite rates were similar between indoor methods, although precision was limited. Compared to outdoor HLCs, vector density was higher using pit trap collections (3.53 vs 6.43, DR 1.82, 95% CIs 1.61–2.05, p < 0.001), while the sporozoite rate was lower (0.018 vs 0.004, rate ratio [RR] 0.23, 95% CIs 0.07–0.75, p = 0.008). Prokopacks collected a higher proportion of Anopheles funestus (75.0%) than indoor HLCs (25.8%), while pit traps collected a higher proportion of Anopheles arabiensis (84.3%) than outdoor HLCs (36.9%).

Conclusion

In this setting, the density and species of mosquitoes collected with alternative methods varied, reflecting the feeding and resting characteristics of the common vectors and the different collection approaches. These differences could impact on the accuracy of entomological indicators and estimates of malaria transmission, when using the alternative methods for sampling mosquitos, as compared to HLCs.
CircNTNG1 inhibits renal cell carcinoma progression via HOXA5-mediated epigenetic silencing of Slug
Authors: Liang Yanping , Cen Junjie , Huang Yong , Fang Yong , Wang Yunfei , Shu Guannan , Pan Yihui , Huang Kangbo , Dong Jiaqi , Zhou Mi , Xu Yi , Luo Junhang , Liu Min , Zhang Jiaxing
Published: December 2022

Background

Recent studies have identified that circular RNAs (circRNAs) have an important role in cancer via their well-recognized sponge effect on miRNAs, which regulates a large variety of cancer-related genes. However, only a few circRNAs have been well-studied in renal cell carcinoma (RCC) and their regulatory function remains largely elusive.

Methods

Bioinformatics approaches were used to characterize the differentially expressed circRNAs in our own circRNA-sequencing dataset, as well as two public circRNA microarray datasets. CircNTNG1 (hsa_circ_0002286) was identified as a potential tumor-suppressing circRNA. Transwell assay and CCK-8 assay were used to assess phenotypic changes. RNA pull-down, luciferase reporter assays and FISH experiment were used to confirm the interactions among circNTNG1, miR-19b-3p, and HOXA5 mRNA. GSEA was performed to explore the downstream pathway regulated by HOXA5. Immunoblotting, chromatin immunoprecipitation, and methylated DNA immunoprecipitation were used to study the mechanism of HOXA5.

Results

In all three circRNA datasets, circNTNG1, which was frequently deleted in RCC, showed significantly low expression in the tumor group. The basic properties of circNTNG1 were characterized, and phenotype studies also demonstrated the inhibitory effect of circNTNG1 on RCC cell aggressiveness. Clinically, circNTNG1 expression was associated with RCC stage and Fuhrman grade, and it also served as an independent predictive factor for both OS and RFS of RCC patients. Next, the sponge effect of circNTNG1 on miR-19b-3p and the inhibition of HOXA5 by miR-19b-3p were validated. GSEA analysis indicated that HOXA5 could inactivate the epithelial–mesenchymal transition (EMT) process, and this inactivation was mediated by HOXA5-induced SNAI2 (Slug) downregulation. Finally, it was confirmed that the Slug downregulation was caused by HOXA5, along with the DNA methyltransferase DNMT3A, binding to its promoter region and increasing the methylation level.

Conclusions

Based on the experimental data, in RCC, circNTNG1/miR-19b-3p/HOXA5 axis can regulate the epigenetic silencing of Slug, thus interfering EMT and metastasis of RCC. Together, our findings provide potential biomarkers and novel therapeutic targets for future study in RCC.
Chiropractors in interprofessional practice settings: a narrative review exploring context, outcomes, barriers and facilitators
Authors: Myburgh Corrie , Teglhus Solvej , Engquist Kristian , Vlachos Evgenios
Published: December 2022

To determine the added value of interprofessional interventions over existing mono-professional practice, elucidation of specific health care issues, service delivery contexts and benefits of combining multiple service provider is required. However, from existing literature, it is difficult to develop a sense of the evidence that supports interprofessional practice initiatives involving chiropractors. This review aims to describe and explore the contexts, outcomes, and barriers and facilitators relating to interprofessional practice involving chiropractors available in current literature. A search of Scopus, CINAHL, Cochrane, and Web of Science databases covering the literature from 2005 to October 2021 was conducted, after which a narrative review of identified peer-reviewed articles written in English was performed. We included data from seven studies, conducted across four distinct service delivery contexts. Eight interprofessional practice partners were identified, and eight factors appear to act as barriers and facilitators. Data suggests that incorporating chiropractors into community health and sports medicine interprofessional practice interventions is achievable and appears to impact collaborative practice positively. For older adults with low back pain, quality of life and care-related satisfaction are potential relevant outcomes for the evaluation of interprofessional practice interventions. There is currently very limited evidence from which to judge the value of interprofessional practice interventions, as available literature appears to focus mainly on interprofessional collaboration. Studies conducted specifically to evaluate interprofessional practice solutions and addressing specific health care issues or practice domains are urgently required.
Single-blind, randomized study comparing clinical equivalence of trulene and prolene polypropylene sutures in elective primary coronary artery bypass graft surgery
Authors: Shetty Ravi Shankar , Kaul Ajay , Goyal Aayush , Konda Govardhan Reddy , Srivastava Sushant , Moharana Ashok Kumar , Deepak T. S.
Published: December 2022

Background

Coronary artery bypass graft surgery (CABG) is one of the principle therapies for coronary artery disease, as it improves survival rate and quality of life (QoL). Polypropylene suture is commonly used in vascular and cardiac surgeries for anastomosis due to its long-term tensile strength and minimal tissue trauma. This study compared the clinical equivalence of Trulene® (Healthium Medtech Limited) and Prolene® (Ethicon-Johnson & Johnson) polypropylene sutures regarding incidence of myocardial infarction, stroke, renal failure and cardiac death (MACCE) occurring up to 26 weeks’ period post-CABG surgery.

Methods

This multicenter, prospective, two-arm, parallel-group, randomized (1:1), single-blind study (n = 89) was conducted between August 2020 and September 2021. The primary endpoint, post-surgery cumulative incidence of MACCE was evaluated. In addition, anastomotic revision, surgical site infection (SSI), operative time, length of post-operative hospital stay, repeat revascularization, intraoperative suture handling characteristics, time taken to return to work and resume normal day to day activities, subject satisfaction score and QoL, and other adverse events were also recorded.

Results

A total of 80 (89.89%) males and 9 (10.11%) females participated in the study. No incidence of MACCE was recorded in any of the study participants. Non-significant difference was observed in anastomotic revision, SSI, operative time, post-operative hospital stay, revascularization, return to work and normal day-to-day activities, subject satisfaction score and QoL, and intraoperative handling parameters (except ease of passage) between the treatment groups, Trulene® and Prolene®. Compared to screening visit, proportion of subjects with ‘no problems’ for each QoL dimension and the mean visual analogue scale increased with each subsequent follow-up visit.

Conclusion

Trulene® polypropylene suture is clinically equivalent to Prolene® polypropylene suture and is safe and effective for anastomosis construction in CABG surgery during a routine clinical procedure.

Trial registration CTRI Registration No.: CTRI/2020/05/025157 (Registered on: 13/05/2020).
Patient‐perceived and practitioner‐perceived barriers to accessing foot care services for people with diabetes mellitus: a systematic literature review
Authors: McPherson Megan , Carroll Matthew , Stewart Sarah
Published: December 2022

Background

Foot‐related complications are common in people with diabetes mellitus, however foot care services are underutilized by this population. This research aimed to systematically review the literature to identify patient and practitioner‐perceived barriers to accessing foot care services for people with diabetes.

Methods

PRISMA guidelines were used to inform the data collection and extraction methods. CINAHL, MEDLINE, and Scopus databases were searched in March 2022 to identify original research articles that reported on barriers to accessing diabetes foot care services from the patient and/or practitioner perspective. Both quantitative and qualitative studies were included. The methodological quality of included studies was assessed using the Critical Appraisal Skills Program (CASP) tool for qualitative/mixed methods studies or the National Heart, Lung & Blood Institute (NHLBI) tool for quantitative studies. Following data extraction, content analysis was used to identify reported barriers. Themes and subthemes were presented separately for patient‐perspectives and practitioner‐perspectives. A narrative summary was used to synthesize the findings from the included studies.

Results

A total of 20 studies were included. The majority of CASP and NHLBI criteria were met by most studies, indicating good overall methodological quality. Three predominant themes emerged from the patient perspective that represented barriers to accessing foot care services: lack of understanding, socioeconomic factors, and lack of service availability. Four themes emerged from the practitioner perspective: poor interprofessional communication, lack of resources, lack of practitioner knowledge, and perceived patient factors.

Conclusions

This study has identified a number of barriers to accessing foot care services from both the patient and practitioner perspectives. Although patients focused predominantly on patient‐level factors, while practitioners focused on barriers related to the health care system, there was some overlap between them. This emphasizes the importance of recognising both perspectives for the future integration of policy changes and access facilitators that may help to overcome these barriers.
Effects of aerobic exercise training in oxidative metabolism and mitochondrial biogenesis markers on prefrontal cortex in obese mice
Authors: de Sousa Fernandes Matheus Santos , Aidar Felipe J. , da Silva Pedroza Anderson Apolônio , de Andrade Silva Severina Cássia , Santos Gabriela Carvalho Jurema , dos Santos Henrique Rafael , Clemente Filipe Manuel , Silva Ana Filipa , de Souza Raphael Fabrício , Ferreira Diorginis José , Badicu Georgian , Lagranha Claudia , Nobari Hadi
Published: December 2022

Background

To evaluate the effects of 8 weeks of Aerobic Physical Training (AET) on the mitochondrial biogenesis and oxidative balance in the Prefrontal Cortex (PFC) of leptin deficiency-induced obese mice (ob/ob mice).

Methods

Then, the mice were submitted to an 8-week protocol of aerobic physical training (AET) at moderate intensity (60% of the maximum running speed). In the oxidative stress, we analyzed Malonaldehyde (MDA) and Carbonyls, the enzymatic activity of Superoxide Dismutase (SOD), Catalase (CAT) and Glutathione S Transferase (GST), non-enzymatic antioxidant system: reduced glutathione (GSH), and Total thiols. Additionally, we evaluated the gene expression of PGC-1α SIRT-1, and ATP5A related to mitochondrial biogenesis and function.

Results

In our study, we did not observe a significant difference in MDA (p = 0.2855), Carbonyl’s (p = 0.2246), SOD (p = 0.1595), and CAT (p = 0.6882) activity. However, the activity of GST (p = 0.04), the levels of GSH (p = 0.001), and Thiols (p = 0.02) were increased after 8 weeks of AET. Additionally, there were high levels of PGC-1α (p = 0.01), SIRT-1 (p = 0.009), and ATP5A (p = 0.01) gene expression after AET in comparison with the sedentary group.

Conclusions

AET for eight weeks can improve antioxidant defense and increase the expression of PGC-1α, SIRT-1, and ATP5A in PFC of ob/ob mice.
Solving systems of coupled nonlinear Atangana–Baleanu-type fractional differential equations
Authors: Hammad Hasanen A. , Zayed Mohra
Published: December 2022

In this work, we investigate two types of boundary value problems for a system of coupled Atangana–Baleanu-type fractional differential equations with nonlocal boundary conditions. The fractional derivatives are applied to serve as a nonlocal and nonsingular kernel. The existence and uniqueness of solutions for proposed problems using Krasnoselskii’s and Banach’s fixed-point approaches are established. Moreover, nonlinear analysis is used to build the Ulam–Hyers stability theory. Subsequently, we discuss two compelling examples to demonstrate the utility of our study.
Effects of rearing system and antibiotic treatment on immune function, gut microbiota and metabolites of broiler chickens
Authors: Song Bochen , Li Peng , Xu Huiping , Wang Zhong , Yuan Jianmin , Zhang Bingkun , Lv Zengpeng , Song Zhigang , Guo Yuming
Published: December 2022

Background

In China, cage systems with a high space utilization have gradually replaced ground litter systems, but the disease incidence of chickens in cages is higher. Broilers in the ground litter pens may be stimulated by more environmental microbes during the growth process and show strong immune function and status, but knowledge of which microbes and their metabolites play an immunomodulatory role is still limited. This study aimed to explore the differences and correlations in the immune function, gut microbiota and metabolites and the importance of gut microbiota of broilers raised in cages and ground litter pens.

Methods

The experiment involved a 2 × 2 factorial arrangement, with rearing systems (cages or ground litter pens) and antibiotic treatment (with or without broad-spectrum antibiotics in drinking water) as factors.

Results

The results showed that, compared with the cage group, the ground litter broilers had stronger nonspecific immune function (Macrophages% and NO in blood), humoral immune function (IgG in blood, LPS stimulation index in ileum) and cellular immune function (T%, Tc%, ConA stimulation index and cytokines in blood). Antibiotic (ABX) treatment significantly reduced nonspecific immune function (Macrophages% and NO in blood, iNOS and Mucin2 mRNA expression in ileum), humoral immune function (IgG in blood and sIgA in ileum) and cellular immune function (T% and cytokines in blood, Th and Tc ratio, TLRs and cytokines mRNA expression in ileum). Furthermore, the ground litter broilers had higher α diversity of microbiota in ileum. The relative abundance of Staphylococcus, Jeotgalicoccus, Jeotgalibaca and Pediococcus in the ileum of ground litter broilers were higher. ABX treatment significantly reduced the α diversity of ileal microbiota, with less Chloroplast and Mitochondria. In addition, the levels of acetic acid, isobutyric acid, kynurenic acid and allolithocholic acid in the ileum of ground litter broilers were higher. Spearman correlation analysis showed that Jeotgalibaca, Pediococcus, acetic acid, kynurenic acid and allolithocholic acid were related to the immune function.

Conclusions

There were more potential pathogens, litter breeding bacteria, short-chain fatty acids, kynurenine, allolithocholic acid and tryptophan metabolites in the ileum of broilers in ground litter pens, which may be the reason for its stronger immune function and status.
Optimization and production of holocellulosic enzyme cocktail from fungi Aspergillus nidulans under solid-state fermentation for the production of poly(3-hydroxybutyrate)
Authors: Naitam Mayur G. , Tomar Govind Singh , Kaushik Rajeev
Published: December 2022

The production of petroleum-based plastics increased dramatically following industrialization. Because of multifaceted properties such as durability, thermostability, water resistance, and many others, these plastics have become an indispensable part of daily life. However, while improving people’s quality of life, indiscriminate use of plastics has caused pollution and raised environmental concerns. To address this situation and reduce environmental risks, microbially produced biopolymers such as poly-3-hydroxyalkanoates can be used to make bioplastics that are completely biodegradable under normal environmental conditions. At the moment, the cost of bioplastic production is high when compared to petroleum-based plastics, so alternate strategies for making the bioplastic process economical are urgently needed. Agricultural waste is abundant around the world and can be efficiently used as a low-cost renewable feedstock after pretreatment and enzymatic hydrolysis. Fungi are well known as primary degraders of lignocellulosic waste, and this property was used in the current study to enzymatically hydrolyze the pretreated paddy straw for the production of reducing sugars, which were then used in the microbial fermentation for the production of PHB. In this study, Aspergillus nidulans was used to advance a low-cost and efficient enzyme hydrolysis system for the generation of reducing sugars from lignocellulosic biomass. For the production of the holocellulosic enzyme complex, the fungus was grown on wheat straw with Reese mineral medium as a wetting agent. After 216 h of solid-state fermentation at 30 °C, pH 6.0, the enzyme extract from A. nidulans demonstrated the highest activity, CMCase 68.58 (± 0.55), FPase 12.0 (± 0.06), Xylanase 27.17 (± 0.83), and β-glucosidase 1.89 (± 0.037). The initial pH, incubation temperature, and time all had a significant impact on final enzyme activity. Enzymatic hydrolysis of pretreated paddy straw produced reducing sugars (8.484 to 30.91 gL−1) that were then used to produce poly(3-hydroxybutyrate) using halophilic bacterial isolates. Burkholderia gladioli 2S4R1 and Bacillus cereus LB7 accumulated 26.80% and 20.47% PHB of the cell dry weight, respectively. This suggests that the holocellulosic enzyme cocktail could play a role in the enzymatic hydrolysis of lignocellulosic materials and the production of PHA from less expensive feedstocks such as agricultural waste.
Using simulation-based training during hospital relocation: a controlled intervention study
Authors: Schram Anders Lund , Lindhard Morten Søndergaard , Bie Magnus , Gamborg Maria Louise , Toxvig Neel , Skov Gitte , Jensen Rune Dall
Published: December 2022

Background

During hospital relocations, it is important to support healthcare professionals becoming familiar with new settings. Simulation-based training seems promising and in situ simulation has been suggested as a beneficial educational tool to prepare healthcare professionals for relocation. This study aimed to investigate the impact of a simulation-based training intervention on health professionals´ readiness to work in their new environment, as well as investigate sick leave before and after relocation.

Methods

The study was a controlled intervention study implemented at a university hospital in Denmark. Simulation was used to prepare employees for workflows prior to relocation. Before relocation, 1199 healthcare professionals participated in the in situ simulation-based training program. Questionnaires on readiness to perform were distributed to participants at pre-, post-, and follow-up (6 months) measurement. In addition, data on participants’ sick leave was gathered from a business intelligence portal. To compare dependent and independent groups, paired and unpaired t tests were performed on mean score of readiness to perform and sick leave.

Results

Compared to the control group, healthcare professionals participating in the intervention felt significantly more ready to work in a new hospital environment. As a measure of psychological wellbeing, register data indicated no difference in sick leave, when comparing intervention and control groups before and after participating in the in situ simulation-based training program.

Conclusions

Healthcare professionals felt significantly more ready to work in a new environment, after participating in the in situ simulation-based training program, indicating that the intervention supported healthcare professionals during relocations. This may mitigate feelings of uncertainty; however, further research is needed to explore such effects.

Trial registration

The study was approved by The Regional Ethics Committee (no. 1-16-02-222-22).
Patients’ self-management of adverse events and patient-reported outcomes in advanced renal cell carcinoma treated with targeted therapies: A prospective, longitudinal, observational study
Authors: Hong Sung-Hoo , Chung Ho Seok , Seo Ill-Young , Kwon Tae Gyun , Jeong Hyeon , Chung Jae-Il , Jeon Seung Hyun , Park Jae Young , Ha Hong Koo , Chung Byung-Ha , Song Wan , Kim Young-Joo , Kim Sang-Hee , Lee Jee-Sun , Lee Juneyoung , Chung Jinsoo
Published: December 2022

Background

Early intervention to reduce the impact of adverse events (AEs) may improve patients’ quality of life and enable optimal treatment duration.

Methods

This nationwide, multicenter, prospective, longitudinal, 1-year observational study investigated patients’ self-management of AEs associated with targeted therapy for advanced renal cell carcinoma (RCC) and explored corresponding outcomes, including treatment duration and patient-reported outcomes (PROs).

Results

We enrolled 77 advanced RCC patients (mean age 62 years) treated with a first targeted therapy. 210 cases of seven AEs of interest (fatigue, hand-foot syndrome, oral mucosal inflammation, diarrhea, gastrointestinal symptoms, hypertension, and anorexia) were observed. Most AEs were mild to moderate. Overall, 63.4% of patients were identified as managing their AEs well, reporting numerically longer treatment duration and significantly higher PRO scores than patients identified as poor managers.

Conclusions

Longer treatment duration and improved PROs were observed when advanced RCC patients managed targeted therapy-associated AEs well. Repeated education for consolidating AE self-management could be considered to enhance overall treatment outcomes.
Management of severe symptomatic abdominal lymphatic malformation complicated by abscess formation, protein-losing gastroenteropathy, and bleeding
Authors: Ono Hitoshi , Honda Shohei , Miyagi Hisayuki , Minato Masashi , Ara Momoko , Kondo Takafumi , Okumura Kazuyoshi , Okada Tadao , Taketomi Akinobu
Published: December 2022

Background

The optimal strategy for the management of patients with severe symptomatic abdominal lymphatic malformation (ALM) complicated by abscess formation, protein-losing gastroenteropathy, and bleeding has not yet been established. The present study aimed to determine an appropriate management for patients with severe symptomatic ALM, particularly for those with abdominal complications.

Materials and methods

Eight infants and young adults who underwent emergency surgery for ALM in our department, between the years 1997 and 2020, were selected for the study. We also evaluated and compared the operative procedures, operative timing, and postoperative surgical outcomes.

Results

Emergency resection was performed in all patients with bleeding. Some patients presented with ALMs that invaded the adjacent organs. Resections that included the involved organs were necessary to achieve full resolution in three patients. After evaluating the diagnostic modalities for symptomatic ALM, we also performed elective surgery for patients without bleeding.

Conclusions

Clinicians should be aware of severe symptomatic ALM with or without bleeding, as well as its associated complications, in order to select the best surgical management plan.
ERRα Attenuates Vascular Inflammation via Enhanced NFκB Degradation Pathway
Authors: Yamamoto Hiroyasu , Tanaka Yuya , Sawada Miho , Kihara Shinji
Published: December 2022

We have previously reported that β-aminoisobutyric acid (BAIBA), a muscle-derived exercise mimetic, had anti-inflammatory and reactive oxygen species (ROS) scavenging effects in vascular endothelial cells through the enhanced expression of peroxisome proliferator-activated receptor gamma coactivator-1β (PGC-1β). Although BAIBA also increased the expression of estrogen-related receptor α (ERRα), the roles of ERRα in vascular endothelial cells have yet to be fully elucidated. Here, we found that human aortic endothelial cells (HAECs) infected with ERRα-expressing adenovirus had significantly decreased mRNA levels of tumor necrosis factor α–stimulated proinflammatory molecules. However, ERRα overexpression had little effect on the mRNA levels of PGC-1β, peroxisome proliferator-activated receptors, and almost all ROS scavenging molecules, except for superoxide dismutase 2. ERRα expression significantly decreased NFκB reporter activities in a dose-dependent manner with unaltered IκBα phosphorylation levels but with a significant increase in the mRNA levels of PDZ and LIM domain protein 2 (PDLIM2) and copper metabolism gene MURR1 domain-containing protein (COMMD1), which enhance the ubiquitination and degradation of NFκB. Also, PDLIM2 and COMMD1 mRNA levels were upregulated in BAIBA-treated HAECs. Finally, we identified the ERRα-response element in the COMMD1 promoter region (−283 to −29 bp). These results indicated that ERRα exerted anti-inflammatory effects in vascular endothelial cells through COMMD1-mediated attenuation of NFκB activity, which could be an atheroprotective mechanism of physical exercise.
Dynamical Interaction Analysis of Proteins by a Random Forest-Fragment Molecular Orbital (RF-FMO) Method and Application to Src Tyrosine Kinase
Authors: Yamamoto Yuta , Nakano Shogo , Shigeta Yasuteru
Published: December 2022

Identifying key intermolecular (amino acid) interactions is crucial for understanding intrinsic protein functions. In this study, we established an efficient method for discovering key interactions by combining the random forest (RF) method, a machine learning algorithm, and an interaction analysis based on the fragment molecular orbital (FMO) method.

We applied this method to Src tyrosine kinase and verified its efficacy. We performed molecular dynamics simulations of both the open and closed forms of Src and selected 50 snapshots for each. Then, pair interaction energy (PIE) or inter-fragment interaction energy (IFIE) analyses were performed using FMO with the van der Waals (vdW)-corrected density functional tight-binding (DFTB) method. Among the 100 × 34453 data sets, we can identify the key amino acid pair regulating the open-close transition. This is consistent with the experimental and theoretical results, indicating the usefulness of the presented method. In contrast to the conventional FMO PIE interaction analysis, in the proposed method, the protein dynamics can be partially included using hundreds of trajectory data.