bluuebunny/crossref_metadata_2025 huggingface dataset:
Six-year mortality associated with living alone and loneliness in Swedish men and women born in 1930
Authors: Novak Masuma , Waern Margda , Johansson Lena , Zettergren Anna , Ryden Lina , Wetterberg Hanna , Sterner Therese Rydberg , Fässberg Madeleine Mellqvist , Gudmundsson Pia , Skoog Ingmar
Published: December 2023

Background

This study examined how living alone and loneliness associate with all-cause mortality in older men and women.

Methods

Baseline data from the Gothenburg H70 Birth Cohort Studies, including 70-year-olds interviewed in 2000 and 75-year-olds (new recruits) interviewed in 2005 were used for analyses (N = 778, 353 men, 425 women). Six-year mortality was based on national register data.

Results

At baseline, 36.6% lived alone and 31.9% reported feelings of loneliness. A total of 72 (9.3%) participants died during the 6-year follow-up period. Cumulative mortality rates per 1000 person-years were 23.9 for men and 9.6 for women. Mortality was increased more than twofold among men who lived alone compared to men living with someone (HR 2.40, 95% CI 1.34–4.30). Elevated risk remained after multivariable adjustment including loneliness and depression (HR 2.56, 95% CI 1.27–5.16). Stratification revealed that mortality risk in the group of men who lived alone and felt lonely was twice that of their peers who lived with someone and did not experience loneliness (HR 2.52, 95% CI 1.26–5.05). In women, a more than fourfold increased risk of mortality was observed in those who experienced loneliness despite living with others (HR 4.52, 95% CI 1.43–14.23).

Conclusions

Living alone was an independent risk factor for death in men but not in women. Mortality was doubled in men who lived alone and felt lonely. In contrast, mortality was particularly elevated in women who felt lonely despite living with others. In the multivariable adjusted models these associations were attenuated and were no longer significant after adjusting for mainly depression in men and physical inactivity in women. Gender needs to be taken into account when considering the health consequences of living situation and loneliness.
Unfolding biographies—a participatory narrative study on how older adults with multiple sclerosis make sense of and manage their everyday lives
Authors: Bergien Sofie Olsgaard , Skovgaard Lasse , Kristiansen Maria
Published: December 2023

Background

Today, public health research on later life, including the literature on aging with multiple sclerosis, is often centered on aging as a biological phenomenon. By applying a participatory narrative approach, this study conveys how studying biographical aging provides important insights into the elements of aging that people find relevant and meaningful. Based on narratives told by older adults living with multiple sclerosis, we explore how sensemaking unfolds and shapes the management of later life with a chronic and progressive disease.

Methods

Twenty-four older adults (aged 65 years or older) living with multiple sclerosis in Denmark were engaged in taking photographs of their everyday lives and unfold the stories framed in their photographs in subsequent narrative interviews. Interview data were analyzed using a thematic narrative analysis. Aligned with the narrative approach, the findings of the analysis are presented using five cases chosen because they provide insight into the general patterns and themes identified across the narratives of the 24 participants.

Results

Based on their photographs, the participants narrated stories centered around what they perceived as meaningful activities and social identity when aging with a progressive disease. Three themes emerged from the analysis in relation to how participants made sense of and managed aging with multiple sclerosis: 1) a life woven by non-detachable life experiences, 2) envisioning the future and 3) challenging life circumstances.

Conclusion

The findings of the study highlight that aging with multiple sclerosis is not only a biological phenomenon but also something nested in people’s biographies. How people make sense of and manage their everyday lives is shaped by strategies from all parts of their lives—past, present and future. This understanding of later life with multiple sclerosis may enhance the care offered to older adults living with multiple sclerosis if greater emphasis is placed on the exploration of their narratives and the things they find meaningful.
Community-based actions in consulates: a new paradigm for opportunities for systematic integration in Chagas disease detection
Authors: Gómez i Prat Jordi , Gregori Maria Serrano , Guiu Isabel Claveria , Choque Estefa , Flores-Chavez Maria Delmans , Molina Israel , Zarzuela Francesc , Sulleiro Elena , Dehousse Aurore , Albajar-Vinas Pedro , Ouaarab Hakima
Published: December 2023

Research has shown that multidimensional approaches to Chagas disease (CD), integrating its biomedical and psycho-socio-cultural components, are successful in enhancing early access to diagnosis, treatment and sustainable follow-up.

For the first time, a consulate was selected for a community-based CD detection campaign. Two different strategies were designed, implemented and compared between 2021 and 2022 at the Consulate General of Bolivia and a reference health facility in Barcelona open to all Bolivians in Catalonia.

Strategy 1 consisted in CD awareness-raising activities before referring those interested to the reference facility for infectious disease screening. Strategy 2 offered additional in-situ serological CD screening. Most of the 307 participants were Bolivian women residents in Barcelona. In strategy 1, 73 people (35.8% of those who were offered the test) were screened and 19.2% of them were diagnosed with CD. Additionally, 53,4% completed their vaccination schedules and 28.8% were treated for other parasitic infections (strongyloidiasis, giardiasis, eosinophilia, syphilis). In strategy 2, 103 people were screened in-situ (100% of those who were offered the test) and 13.5% received a CD diagnosis. 21,4% completed their vaccination schedule at the reference health facility and 2,9% were referred for iron deficiency anemia, strongyloidiasis or chronic hepatitis C.

The fact that the screening took place in an official workplace of representatives of their own country, together with the presence of community-based participants fueled trust and increased CD understanding. Each of the strategies assessed had different benefits. Opportunities for systematic integration for CD based on community action in consulates may enhance early access to diagnosis, care and disease prevention.
Alterations in the mammary gland and tumor microenvironment of formerly obese mice
Authors: Kuziel Genevra , Moore Brittney N. , Haugstad Grace P. , Xiong Yue , Williams Abbey E. , Arendt Lisa M.
Published: December 2023

Background

Obesity is a risk factor for breast cancer, and women with obesity that develop breast cancer have a worsened prognosis. Within the mammary gland, obesity causes chronic, macrophage-driven inflammation and adipose tissue fibrosis. Weight loss is a recommended intervention to resolve obesity, but the impact of weight loss on the mammary gland microenvironment and in tumors has not been well identified.

Methods

To examine the effects of weight loss following obesity, mice were fed a high-fat diet for 16 weeks to induce obesity, then switched to a low-fat diet for 6 weeks. We examined changes in immune cells, including fibrocytes, which are myeloid lineage cells that have attributes of both macrophages and myofibroblasts, and collagen deposition within the mammary glands of non-tumor-bearing mice and within the tumors of mice that were transplanted with estrogen receptor alpha positive TC2 tumor cells.

Results

In formerly obese mice, we observed reduced numbers of crown-like structures and fibrocytes in mammary glands, while collagen deposition was not resolved with weight loss. Following transplant of TC2 tumor cells into the mammary glands of lean, obese, and formerly obese mice, diminished collagen deposition and cancer-associated fibroblasts were observed in tumors from formerly obese mice compared to obese mice. Within tumors of obese mice, increased myeloid-derived suppressor cells and diminished CD8+ T cells were identified, while the microenvironment of tumors of formerly obese mice were more similar to tumors from lean mice. When TC2 tumor cells were mixed with CD11b+CD34+ myeloid progenitor cells, which are the cells of origin for fibrocytes, and transplanted into mammary glands of lean and obese mice, collagen deposition within the tumors of both lean and obese was significantly greater than when tumor cells were mixed with CD11b+CD34− monocytes or total CD45+ immune cells.

Conclusions

Overall, these studies demonstrate that weight loss resolved some of the microenvironmental conditions within the mammary gland that may contribute to tumor progression. Additionally, fibrocytes may contribute to early collagen deposition in mammary tumors of obese mice leading to the growth of desmoplastic tumors.
Comparison of the efficacy of two natural surfactants (BERAKSURF and BLES) in the treatment of respiratory distress syndrome among preterm neonates
Authors: Sabzevari Fatemeh , Eslamian Mahdie , Karami Robati Fatemeh , Bahmanbijari Bahareh , Daei Parizi Zahra , Jamali Zahra
Published: December 2023

Background

The benefit of surfactant replacement therapy for respiratory distress syndrome (RDS) has been demonstrated. However, some surfactants are expensive and usually inaccessible. Consequently, the Iranian Survanta was produced, but its effect on complications and mortality of RDS is unknown. This study aimed to compare the therapeutic outcomes of Iranian surfactant (beraksurf) and BLES (bovine lipid extract surfactant) on RDS treatment among preterm neonates.

Methods

This triple blinded randomized controlled trial study was performed on 128 eligible neonates diagnosed with RDS in Afzalipour hospital in Kerman, Iran. Diagnosis of RDS, gestational age of 28–34 weeks and weight ≥ 1 kg were considered as inclusion criteria. Congenital anomalies such as congenital cyanotic heart diseases, digestive system anomalies and chromosome abnormalities were the exclusion criteria Neonates were randomly assigned into two equal groups: (1) those treated with BLES (n = 64) and (2) those treated with beraksurf (n = 64). Complications including patent ductus arteriosus (PDA), sepsis, intraventricular hemorrhage (IVH), pneumothorax, pulmonary hemorrhage, mortality, and also, the number of days required for invasive mechanical ventilation (using ventilator) and non-invasive continuous positive airway pressure (CPAP) were evaluated for all neonates. The risk ratio (RR) was calculated at 95% of confidence intervals (CI).

Results

Compared with BLES group, the RR estimate among neonates in beraksurf group was 0.89 (0.66–1.20) for PDA, 0.71 (0.23–2.13) for IVH, 0.44 (0.14–1.36) for sepsis, 0.35 (0.13–0.93) for pneumothorax, 0.33 (0.12–0.86) for pulmonary hemorrhage, and 0.55 (0.28–1.05) for mortality.

Conclusions

Despite advances in the use of exogenous surfactants for the treatment of neonatal respiratory distress syndrome; There are still some controversial topics in this field. The results obtained in the present study showed that the two types of surfactant (BERAKSURF and BLES) have similar efficacy for the treatment and short-term outcomes in preterm infants with respiratory distress syndrome. Therefore, due to the cost-effectiveness of BRAKSURF compared to BLES, We recommend choosing BERAKSURF in terms of treatment.
Characteristics of neonatal hypoxic-ischemic encephalopathy at high altitude and early results of therapeutic hypothermia
Authors: Li Jia , Zhang Guofei , Wang Xiaorong , Qiangba Cuozhen , Song Xiaoyan , Lin Rouyi , Huang Chantao , Yang Xiaoying , Ning Shuyao , Zhang Jian , Liao Haiyan , Xie Siyuan , Suo Zhen , Qi Haiying , Yu Zhen , Shi Runling , Yao Yanli
Published: December 2023

Background

Altitude hypoxia and limited socioeconomic conditions may result in distinctive features of neonatal hypoxic-ischemic encephalopathy (HIE). Therapeutic hypothermia (TH) has not been used at altitude. We examined characteristics of HIE and early outcomes of TH in 3 centers at two high altitudes, 2 at 2,261 m and 1 at 3,650 m.

Methods

The incidence of HIE at NICUs was noted. TH was conducted when personnel and devices were available in 2019~2020. Standard inclusion criteria were used, with the addition of admission age >6 hours and mild HIE. Demographic and clinical data included gestational age, gender, weight, Apgar score, ethnics, age on admission, age at TH and clinical degree of HIE. EEG was monitored for 96 hours during hypothermia and rewarming. MRI was performed before discharge.

Results

There was significant difference in ethnics, HIE degree, age at TH across 3 centers. The overall NICU incidence of HIE was 4.0%. Among 566 HIE patients, 114 (20.1%) received TH. 63 (55.3%) patients had moderate/severe HIE. Age at TH >6 hours occurred in 34 (29.8%) patients. EEG discharges showed seizures in 7~11% of patients, whereas spikes/sharp waves in 94~100%, delta brushes in 50~100%. After TH, MRI showed moderate to severe brain injury in 77% of patients, and correlated with center, demographic and clinical variables (Ps≤0.0003). Mortality was 5% during hospitalization and 11% after discharge until 1 year.

Conclusions

At altitude, the incidence of HIE was high and brain injury was severe. TH was limited and often late >6 hours. EEG showed distinct patterns attributable to altitude hypoxia. TH was relatively safe.

Trial registration

The study was registered on February 23, 2019 in Chinese Clinical Trial Register (ChiCTR1900021481).
Measuring generic health using the minimum european health module: does it work and is it better than self-rated health?
Authors: Lazarevič Patrick
Published: December 2023

Background

Health is a fundamental aspect of many scientific disciplines and its definition and measurement is the analytical core of many empirical studies. Comprehensive measures of health, however, are typically precluded in survey research due to financial and temporal restrictions. Self-rated health (SRH) as a single indicator of health, on the other hand, exhibits a lack of measurement invariance by age and is biased due to non-health influences. In the three-item Minimum European Health Module (MEHM), SRH is complemented with questions on chronic health conditions and activity limitations, thus providing a compromise between single indicators and comprehensive measures.

Methods

Using data from the German Ageing Survey (2008 & 2014; n = 12,037), I investigated the feasibility to combine the MEHM into a generic health indicator and judged its utility in comparison to SRH as a benchmark. Additionally, I explored the option of an extended version of the MEHM by adding information on multimorbidity and the presence and intensity of chronic pain.

Results

The analyses showed that both versions of the MEHM had a good internal consistency and each represented a single latent variable that can be computed using generalized structural equation modeling. The utility of this approach showed great promise as it significantly reduced age-specific reporting behavior and some non-health biases present in SRH.

Conclusions

Using the MEHM to measure generic (physical) health is a promising approach with a wide array of applications. Further research could extend these analyses to additional age groups, other countries, and establish standardized weights for greater comparability.
Protective strategies and motivations to control drinking among Brazilian college students: a qualitative study
Authors: Faria Marina Noto , dos Santos Elaine Lucas , Noto Ana Regina , Bedendo André , Souza-Formigoni Maria Lucia O.
Published: December 2023

Background

To develop prevention programs or early interventions to reduce alcohol consumption and related problems among college students, it is essential to understand their motivations for drinking and the spontaneous (effective and non-effective) strategies they employ to control, considering the social and cultural contexts influence. This study aimed to explore these factors and the student’s application of selfcare in different situations and environments, as well as to identify their reasons for not drinking.

Methods

The students were invited to participate using a snowball sampling, up to the theoretical saturation point. Qualitative individual semi-structured interviews were carried out and the interviews contents were analyzed using the NVivo software. The participants were 23 college students between 18 and 24 years old, with diverse patterns of alcohol use (low-risk to suggestive of dependence).

Results

Data analysis highlighted three main themes: (a) Contexts (such as bars, “open bar” parties and others) and consumption patterns; (b) Protective Strategies (such as stop-drinking intervals, eating before or during drinking, returning home in the company of a friend); (c) Motivations to control drinking (such as sense of responsibility, bad previous experiences, family and religious issues). Protective strategies and motivation to control drinking were perceived to be less prominent in specific contexts that favor high alcohol consumption, as open bar parties.

Conclusions

Motivations and protective strategies varied according to the drinkers’ profile, social situations and settings in which they consumed alcohol. The results highlight the need for preventive interventions planned for specific drinking patterns and contexts.
Both/And: Mixed methods analysis of network composition, communication patterns, and socio-economic support within social networks of transgender women involved in sex work in Lima, Peru
Authors: Temelkovska Tijana , Moriarty Kathleen , Huerta Leyla , Perez-Brumer Amaya G. , Segura Eddy R. , Passaro Ryan Colby , Lake Jordan E. , Clark Jesse L. , Blair Cheríe S.
Published: December 2023

Introduction

Social networks contribute to normative reinforcement of HIV prevention strategies, knowledge sharing, and social capital, but little research has characterized the social networks of transgender women (TW) in Latin America. We conducted a mixed methods analysis of three network clusters of TW in Lima, Peru, to evaluate network composition, types of support exchanged, and patterns of communication.

Methods

We recruited TW residing in or affiliated with three “casas trans” (houses shared among TW) in Lima between April-May 2018. Eligible participants were 18 or older, self-reported HIV-negative, and reported recent intercourse with a cis-male partner. Participants completed demographic questionnaires, social network interviews, and semi-structured interviews to assess egocentric network structures, support exchanged, and communication patterns. Quantitative and qualitative data were analyzed using Stata v14.1 and Atlas.ti, respectively.

Results

Of 20 TW, median age was 26 years and 100% reported involvement in commercial sex work. Respondents identified 161 individuals they interacted with in the past month (alters), of whom 33% were TW and 52% family members. 70% of respondents reported receiving emotional support from family, while 30% received financial support and instrumental support from family. Of the 13 (65%) respondents who nominated someone as a source of HIV prevention support (HPS), the majority (69%) nominated other TW. In a GEE regression analysis adjusted for respondent education and region of birth, being a family member was associated with lower likelihood of providing financial support (aOR 0.21, CI 0.08–0.54), instrumental support (aOR 0.16, CI 0.06–0.39), and HPS (aOR 0.18, CI 0.05–0.64). In qualitative interviews, most respondents identified a cis-female family member as their most trusted and closest network member, but other TW were more often considered sources of day-to-day support, including HPS.

Conclusion

TW have diverse social networks where other TW are key sources of knowledge sharing and support, and family members may also represent important and influential components. Within these complex networks, TW may selectively solicit and provide support from different network alters according to specific contexts and needs. HIV prevention messaging could consider incorporating network-based interventions with TW community input and outreach efforts for supportive family members.
Iodized household salt utilization and associated factors among households in East Africa: a multilevel modelling analysis using recent national health surveys
Authors: Terefe Bewuketu , Jembere Mahlet Moges , Assimamaw Nega Tezera
Published: December 2023

Introduction

Iodine deficiency disorders (IDDs) are a significant global public health issue that affects the physical and mental development of every age group, with children and nursing mothers being the most vulnerable. Approximately 50 million of approximately 2 billion people with iodine deficiency (ID) globally exhibit clinical symptoms. Identifying iodine levels using various techniques is important when considering treatment choices. Screening programs and early ID diagnostics are crucial for the follow-up of pregnant women, especially in iodine-deficient nations. There have been calls for universal salt iodization programs, but only approximately 71% of people have access to them. The problem is more common in developing nations; however, there is a shortage of literature on the individual-, family-, and community-level factors influencing iodized salt use in East Africa. This study aimed to investigate individual- and community-level factors of household iodized salt usage in East Africa.

Methods

Using Stata 17, this study used the most recent demographic and health survey datasets from twelve East African countries. The survey included a weighted sample of 154,980 households. To assess factors related to iodized salt use in the region, bivariable and multivariable multilevel logistic regressions were used. P values less than or equal to 0.2, and < 0.05 were used in the binary regression, and to deem variables statistically significant in the final model respectively.

Results

About 87.73% (95% CI = 87.56,87.89) households have utilized iodized household salt. Secondary and above education (AOR = 1.23, 95% CI = 1.17–1.30), household heads with ages of 25–35 years, 36–45 years (AOR = 1.20, 95% CI = 1.12,1.28), 36–45 years (AOR = 1.16, 95% CI = 1.09,1.24), and more than 45 years (AOR = 1.18, 95% CI = 1.11,1.25), lower and middle wealth (AOR = 0.89, 95% CI = 0.76,0.89) and (AOR = 0.97, 95% CI = 0.81,0.93), media exposure (AOR = 1.10, 95% CI = 1.07–1.14), female household leaders (AOR = 1.08, 95% CI = 1.04–1.12), access to improved drinking water and better toilet facility (AOR = 2.26, 95% CI = 2.18–2.35) and (AOR = 1.50, 95% CI = 1.44,1.56), larger than five family members (AOR = 0.96, 95% CI = 0.93–0.99), high community level wealth (AOR = 1.54, 95% CI = 1.27–1.87), and low community education(AOR = 0.40, 95% CI = 0.33,0.49) were statistically associated with utilization of iodized household salt in East Africa respectively.

Conclusion

In East Africa, household salt iodization is moderately good. To expand the use of iodized salt in the region, access to improved drinking water and toilet facilities, participating family leaders, using the opportunity of family planning services, media sources, and the improvement of the community’s socioeconomic level are all needed.
Serial multiple mediation of perceived professional healthcare support and social structural factors in the relationship between care-seeking behavior and perinatal mental health in Chinese mothers
Authors: An Shanshan , Sun Sheng
Published: December 2023

Background

In previous studies, it has been observed that mother’s perinatal mental health (PMH) problems can be improved by engaging in appropriate health care-seeking behaviors. However, the exact mechanism that influences the relationship between these two factors is still not fully understood. This cross-sectional study aims to examine the serial multiple mediating effects of perceived professional healthcare support (PPHS) and social structural factors on the association between care-seeking behavior and PMH.

Methods

The cross-sectional study evaluated 1705 Chinese mothers (pregnancy 12 to 41 weeks) through questionnaires from October 2021 to November 2022. These mothers were selected from three hospitals in Wuxi, with an annual delivery volume of at least 5000. We conducted a structural equation model (SEM) analysis to examine the multiple mediating effect of PPHS and social structural factors (social stigma or social trust) between care-seeking behavior and PMH. After analyzing the results of the SEM, we used bootstrapping to further test the mediating effect.

Results

Among the 1705 Chinese mothers surveyed, 636 (37.3%) sought help from professionals. It was observed that more women tended to seek professional help during the early stages of pregnancy (12 to 28 weeks) compared to the later stages (28 to 41 weeks) (t = 1.47, p < 0.05). The results of the SEM analysis indicated that the mother’s care-seeking behavior did not have a significant direct effect on PMH. However, it was identified as a crucial distal variable, with its significant effect being fully mediated by PPHS and social structural factors. The mediation effect of PPHS and social stigma on the pathway from care-seeking behavior to PMH was found to be 92.9% (direct effect = 0.002; indirect effect = 0.026). Additionally, the mediating effect of stigma contributed to 21.9% of the association between care-seeking behavior and PPHS (direct effect = 0.405; indirect effect = 0.114). Similarly, the mediation effect of PPHS and social trust on the pathway from care-seeking behavior to PMH was 73.3% (direct effect = 0.008; indirect effect = 0.022). Moreover, the mediating effect of social trust contributed to 22.0% of the association between care-seeking behavior and PPHS (direct effect = 0.407; indirect effect = 0.115). The proposed model showed a good fit with the collected data.

Conclusion

This study examines the serial multiple mediation effect, in which PPHS and social structural factors mediate the relationship between PMH and professional care-seeking behavior. We suggest three levels of intervention: implementing mental health in all policies, providing training for healthcare providers, and establishing healthcare channels with easily accessible information.
Diagnostic model based on key autophagy-related genes in intervertebral disc degeneration
Authors: Wang Yifeng , Wang Zhiwei , Tang Yifan , Chen Yong , Fang Chuanyuan , Li Zhihui , Jiao Genlong , Chen Xiongsheng
Published: December 2023

Background

Current research on autophagy is mainly focused on intervertebral disc tissues and cells, while there is few on human peripheral blood sample. therefore, this study constructed a diagnostic model to identify autophagy-related markers of intervertebral disc degeneration (IVDD).

Methods

GSE150408 and GSE124272 datasets were acquired from the Gene Expression Omnibus database, and differential expression analysis was performed. The IVDD-autophagy genes were obtained using Weighted Gene Coexpression Network Analysis, and a diagnostic model was constructed and validated, followed by Gene Set Variation Analysis (GSVA) and Gene Set Enrichment Analysis (GSEA). Meanwhile, miRNA–gene and transcription factor–gene interaction networks were constructed. In addition, drug-gene interactions and target genes of methylprednisolone and glucosamine were analyzed.

Results

A total of 1,776 differentially expressed genes were identified between IVDD and control samples, and the composition of the four immune cell types was significantly different between the IVDD and control samples. The Meturquoise and Mebrown modules were significantly related to immune cells, with significant differences between the control and IVDD samples. A diagnostic model was constructed using five key IVDD-autophagy genes. The area under the curve values of the model in the training and validation datasets were 0.907 and 0.984, respectively. The enrichment scores of the two pathways were significantly different between the IVDD and healthy groups. Eight pathways in the IVDD and healthy groups had significant differences. A total of 16 miRNAs and 3 transcription factors were predicted to be of great value. In total, 84 significantly related drugs were screened for five key IVDD-autophagy genes in the diagnostic model, and three common autophagy-related target genes of methylprednisolone and glucosamine were predicted.

Conclusion

This study constructs a reliable autophagy-related diagnostic model that is strongly related to the immune microenvironment of IVD. Autophagy-related genes, including PHF23, RAB24, STAT3, TOMM5, and DNAJB9, may participate in IVDD pathogenesis. In addition, methylprednisolone and glucosamine may exert therapeutic effects on IVDD by targeting CTSD, VEGFA, and BAX genes through apoptosis, as well as the sphingolipid and AGE-RAGE signaling pathways in diabetic complications.
Effect of thermal manipulation on the biological and mechanical characteristics of horizontal platelet rich fibrin membranes
Authors: Wu Qian , Yu Shimin , Wang Yulan , Zhang Xiaoxin
Published: December 2023

Backgroud

Regardless of application scenarios, proper mechanical characteristics and degradation properties are prerequisites for horizontal platelet rich fibrin (H-PRF) to manifest its ability. Among the methods used to modify PRF, thermal manipulation is promising as it is easy to handle without adding extra additives. Yet there is no consensus on optimal temperature treatment. This study aimed to investigate the effects of heating on the biological and mechanical characteristics of H-PRF and explore the optimum heating temperature for H-PRF thermal treatment.

Methods

We employed a series of temperature gradients, room temperature, 50℃, 75℃, 90℃, 105℃. The microstructure and the mechanical properties were recorded by Scanning Electron Microscope (SEM) and tensile strength tests respectively. The degradation rate of H-PRF membranes was examined by digestion assay with plasmin and trypsin. The viability of cells within H-PRF membranes and the proliferation of osteoblasts cultured with extracts from different H-PRF groups was evaluated using CCK-8 assays.

Results

Compared with the nonheated group, overheated manipulation beyond 90℃ can significantly prolong the degradation properties for up to 3 to 4 weeks and enhance the mass stress of H-PRF membranes. A high-temperature treatment of 105℃ accompanied by the cell activity beneath H-PRF reduced more than half, and thus, the biological effect on human osteoblasts (hFOBs) also reduced dramatically.

Conclusions

High thermal manipulation can prolong the degradation properties and enhance the mechanical properties of PRF membranes accompanied by the loss of biological effect.
Formulation and antibacterial properties of lollipops containing of chitosan- zinc oxide nano particles on planktonic and biofilm forms of Streptococcus mutans and Lactobacillus acidophilus
Authors: Mohammadipour Hamideh Sadat , Tajzadeh Parastoo , Atashparvar Mahshid , Yeganehzad Samira , Erfani Maryam , Akbarzadeh Fatemeh , Gholami Sima
Published: December 2023

This study aimed to formulate and characterize the experimental lollipops containing chitosan- zinc oxide nanoparticles (CH-ZnO NPs) and investigate their antimicrobial effects against some cariogenic bacteria. The CH-ZnO NPs were synthesized and characterized by X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR) analysis, and Transmission electron microscope (TEM). Then, four groups were made, including lollipops coated with 2 and 4 ml of CH-ZnO NPs, 0.7 ml CH-ZnO NPs incorporated lollipops, and those with no CH-ZnO NPs. Their antibacterial effectiveness againstStreptococcus mutansandLactobacillus acidophiluswas evaluated by direct contact test and tissue culture plate method in planktonic and biofilm phases, respectively. Chlorhexidine mouthrinse (CHX) was used as a positive control group. In the planktonic phase, the antibacterial properties of both groups coated with CH-ZnO NPs were comparable and significantly higher than incorporated ones. There was no significant difference between CHX and the lollipops coated with 4 ml of NPs againstS. mutansand CHX and two coated groups againstL. acidophilus. None of the experimental lollipops in the biofilm phase could reduce both bacteria counts. The experimental lollipops coated with 2 and 4 ml of CH-ZnO NPs could reveal favorable antimicrobial properties against two cariogenic bacteria in the planktonic phase.
Implementation of national guidance for self-harm among general practice nurses: a qualitative exploration using the capabilities, opportunities, and motivations model of behaviour change (COM-B) and the theoretical domains framework
Authors: Leather Jessica Z. , Keyworth Chris , Kapur Nav , Campbell Stephen M. , Armitage Christopher J.
Published: December 2023

Background

Patients who self-harm may consult with primary care nurses, who have a safeguarding responsibility to recognise and respond to self-harm. However, the responses of nursing staff to self-harm are poorly understood, and opportunities to identify self-harm and signpost towards treatment may be missed. It is unclear how to support nursing staff to implement national guidelines.

Aims

Among primary care nursing staff to: [1] Examine reported barriers and enablers to nurses’ use of, and adherence to, national guidance for self-harm; and [2] Recommend potential intervention strategies to improve implementation of the NICE guidelines.

Methods

Twelve telephone interviews partly structured around the capabilities, opportunities and motivations model of behaviour change (COM-B) were conducted with primary care nurses in the United Kingdom. The Theoretical Domains Framework was used as an analytical framework, while the Behaviour Change Wheel was used to identify exemplar behaviour change techniques and intervention functions.

Results

Nursing staff identified a need to learn more about risk factors (knowledge), and strategies to initiate sensitive conversations about self-harm (cognitive and interpersonal skills) to support their professional competencies (professional role and identity). Prompts may support recall of the guidance and support a patient centred approach to self-harm within practices (memory, attention, and decision making). GPs, and other practice nurses offer guidance and support (social influences), which helps nurses to navigate referrals and restricted appointment lengths (environmental context and influences).

Conclusions

Two converging sets of themes relating to information delivery and resource availability need to be targeted. Nine groups of behaviour change techniques, and five intervention functions offer candidate solutions for future intervention design. Key targets for change include practical training to redress conversational skill gaps about self-harm, the integration of national guidance with local resources and practice-level protocols to support decision-making, and creating opportunities for team-based mentoring.
Participant and GP perspectives and experiences of screening for undiagnosed type 2 diabetes in community pharmacy during the Pharmacy Diabetes Screening Trial
Authors: Krass Ines , Twigg Michael J. , Mitchell Bernadette , Wilson Frances , Mohebbi Mohammadreza , Trinder Peta , Shih Sophy T. F. , Carter Rob , Versace Vincent L. , McNamara Kevin
Published: December 2023

Background

The Pharmacy Diabetes Screening Trial (PDST) evaluated three approaches to screening for undiagnosed type 2 diabetes mellitus (T2DM) in community pharmacy: (1) paper-based risk assessment (AUSDRISK) alone; and AUSDRISK followed by a point of care test if AUSDRISK ≥ 12; with either (2) HbA1c; or (3) small capillary blood glucose Test (scBGT). This paper reports the perspectives and experiences of the pharmacy screening service of two key stakeholder groups: screening participants and general practitioners (GPs).

Methods

All referred participants (n = 2242) received an online survey to determine the outcome of the referral, as well as their level of satisfaction with the service. In addition, a random sample of 2,989 (20%) of non-referred participants were surveyed to determine their overall experience and level of satisfaction with the service. GPs to whom participants were referred were contacted to establish if, since the date of the screening service, their patient had (1) been to see them; (2) had further tests performed (FBG, RBG, OGTT, HbA1c); or (3) been diagnosed with diabetes or prediabetes. Descriptive statistics were reported for quantitative data. Factors associated with visiting the GP following screening were assessed using multivariable logistic regression. Qualitative data were analysed using content analysis.

Results

Response rates 16% (n = 369) and 17% (n = 520) were achieved for the three-month referred and non-referred participant surveys, respectively. Over 90% of respondents were very positive about the screening service (n = 784/853) and would recommend it to a family member or friend (n = 784/853). Participants also reported making significant improvements in diet and exercise, because of the screening. Among referred respondents, those who received a POC test were twice as likely to visit their GP compared to those who received a risk assessment only (OR 2.11 95% CI 1.46–3.06). GPs (15.8% response rate, n = 57/361) indicated that the referral worked well and that recommendations for follow-up care by the pharmacist were appropriate.

Conclusion

Opportunistic screening of individuals during routine encounters with the community pharmacy in a previously undiagnosed population has been shown to foster positive engagement with consumers and GPs, which may assist in reducing the burden of T2DM on the individual and the community.
Change of the vaginal microbiome with oral contraceptive therapy in women with polycystic ovary syndrome: a 6-month longitudinal cohort study
Authors: Hong Xiang , Qin Pengfei , Gao Liting , Huang Lingling , Shi Yong , Peng Danhong , Wang Bei
Published: December 2023

Background

The association between the vaginal microbiome and polycystic ovary syndrome (PCOS) is reported, but the longitudinal changes in the vaginal microbiome that accompany oral contraceptive therapy have not been described.

Methods

This cohort study included 50 PCOS patients who wanted to make their menstrual periods more regular and accepted only oral contraceptive therapy and lifestyle coaching, then they were successfully followed up for 6 months. Venous blood was collected, and follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (T), anti-Müllerian hormone (AMH), and estradiol (E2) were assayed at baseline and at months 3 and 6. Vaginal swabs were collected at baseline and at months 3 and 6. 16S rRNA genes were sequenced to identify the microbiota structure. Latent class trajectory models were used to explore the trajectory of the changes inLactobacillusabundance.

Results

At 3 months, all patients reported regular periods, and the improvement lasted until 6 months. The body mass index and waist-to-hip ratio decreased with treatment (P < 0.01), and the AMH and T levels showed downward trends. We did not find a statistically significant relationship between hormone levels at the previous time point and the vaginal microbiota at subsequent time points (P > 0.05). The relative abundance ofLactobacillusincreased with treatment, and trajectory analysis revealed five classes ofLactobacilluschanges. Class 1, stable high level, accounted for 26%; class 2, decrease followed by increase, accounted for 18%; class 3, stable low level, accounted for 10%; class 4, increase, accounted for 20%; class 5, increase followed by decrease, accounted for 26%. Logistic models showed that compared to class 1, a higher baseline T level was associated with a reduced risk of class 2 change (odds ratio (OR) = 0.03, 95% confidence interval (CI):0.01–0.52) and class 4 change (OR = 0.10, 95% CI:0.01–0.93).

Conclusions

The abundance ofLactobacilliincreased with PCOS treatment; however, the trajectory was inconsistent for each individual. Evidence of the effects of female hormone levels on the vaginal microbiome is insufficient.
Prenatal diagnosis of 1408 foetuses at risk of DMD/BMD by MLPA and Sanger sequencing combined with STR linkage analysis
Authors: Hua Chunxiao , Liu Lina , Kong Xiangdong
Published: December 2023

Objective

This study is a retrospective analysis of the prenatal genetic diagnosis results of 1408 foetuses at high risk of DMD/BMD to provide information for clinical genetic counselling.

Background

Duchenne muscular dystrophy (DMD) is a severe neuromuscular disorder characterized by skeletal and cardiac muscle weakness. With the deepening of disease research, some treatments have been applied in clinics. Therefore, early and accurate prenatal diagnosis can inform pregnancy choices for high-risk families.

Methods

A total of 1316 unrelated DMD/BMD families with confirmed genetic diagnoses were recruited from the Genetic and Prenatal Diagnosis Center of the First Affiliated Hospital of Zhengzhou University. Prenatal diagnosis of 1408 high-risk foetuses was performed by MLPA and Sanger sequencing combined with STR linkage analysis for all families.

Results

Among the 1316 families, large deletions, duplications, and small variants of the DMD gene accounted for 70.4% (927/1316), 8.2% (108/1316), and 21.4% (281/1316), respectively. Among 1316 mothers, 863 (65.6%) were carriers, and 453 (34.4%) were not carriers. The rate of de novo variants was 34.4% (453/1316) in our study. In addition, gonadal mosaicism was observed in 11 pregnant females. Prenatal diagnosis was provided for 1408 high-risk foetuses; 282 foetuses were identified as male patients, 219 foetuses were female carriers, and the remainder had normal genetics. The results of prenatal diagnosis were consistent with the results of follow-up.

Conclusions

Accurate and rapid prenatal diagnosis can be achieved using MLPA, Sanger sequencing, and STR linkage analysis. Furthermore, germline mosaicism in DMD should not be ignored; considering this, a prenatal diagnosis for all pregnant women with a family history of DMD/BMD regardless of whether they carried disease-causing variants is proposed. Genetic counselling and targeted prenatal diagnosis will continue to be a cornerstone of DMD/BMD family management in the future.
Cancer stem cells and their niche in cancer progression and therapy
Authors: Liu Qiuping , Guo Zongliang , Li Guoyin , Zhang Yunxia , Liu Xiaomeng , Li Bing , Wang Jinping , Li Xiaoyan
Published: December 2023

High recurrence and metastasis rates and poor prognoses are the major challenges of current cancer therapy. Mounting evidence suggests that cancer stem cells (CSCs) play an important role in cancer development, chemoradiotherapy resistance, recurrence, and metastasis. Therefore, targeted CSC therapy has become a new strategy for solving the problems of cancer metastasis and recurrence. Since the properties of CSCs are regulated by the specific tumour microenvironment, the so-called CSC niche, which targets crosstalk between CSCs and their niches, is vital in our pursuit of new therapeutic opportunities to prevent cancer from recurring. In this review, we aim to highlight the factors within the CSC niche that have important roles in regulating CSC properties, including the extracellular matrix (ECM), stromal cells (e.g., associated macrophages (TAMs), cancer-associated fibroblasts (CAFs), and mesenchymal stem cells (MSCs)), and physiological changes (e.g., inflammation, hypoxia, and angiogenesis). We also discuss recent progress regarding therapies targeting CSCs and their niche to elucidate developments of more effective therapeutic strategies to eliminate cancer.
Determining the optimal cut-off scores for the Chinese version of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC)
Authors: Huang Qingmei , Jiang Ping , Ding Yuanqi , Zheng Yaning , Zheng Li , Luo Jie , Dai Yun , Wu Fulei , Wang Wei
Published: December 2023

Purpose

Anxiety is a common emotion experienced by patients with prostate cancer (PCa), and can be exacerbated by testing the prostate-specific antigen (PSA) index. The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) was developed to assess the cancer-specific anxiety of these patients, but lack of appropriate thresholds for this scale limits its use. This study aimed to utilize ROC curve analysis to identify the best cut-off values for the Chinese version of the MAX-PC scale.

Methods

A cross-sectional survey was conducted using the Chinese version of the MAX-PC scale and the Generalized Anxiety Disorder Scale (GAD). ROC curve analysis, Youden index, Kappa consistency test and McNemar test were used for the optimal cutoff points for screening mild, moderate, and severe cancer-specific anxiety levels in patients with PCa, on the Chinese version of the MAX-PC scale.

Results

Two hundred eighty-seven patients with PCa completed the survey. The appropriate cut-off values for the MAX-PC scale for screening patients with PCa for cancer-specific anxiety were 20, 28, and 38 for mild, moderate, and severe anxiety, respectively with the highest Youden indices. The Kappa and McNemar’s test showed the best level of consistency with values of 0.627, 0.580, and 0.606 for screening mild, moderate, and severe anxiety, respectively.

Conclusions

The scores 20, 28, and 38 are the best cut-off values for the Chinese version of the MAX-PC scale. This scale should be used for screening cancer-specific anxiety for patients with PCa to assess and evaluate their anxiety levels and provide targeted interventions.
Development of a neutralization monoclonal antibody with a broad neutralizing effect against SARS-CoV-2 variants
Authors: Ko Hae Li , Lee Deuk-ki , Kim Younghyeon , Jang Hui Jeong , Lee Youn Woo , Lee Ho-Young , Seok Sang-Hyuk , Park Jun Won , Limb Jin-Kyung , On Da In , Yun Jun-Won , Lyoo Kwang-Soo , Song Daesub , Yeom Minjoo , Lee Hanbyeul , Seong Je Kyung , Lee Sungjin
Published: December 2023

Background

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants has challenged the effectiveness of current therapeutic regimens. Here, we aimed to develop a potent SARS-CoV-2 antibody with broad neutralizing effect by screening a scFv library with the spike protein receptor-binding domain (RBD) via phage display.

Methods

SKAI-DS84 was identified through phage display, and we performed pseudovirus neutralization assays, authentic virus neutralization assays, and in vivo neutralization efficacy evaluations. Furthermore, surface plasmon resonance (SPR) analysis was conducted to assess the physical characteristics of the antibody, including binding kinetics and measure its affinity for variant RBDs.

Results

The selected clones were converted to human IgG, and among them, SKAI-DS84 was selected for further analyses based on its binding affinity with the variant RBDs. Using pseudoviruses, we confirmed that SKAI-DS84 was strongly neutralizing against wild-type, B.1.617.2, B.1.1.529, and subvariants of SARS-CoV-2. We also tested the neutralizing effect of SKAI-DS84 on authentic viruses, in vivo and observed a reduction in viral replication and improved lung pathology. We performed binding and epitope mapping experiments to understand the mechanisms underlying neutralization and identified quaternary epitopes formed by the interaction between RBDs as the target of SKAI-DS84.

Conclusions

We identified, produced, and tested the neutralizing effect of SKAI-DS84 antibody. Our results highlight that SKAI-DS84 could be a potential neutralizing antibody against SARS-CoV-2 and its variants.