bluuebunny/crossref_metadata_2025 huggingface dataset:
Genotypic variation in Na, K and their ratio in 45 commercial cultivars of Indian tropical onion: A pressing need to reduce hypertension among the population
Authors: Singh Hira , Lombardo Mauro , Goyal Abhishek , Kumar Amrender , Khar Anil
Published: February 2023

The intake of diets with higher sodium (Na) and lower potassium (K) has been considered a leading factor for the development of hypertension (HTN). Majority of junk, processed and packaged food have higher Na contents. To counter the effects of diet on HTN, the identification of high K/Na ratio plant-based food is needed. Among fruits and vegetables, onion could be the ideal option since it contains high K content. Keeping this in mind, 45 commercially well adapted short day Indian onion cultivars were evaluated for K and Na content and their ratio to isolate suitable cultivars to prevent HTN in the Indian population. The data suggested wide variation among the genotypes for K, Na, and K/Na ratio ranging from 490.2 ± 17.0 to 9160.0 ± 96.7 mg/kg on dry matter basis, 52.7 ± 3.0 to 458.2 ± 61.7 mg/kg on dry matter basis and 3.1 ± 0.7 to 109.5 ± 17.3, respectively. The K content was recorded as significantly highest in the yellow-coloured bulb variety “Arka Pitamber” (9160.1 ± 96.7) followed by Pusa Sona (7933.2 ± 292.8). On the other hand, minimal K was assessed in the white-coloured bulb variety “Agrifound White” (490.3 ± 17.0) followed by Udaipur Local (732.9 ± 93.4). Twelve cultivars exhibited > 7000 mg K content, while nine cultivars recorded < 1500 mg. On the contrary, Na was recorded as significantly highest in the dark-red-coloured bulbs and the lowest in white bulbs. Furthermore, it was determined that there was a more than 35-fold difference observed between the highest (109.5) and lowest (3.1) K/Na ratio in the bulbs of tested cultivars. Cluster analysis revealed three major groups comprising of 23, 13 and 9 genotypes. This information could form the base for public health, food and onion researchers to design suitable cultivars to prevent HTN as a population-wide approach. The next century is going to be food-based for the amelioration of human diseases in a sustainable way without any after-effects on the human body.
Breast milk jaundice affects breastfeeding: From the perspective of intestinal flora and SCFAs-GPR41/43
Authors: Huang Huan , Huang Juan , Huang Wendi , Huang Nanqu , Duan Miao
Published: February 2023

Breast milk jaundice (BMJ) is one of the main factors leading to interruption or early termination of breastfeeding. Interrupting breastfeeding to treat BMJ may increase the adverse consequences for infant growth and disease prevention. The Intestinal flora and metabolites are increasingly recognized as a potential therapeutic target in BMJ. First, dysbacteriosis can lead to a decrease in the metabolite short-chain fatty acids. At the same time, SCFA can act on specific G protein-coupled receptors 41 and 43 (GPR41/43), and a decrease in SCFA downregulates the GPR41/43 pathway, leading to a diminished inhibition of intestinal inflammation. In addition, intestinal inflammation leads to a decrease in intestinal motility and a large amount of bilirubin enters the enterohepatic circulation. Ultimately, these changes will result in the development of BMJ. In this review, we will describe the underlying pathogenetic mechanism of the intestinal flora effects on BMJ.
The syndromic triad of COVID-19, type 2 diabetes, and malnutrition
Authors: Mechanick Jeffrey I. , Christofides Elena A. , Marchetti Albert E. , Hoddy Kristin K. , Joachim Jim , Hegazi Refaat , Hamdy Osama
Published: February 2023

The coronavirus disease 2019 (COVID-19) pandemic challenges our collective understanding of transmission, prevention, complications, and clinical management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Risk factors for severe infection, morbidity, and mortality are associated with age, environment, socioeconomic status, comorbidities, and interventional timing. Clinical investigations report an intriguing association of COVID-19 with diabetes mellitus and malnutrition but incompletely describe the triphasic relationship, its mechanistic pathways, and potential therapeutic approaches to address each malady and their underlying metabolic disorders. This narrative review highlights common chronic disease states that interact epidemiologically and mechanistically with the COVID-19 to create a syndromic phenotype—the COVID-Related Cardiometabolic Syndrome—linking cardiometabolic-based chronic disease drivers with pre-, acute, and chronic/post-COVID-19 disease stages. Since the association of nutritional disorders with COVID-19 and cardiometabolic risk factors is well established, a syndromic triad of COVID-19, type 2 diabetes, and malnutrition is hypothesized that can direct, inform, and optimize care. In this review, each of the three edges of this network is uniquely summarized, nutritional therapies discussed, and a structure for early preventive care proposed. Concerted efforts to identify malnutrition in patients with COVID-19 and elevated metabolic risks are needed and can be followed by improved dietary management while simultaneously addressing dysglycemia-based chronic disease and malnutrition-based chronic disease.
Primary extra-gastrointestinal stromal tumor of retroperitoneum: Clinicopathologic characteristics and prognosis of six cases
Authors: Lin Jiaxin , Liao Weilin , Wang Jiahao , Li Wenjuan , Tang Xin , Li Hongming , Yi Xiaojiang , Lu Xinquan , Chen Zhaoyu , Zhu Bosen , Feng Xiaochuang , Diao Dechang
Published: February 2023

Aim

This study investigates the clinicopathological features and prognostic genic biomarker factors of primary retroperitoneal extra-gastrointestinal stromal tumors (EGISTs).

Methods

The clinicopathological data of six patients with primary retroperitoneal EGIST were analyzed, including cell type (epithelioid or spindle), mitoses, and the presence of intratumoral necrosis and hemorrhage. Mitoses were counted and summed from 50 high power fields (HPFs). Mutations of exons 9, 10, 11, 13, 14, and 17 of the C-kit genes and those of exons 12 and 18 of the PDGFRA gene were examined. Follow-up was performed via telephone, and all outpatient records were reviewed. The last follow-up date was February 2022, the median follow-up was 27.5m and the postoperative status, medication, and survival of the patients were recorded.

Result

The patients were treated with radical intent. Four cases (patients 3, 4, 5, and 6) underwent multivisceral resection for encroachment on the adjacent viscera. The postoperative pathological results demonstrated that all biopsy specimens were negative for S-100 and desmin, and positive for DOG1 and CD117. Additionally, four patients (case 1, 2, 4, and 5) were positive for CD34, four (case 1, 3, 5, and 6) were positive for SMA, four (case 1, 4, 5, and 6) had >5/50 HPFs, and three (case 1, 4, and 5) had Ki67 >5%. According to the modified National Institutes of Health (NIH) guidelines, all patients were graded as high-risk cases. By exome sequencing, exon11 mutations were detected in the six patients, while exon10 mutations were detected in two cases (patients 4 and 5). The median follow-up time was 30.5 (11–109) months, with only one fatality at 11 months.

Conclusion

Retroperitoneal EGIST is a rare mesenchymal tumor that is difficult to distinguish from other retroperitoneal tumors. To diagnose this highly malignant tumor, low-threshold suspicion is necessary, and Kit and PDGFRA gene mutations should be routinely tested to confirm the diagnosis and guide subsequent treatment.
Angiogenesis regulators S100A4, SPARC and SPP1 correlate with macrophage infiltration and are prognostic biomarkers in colon and rectal cancers
Authors: Kazakova Elena , Rakina Militsa , Sudarskikh Tatiana , Iamshchikov Pavel , Tarasova Anna , Tashireva Liubov , Afanasiev Sergei , Dobrodeev Alexei , Zhuikova Lilia , Cherdyntseva Nadezhda , Kzhyshkowska Julia , Larionova Irina
Published: February 2023

Introduction

Increasing evidence suggests that it is necessary to find effective and robust clinically validated prognostic biomarkers that can identify “high-risk” colorectal cancer (CRC) patients. Currently, available prognostic factors largely include clinical-pathological parameters and focus on the cancer stage at the time of diagnosis. Among cells of tumor microenvironment (TME) only Immunoscore classifier based on T lymphocytes showed high predictive value.

Methods

In the present study, we performed the complex analysis of mRNA and protein expression of crucial regulators of tumor angiogenesis and tumor progression, expressed by tumor-associated macrophages (TAMs): S100A4, SPP1 and SPARC. Colon and rectal cancer patients were investigated independently and in a combined cohort (CRC). For mRNA expression, we analyzed RNA sequencing data obtained from TCGA (N=417) and GEO (N=92) cohorts of colorectal cancer patients. For protein expression, we performed IHC digital quantification of tumor tissues obtained from 197 patients with CRC treated in the Department of abdominal oncology in Clinics of Tomsk NRMC.

Results

High S100A4 mRNA expression accurately predicted poor survival for patients with CRC independently of cancer type. SPARC mRNA level was independent prognostic factors for survival in colon but not in rectal cancer. SPP1 mRNA level had significant predictive value for survival in both rectal and colon cancers. Analysis of human CRC tissues revealed that S100A4, SPP1 and SPARC are expressed by stromal compartments, in particular by TAMs, and have a strong correlation with macrophage infiltration. Finally, our results indicate that chemotherapy-based treatment can change the predictive direction of S100A4 for rectal cancer patients. We found that S100A4 stromal levels were higher in patients with better response to neoadjuvant chemotherapy/chemoradiotherapy, and S100A4 mRNA levels predicted better DFS among non-responders.

Discussion

These findings can help improve the prognosis of patients with CRC based on S100A4, SPP1 and SPARC expression levels.
Multiparametric magnetic resonance imaging-based radiomics nomogram for predicting tumor grade in endometrial cancer
Authors: Yue Xiaoning , He Xiaoyu , He Shuaijie , Wu Jingjing , Fan Wei , Zhang Haijun , Wang Chengwei
Published: February 2023

Background

Tumor grade is associated with the treatment and prognosis of endometrial cancer (EC). The accurate preoperative prediction of the tumor grade is essential for EC risk stratification. Herein, we aimed to assess the performance of a multiparametric magnetic resonance imaging (MRI)-based radiomics nomogram for predicting high-grade EC.

Methods

One hundred and forty-three patients with EC who had undergone preoperative pelvic MRI were retrospectively enrolled and divided into a training set (n =100) and a validation set (n =43). Radiomic features were extracted based on T2-weighted, diffusion-weighted, and dynamic contrast-enhanced T1-weighted images. The minimum absolute contraction selection operator (LASSO) was implemented to obtain optimal radiomics features and build the rad-score. Multivariate logistic regression analysis was used to determine the clinical MRI features and build a clinical model. We developed a radiomics nomogram by combining important clinical MRI features and rad-score. A receiver operating characteristic (ROC) curve was used to evaluate the performance of the three models. The clinical net benefit of the nomogram was assessed using decision curve analysis (DCA), net reclassification index (NRI), and integrated discrimination index (IDI).

Results

In total, 35/143 patients had high-grade EC and 108 had low-grade EC. The areas under the ROC curves of the clinical model, rad-score, and radiomics nomogram were 0.837 (95% confidence interval [CI]: 0.754–0.920), 0.875 (95% CI: 0.797–0.952), and 0.923 (95% CI: 0.869–0.977) for the training set; 0.857 (95% CI: 0.741–0.973), 0.785 (95% CI: 0.592–0.979), and 0.914 (95% CI: 0.827–0.996) for the validation set, respectively. The radiomics nomogram showed a good net benefit according to the DCA. NRIs were 0.637 (0.214–1.061) and 0.657 (0.079–1.394), and IDIs were 0.115 (0.077–0.306) and 0.053 (0.027–0.357) in the training set and validation set, respectively.

Conclusion

The radiomics nomogram based on multiparametric MRI can predict the tumor grade of EC before surgery and yield a higher performance than that of dilation and curettage.
Efficacy of third-line anti-EGFR-based treatment versus regorafenib or trifluridine/tipiracil according to primary tumor site in RAS/BRAF wild-type metastatic colorectal cancer patients
Authors: Salvatore Lisa , Bensi Maria , Vivolo Raffaella , Zurlo Ina Valeria , Dell’Aquila Emanuela , Grande Roberta , Anghelone Annunziato , Emiliani Alessandra , Citarella Fabrizio , Calegari Maria Alessandra , Ribelli Marta , Basso Michele , Pozzo Carmelo , Tortora Giampaolo
Published: February 2023

Background

Right- (R) and left-sided (L) metastatic colorectal cancer (mCRC) exhibit different clinical and molecular features. Several retrospective analyses showed that survival benefit of anti-EGFR-based therapy is limited to RAS/BRAF wt L-sided mCRC patients. Few data are available about third-line anti-EGFR efficacy according to primary tumor site.

Methods

RAS/BRAF wt patients mCRC treated with third-line anti-EGFR-based therapy versus regorafenib or trifluridine/tipiracil (R/T) were retrospectively collected. The objective of the analysis was to compare treatment efficacy according to tumor site. The primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), response rate (RR) and toxicity.

Results

A total of 76 RAS/BRAF wt mCRC patients, treated with third-line anti-EGFR-based therapy or R/T, were enrolled. Of those, 19 (25%) patients had a R-sided tumor (9 patients received anti-EGFR treatment and 10 patients R/T) and 57 (75%) patients had a L-sided tumor (30 patients received anti-EGFR treatment and 27 patients R/T). A significant PFS [7.2 vs 3.6 months, HR 0.43 (95% CI 0.2-0.76), p= 0.004] and OS benefit [14.9 vs 10.9 months, HR 0.52 (95% CI 0.28-0.98), p= 0.045] in favor of anti-EGFR therapy vs R/T was observed in the L-sided tumor group. No difference in PFS and OS was observed in the R-sided tumor group. A significant interaction according to primary tumor site and third-line regimen was observed for PFS (p= 0.05). RR was significantly higher in L-sided patients treated with anti-EGFR vs R/T (43% vs. 0%; p <0.0001), no difference was observed in R-sided patients. At the multivariate analysis, third-line regimen was independently associated with PFS in L-sided patients.

Conclusions

Our results demonstrated a different benefit from third-line anti-EGFR-based therapy according to primary tumor site, confirming the role of L-sided tumor in predicting benefit from third-line anti-EGFR vs R/T. At the same time, no difference was observed in R-sided tumor.
PMS2-associated Lynch syndrome: Past, present and future
Authors: Andini Katarina D. , Nielsen Maartje , Suerink Manon , Helderman Noah C. , Koornstra Jan Jacob , Ahadova Aysel , Kloor Matthias , Mourits Marian J.E. , Kok Klaas , Sijmons Rolf H. , Bajwa–ten Broeke Sanne W.
Published: February 2023

Carriers of any pathogenic variant in one of the MMR genes (path_MMR carriers) were traditionally thought to be at comparable risk of developing a range of different malignancies, foremost colorectal cancer (CRC) and endometrial cancer. However, it is now widely accepted that their cancer risk and cancer spectrum range notably depending on which MMR gene is affected. Moreover, there is increasing evidence that the MMR gene affected also influences the molecular pathogenesis of Lynch syndrome CRC. Although substantial progress has been made over the past decade in understanding these differences, many questions remain unanswered, especially pertaining to path_PMS2 carriers. Recent findings show that, while the cancer risk is relatively low, PMS2-deficient CRCs tend to show more aggressive behaviour and have a worse prognosis than other MMR-deficient CRCs. This, together with lower intratumoral immune infiltration, suggests that PMS2-deficient CRCs might have more in common biologically with sporadic MMR-proficient CRCs than with other MMR-deficient CRCs. These findings could have important consequences for surveillance, chemoprevention and therapeutic strategies (e.g. vaccines). In this review we discuss the current knowledge, current (clinical) challenges and knowledge gaps that should be targeted by future studies.
MEK inhibition causes BIM stabilization and increased sensitivity to BCL-2 family member inhibitors in RAS-MAPK-mutated neuroblastoma
Authors: Eleveld Thomas F. , Vernooij Lindy , Schild Linda , Koopmans Bianca , Alles Lindy K. , Ebus Marli E. , Dandis Rana , van Tinteren Harm , Caron Huib N. , Koster Jan , van Noesel Max M. , Tytgat Godelieve A. M. , Eising Selma , Versteeg Rogier , Dolman M. Emmy M. , Molenaar Jan J.
Published: February 2023

Introduction

Mutations affecting the RAS-MAPK pathway occur frequently in relapsed neuroblastoma tumors and are associated with response to MEK inhibition in vitro. However, these inhibitors alone do not lead to tumor regression in vivo, indicating the need for combination therapy.

Methods and results

Via high-throughput combination screening, we identified that the MEK inhibitor trametinib can be combined with BCL-2 family member inhibitors, to efficiently inhibit growth of neuroblastoma cell lines with RAS-MAPK mutations. Suppressing the RAS-MAPK pathway with trametinib led to an increase in pro-apoptotic BIM, resulting in more BIM binding to anti-apoptotic BCL-2 family members. By favoring the formation of these complexes, trametinib treatment enhances sensitivity to compounds targeting anti-apoptotic BCL-2 family members. In vitro validation studies confirmed that this sensitizing effect is dependent on an active RAS-MAPK pathway. In vivo combination of trametinib with BCL-2 inhibitors led to tumor inhibition in NRAS-mutant and NF1-deleted xenografts.

Conclusion

Together, these results show that combining MEK inhibition with BCL-2 family member inhibition could potentially improve therapeutic outcomes for RAS-MAPK-mutated neuroblastoma patients.
Distinctive modulation of hepcidin in cancer and its therapeutic relevance
Authors: Lin Feng , Tuffour Alex , Hao Guijie , Peprah Frank Addai , Huang Aixia , Zhou Yang , Zhang Haiqi
Published: February 2023

Hepcidin, a short peptide synthesized primarily by hepatocytes in response to increased body iron and inflammation, is a crucial iron-regulating factor. Hepcidin regulates intestinal iron absorption and releases iron from macrophages into plasma through a negative iron feedback mechanism. The discovery of hepcidin inspired a torrent of research into iron metabolism and related problems, which have radically altered our understanding of human diseases caused by an excess of iron, an iron deficiency, or an iron disparity. It is critical to decipher how tumor cells manage hepcidin expression for their metabolic requirements because iron is necessary for cell survival, particularly for highly active cells like tumor cells. Studies show that tumor and non-tumor cells express and control hepcidin differently. These variations should be explored to produce potential novel cancer treatments. The ability to regulate hepcidin expression to deprive cancer cells of iron may be a new weapon against cancer cells.
Single-site laparoscopic ligation of the hernia sac in infants with congenital Morgagni hernia
Authors: Wang Cao , Liu Xiang , Shu Zhen , Yin Jia , Luo Zheng , Zhou Guangxu , Liu Bin
Published: February 2023

Background

Congenital Morgagni hernia (CMH) is a rare midline defect involving herniation of abdominal viscera into the thoracic cavity through triangular parasternal gaps in the diaphragm.

Methods

The medical records of three patients with CMH admitted to the Department of Pediatric Surgery at the Affiliated Hospital of Zunyi Medical University between 2018 and 2022 were retrospectively reviewed. Pre-operative diagnosis was based on chest x-ray, chest computerized tomography, and barium enema. All patients were treated with single-site laparoscopic ligation of the hernia sac.

Results

Hernia repair was successful in all patients (males; age: 14 months, 30 months, 48 months). The average operative time for repair of a unilateral hernia was 20 ± 5 min. Volume of surgical blood loss was 2–3 ml. There was no damage to organs such as the liver or intestines, or to tissues such as the pericardium or the phrenic nerve. Patients were allowed a fluid diet 6–8 h after surgery, and remained on bed rest until 16 h after surgery. No postoperative complications occurred, and patients were discharged on postoperative Day 2 or 3. No symptoms or complications were noted during the 1–48 months of follow-up. Aesthetic outcomes were satisfactory.

Conclusions

Single-site laparoscopic ligation of the hernia sac provides pediatric surgeons a safe and effective technique for repair of CMH in infants and children. The procedure is straightforward, operative time and surgical blood loss are minimal, recurrence is unlikely, and aesthetic outcomes are satisfactory.
A combination of flexible and rigid bronchoscopy in the successful removal of a residual fish bone from a peripheral bronchus: A case report
Authors: Shao Hanqing , Li Shuxian , He Jing , Wu Lei , Chen Zhimin
Published: February 2023

Although rigid bronchoscopy remains the gold standard for the management of foreign body (FB) inhalation, sometimes it still misses residual FBs. Inhalation of sharp FBs by infants is an uncommon but hazardous occurrence, which presents a significant challenge and demands expertise in therapeutic bronchoscopy. Particularly, residual sharp FBs in the peripheral tracheobronchial tree may pose challenging management problems for bronchoscopists. Herein, we describe the case of 1-year-old girl, who presented with persistent atelectasis in the left lower lobe for 20 days without responding to antibiotic therapy after removal of fish bone by rigid bronchoscopy at local hospital. Flexible bronchoscopy at our department showed a residual fish bone in the outer basal segment of the left lower lobe. A combined flexible and rigid bronchoscopy was then applied, and a fish bone measuring 1.5 cm in length was extracted on multiple attempts without any complications. Thus, our reports demonstrated that removal of challenging residual sharp FBs in the distal airways is possible with the aid of combined flexible and rigid bronchoscopy by an experienced multidisciplinary team. Additionally, a physician should pay special attention to abnormal chest images after removal of FBs.
RETRACTED: A novel mathematical model for the effects of wall properties on pumping flow of a biofluid in a symmetrical three-dimensional curved duct
Authors: Alfwzan Wafa F. , Riaz Arshad , Alammari Maha , Hejazi Hala A. , Tag El-Din ElSayed M.
Published: February 2023

Most pumping actions entail a physical volume change of the duct, which is frequently achieved by having a compliant wall or membrane. To the best of our knowledge, the current study is the first report on a mathematical model developed to analyze the peristaltic transport of a Newtonian fluid in a curved duct with rectangular face and compliant walls. Such geometries are most commonly used in clinical and biological equipment, where the walls of the duct need to be flexible. Flexible ducts are more useful than rigid ones because they do not require any extra modifications or accessories. Here, we have used the conditions of lubrication theory to construct an accurate model, and a common perturbation technique was incorporated to handle the Navier-Stokes equations with emphasis on various aspect ratios and curvatures. A system of curvilinear coordinates operating according to the principles of the cylindrical system was employed to represent the mathematical problem. No-slip boundary limitations were considered at the walls along with the extra constraint of compliant walls showing damping force and stiffness. Comprehensive graphical representations were made to illustrate the effects of all emerging factors of the study in both two- and three-dimensional formats. We found that large curvatures and flexure rigidity decreased the fluid velocity uniformly, but the aspect ratio and amplitude parameters could promote fluid velocity. Validation of the results was performed through the generation of a residual error curve. The current readings were taken again with a straight duct to make a comparison with the existing literature.
A precision refractometer using strict dual-mode elliptical multilayer-core fibers with temperature and strain decoupled
Authors: Liang Xiao , Zuo Binzhou
Published: February 2023

To accurately measure the surrounding refractive index (SRI), an all-fiber microstructure multi-parameters optical sensor based on Mach–Zehnder interferometer (MZI) has been designed. A homemade elliptical multilayer-core fiber (EMCF), in which only two modes could be propagated, is used in this sensor. This sensor has a sandwich structure of EMCF-SMF-EMCF (ESE). The sensitivities of RI, temperature, and strain are analyzed practically, and different from each other which would provide a basis for restraining cross-sensitivity of sensor and improving measuring precision. According to the numerical simulation, the relationship between the guided mode and relevant excitation coefficient is shown, and the sensing characteristic of the interference spectrum is well expatiated. Maximum sensitivities of ∼31.83 nm per refractive index unit (RIU), ∼69 pm/°C, and ∼2.06 pm/µε have been experimentally achieved. The monitoring system is promoted by the fact that the resonance dips have their individual sensitivities, and the standard matrix inversion method is used for simultaneous three parameters determination. Consequently, this fiber sensor could ensure the completion of accurate SRI measurements with temperature and strain decoupled.
Performance of an ultra-pure NaI(Tl) detector produced by an indigenously-developed purification method and crystal growth for the COSINE-200 experiment
Authors: Lee H. , Park B. J. , Choi J. J. , Gileva O. , Ha C. , Iltis A. , Jeon E. J. , Kim D. Y. , Kim K. W. , Kim S. H. , Kim S. K. , Kim Y. D. , Ko Y. J. , Lee C. H. , Lee H. S. , Lee I. S. , Lee M. H. , Ra S. J. , Son J. K. , Shin K. A.
Published: February 2023

The COSINE-100 experiment has been operating with 106 kg of low-background NaI(Tl) detectors to test the results from the DAMA/LIBRA experiment, which claims to have observed dark matter. However, since the background of the NaI(Tl) crystals used in the COSINE-100 experiment is 2–3 times higher than that in the DAMA detectors, no conclusion regarding the claimed observation from the DAMA/LIBRA experiment could be reached. Therefore, we plan to upgrade the current COSINE-100 experiment to the next phase, COSINE-200, by using ultra-low background NaI(Tl) detectors. The basic principle was already proved with the commercially available Astro-grade NaI powder from Sigma-Aldrich (now Merck) company. However, we have developed a mass production process of ultra-pure NaI powder at the Center for Underground Physics (CUP) of the Institute for Basic Science (IBS), Korea, using the direct purification of the raw NaI powder. We plan to produce more than 1,000 kg of ultra-pure powder for the COSINE-200 experiment. With our crystal grower installed at CUP, we have successfully grown a low-background crystal using our purification technique for the NaI powder. We have assembled a low-background NaI(Tl) detector. In this article, we report the performance of this ultra-pure NaI(Tl) crystal detector produced at IBS, Korea.
Association of Ang/Tie2 pathway mediators with endothelial barrier integrity and disease severity in COVID-19
Authors: Moraes Carla Roberta Peachazepi , Borba-Junior Ivanio Teixeira , De Lima Franciele , Silva Jéssica Ribeiro Alves , Bombassaro Bruna , Palma André C. , Mansour Eli , Velloso Lício Augusto , Orsi Fernanda Andrade , Costa Fábio Trindade Maranhão , De Paula Erich Vinicius
Published: February 2023

Endothelial barrier (EB) disruption contributes to acute lung injury in COVID-19, and levels of both VEGF-A and Ang-2, which are mediators of EB integrity, have been associated with COVID-19 severity. Here we explored the participation of additional mediators of barrier integrity in this process, as well as the potential of serum from COVID-19 patients to induce EB disruption in cell monolayers. In a cohort from a clinical trial consisting of thirty patients with COVID-19 that required hospital admission due to hypoxia we demonstrate that i) levels of soluble Tie2 were increase, and of soluble VE-cadherin were decreased when compared to healthy individuals; ii) sera from these patients induce barrier disruption in monolayers of endothelial cells; and iii) that the magnitude of this effect is proportional to disease severity and to circulating levels of VEGF-A and Ang-2. Our study confirms and extends previous findings on the pathogenesis of acute lung injury in COVID-19, reinforcing the concept that EB is a relevant component of this disease. Our results pave the way for future studies that can refine our understanding of the pathogenesis of acute lung injury in viral respiratory disorders, and contribute to the identification of new biomarkers and therapeutic targets for these conditions.
Case report: Changes in defense mechanisms, personality functioning, and body mass index during psychotherapy with patients with anorexia nervosa
Authors: Conversano Ciro , Di Giuseppe Mariagrazia , Lingiardi Vittorio
Published: February 2023

Eating disorders (EDs) are difficult to treat in psychotherapy due to their pervasive symptomatology and frequent and rapid relapses. Restrictive anorexia nervosa (AN) is the most challenging ED, often associated with severe physical and mental conditions. Perceived as an ego-syntonic syndrome that somehow protects the patient from a number of developmental tasks, treating AN requires extensive multidisciplinary long-term intervention. As with other emotion regulation strategies, defense mechanisms mediate an individual's reaction to internal or external stressors, including those related to ED conditions. Improving defensive functioning adaptiveness predicts psychotherapy outcomes and is an essential component of the therapeutic process. In this study, we qualitatively described changes in the use of defense mechanisms, personality functioning (PF), and body mass index (BMI) in two patients with severe AN in treatment with intense dynamic psychotherapy. Changes in personality functioning and defense mechanisms were periodically assessed every 6 months using clinician report measures such as the Shedler-Westen Assessment Procedure-200 (SWAP-200) and the Defense Mechanisms Rating Scales Q-sort (DMRS-Q), respectively. BMI was also monitored throughout the treatment. A qualitative description of the patient's defensive profile and the quantitative score on all ranges of defense mechanisms were used for studying changes in patients' use of defenses during the treatment and relationships between defenses and outcome indexes. Personality and defensive functioning improved after 1 year of intense dynamic psychotherapy, independently from BMI improvement. All outcome indexes dramatically decreased before a scheduled interruption of the treatment, underling that an integrated therapeutic approach is essential for improving and eventually orienting toward complete ED symptoms remission. Long-term dynamic psychotherapy fosters self-awareness of psychological distress and enhances more mature ways of coping. Monitoring changes in personality and defense mechanisms helps in understanding patients' reactions to stressful life events and in developing specific therapeutic interventions.
Understanding consumers’ purchase intentions of single-use plastic products
Authors: Sun Ying , He Haonan
Published: February 2023

Human health and marine life are facing the hazards and threats of plastic waste. China is the world’s largest producer and consumer of disposable plastic products, thus paying more attention to the threats and challenges of single-use plastics products in China is urgent. This study aims to explore the intention to purchase single-use plastic products based on the theory of planned behavior. Data collection using self-reported questionnaires, and 402 valid questionnaires were obtained, thus analyzed using Amos 22.0 and SPSS 18.0 software. Results indicate that attitude, perceived behavioral control, normative social influence, informational social influence, and positive anticipated emotion positively affect intention to purchase single-use plastic products. Meanwhile, positive anticipated emotion positively moderates the relationship between normative social influence and intention to purchase single-use plastic products, but negatively moderates the relationship between informational social influence and intention to purchase single-use plastic products. This research provides some theoretical and policy implications to help relevant agencies design targeted interventions to address environmental issues related to single-use plastic consumption.
Psychometric evaluation of the academic involution scale for college students in China: An application of Rasch analysis
Authors: Yang Yanchao , Peng Yan , Li Wangze , Lu Shan , Wang Chen , Chen Sirui , Zhong Jialiang
Published: February 2023

Recent academic attention on educational involution in China underpins the need for a valid and reliable instrument to precisely measure college students’ academic involution behaviors. Seeing the scarcity of a proper instrument, the current study attempted to analyze the item-level psychometric properties of the newly developed Academic Involution Scale for College Students (AISCS) in China by using a Rasch model. A total of 637 college students in a public university in northern China participated in the study. Data were examined with respect to unidimensionality, rating scale functioning, item fit statistics, item polarity, item- and person-level reliability and separation, item hierarchy and invariance across educational background with Winsteps. The results show that AISCS was a single unidimensional construct with good psychometric properties. Although two items demonstrated differential item functioning, it is plausible given the differences between assessment methods for undergraduates and postgraduates. Limitations and future research directions with regard to sample selection, inclusion of more validity evidence and adding prospective additional academic involution were discussed.
Procedural justice, relative deprivation, and intra-team knowledge sharing: The moderating role of group identification
Authors: Wan Jin , Qin Mingyue , Zhou Wenjun , Zhou Haiming , Li Pingping
Published: February 2023

How to promote employees’ knowledge-sharing behaviors has become a focus of managers and researchers. Based on the theory of relative deprivation, this study explored the mechanism of organizational procedural justice on employees’ intra-team knowledge sharing, as well as the mediating role of relative deprivation and the moderating role of group identification. A path analysis was conducted on 416 valid questionnaire data, and the results revealed that: (1) Procedural justice has a positive effect on intra-team knowledge sharing; (2) Both group relative deprivation and individual relative deprivation play a mediating role between procedural justice and intra-team knowledge sharing, but they have opposite effects. Procedural justice reduces both group relative deprivation and individual relative deprivation, but individual relative deprivation decreases employees’ intra-team knowledge sharing, while group relative deprivation increases it. (3) Group identification has an enhancing moderating effect on the relationship between group relative deprivation and intra-team knowledge sharing, while the moderating effect on the relationship between individual relative deprivation and intra-team knowledge sharing is not significant. Therefore, enterprises should make procedures such as performance appraisal and salary allocation justify and transparent to reduce individual relative deprivation, but should moderately trigger group relative deprivation flexibly according to the situation, while enhancing employee group identification through cultural construction.
Gender neutral HPV vaccination programs: Reconsidering policies to expand cancer prevention globally
Authors: Dykens J. Andrew , Peterson Caryn E. , Holt Hunter K. , Harper Diane M.
Published: February 2023

Human papillomavirus (HPV) infection is responsible for many cancers in both women and men. Cervical cancer, caused by HPV, is the fourth most common cancer among women worldwide, even though it is one of the most preventable cancers. Prevention efforts include HPV vaccination, however these programs remain nascent in many countries. In 2020 the World Health Assembly adopted the Global Strategy for cervical cancer elimination including a goal to fully vaccinate 90% of girls with the HPV vaccine by the age of 15. However, very few countries have reached even 70% coverage. Increased vaccine availability in the future may allow the opportunity to vaccinate more people. This could add to the feasibility of introducing gender-neutral HPV vaccination programs. Adopting a gender-neutral HPV vaccine approach will reduce HPV infections transmitted among the population, combat misinformation, minimize vaccine-related stigma, and promote gender equity. We propose approaching programmatic research through a gender-neutral lens to reduce HPV infections and cancers and promote gender equality. In order to design more effective policies and programs, a better understanding of the perspectives of clients, clinicians, community leaders, and policy-makers is needed. A clear, multi-level understanding of these stakeholders' views will facilitate the development of target policy and programs aimed at addressing common barriers and optimizing uptake. Given the benefit of developing gender-neutral HPV vaccination programs to eliminate cervical cancer and address other HPV associated cancers, we must build knowledge through implementation research around this topic to inform policy-makers and funders for future policy shifts.
Delay in seeking health care from community residents during a time with low prevalence of COVID-19: A cross-sectional national survey in China
Authors: Wang Ziyu , Tang Yurong , Cui Yu , Guan Hanwen , Cui Xiaoqian , Liu Yuan , Liu Yanni , Kang Zheng , Wu Qunhong , Hao Yanhua , Liu Chaojie
Published: February 2023

Background

The pandemic of COVID-19 has significant implications on health resources allocation and health care delivery. Patients with non-COVID illness may have to change their care seeking behaviors to mitigate the risk of infections. The research aimed to investigate potential delay of community residents in seeking health care at a time with an overall low prevalence of COVID-19 in China.

Methods

An online survey was conducted in March 2021 on a random sample drawn from the registered survey participants of the survey platform Wenjuanxing. The respondents who reported a need for health care over the past month (n = 1,317) were asked to report their health care experiences and concerns. Logistic regression models were established to identify predictors of the delay in seeking health care. The selection of independent variables was guided by the Andersen's service utilization model. All data analyses were performed using SPSS 23.0. A two-sided p value of <0.05 was considered as statistically significant.

Key results

About 31.4% of respondents reported delay in seeking health care, with fear of infection (53.5%) as a top reason. Middle (31–59 years) age (AOR = 1.535; 95% CI, 1.132 to 2.246), lower levels of perceived controllability of COVID-19 (AOR = 1.591; 95% CI 1.187 to 2.131), living with chronic conditions (AOR = 2.008; 95% CI 1.544 to 2.611), pregnancy or co-habiting with a pregnant woman (AOR = 2.115; 95% CI 1.154 to 3.874), access to Internet-based medical care (AOR = 2.529; 95% CI 1.960 to 3.265), and higher risk level of the region (AOR = 1.736; 95% CI 1.307 to 2.334) were significant predictors of the delay in seeking health care after adjustment for variations of other variables. Medical consultations (38.7%), emergency treatment (18.2%), and obtainment of medicines (16.5%) were the top three types of delayed care, while eye, nose, and throat diseases (23.2%) and cardiovascular and cerebrovascular diseases (20.8%) were the top two conditions relating to the delayed care. Self-treatment at home was the most likely coping strategy (34.9%), followed by Internet-based medical care (29.2%) and family/friend help (24.0%).

Conclusions

Delay in seeking health care remained at a relatively high level when the number of new COVID-19 cases was low, which may present a serious health risk to the patients, in particular those living with chronic conditions who need continuous medical care. Fear of infection is the top reason for the delay. The delay is also associated with access to Internet-based medical care, living in a high risk region, and perceived low controllability of COVID-19.
Older people's out-of-home mobility and wellbeing in Australia: Personal, built environment, and transportation factors associated with unmet mobility needs
Authors: Ma Tracey , Kobel Conrad , Ivers Rebecca
Published: February 2023

Out-of-home mobility is fundamental to older people's wellbeing and quality of life. Understanding the unmet mobility needs of older people is a necessary starting point for determining how they can be supported to be mobile. This study estimates the extent of unmet mobility needs among older Australians and identifies the characteristics of those most likely to report unmet mobility needs. Analysis was conducted on nationally representative data of 6,685 older Australians drawn from the 2018 Survey of Disability, Aging and Carers conducted by the Australian Bureau of Statistics. Twelve predictor variables from two conceptual frameworks on older people's mobility were included in the multiple logistic regression model. Twelve percent (n = 799) of participants had unmet mobility needs, and associated factors significant in multivariable models included being among the “young-old”, having a lower income, having lower levels of self-rated health, having a long-term condition, being limited in everyday physical activities, experiencing a higher level of distress, being unlicensed, having decreased public transport ability, and residing in major cities. Efforts to support older people's mobility must make equity an explicit consideration, reject a one-size-fits-all approach, and prioritize the accessibility of cities and communities.
A typology of integrated care policies in the care home sector: A policy document analysis
Authors: Simpson Glenn , Entwistle Charlotte , Short Andrea D. , Morciano Marcello , Stokes Jonathan
Published: February 2023

Background

Health and social care systems in many countries have begun to trial and adopt “integrated” approaches. Yet, the significant role care homes play within the health and social care system is often understated. A key first step to identifying the care home integration interventions that are most (cost-)effective is the ability to precisely identify and record what has been implemented, where, and when—a “policy map.”

Methods

To address gaps relating to the identification and recording of (cost-)effective integrated care home interventions, we developed a new typology tool. We conducted a policy mapping exercise in a devolved region of England—Greater Manchester (GM). Specifically, we carried out systematic policy documentary searches and extracted a range of qualitative data relating to integrated health and social care initiatives in the GM region for care homes. The data were then classified according to existing national ambitions for England as well as a generic health systems framework to illustrate gaps in existing recording tools and to iteratively develop a novel approach.

Results

A combined total of 124 policy documents were identified and screened, in which 131 specific care home integration initiatives were identified. Current initiatives emphasized monitoring quality in care homes, workforce training, and service delivery changes (such as multi-disciplinary teams). There was comparatively little emphasis on financing or other incentive changes to stimulate provider behavior for the care home setting. We present a novel typology for capturing and comparing care home integration policy initiatives, largely conceptualizing which part of the system or specific transition point the care home integration is targeting, or whether there is a broader cross-cutting system intervention being enacted, such as digital or financial interventions.

Conclusions

Our typology builds on the gaps in current frameworks, including previous lack of specificity to care homes and lack of adaptability to new and evolving initiatives internationally. It could provide a useful tool for policymakers to identify gaps in the implementation of initiatives within their own areas, while also allowing researchers to evaluate what works most effectively and efficiently in future research based on a comprehensive policy map.
Pediatric tele-coaching fidelity evaluation: Feasibility, perceived satisfaction and usefulness of a new measure
Authors: Ogourtsova Tatiana , Majnemer Annette , Brown Amelie , Filliter Helen Jillian , Wittmeier Kristy , Hanson Jessica , O’Donnell Maureen
Published: February 2023

Background

To promote and ensure coaches' fidelity in delivering an online health coaching program to parents of children with suspected developmental delay, we developed and implemented a novel coaching fidelity rating tool, CO-FIDEL (COaches Fidelity in Intervention DELivery). We aimed to (1) Demonstrate CO-FIDEL's feasibility in evaluating coaches' fidelity and its change over time; and (2) Explore coaches' satisfaction with and usefulness of the tool.

Methods

In an observational study design, coaches (n = 4) were assessed using the CO-FIDEL following each coaching session (n = 13–14 sessions/parent-participant) during the pilot phase of a large randomized clinical trial involving eleven (n = 11) parent-participants. Outcome measures included subsections' fidelity measures, overall coaching fidelity, and coaching fidelity changes over time analyzed using descriptive and non-parametric statistics. In addition, using a four-point Likert Scale and open-ended questions, coaches were surveyed on their satisfaction and preference levels, as well as facilitators, barriers, and impacts related to the use of CO-FIDEL. These were analyzed using descriptive statistics and content analysis.

Results

One hundred and thirty-nine (n = 139) coaching sessions were evaluated with the CO-FIDEL. On average, overall fidelity was high (88.0 ± 6.3 to 99.5 ± 0.8%). Four coaching sessions were needed to achieve and maintain a ≥ 85.0% fidelity in all four sections of the tool. Two coaches showed significant improvements in their coaching skills over time in some of the CO-FIDEL sections (Coach B/Section 1/between parent-participant B1 and B3: 89.9 ± 4.6 vs. 98.5 ± 2.6, Z = −2.74, p = 0.00596; Coach C/Section 4/between parent-participant C1 and C2: 82.4 ± 7.5 vs. 89.1 ± 4.1, Z = −2.66; p = 0.00758), and in overall fidelity (Coach C, between parent-participant C1 and C2: 88.67 ± 6.32 vs. 94.53 ± 1.23, Z = −2.66; p = 0. 00758). Coaches mainly reported moderate-high satisfaction with and usefulness of the tool, and pointed out areas of improvement (e.g., ceiling effect, missing elements).

Conclusions

A new tool ascertaining coaches' fidelity was developed, applied, and shown to be feasible. Future research should address the identified challenges and examine the psychometric properties of the CO-FIDEL.