bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and predictive risk factors of self-stigmatization in patients with rare diseases: Based on health ecology model
Authors: Liang Haixu , Zheng Jiaqi , Sun Yongkang
Published: April 2023

Background and aims:

Given the cause of self-stigmatization of patients with rare diseases is complicated, and the self-stigmatization can be prevented by managing the related risk factors. This study aimed to report the prevalence as well as influencing factors associated with self-stigmatization in patients with rare diseases.

Methods:

From January to April 2022, the respondent-driven sampling (RDS) method was used to select patients with rare diseases through the Chinese Organization for Rare Disorders as the subjects. Based on the theoretical model of health ecology, logistic regression analysis was used to explore the association between self-stigmatization level and sample characteristics of patients with rare diseases.

Results:

A total of 530 patients were included, 50.2% of whom were male, and most of them are under 45 years old (86.5%). The prevalence of self-stigmatization in patients with rare diseases was 85.7%. Logistic regression analysis indicated that age (OR: 0.624, 95% CI: [0.399, 0.976]), mental health status (OR: 0.184, 95% CI: [0.076, 0.445]), family relations (OR: 0.180, 95% CI: [0.074, 0.434]), full time work (OR: 2.835, 95% CI: [1.024, 7.849]) and medical insurance (OR: 0.296, 95% CI: [0.105, 0.835]) were risk factors for self-stigmatization of patients with rare diseases.

Conclusions:

Chinese patients with rare diseases have a high level of self-stigmatization, and the potential risk factors are multi-level and multi-dimensional.
Designs of lattice truss core sandwich structures with improved compressive strength and stiffness
Authors: Dastan Tohid , Nedoushan Reza Jafari , Sheikhzadeh Mohammad , Yu Woong-Ryeol
Published: April 2023

Lattice truss core sandwich composite (LTCSC) panels can exhibit high compressive performance until failure is caused by compressive fracture of the composite strut. Early failure of the core-facesheet and central nodes, as well as fiber misalignment, can hinder the full potential of an LTCSC. This study aimed at improving the compressive stiffness and strength of LTCSC panels through minimizing the fiber misalignment and fabrication issues, while strengthening the central and core-facesheet nodes. The lost-molding technique was used to fabricate LTCSC panels, which were then subjected to quasi-static flatwise compression testing. Relative positioning of neighboring composite struts, modification of the carbon fiber path, and strengthening of the core-facesheet node significantly improved the compressive performance of the panels. Based on the findings, compressive strength and stiffness of LTCSC panels can be improved about 100% and 300%, respectively, with minimal increase in weight. Fabricated LTCSC panels were found to demonstrate competitive specific compressive properties in comparison with conventional core materials.
Leveraging Empowering Leadership to Improve Employees’ Improvisational Behavior: The Role of Promotion Focus and Willingness to Take Risks
Authors: Ye Suyang , Yao Kaibo , Xue Jiale
Published: April 2023

Improvisational behavior is an individual’s spontaneous and creative behavior in the face of emergencies, using existing material and emotional resources to respond quickly and effectively to uncertain situations. Despite increasing interest in this behavior, its antecedents remain unclear, with particular ambiguity regarding the relationship between empowering leadership and employee improvisational behavior. The present article addresses this ambiguity with the theory of reasoned action to examine whether the impact of empowering leadership on employees’ improvisational behavior is determined by employees’ attitudes toward such behavior. In this study, a multi-source design was adopted, and data (339 valid samples) were collected from five Internet companies in China’s Jiangsu and Zhejiang provinces. Hierarchical regression and bootstrapping methods were used to test the hypotheses. The results reveal that (1) employees’ promotion focus moderates the relationship between empowering leadership and improvisational behavior and (2) employees’ willingness to take risks mediates the moderating effect of promotion focus. Our findings demonstrate employees’ attitudinal utility in explaining when improvisational behavior is most likely to occur under empowering leadership.
Commodifying Havana? Private accumulation, assetisation and marketisation in the Cuban metropolis
Authors: Wijburg Gertjan
Published: April 2023

In the Global South, cities are increasingly restructuring themselves around the financial pressures of international capital markets. Therefore, it is sometimes hypothesised that financial innovations created in the Global North are moving ‘South’. However, even though transnational capital is finding its way into Southern regions and other areas of reform, the road towards urban commodification is bumpy and uneven. In Havana, Cuba, the government recently legalised free market home sales, contributing to an unprecedented transnational property boom where many homes were acquired by Cuban émigrés and nationals and converted into restaurants, hotels or short-term rentals. Nevertheless, due to endogenous and exogenous market restraints, the pandemic and complex interactions between state authorities and property-owning private entrepreneurs, Cuban-style commodification remains an incomplete and contested process. Even so, non-debt bearing assetisation pressures are clearly redefining Havana’s socialist property market. While the state encourages foreign direct investment into state-owned hotels and joint ventures, transnational remittances contribute to the commodification of Havana’s private housing stock.
Synchronous slew/translation positioning and swing suppression control for 4-DOF tower crane system
Authors: Huang Jingwen , Zhao Zihao
Published: April 2023

This paper introduces a method to navigate the tower crane movement and suppress the payload swing synchronously. Special error signals are introduced, which bring the coupling of dynamics among various states of the crane and enable the control to meet the synchronous operation in practice. The special angle-dependent energy functions are designed as the candidate sub-Lyapunov functions for decoupling the states. The controller is then stepwise designed with the help of the dynamics model. The stability of the control is proven in the Lyapunov sense. Extensive simulations and experiments have been carried out to demonstrate the effectiveness of the proposed nonlinear coupling control. A popular control approach in the literature is chosen to compare with the current work. It is found that the proposed control is quite effective in suppressing the payload swing while tracking the pre-determined path at the same time.
Facial expressions of emotions by people with visual impairment and blindness via video conferencing
Authors: Nam Kim Hyung
Published: April 2023

Many people including those with visual impairment and blindness take advantage of video conferencing tools to meet people. Video conferencing tools enable them to share facial expressions that are considered as one of the most important aspects of human communication. This study aims to advance knowledge of how those with visual impairment and blindness share their facial expressions of emotions virtually. This study invited a convenience sample of 28 adults with visual impairment and blindness to Zoom video conferencing. The participants were instructed to pose facial expressions of basic human emotions (anger, fear, disgust, happiness, surprise, neutrality, calmness, and sadness), which were video recorded. The facial expressions were analyzed using the Facial Action Coding System (FACS) that encodes the movement of specific facial muscles called Action Units (AUs). This study found that there was a particular set of AUs significantly engaged in expressing each emotion, except for sadness. Individual differences were also found in AUs influenced by the participants’ visual acuity levels and emotional characteristics such as valence and arousal levels. The research findings are anticipated to serve as the foundation of knowledge, contributing to developing emotion-sensing technologies for those with visual impairment and blindness.
New regions in the periphery: Agency and politics in shaping the governance of regional development in the Scotland–England border region
Authors: Clelland David
Published: April 2023

The restructuring of sub-national economic governance has been one response to persistent regional inequalities; in the United Kingdom, this has entailed a rescaling of strategic economic governance around city-regions. The variety of ‘left behind’ places, however, also includes peripheral and non-urban regions, prompting actors across different scales to seek arrangements for those places outside the city-regional paradigm. This paper provides insights into these processes through tracing the emergence of two new and overlapping spaces of governance in the largely rural South of Scotland, and across a larger area also including the far North of England. While driven by top-down priorities of the centre, new spaces are created through political processes contested across multiple scales, layered onto existing arrangements. These episodes demonstrate how regional actors exercise agency in shaping governance arrangements by articulating regional problems, and proposed responses, with political concerns of the centre. They also indicate the potential for dominant approaches, based on city-regional imaginaries, to be challenged. New regions offer at least the potential for actors in the periphery to secure resources for place-based development, within a fragmented and competitive landscape. They may however prove to be transient, requiring ongoing coupling of regional and central interests to be maintained.
Localization of the Adductor Tubercle in the Skeletally Immature: A Computed Tomography Study With Patellofemoral Surgical Implications
Authors: Jabbouri Sahir S. , McLaughlin William , Joo Peter , Cooperman Daniel , Fulkerson John P. , Frumberg David B.
Published: April 2023

Background:

The adductor tubercle of the distal femur is utilized by surgeons as an anatomic landmark to identify graft anchor placement during medial patellofemoral ligament (MPFL) and medial quadriceps tendon femoral ligament (MQTFL) reconstruction for patellofemoral instability. In the skeletally immature population, its location relative to the physis has not been well defined.

Purpose:

To identify the location of the adductor tubercle relative to the distal femoral physis in skeletally immature individuals and gain insight regarding optimal graft anchor placement for pediatric patients undergoing MPFL and MQTFL reconstruction.

Study Design:

Descriptive laboratory study.

Methods:

Thin-cut computed tomography scans of 37 male cadaveric specimens (age, 4-16 years) were obtained from the New Mexico Decedent Image Database. A measurement protocol to identify the adductor tubercle was created with guidance from a fellowship-trained musculoskeletal radiologist. By utilizing axial, coronal, and sagittal views of knee computed tomography scans, the adductor magnus tendon was identified and followed distally to its insertion (adductor tubercle) on the distal femur. Distance from the midpoint of the adductor magnus tendon insertion relative to the physis in the proximal-distal orientation was measured. The anterior-posterior distance of the midpoint tendon insertion relative to the posterior femoral cortex line was also evaluated.

Results:

The midpoint of the adductor magnus tendon was at the physis in 30 specimens. One 8-year-old cadaveric specimen had an insertion 1.1 mm distal to the physis. In all specimens ≥15 years old (n = 6), the adductor magnus tendon insertion was distal to the physis with a mean distance of 2.73 mm. The location of the adductor tubercle was always posterior (mean, 5.1 mm) with respect to the posterior femoral cortex line.

Conclusion:

The location of the adductor tubercle in male pediatric patients is likely at or distal to the physis. Thus, the findings of this study directly conflict with previous studies that suggested a more proximal location.

Clinical Relevance:

Optimal graft anchor placement during MPFL and MQTFL reconstruction in the skeletally immature patient can be challenging because of the variability reported in previous studies of the medial patellofemoral complex origin relative to the physis. This study suggests that distal—rather than proximal—graft anchor placement might better help restore patellofemoral isometry.
Thermal and tensile properties of 3D printed ABS-glass fibre, ABS-glass fibre-carbon fibre hybrid composites made by novel hybrid manufacturing technique
Authors: Aravind D , Krishnasamy Senthilkumar , Rajini N , Siengchin Suchart , Kumar T Senthil Muthu , Chandrasekar M , Yorseng Krittirash
Published: April 2023

This study was an attempt to combine fused deposition modelling and hot press moulding technique to fabricate hybrid polymer composites using acrylonitrile butadiene styrene (ABS) polymer, woven glass fibre (GF) and woven carbon fibre (CF). The composite specimens were subjected towere subjected to mechanical and thermal characterization.Tensile strength of GF/ABS and GF/CF/ABS composite were far higher than the virgin ABS. GF/ABS composites displayedimproved thermal resistance by giving a final residue of 42.36%, followed by GF/CF/ABS hybrid composites as per the thermogravimetric analysis. Thermomechanical analysis revealed the coefficient of thermal expansion in the order: ABS > GF/ABS > GF/CF/ABS. The entropy obtained from the DSC curve was of higher value for composites than the ABS. The ABS based composites fabricated from this technique can be applicable to structural parts in the automobiles, aircrafts, shipping vessels, etc.
Fabrication of bio-fiber based Eichhornia crassipes/Al2O3 particles hybrid biocomposites and investigation of important properties
Authors: Herlina Sari Nasmi , Suteja  , Sujita  , Ilyas Rushdan Ahmad , Sari Eka , Sanjay Mavinkere Rangappa , Siengchin Suchart
Published: April 2023

The need for environmentally friendly composite materials that meet the necessary criteria is growing. Making novel environmentally acceptable composites with hybrid Eichhornia crassipes (EGs)/Al2O3 particles is an option. This paper aims to investigate the thermal, tensile strength, and flexural strength properties of a polyester composite filled with hybrid EG/Al2O3 particles. The tensile strength, flexural strength, and morphology of EGs/Al2O3 hybrid composite will be investigated in this work. The hot pressed for 60 minutes at 170°C procedure was used to shape the hybrid composite. EGs/Al2O3 particles content was altered from 0:25 to 5:20, 10:15 to 15:10, 20:5, and 25:0 (vol.%). The results reveal that when the EGs content of the composite is in the range of 10–15% (vol.%), the tensile and bending strength of the composite increases. The EGI (15% EGs:10% Al2O3) and EGH (10% EGs:10% Al2O3) composites had the highest tensile and bending strengths, with 38.697 and 77.786 MPa, respectively. The boost in strength is thought to be due to Al2O3 acting as a cursor in the composite, preventing fracture progression. The scanning electron microscope (SEM) fracture morphology reveals a strong and tight interfacial connection between the EGs, Al2O3, and polyester layers. In addition, when the EGs grew, the composites’ thermal characteristics improved. According to the findings, the EGs/ Al2O3 particle hybrid composite can be used in automotive applications.
Surface integrity evaluation in ecological nanofluids assisted grinding of Inconel 718 superalloy
Authors: Sinha Manoj Kumar , Kishore Kamal , Sharma Pankaj
Published: April 2023

Surface integrity is an important term that describes the surface behaviour of a ground component. Grinding is defined as a finishing operation that has high specific energy consumption. High heat generation while grinding, adversely affects the surface integrity of the ground surfaces. With the development of advanced materials such as superalloys, this process is widely used in bulk machining for making critical components used in dynamic loading. Therefore, it becomes necessary to investigate the surface integrity of the ground components, as their surface integrity primarily determines their performance and durability. The purpose of this work is to enhance the grinding performance of Inconel 718, a difficult-to-grind material, by employing silver and zinc oxide (ZnO)-based ecological nanofluids in a minimum quantity lubrication (MQL) mode. The grinding parameters such as wheel speed and table speed are kept constant with variations in the grinding infeed. The grinding performance in terms of grinding forces, apparent coefficient of friction, surface roughness and residual stresses on the ground surfaces have been investigated. Skewness, kurtosis and the Abbott–Firestone curve have also been analysed using two-dimensional and three-dimensional plots for an in-depth study of ground surface behaviour. The finding suggests that ZnO-based nanofluid outclass the silver-based nanofluid using MQL mode in terms of reduced grinding forces and favourable residual stress. Therefore, it appears as the potential grinding environment for the improved grinding performance of Inconel 718.
Radiotherapy Increases aMMP-8-Levels and Neutrophil/Lymphocyte Ratio Rapidly in Head and Neck Cancer Patients: A Pilot Study
Authors: Brandt Ella , Keskin Mutlu , Tervahartiala Taina , Yılmaz Mustafa , Harmankaya İlknur , Karaçetin Didem , İpek Turgut , Gürsoy Ulvi Kahraman , Rautava Jaana , Gupta Shipra , Hagström Jaana , Räisänen Ismo T. , Sorsa Timo
Published: April 2023

Radiotherapy for head and neck carcinoma (HNC) has both curative and palliative purposes. This study investigated mouthrinse aMMP-8 levels, molecular forms of MMP-8, blood neutrophil counts and neurophil/lymphocyte ratios before and 3 weeks after HNC radiotherapy started. Thirteen HNC patients undergoing radiotherapy were included. Mouthrinse samples (before and 3 weeks after HNC radiotherapy had started) were assayed quantitatively by aMMP-8 point-of-care-kit (PerioSafe®/ORALyzer®) and by western immunoblot. Total neutrophil counts and neutrophil/lymphocyte ratios were evaluated in the hemogram results. Three weeks after HNC radiotherapy started, significant increases in aMMP-8 levels and neutrophil/lymphocyte ratios were observed. No significant difference was found in total neutrophil counts. Elevations of the activated and fragmented MMP-8 levels after HNC radiotherapy application were observed on western immunoblot analysis. The increase in the aMMP-8 levels and neutrophil/lymphocyte ratios indicate inflammation both locally and systemically suggesting increased risk for periodontitis due to the HNC radiotherapy.
Rewriting Social Science: The Literary Turn in Qualitative Research
Authors: Hammersley Martyn
Published: April 2023

In the past few decades, there have been efforts to transform qualitative inquiry, drawing on resources from both imaginative literature and art. There have long been tensions within social science that have encouraged the use of these resources, but the recent “literary turn” is more radical. The assumptions underpinning it are examined, and it is argued that what is most important is the purpose for which modes of expression are employed and how well they serve this. The problem with the literary turn is that it frequently involves substitution of the purposes of art or politics for those of social science.
Axial length and corneal curvature of normal eyes in the first decade of life
Authors: Oke Isdin , Nihalani Bharti R , VanderVeen Deborah K
Published: April 2023

Background/Aims

To establish normative curves for axial length and corneal curvature in the first decade of life.

Methods

This is a cross-sectional study from a single institution in the United States. Children from 0- to 10-years of age with no underlying ocular pathology were prospectively enrolled to obtain ultrasound biometry and hand-held keratometry while under anaesthesia for an unrelated procedure. Older cooperative children had optical biometry obtained in-office. Logarithmic quantile regression models were used to determine the change in axial length and average keratometry as a function of age.

Results

Single-eye measurements from 100 children were included. 75% of children were White and 49% female. Median axial length ranged from 20.6 mm (IQR, 20.2 to 21.1 mm) at age one year to 23.1 mm (IQR, 22.5 to 23.8 mm) at age ten years. Median average keratometry ranged from 44.1 D (IQR, 42.6 to 45.4 D) at age one year to 43.5 (IQR, 42.2 to 44.0 D) at age ten years. As age increased, there was a significant increase in axial length (0.74 mm per doubling of age; 95% CI, 0.62 to 0.82 mm), and a non-significant trend towards lower average keratometry (−0.21 D per doubling of age; 95% CI, −0.62 to 0.08 D).

Conclusions

We provide a set of normative charts for axial length and corneal curvature which may facilitate the identification of eyes outside the normal range and assist in the management of ocular conditions such as glaucoma or cataract.
Short-term clinical results with a trifocal diffractive toric intraocular lens using an optimized preoperative and intraoperative protocol
Authors: Paredes Beatriz , Mora Javier , Martín M. Dolores , Larrosa Adrian , Piñero David P.
Published: April 2023

Purpose

To evaluate the short-term clinical outcomes of a specific toric diffractive trifocal intraocular lens (IOL) implanted following an optimized clinical protocol in a large population.

Methods

Retrospective analysis of 337 eyes of 231 patients (mean age, 62.2 years) undergoing cataract surgery with implantation of the trifocal diffractive IOL AT.LISA tri toric 939M/MP (Carl Zeiss Meditec). A strict and careful clinical protocol was followed, including an accurate measurement of corneal astigmatism, use of a latest generation IOL power calculator, photography-based method intraoperative control of IOL alignment and IOL reposition at 1 week postoperatively if needed. Clinical outcomes in terms of visual acuity, refraction, efficacy of astigmatic correction analysed by vector analysis and patient satisfaction were evaluated during a 3-month follow-up.

Results

A total of 82% and 98% of eyes achieved a postoperative uncorrected distance visual acuity of 0.00 and 0.10 logMAR or better, respectively. Furthermore, 99.7%, and 100.0% of eyes showed a postoperative spherical equivalent within ± 0.50 D and ± 1.00 D, with 97.9% of eyes having a postoperative cylinder ≤ 0.50 D. Uncorrected near and intermediate visual acuities were 0.2 logMAR or better in 89.0% and 99.1% of eyes, respectively. Mean difference vector, magnitude of error and angle of error were 0.02  ±  0.14 D, 0.02  ±  0.13 D and 0.11  ±  1.18°. Patient satisfaction was referred as high or very high by 97.6% of patients.

Conclusions

The implantation of the trifocal toric IOL evaluated following a careful clinical protocol provides an efficacious visual rehabilitation and astigmatic correction, leading to high levels of patient satisfaction.
Constructing therapeutic support and negotiating competing agendas: A discourse analysis of vocational advice provided to individuals who are absent from work due to ill-health
Authors: Saunders Benjamin , Chew-Graham Carolyn , Sowden Gail , Cooke Kendra , Walker-Bone Karen , Madan Ira , Parsons Vaughan , Linaker Cathy H , Wynne-Jones Gwenllian
Published: April 2023

Work participation is known to benefit people’s overall health and wellbeing, but accessing vocational support during periods of sickness absence to facilitate return-to-work can be challenging for many people. In this study, we explored how vocational advice was delivered by trained vocational support workers (VSWs) to people who had been signed-off from work by their General Practitioner (GP), as part of a feasibility study testing a vocational advice intervention. We investigated the discursive and interactional strategies employed by VSWs and people absent from work, to pursue their joint and respective goals. Theme-oriented discourse analysis was carried out on eight VSW consultations. These consultations were shown to be complex interactions, during which VSWs utilised a range of strategies to provide therapeutic support in discussions about work. These included; signalling empathy with the person’s perspective; positively evaluating their personal qualities and prior actions; reflecting individuals’ views back to them to show they had been heard and understood; fostering a collaborative approach to action-planning; and attempting to reassure individuals about their return-to-work concerns. Some individuals were reluctant to engage in return-to-work planning, resulting in back-and-forth interactional negotiations between theirs and the VSW’s individual goals and agendas. This led to VSWs putting in considerable interactional ‘work’ to subtly shift the discussion towards return-to-work planning. The discursive strategies we have identified have implications for training health professionals to facilitate work-orientated conversations with their patients, and will also inform training provided to VSWs ahead of a randomised controlled trial.
Agribusiness and the COVID-19 syndemic: The unsustainable pathways
Authors: Diderichsen Finn , Friedrich Karen , Da Silva Giraldo Lia Augusto
Published: April 2023

It has been suggested that it would be more appropriate to term the COVID-19 pandemic a syndemic, as the infection interacts synergistically with pre-existing chronic conditions such as obesity. Both conditions occur with steep socio-economic inequalities, and Brazil is suffering a heavy burden from both. What and who drives the clustering and interaction of these disorders? In this commentary, we examine the pathways leading to the COVID-19 syndemic. Deforestation, declining biodiversity and factory farming are promoting the emergence of new pathogens. Widespread use of pesticides influences immune, endocrine and metabolic systems. The ingestion of ultra-processed food promotes malnutrition and obesity in a country where at the same time poverty and food insecurity is rising. Brazilian agribusiness is focused on the production and global export of agricultural commodities, mainly for animal food and meat production. It is made possible through a combination of expanded land use, with deforestation in Amazonas and other Brazilian biomes, and the intensification of land use and cultivation of genetically modified crops with fertilizers and pesticides. This development is not sustainable for either population health or the environment.
A vibration analysis and control method of a heavy buoyancy regulator in an underwater vehicle
Authors: Liu Jing , Yang Danyi , Liu Yujun , Pan Guang
Published: April 2023

Vibration analysis and control are the main issues of heavy buoyancy regulators, which can improve the runtime performance and reduce the power loss. It is an effective approach to add rubber-based isolators to control the vibrations of the heavy buoyancy regulator. However, the vibration reduction effect of the rubber-based isolators is closely related to their structures and material performance. In this study, according to the geometrics of the connecting components, the structures of the rubber-based isolators are designed by using the vibration theory. The rubber-based isolators with different structures and hardness are considered in the finite element models, whose results are used to achieve the optimal design cases. The vibration isolation transmissibility and static deformation ratio of the rubber-based isolator are discussed. The frequency–displacement characteristics of the heavy buoyancy regulator are also analyzed. The results show that the two presented rubber-based isolators can be used to control the vibrations of the heavy buoyancy regulator. It seems that the presented method can be used for the vibration analysis and control of the heavy buoyancy regulators in underwater vehicles.
Performance of Pretreatment MRI-Based Radiomics in Recombinant Human Endostatin Plus Concurrent Chemoradiotherapy Response Prediction in Nasopharyngeal Carcinoma: A Retrospective Study
Authors: Huang Lixuan , Yang Zongxiang , Kang Min , Ren Hao , Jiang Muliang , Tang Cheng , Hu Yao , Shen Mingjun , Lin Huashan , Long Liling
Published: April 2023

Purpose

To investigate the capability of an Magnetic resonance imaging (MRI) radiomics model based on pretreatment texture features in predicting the short-term efficacy of recombinant human endostatin (RHES) plus concurrent chemoradiotherapy (CCRT) for nasopharyngeal carcinoma (NPC).

Methods

We retrospectively enrolled 65 patients newly diagnosed as having NPC and treated with RHES + CCRT. A total of 144 texture features were extracted from the MRI before RHES + CCRT treatment of all the NPC patients. The maximum relevance minimum redundancy (mRMR) method was used to remove redundant, irrelevant texture features, and calculate the Rad score of the primary tumor. Multivariable logistic regression was used to select the most predictive features subset, and prediction models were constructed. The performance of the 3 models in predicting the early response of RHES + CCRT for NPC was explored.

Results

The diagnostic efficiency of combined model and radiomics model in distinguishing between the effective and the ineffective groups of patients was found to be moderate. The area under the ROC curve (AUC) of the combined model and radiomics model was 0.74 (95% confidence interval [CI]: 0.62-0.86) and 0.71 (95% CI: 0.58-0.84), respectively, with both being higher than the AUC of the clinics model (0.63, 95% CI: 0.49-0.78). Compared with the radiomics model, the combined model showed marginally improved diagnostic performance in predicting RHES + CCRT treatment response. The accuracy of combined model and radiomics model for RHES + CCRT response assessment in NPC were higher than those of the clinics model (0.723, 0.723 vs 0.677).

Conclusion

The pretreatment MRI-based radiomics may be a noninvasive and effective method for the prediction of RHES + CCRT early response in patients with NPC.
Identification of biomarkers, pathways, and potential therapeutic targets for heart failure using next-generation sequencing data and bioinformatics analysis
Authors: Ganekal Prashanth , Vastrad Basavaraj , Vastrad Chanabasayya , Kotrashetti Shivakumar
Published: April 2023

Background:

Heart failure (HF) is the most common cardiovascular diseases and the leading cause of cardiovascular diseases related deaths. Increasing molecular targets have been discovered for HF prognosis and therapy. However, there is still an urgent need to identify novel biomarkers. Therefore, we evaluated biomarkers that might aid the diagnosis and treatment of HF.

Methods:

We searched next-generation sequencing (NGS) dataset (GSE161472) and identified differentially expressed genes (DEGs) by comparing 47 HF samples and 37 normal control samples using limma in R package. Gene ontology (GO) and pathway enrichment analyses of the DEGs were performed using the g: Profiler database. The protein–protein interaction (PPI) network was plotted with Human Integrated Protein–Protein Interaction rEference (HiPPIE) and visualized using Cytoscape. Module analysis of the PPI network was done using PEWCC1. Then, miRNA-hub gene regulatory network and TF-hub gene regulatory network were constructed by Cytoscape software. Finally, we performed receiver operating characteristic (ROC) curve analysis to predict the diagnostic effectiveness of the hub genes.

Results:

A total of 930 DEGs, 464 upregulated genes and 466 downregulated genes, were identified in HF. GO and REACTOME pathway enrichment results showed that DEGs mainly enriched in localization, small molecule metabolic process, SARS-CoV infections, and the citric acid tricarboxylic acid (TCA) cycle and respiratory electron transport. After combining the results of the PPI network miRNA-hub gene regulatory network and TF-hub gene regulatory network, 10 hub genes were selected, including heat shock protein 90 alpha family class A member 1 (HSP90AA1), arrestin beta 2 (ARRB2), myosin heavy chain 9 (MYH9), heat shock protein 90 alpha family class B member 1 (HSP90AB1), filamin A (FLNA), epidermal growth factor receptor (EGFR), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), cullin 4A (CUL4A), YEATS domain containing 4 (YEATS4), and lysine acetyltransferase 2B (KAT2B).

Conclusions:

This discovery-driven study might be useful to provide a novel insight into the diagnosis and treatment of HF. However, more experiments are needed in the future to investigate the functional roles of these genes in HF.
Concordance Between Active Partial Thromboplastin Time and Anti-Factor Xa Assays in Neurocritically Ill Patients Receiving Subcutaneous Heparin Prophylaxis
Authors: Shinn Grace , Berger Karen , Roh David , Doyle Kevin , Boehme Amelia K. , Connolly Edward Sander , Park Soojin , Agarwal Sachin , Claassen Jan , Der-Nigoghossian Caroline
Published: April 2023

Background

Laboratory monitoring is not recommended when subcutaneous unfractionated heparin (SQ-UFH) is administered at prophylactic doses. However, aPTT prolongation and associated hemorrhage has been reported in the neurocritically ill. At our institution, Neuroscience Intensive Care Unit (Neuro-ICU) patients with prolonged aPTT are further evaluated with a follow up aPTT and anti-factor Xa.

Purpose

The purpose of this study was to describe concordance between aPTT and anti-factor Xa in neurocritically ill patients receiving prophylactic SQ-UFH with evidence of aPTT prolongation.

Methods

A retrospective chart review of adult patients admitted to the Neuro-ICU from June 2017 to June 2019 was performed. Patients were included if they received SQ-UFH with aPTT levels and at least one anti-factor Xa level drawn within one hour of each other. Concordance between paired aPTT and anti-factor Xa was evaluated using Cohen’s weighted kappa.

Results

Forty two patients with 56 paired aPTT and anti-factor Xa levels were included. The most prescribed SQ-UFH regimen was 5000 units every 8 hours (60.7%) and anti-factor Xa levels were drawn a median (IQR) of 5.7 (3.1-10.7) hours after the SQ-UFH dose. Only 16 (28.6%) pairs were in concordance. The analysis showed a weighted kappa of .09; 95% CI [−.05 to .22] indicating poor agreement.

Conclusions

In neurocritically ill patients receiving prophylactic SQ-UFH with aPTT prolongation, there was poor concordance between aPTT and anti-factor Xa. This suggests that aPTT prolongation may not be solely driven by heparin activity and further evaluation of mechanistic drivers for coagulopathy in this population is necessary.
When Paying Is (Even More) Painful: Personality-Based Heterogeneity in Consumption Responses to Economic Hardship
Authors: Gladstone Joe J. , Masters-Waage Theodore C.
Published: April 2023

Economic downturns lead to declining consumer spending, but people vary considerably in their consumption responses. We investigate an important driver of this heterogeneity, personality. Trait level variation has been observed in the levels of psychological discomfort when making a purchase (“the pain of paying”). We test whether individuals who experience more pain when paying are not only reluctant spenders in general but also decrease spending more sharply when experiencing economic hardship, indicating an increased “pain sensitivity.” Evidence from a two-wave online survey ( N = 942), a representative longitudinal database ( N = 3,181) and a cross-national survey ( N=11,972) converge to support the hypothesis that the pain of paying moderates the relationship between economic hardship and spending. Our findings provide evidence that personality can shape people’s responses to economic downturns and indicate the potential role of psychology-based interventions in macro-economic policy.
Prevalence of cardiovascular risk factors in a historical cohort of people living with human immunodeficiency virus during a 10-year period
Authors: García-Peña Ángel , Aldana Jairo , Botero Juan David , Vasquez Juan Manuel , León Miguel , Rodríguez-Lugo Diego , Villamil Lina , Barahona-Correa Julián E , Tamara Jose
Published: April 2023

Objective:

Data on the frequency of cardiovascular disease in people living with human immunodeficiency virus from low- and middle-income countries is scarce.

Methods:

We performed an observational study based on data from a historical cohort of people living with human immunodeficiency virus in Colombia during a 10-year follow-up to describe the prevalence of cardiovascular risk factors and their behavior according to CD4 count.

Results:

One thousand patients were initially included, out of which 390 had a 10-year follow-up. The mean age was 34 (standard deviation 10) years, and 90% were male. We observed an increase in the prevalence of dyslipidemia (29%–52%, p < 0.001) and obesity (1.1%–3.5%, p < 0.001). Major cardiovascular events occurred in less than 1% of patients. Patients with a CD4 count <200 cells/mm3 had a higher frequency of acute myocardial infarction and obesity.

Conclusion:

Over time, people living with human immunodeficiency virus present with an increasing prevalence of cardiovascular risk factors, particularly those with a lower CD4 count.
The Importance of Instructor Affirming Messages in Business Communication Students’ Writing Apprehension
Authors: Violanti Michelle T , Kelly Stephanie , Denton Emily , Schill Makayla
Published: April 2023

Through the guidance of social presence theory, this study sought to understand how instructors’ affirming messages and social presence behaviors affect students’ writing apprehension in online business communication courses. The data were consistent with two models, both of which indicate that instructor affirming messages indirectly affect students’ writing apprehension in the business communication classroom. Both models also indicate that students’ burnout mediates that indirect effect. The results show how important it is for instructors to take the time to leave affirming message feedback when teaching business communication online.
Effect of Home-Based Cardiac Rehabilitation Program on Self-Efficacy of Patients With Implantable Cardioverter Defibrillator
Authors: Heidari Mohammad , Harandi Parviz Nadimi , Moghaddasi Jaefar , Kheiri Soleiman , Azhari Amirhossein
Published: April 2023

Introduction

For more effective control and treatment of cardiac dysrhythmias caused by diseases, ischemia, or other causes, an implantable cardioverter defibrillator (ICD) is used. One of the effective ways for secondary prevention is the home-based cardiac rehabilitation (HBCR) which nurses have an effective role in its implementation.

Objective

The study aimed to investigate the effect of implementing HBCR programs on the self-efficacy of patients with ICD.

Methods

This is a semi-experimental study conducted on 70 patients who received ICD in Shahid Chamran Heart Center of Isfahan University of Medical Sciences (IUMS) in 2021. The patients were randomly assigned to intervention and control groups and were introduced to the practical concepts of HBCR during four training sessions. In the following, 3-month follow-up and trainings were continued by home visits, telephone follow-up, and use of social messaging networks due to the conditions of coronavirus disease 2019 (COVID-19) pandemic. The data were analyzed with SPSS/21.

Results

The findings showed that performing HBCR programs was effective in improving the self-efficacy of patients with ICDs. A significant trend in the implementation of the HBCR programs in two groups was shown using chi-square test and independent t-test and variance with repeated measurements ( p < .001). There was no significant difference in self-efficacy score in both groups at the beginning of the study ( p < .056).

Conclusion

Considering the effectiveness of HBCR programs on improving the self-efficacy of patients with ICDs, it can be used in the educational care programs of healthcare workers and in the strategic policies of health care services.
TRIM21 enhances bortezomib sensitivity in multiple myeloma by halting prosurvival autophagy
Authors: Chen Jing , Cao Wen , Huang Xi , Chen Qingxiao , Ye Shuting , Qu Jianwei , Liu Yang , Guo Xing , Yao Shunnan , Zhang Enfan , He Jingsong , Li Anqi , Yang Li , Cai Zhen
Published: April 2023

Bortezomib (bort) is an effective therapeutic agent for patients with multiple myeloma (MM); however, most patients develop drug resistance. Autophagy, a highly conserved process that recycles cytosol or entire organelles via lysosomal activity, is essential for the survival, homeostasis, and drug resistance in MM. Growing evidence has highlighted that E3 ligase tripartite motif–containing protein 21 (TRIM21) not only interacts with multiple autophagy regulators but also participates in drug resistance in various cancers. However, to date, the direct substrates and additional roles of TRIM21 in MM remain unexplored. In this study, we demonstrated that low TRIM21 expression is a factor for relapse in MM. TRIM21 knockdown (KD) made MM cells more resistant to bort, whereas TRIM21 overexpression (OE) resulted in increased MM sensitivity to bort. Proteomic and phosphoproteomic studies of TRIM21 KD MM cells showed that bort resistance was associated with increased oxidative stress and elevated prosurvival autophagy. Our results showed that TRIM21 KD MM cell lines induced prosurvival autophagy after bort treatment, suppressing autophagy by 3-methyladenine treatment or by the short hairpin RNA of autophagy-related gene 5 (ATG5)-restored–bort sensitivity. Indeed, ATG5 expression was increased and decreased by TRIM21 KD and OE, respectively. TRIM21 affected autophagy by ubiquitinating ATG5 through K48 for proteasomal degradation. Importantly, we confirmed that TRIM21 could potentiate the antimyeloma effect of bort through in vitro and in vivo experiments. Overall, our findings define the key role of TRIM21 in MM bort resistance and provide a foundation for a novel targeted therapeutic approach.
The mechanism by which miR-494-3p regulates PGC1-α-mediated inhibition of mitophagy in cardiomyocytes and alleviation of myocardial ischemia—reperfusion injury
Authors: Mu Ninghui , Zhang Tong , Zhu Ying , Lu Bingtuan , Zheng Qi , Duan Jinlan
Published: April 2023

Objective

The purpose of this study was to explore whether miR-494-3p inhibits the occurrence of mitochondrial autophagy in cardiomyocytes by inhibiting the expression of PGC1-α and to supplement the theoretical basis for the role of autophagy in cardiac injury induced by hypoxia/reperfusion (H/R).

Methods

The expression of miR-494-3p was detected by RT‒qPCR, and the expression of PGC1-α, autophagy-related proteins (LC3, Beclin 1), apoptosis-related proteins (Bax and Bcl-2), PINK1/Parkin signaling pathway-related proteins (PINK1, Parkin) and mitochondrial change-related proteins (Mfn1, Mfn2, OPA1) was detected by Western blotting. The changes in mitochondrial membrane potential were detected by JC-1 staining (ΔΨm). The formation of autophagosomes was observed by transmission electron microscopy. Cell proliferation activity was detected by CCK-8, and cell apoptosis was detected by flow cytometry. A dual-luciferase gene reporter assay identified a targeted binding site between miR-494-3p and PGC1-α.

Results

The results showed that miR-494-3p and PGC1-α were differentially expressed in H/R cardiomyocytes; that is, the expression of miR-494-3p was downregulated, and the expression of PGC1-α was upregulated. In addition, mitochondrial autophagy occurred in H/R cardiomyocytes. That is, LC3-II/LC3-I, Beclin 1, PINK1, and Parkin expression was upregulated, Mfn1, Mfn2, and OPA1 expression was downregulated, and the mitochondrial membrane potential was decreased. The transfection of miR-494-3p mimic can significantly improve the cell proliferation activity of cardiomyocytes and inhibit the occurrence of cardiomyocyte apoptosis and autophagy, while the transfection of miR-494-3p inhibitor has the opposite result. After transfection of the miR-494-3p mimic, treatment with autophagy inhibitors and activators changed the effects of miR-494-3p on cardiomyocyte proliferation and apoptosis. At the same time, the overexpression of PGC1-α reversed the promoting effect of miR-494-3p on cardiomyocyte proliferation and the inhibitory effect on apoptosis and autophagy.

Conclusion

MiR-494-3p can target and negatively regulate the expression of PGC1-α to inhibit mitophagy in cardiomyocytes.
Challenges faced by midwives in the implementation of facility-based maternal death reviews in Malawi
Authors: Chirwa Mercy Dokiso , Nyasulu Juliet , Modiba Lebitsi , Limando Makombo Ganga-
Published: April 2023

Background

Maternal death reviews provide an in-depth understanding of the causes of maternal deaths. Midwives are well positioned to contribute to these reviews. Despite midwives’ participation as members of the facility-based maternal death review team, maternal mortality continues to occur, therefore, this study aimed to explore the challenges faced by midwives as they participate in maternal death reviews in the context of the healthcare system in Malawi.

Methods

This was a qualitative exploratory study design. Focus group discussions and individual face-to-face interviews were used to collect data in the study. A total of 40 midwives, who met the inclusion criteria, participated in the study. Data was analyzed manually using a thematic content procedure.

Results

Challenges identified were: knowledge and skill gaps; lack of leadership and accountability; lack of institutional political will and inconsistency in conducting FBMDR, impeding midwives’ effective contribution to the implementation of maternal death review. The possible solutions and recommendations that emerged were need-based knowledge and skills updates, supportive leadership, effective and efficient interdisciplinary work ethics, and sustained availability of material and human resources.

Conclusion

Midwives have the highest potential to contribute to the reduction of maternal deaths. Practice development strategies are required to improve their practice in all the areas they are challenged with.
The clinical experience of early skin-to-skin contact combined with non-nutritive comfort sucking in mothers of preterm infants: a qualitative study
Authors: Li Liling , Ji Futing , Wang Yuejue , Wang Li , Yu Ling , Wu Xi , Lyu Tianchan , Dou Yalan , Cao Yun , Hu Xiao-jing
Published: April 2023

Background

In most areas of China, mothers typically do not participate in early care of preterm infants in NICU. This study aims to examine the early experience of mothers of preterm infants participating in skin-to-skin contact combined with non-nutritive comfort sucking in China.

Methods

This qualitative research study used one-on-one, face-to-face, semi-structured in-depth interviews. Eighteen mothers who participated in early skin-to-skin contact combined with non-nutritive comfort sucking were interviewed in the NICU of a tertiary children’s hospital in Shanghai between July and December 2020. Their experiences were analyzed using the inductive topic analysis method.

Results

Five themes about skin-to-skin contact combined with non-nutritive comfort sucking were identified, including alleviation of maternal anxiety and fear during mother infant separation, reshaping the maternal role, promotion of active breast pumping, enhances the mother’s willingness to actively breast feed and building the maternal confidence in baby care.

Conclusion

Skin-to-skin contact combined with non-nutritive comfort sucking in the NICU can not only enhance the identity and responsibility of the mother’s role, but also provide non-nutritive sucking experience for promoting the establishment of oral feeding in preterm infants.