bluuebunny/crossref_metadata_2025 huggingface dataset:
Scenario-based dialogue system based on pause detection toward daily health monitoring
Authors: Kumagai Kazumi , Tokunaga Seiki , Miyake Norihisa P , Tamura Kazuhiro , Mizuuchi Ikuo , Otake-Matsuura Mihoko
Published: October 2022

Introduction

We have conducted research on building a robot dialogue system to support the independent living of older adults. In order to provide appropriate support for them, it is necessary to obtain as much information, particularly related to their health condition, as possible. As the first step, we have examined a method to allow dialogue to continue for longer periods.

Methods

A scenario-based dialogue system utilizing pause detection for turn-taking was built. The practicality of adjusting the system based on the dialogue rhythm of each individual was studied. The system was evaluated through user studies with a total of 20 users, 10 of whom were older adults.

Results

The system detected pauses in the user’s speech using the sound level of their voice, and predicted the duration and number of pauses based on past dialogue data. Thus, the system initiated the robot’s voice-call after the user’s predicted speech.

Conclusions

Multiple turns of dialogue between robot and older adults are found possible under the system, despite several overlaps of robot’s and users’ speech observed. The users responded to the robot, including the questions related to health conditions. The feasibility of a scenario-based dialogue system was suggested; however, improvements are required.
Use of a Smartphone Medication Reminder Application to Support Emerging Adult Adherence to Non-Antibiotic Treatment for Viral Upper Respiratory Tract Infection
Authors: Brinker David L. , Foley Kasey A. , Zhou Yanmengqian , Acevedo-Callejas Michelle , Li Yuwei , Farrell Erina L.
Published: October 2022

Objective:

This research study is a test of the efficacy of a smartphone-installed medication reminder application to support provider-recommended treatment plans for young adult patients who were seen for upper respiratory tract infections (URTIs) and were not prescribed an antibiotic.

Methods:

Two hundred seventy-five patients seen at a university student health center for URTI symptoms were randomly assigned to the medication reminder app intervention or a control group and then surveyed both 1 and 14 days after their medical visits with questions about the treatment plan, their satisfaction with medical care, and the electronic support tools.

Results:

Compared to the control condition, patients using the reminder app reported more adherence to provider-recommended treatment plans. Patients with lower social support availability benefited more from being provided with these tools.

Conclusion:

These findings suggest that medication reminder apps have utility for increasing patient adherence to non-antibiotic URTI treatment plans, particularly among patients who lack high-quality informational and tangible social support.

Innovation:

This study demonstrates innovation in use of the medication reminder app to promote antibiotic stewardship with young adult patients in primary care.
Perceived China Threat, Conspiracy Belief, and Public Support for Restrictive Immigration Control During the COVID-19 Pandemic
Authors: Kim Ji Hye , Park Jihye
Published: October 2022

During the COVID-19 pandemic, there has been an unprecedented increase in the level of political blame attributed to China for the health crisis and other associated xenophobic discourses. Although previous research has revealed the effects of perceived outgroup threats on popular support for policies that control outgroups, threats posed by foreign countries have received little empirical attention. This study advances previous research by focusing on the independent effects of the perceived China threat to public support for restrictive immigration control during the COVID-19 pandemic. Using a sample drawn from the 2020 American National Election Studies, the results showed that the perceived China threat substantially heightened public support for restrictive immigration control. More importantly, demand for restrictive immigration control intensified when individuals had stronger perceptions of threats and conspiracy beliefs about the virus leak from a Chinese lab. Taken together, our findings demonstrate the roles of politically constructed threats and conspiracy beliefs during the COVID-19 pandemic, revealing new mechanisms of popular attitudes toward social control.
Advocacy of School Counselors Working With ELL Students
Authors: Farrell Isabel C. , Binkley Erin E. , Garcia Mia A. , Jackson Tamika N.
Published: October 2022

English language learners (ELLs) experience higher barriers to education than non-ELLs. School counselors are uniquely positioned to identify and respond to the needs of these students. This phenomenological study explored the advocacy efforts of 14 school counselors working with ELLs. Major themes included creating space for culture and context, going the extra mile, and concerns regarding equity. We discuss the themes, subthemes, implications, and areas for future research.
Attitude Toward and Associating Factors of Menopause: A Study on Cambodian Women
Authors: Thapa Roshna , Yang Youngran
Published: October 2022

This study aimed to assess the attitudes of Cambodian women toward menopause and its associating factors. A cross-sectional study design was used to examine the attitudes of 181 Cambodian women ages 40–60 years toward menopause using the Attitude toward Menopause (ATM) scale. The mean total attitude score was determined as 84.54 ± 11.55 on a scale of 35–140, indicating that most participants had negative attitudes toward menopause. Perimenopausal women had more negative attitudes (80.02 ± 9.19) while postmenopausal women had more positive attitudes (86.63 ± 12.07) and was statistically significant ( p = .006). Perimenopausal women perceived menopause as a health concerning medical issue requiring treatment, and something unpleasant in their lives. Older age and employment were the independent factors associated with positive attitudes to menopause. Tailored menopausal interventions and counseling for women in perimenopause, and younger and unemployed women regarding the symptoms of menopause should be considered as crucial for midlife Cambodian women.
Journey to the Garden: History of Tea, Labour and Recruitment Policies in Colonial Assam
Authors: Singh Geetashree
Published: October 2022

Tea is one of the popular beverages in the world. It was the British government which took the initiative to propagate the use of tea as a beverage and its commercialisation. In this article, an attempt is made to trace the discovery of the tea plant in Assam and describe the process of securing labour supply, mode of labour recruitment and subsequent treatment of labour in the tea gardens of Assam.
An Early Tombstone and the Office of

Kh

alīfatu’l

Kh

ulafā under the Safavids
Authors: Parvin Samad , Afkhami Behrouz , Sattarnejad Saeid
Published: October 2022

At Unar, in Northwestern Iran, a tombstone inscription has been found by the authors. It names the buried one as Ismā‘il bin Sultān, Khalīfatu’l Khulafā, with the date 881 AH. This is the first record of the holder of an office which was a major one under the Safavids even before they seized power in Iran. The Khalīfatu’l Khulafā headed the Sufic wing of Safavid ruler’s followers. The office declined in importance as Shi‘ite tendencies tended more and more to set limits to Sufic beliefs and practices.
Book review: A. Azfar Moin and Alan Strathern (ed.), Sacred Kingship in World History: Between Immanence and Transcendence
Authors: Moosvi Shireen
Published: October 2022

A. Azfar Moin and Alan Strathern (ed.), Sacred Kingship in World History: Between Immanence and Transcendence (New York: Columbia University Press), 2022, 390 pp., $40 (pb).
Gandhi, Ambedkar and British Policy on the Communal Award: A Response to Sujay Biswas
Authors: Duncan Ian
Published: October 2022

This article considers the proposition, advanced by Sujay Biswas, that the British ‘manufactured’ the demand for a separate ‘Untouchable’ electorate in the Communal Award of 1932. First, the evidence cited by Biswas is closely examined. His proposition is then assessed in the context of the deliberations of the colonial authorities in India, the provincial administration in the United Provinces (UP) and the Cabinet of the United Kingdom (UK). It is concluded that while communal electorates generally may have been used deliberately to divide Indians, there are no grounds for thinking that it was the case in that of the Depressed Castes.
Frequency, associated variables, and outcomes of acute myocardial injury according to the fourth Universal Definition of Myocardial Infarction in patients with acute ischemic stroke
Authors: Stengl Helena , Ganeshan Ramanan , Hellwig Simon , Klammer Markus G , von Rennenberg Regina , Böhme Sophie , Audebert Heinrich J , Nolte Christian H , Endres Matthias , Scheitz Jan F
Published: October 2022

Background:

Myocardial injury as indicated by elevation of cardiac troponin levels is common after acute ischemic stroke (AIS) and linked to poor outcomes. Previous studies rarely reported on serial hs-cTn measurements to distinguish whether myocardial injury is acute or chronic. Thus, little is known about frequency, associated variables, and outcome of acute myocardial injury in AIS.

Methods and patients:

In this single-centered observational cohort study, from 01/2019 to 12/2020, consecutive patients with neuroimaging-confirmed AIS <48 h after symptom onset, and serial troponin measurements within the first 2 days after admission (Roche Elecsys®, hs-cardiac troponin T) were prospectively registered. Acute myocardial injury was defined according to the fourth Universal Definition of Myocardial Infarction (troponin above the upper reference limit and rise/fall>20%). Outcomes of interest were in-hospital mortality and unfavorable functional status at discharge (modified Rankin Scale >1).

Results:

Out of 1067 analyzed patients, 25.3% had acute myocardial injury, 40.4% had chronic myocardial injury and 34.3% had no myocardial injury. Older age, higher stroke severity, thrombolytic treatment, and impaired kidney function were independently associated with acute myocardial injury. In-hospital mortality was higher in patients with acute myocardial injury than in those without (13% vs 3%, adjusted OR, 2.9% [95% CI, 1.6–5.5]). Compared with no myocardial injury, both acute and chronic myocardial injury were associated with unfavorable functional status at discharge (adjusted OR, 1.6 [95% CI, 1.1–2.5] and OR, 1.7 [95% CI, 1.2–2.4], respectively).

Conclusions:

A quarter of patients with AIS have evidence of acute myocardial injury according to the fourth Universal Definition of Myocardial Infarction. The strong association with in-hospital mortality highlights the need for clinical awareness and future studies on underlying mechanisms.
A molecular dynamics study of the mechanical properties of kaolinite under uniaxial and isothermal compression at various temperatures
Authors: Cui Y. , Wang H. Y. , Zhao H. Y. , Yang H.
Published: October 2022

Uniaxial and isothermal compression tests of kaolinite were carried out using molecular dynamics simulations. Five different temperatures (300, 400, 500, 600 and 700 K) and pressures ranging from 0.0001 to 50 GPa were selected to study the temperature and pressure effects on the mechanical properties of kaolinite. As kaolinite may undergo a phase transition at ~1572 K, a highest temperature of 700 K was chosen to avoid such structural change. The Young's modulus, strength and elastic constants of kaolinite under various temperatures were calculated, and the relative change of the elastic constant C33 with temperature was found to be almost 12 times greater than the relative change of the interlayer constant C11. The microstructures under various compressive strains were tracked and they exhibited various failure modes in three directions. The temperature and pressure effects on the mechanical properties of three crystal directions were analysed. The results showed that the Young's modulus of the z-direction is the most affected by temperature; however, the influence of temperature on the strengths of the three crystal directions was the same. In addition, the structure of the z-direction was the most sensitive to temperature under the same hydrostatic pressure due to the weak interactions between layers.
Gut microbiota-derived succinate aggravates acute lung injury after intestinal ischaemia/reperfusion in mice
Authors: Wang Yi-Heng , Yan Zheng-Zheng , Luo Si-Dan , Hu Jing-Juan , Wu Mei , Zhao Jin , Liu Wei-Feng , Li Cai , Liu Ke-Xuan
Published: October 2022

Introduction

Acute lung injury (ALI) is a major cause of morbidity and mortality after intestinal ischaemia/reperfusion (I/R). The gut microbiota and its metabolic byproducts act as important modulators of the gut–lung axis. This study aimed to define the role of succinate, a key microbiota metabolite, in intestinal I/R-induced ALI progression.

Methods

Gut and lung microbiota of mice subjected to intestinal I/R were analysed using 16S rRNA gene sequencing. Succinate level alterations were measured in germ-free mice or conventional mice treated with antibiotics. Succinate-induced alveolar macrophage polarisation and its effects on alveolar epithelial apoptosis were evaluated in succinate receptor 1 (Sucnr1)-deficient mice and in murine alveolar macrophages transfected withSucnr1-short interfering RNA. Succinate levels were measured in patients undergoing cardiopulmonary bypass, including intestinal I/R.

Results

Succinate accumulated in lungs after intestinal I/R, and this was associated with an imbalance of succinate-producing and succinate-consuming bacteria in the gut, but not the lungs. Succinate accumulation was absent in germ-free mice and was reversed by gut microbiota depletion with antibiotics, indicating that the gut microbiota is a source of lung succinate. Moreover, succinate promoted alveolar macrophage polarisation, alveolar epithelial apoptosis and lung injury during intestinal I/R. Conversely, knockdown ofSucnr1or blockage of SUCNR1in vitroandin vivoreversed the effects of succinate by modulating the phosphoinositide 3-kinase-AKT/hypoxia-inducible factor-1α pathway. Plasma succinate levels significantly correlated with intestinal I/R-related lung injury after cardiopulmonary bypass.

Conclusion

Gut microbiota-derived succinate exacerbates intestinal I/R-induced ALI through SUCNR1-dependent alveolar macrophage polarisation, identifying succinate as a novel target for gut-derived ALI in critically ill patients.
Developing a self-management package for pulmonary fibrosis: an international Delphi study
Authors: Lee Joanna Y.T. , Tikellis Gabriella , Khor Yet H. , Holland Anne E.
Published: October 2022

Rationale

Self-management is considered as an important part of disease management for people with pulmonary fibrosis (PF), but there is a lack of consensus regarding what components should be included. This study aimed to attain consensus from experts in PF and people living with the disease on the essential components and format of a PF self-management package.

Methods

A two-round Delphi process was conducted. In each round, a panel of experts completed an online survey to rate a range of components, formats and delivery methods, followed by an online patient focus group to integrate patient perspectives. Consensus was defineda priori.

Results

45 experts participated in Round 1 and 51 in Round 2. Both focus groups included six people with PF. 12 components were considered essential for self-management in PF: 1) understanding treatment options; 2) understanding and accessing clinical trials; 3) managing medications; 4) role of oxygen therapy; 5) role and importance of pulmonary rehabilitation and regular physical activity; 6) managing shortness of breath; 7) managing fatigue; 8) managing mood; 9) managing comorbidities; 10) smoking cessation advice and support; 11) accessing community support; and 12) how to communicate with others when living with PF. Both groups agreed that self-management in PF required individualisation, goal setting and feedback.

Conclusion

This study identified 12 essential components and highlighted individualisation, goal setting and feedback in self-management of PF. The findings provide a basis for the development of PF self-management interventions.
Role of microglia in blood pressure and respiratory responses to acute hypoxic exposure in rats
Authors: Yoshizawa Masashi , Fukushi Isato , Takeda Kotaro , Kono Yosuke , Hasebe Yohei , Koizumi Keiichi , Ikeda Keiko , Pokorski Mieczyslaw , Toda Takako , Okada Yasumasa
Published: October 2022

Microglia modulate cardiorespiratory activities during chronic hypoxia. It has not been clarified whether microglia are involved in the cardiorespiratory responses to acute hypoxia. Here we investigated this issue by comparing cardiorespiratory responses to two levels of acute hypoxia (13% O2 for 4 min and 7% O2 for 5 min) in conscious unrestrained rats before and after systemic injection of minocycline (MINO), an inhibitor of microglia activation. MINO increased blood pressure but not lung ventilation in the control normoxic condition. Acute hypoxia stimulated cardiorespiratory responses in MINO-untreated rats. MINO failed to significantly affect the magnitude of hypoxia-induced blood pressure elevation. In contrast, MINO tended to suppress the ventilatory responses to hypoxia. We conclude that microglia differentially affect cardiorespiratory regulation depending on the level of blood oxygenation. Microglia suppressively contribute to blood pressure regulation in normoxia but help maintain ventilatory augmentation in hypoxia, which underscores the dichotomy of central regulatory pathways for both systems.
A joint use of pooling and imputation for genotyping SNPs
Authors: Clouard Camille , Ausmees Kristiina , Nettelblad Carl
Published: October 2022

Background

Despite continuing technological advances, the cost for large-scale genotyping of a high number of samples can be prohibitive. The purpose of this study is to design a cost-saving strategy for SNP genotyping. We suggest making use of pooling, a group testing technique, to drop the amount of SNP arrays needed. We believe that this will be of the greatest importance for non-model organisms with more limited resources in terms of cost-efficient large-scale chips and high-quality reference genomes, such as application in wildlife monitoring, plant and animal breeding, but it is in essence species-agnostic. The proposed approach consists in grouping and mixing individual DNA samples into pools before testing these pools on bead-chips, such that the number of pools is less than the number of individual samples. We present a statistical estimation algorithm, based on the pooling outcomes, for inferring marker-wise the most likely genotype of every sample in each pool. Finally, we input these estimated genotypes into existing imputation algorithms. We compare the imputation performance from pooled data with the Beagle algorithm, and a local likelihood-aware phasing algorithm closely modeled on MaCH that we implemented.

Results

We conduct simulations based on human data from the1000 Genomes Project, to aid comparison with other imputation studies. Based on the simulated data, we find that pooling impacts the genotype frequencies of the directly identifiable markers, without imputation. We also demonstrate how a combinatorial estimation of the genotype probabilities from the pooling design can improve the prediction performance of imputation models. Our algorithm achieves 93% concordance in predicting unassayed markers from pooled data, thus it outperforms the Beagle imputation model which reaches 80% concordance. We observe that the pooling design gives higher concordance for the rare variants than traditional low-density to high-density imputation commonly used for cost-effective genotyping of large cohorts.

Conclusions

We present promising results for combining a pooling scheme for SNP genotyping with computational genotype imputation on human data. These results could find potential applications in any context where the genotyping costs form a limiting factor on the study size, such as in marker-assisted selection in plant breeding.
Diagnostic accuracy of multiplex respiratory pathogen panels for influenza or respiratory syncytial virus infections: systematic review and meta-analysis
Authors: Jullien Sophie , Fitzgerald Felicity , Keddie Suzanne , Baerenbold Oliver , Bassat Quique , Bradley John , Falconer Jane , Fink Colin , Keogh Ruth , Hopkins Heidi , Voice Marie
Published: October 2022

Respiratory syncytial virus (RSV) and influenza viruses are important global causes of morbidity and mortality. We evaluated the diagnostic accuracy of the Luminex NxTAG respiratory pathogen panels (RPPs)™ (index) against other RPPs (comparator) for detection of RSV and influenza viruses. Studies comparing human clinical respiratory samples tested with the index and at least one comparator test were included. A random-effect latent class meta-analysis was performed to assess the specificity and sensitivity of the index test for RSV and influenza. Risk of bias was assessed using the QUADAS-2 tool and certainty of evidence using GRADE. Ten studies were included. For RSV, predicted sensitivity was 99% (95% credible interval [CrI] 96–100%) and specificity 100% (95% CrI 98–100%). For influenza A and B, predicted sensitivity was 97% (95% CrI 89–100) and 98% (95% CrI 88–100) respectively; specificity 100% (95% CrI 99–100) and 100% (95% CrI 99–100), respectively. Evidence was low certainty. Although index sensitivity and specificity were excellent, comparators’ performance varied. Further research with clear patient recruitment strategies could ascertain performance across different populations.

Protocol Registration: Prospero CRD42021272062.
Addressing racial disparities in perinatal care for African American/Black individuals in the Chicago community health setting: a qualitative study
Authors: Alhalel Jonathan , Patterson Lane , Francone Nicolás O. , Danner Sankirtana , Osei Cassandra , O’Brian Catherine Ann , Tom Laura S. , Masinter Lisa , Adetoro Elizabeth , Lazar Danielle , Ekong Abbey , Simon Melissa A.
Published: October 2022

Background

There are persistent disparities in maternal and infant perinatal outcomes experienced by Black birthing persons compared with non-Hispanic white (NHW) individuals in the US. The differences in outcomes arise from not only socioeconomic factors and individual health behaviors but also structural racism. Recent research is beginning to elucidate the benefits of patient navigation to support underserved minoritized individuals who experience this constellation of barriers to equitable care. Qualitative research that utilizes both the experiences of Black birthing individuals and the expert opinion of healthcare providers working with them can serve to guide a patient navigation intervention to further decrease disparities in perinatal outcomes.

Methods

We conducted 30 interviews between August and December 2020 with Black birthing individuals in the Chicago metropolitan area and healthcare providers who care for this population both in Chicago and across the nation to explore their experiences, perceptions of barriers to care and ways to decrease inequities.

Results

Clinical care team members acknowledged the presence of health disparities experienced by Black pregnant individuals compared with their NHW counterparts stemming from racism, discrimination, and lack of resources. Patients similarly reported personal experiences with these disparities and barriers to care. The successful methods used by clinical care teams to help decrease these differences in the past included patient education on important topics such as breastfeeding and the use of patient advocates. Effectively screening for social determinants of health by someone the patient trusts was also cited as important. Regarding perinatal care practices, clinical care team members described the importance of patient education needs and care team cultural competency. Patients’ reported positive and negative experiences corroborated these findings, emphasizing the importance of trust, listening, education, access to care, support, and patient advocacy. Finally, the care team members and patients agreed that active trust-building can help the provider/patient relationship and ultimately improve outcomes.

Conclusions

These qualitative research findings improve the understanding of barriers to care and will help guide development of an intervention to reduce the health disparities experienced by Black pregnant persons.
Vitamin/mineral/micronutrient supplement for autism spectrum disorders: a research survey
Authors: Adams James B. , Kirby Jasmine , Audhya Tapan , Whiteley Paul , Bain Jaclyn
Published: October 2022

Background

Vitamin and mineral supplements are widely used by children and adults diagnosed with autism spectrum disorder (ASD). Several studies have reported benefits of such supplements in resolving nutritional deficiencies, treating various metabolic problems and improving symptoms and overall quality of life.

Methods

This research survey collected evaluations from 161 people about the effectiveness of ANRC-Essentials Plus (ANRC-EP), a vitamin/mineral/micronutrient supplement designed for children and adults with autism. Although this was an open-label survey, results were compared with a three-month randomized double-blind placebo-controlled study of an earlier version of the supplement. Evaluations included the Parent Global Impressions of Autism (PGIA) and the Overall Benefit/Adverse Effect scale of the National Survey on Treatment Effectiveness for Autism (NSTEA).

Results

The participants reported substantially higher Average PGIA Scores than the placebo group in a similar previous study, with an estimated effect size of 0.66. Based on the NSTEA questionnaire, 73% of participants rated the Overall Benefit as Moderate, Good, or Great, with scores that were substantially higher than the NSTEA study found for multi-vitamins, the average of 58 nutraceuticals, and the average of 28 psychiatric and seizure medications. The Overall Adverse Effect score was low (0.25/3.0), similar or slightly higher than other nutraceuticals, and much lower than the average of 28 psychiatric and seizure medications (0.9/3.0). Sub-analysis found that the Overall Benefit of ANRC-EP was not significantly affected by gender, age, autism severity, diet quality, self-limited diet, use of psychiatric or seizure medications, dosage, developmental history, intellectual disability, or seizures. This indicates that ANRC-EP may be beneficial for a wide range of children and adults with ASD.

A limitation of this study is the retrospective nature of the survey, and that participants who had good benefits were more likely to respond.

Conclusions

This study found that ANRC-EP had significant benefits for a wide range of symptoms, and low adverse effects.
Healthcare utilisation among patients with stress-induced exhaustion disorder treated with a multimodal rehabilitation programme – a longitudinal observational study
Authors: Norström Fredrik , Järvholm Lisbeth Slunga , Eskilsson Therese
Published: October 2022

Background

Stress-induced exhaustion disorder is a major challenge in Swedish working life. Despite its increase in prevalence, there is still limited knowledge about the effectiveness of different rehabilitation methods. In this study, we aim to describe the healthcare utilisation for patients with stress-induced exhaustion disorder before, during and after a multi-modal rehabilitation (MMR) programme, as well as the health-related quality of life, work ability, sick leave level and psychological measures, and their possible relations.

Methods

In this longitudinal observational study, 53 patients who were part of an MMR programme at the Stress Rehabilitation Clinic participated with survey data, and among them 43 also contributed with healthcare data. Data were collected from one year before start of MMR to one year after the end of it. The patients also answered a questionnaire at the start of, end of and at a one-year follow-up of the MMR, which included questions about health-related quality of life, work ability, clinical burnout, sick leave level, anxiety and depression.

Results

There was a statistically significant increase in healthcare consumption during MMR, if including visits to the Stress Rehabilitation Clinic, while it decreased if excluding such visits, when comparing with before and after MMR. During the follow-up period there was a non-statistically significant (p=0.11), but still rather large difference (15.4 compared with 12.0 visits per patient), in healthcare consumption in comparison with the period before MMR, when excluding follow-up visits at the Stress Rehabilitation Clinic. Health-related quality of life was rated as poor before MMR (mean 0.59). There was a statistically significant improvement, but values were still below normal at the end of follow-up (mean 0.70). In addition, the level of sick leave, the work ability and signs of clinical burnout improved statistically significantly after MMR, but were not fully normalised at the end of follow-up. Individual healthcare consumption was related to residual health problems.

Conclusions

Patients with stress-induced exhaustion disorder have not reduced their healthcare consumption notably after MMR, and residual health problems remain for some patients. More studies are needed for a deeper understanding of the individual effectiveness of MMR, and also of its cost-effectiveness.
Predictive factors for residual leg numbness after decompression surgery for lumbar degenerative diseases
Authors: Zou Tao , Chen Hao , Wang Ping-Chuan , Sun Hui-Hui , Feng Xin-Min
Published: October 2022

Background

The purpose of this study is to evaluate the change patterns of leg numbness (LN) after lumbar decompression surgery (LDS), and to find the predictive factors that affect the recovery of numbness.

Methods

Patients who underwent LDS in our institution between August 2020 and July 2021 were prospectively enrolled in this study, and were followed by a 12-month follow-up. The degree of LN, leg pain (LP) and the disability were assessed using the visual analog scale (VAS) and oswestry disability index (ODI).

Results

A total of 314 patients finished the 12-month follow-up. The preoperative mean VAS-LN score was 3.49 ± 2.44, which decreased to 1.91 ± 1.30 at 3 months, to 1.29 ± 0.97 at 6 months and to 1.26 ± 0.96 at 12 months after surgery. The preoperative mean VAS-LP score was 6.05 ± 1.30, which decreased to 2.00 ± 0.86 at 3 months, to 1.02 ± 0.80 at 6 months, and to 0.49 ± 0.71 at 12 months after surgery. The preoperative mean ODI score was 27.90 ± 7.08, which decreased to 9.73 ± 3.09 at 3 months, to 6.72 ± 2.98 at 6 months, and to 4.57 ± 2.76 at 12 months after surgery. Via multivariate logistic regression analysis, only preoperative VAS-LN score (p < 0.001*) was identified as a significantly independent predictive factor for residual LN after operation.

Conclusion

Clinically significant improvement in LN was observed in the majority of patients within 6 months after LDS, and the improvement of VAS-LN was slower than the VAS-LP. High pre-operative VAS-LN score can independently predict the presence of residual LN after surgery at 12-month follow up.
Risk factors for prolonged preoperative waiting time of intertrochanteric fracture patients undergoing operative treatment
Authors: Liu Fei , Chang Wen-jie , Wang Xu , Gong Rui , Yuan Dao-tong , Zhang Yong-kui , Xie Wen-peng
Published: October 2022

Purpose

Intertrochanteric fracture is a common fracture in older adults. We observed the case characteristics of intertrochanteric fracture and analyzed the risk factors for prolonged preoperative waiting time based on patient data from a 6 year period. Investigate the post-admission treatment of intertrochanteric fracture.

Methods

We retrospectively reviewed the medical records from July 2015 to July 2021 of patients hospitalized for intertrochanteric fracture who had undergone internal fixation surgery in the orthopedic ward of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine. Data regarding gender, age, AO/OTA classification, preoperative waiting time, preoperative medical comorbidities, and complicated deep venous thrombosis (DVT) of lower limbs were collected. Statistical tests were used to evaluate the factors influencing preoperative preparation time and DVT.

Results

A total of 1812 cases were retrospectively analyzed, 1258 patients (69.43%) had three or more medical comorbidities. The average preoperative waiting time was 5.09 ± 3.27 days. Advanced age, more preoperative medical comorbidities and DVT led to longer preoperative waiting times, and preoperative medical comorbidities were an independent risk factor. Patients with advanced age and preoperative medical comorbidities were more likely to have DVT.

Conclusion

Age and preoperative medical comorbidities are risk factors for DVT and prolonged preoperative preparation time in intertrochanteric fracture patients. Preoperative medical comorbidities are an independent risk factors affecting the preoperative waiting time, and a combination of multiple comorbidities almost predicts the delay of the operation time.
Cistanche tubulosa phenylethanoid glycosides suppressed adipogenesis in 3T3-L1 adipocytes and improved obesity and insulin resistance in high-fat diet induced obese mice
Authors: Abudujilile Dilinazi , Wang Weilan , Aimaier Alimu , Chang Lili , Dong Yuliang , Wang Yiye , Fan Xu , Ma Yu , Wang Yongli , Ziyayiding Dilinigeer , Ma Yuan , Lv Jie , Li Jinyao
Published: October 2022

Background

Cistanche tubulosa is an editable and medicinal traditional Chinese herb and phenylethanoid glycosides are its major components, which have shown various beneficial effects such as anti-tumor, anti-oxidant and neuroprotective activities. However, the anti-obesity effect of C. tubulosa phenylethanoid glycosides (CTPG) and their regulatory effect on gut microbiota are still unclear. In the present study, we investigated its anti-obesity effect and regulatory effect on gut microbiota by 3T3-L1 cell model and obesity mouse model.

Methods

3T3-L1 adipocytes were used to evaluate CTPG effects on adipogenesis and lipids accumulation. Insulin resistant 3T3-L1 cells were induced and used to measure CTPG effects on glucose consumption and insulin sensitivity. High-fat diet (HFD)-induced C57BL/6 obese mice were used to investigate CTPG effects on fat deposition, glucose and lipid metabolism, insulin resistance and intestinal microorganism.

Results

In vitro data showed that CTPG significantly decreased the triglyceride (TG) and non-esterified fatty acid (NEFA) contents of the differentiated 3T3-L1 adipocytes in a concentration-dependent manner without cytotoxicity, and high concentration (100 µg/ml) of CTPG treatment dramatically suppressed the level of monocyte chemoattractant protein-1 (MCP-1) in 3T3-L1 mature adipocytes. Meanwhile, CTPG increased glucose consumption and decreased NEFA level in insulin resistant 3T3-L1 cells. We further found that CTPG protected mice from the development of obesity by inhibiting the expansion of adipose tissue and adipocyte hypertrophy, and improved hepatic steatosis by activating AMPKα to reduce hepatic fat accumulation. CTPG ameliorated HFD-induced hyperinsulinemia, hyperglycemia, inflammation and insulin resistance by activating IRS1/Akt/GLUT4 insulin signaling pathway in white adipose tissue. Moreover, gut microbiota structure and metabolic functions in HFD-induced obese mice was changed by CTPG, especially short chain fatty acids-producing bacteria including Blautia, Roseburia, Butyrivibrio and Bacteriodes were significantly increased by CTPG treatment.

Conclusions

CTPG effectively suppressed adipogenesis and lipid accumulation in 3T3-L1 adipocytes and ameliorated HFD-induced obesity and insulin resistance through activating AMPKα and IRS1/AKT/GLUT4 signaling pathway and regulating the composition and metabolic functions of gut microbiota.
Design principles for fully online flipped learning in health professions education: a systematic review of research during the COVID-19 pandemic
Authors: Lo Chung Kwan , Hew Khe Foon
Published: October 2022

Background

During the COVID-19 pandemic, some instructors transitioned their courses into a fully online environment by adopting flipped learning. In this context, this review examined the challenges to fully online flipped learning and identified useful course-design elements for practicing this instructional approach in health professions education.

Methods

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for selecting relevant articles. Thirty-three empirical studies (with 32 unique interventions) published between 2020 and 2021 (i.e., the first 2 years of the pandemic) were selected for analysis.

Results

When the instructors in the reviewed studies designed and implemented their online flipped courses, numerous challenges emerged, which could be broadly categorized into student-related challenges (e.g., unfamiliarity with online flipped learning; N = 5), faculty challenges (e.g., increased workload; N = 8), and operational challenges (e.g., students’ technical problems; N = 9). Nevertheless, we identified various useful elements for online flipped learning practice and organized them based on the following components of the Revised Community of Inquiry (RCoI) framework: cognitive presence (e.g., application of knowledge/skills; N = 12), social presence (e.g., peer interaction; N = 11), teaching presence (e.g., instructors’ real-time demonstration/facilitation; N = 17), and learner presence (e.g., care and emotional support; N = 4).

Conclusions

Based on the findings from the review and the RCoI framework, we developed nine principles for the effective practice of online flipped learning. These principles appear crucial for sustaining quality health professions education in a fully online flipped learning environment.
Early onset of immune-mediated diseases in minority ethnic groups in the UK
Authors: Sharma-Oates Archana , Zemedikun Dawit T. , Kumar Kanta , Reynolds John A. , Jain Avinash , Raza Karim , Williams John A. , Bravo Laura , Cardoso Victor Roth , Gkoutos Georgios , Nirantharakumar Krishnarajah , Lord Janet M.
Published: October 2022

Background

The prevalence of some immune-mediated diseases (IMDs) shows distinct differences between populations of different ethnicities. The aim of this study was to determine if the age at diagnosis of common IMDs also differed between different ethnic groups in the UK, suggestive of distinct influences of ethnicity on disease pathogenesis.

Methods

This was a population-based retrospective primary care study. Linear regression provided unadjusted and adjusted estimates of age at diagnosis for common IMDs within the following ethnic groups: White, South Asian, African-Caribbean and Mixed-race/Other. Potential disease risk confounders in the association between ethnicity and diagnosis age including sex, smoking, body mass index and social deprivation (Townsend quintiles) were adjusted for. The analysis was replicated using data from UK Biobank (UKB).

Results

After adjusting for risk confounders, we observed that individuals from South Asian, African-Caribbean and Mixed-race/Other ethnicities were diagnosed with IMDs at a significantly younger age than their White counterparts for almost all IMDs. The difference in the diagnosis age (ranging from 2 to 30 years earlier) varied for each disease and by ethnicity. For example, rheumatoid arthritis was diagnosed at age 49, 48 and 47 years in individuals of African-Caribbean, South Asian and Mixed-race/Other ethnicities respectively, compared to 56 years in White ethnicities. The earlier diagnosis of most IMDs observed was validated in UKB although with a smaller effect size.

Conclusion

Individuals from non-White ethnic groups in the UK had an earlier age at diagnosis for several IMDs than White adults.
Sustained seropositivity up to 20.5 months after COVID-19
Authors: Dobaño Carlota , Ramírez-Morros Anna , Alonso Selena , Rubio Rocío , Ruiz-Olalla Gemma , Vidal-Alaball Josep , Macià Dídac , Catalina Queralt Miró , Vidal Marta , Casanovas Aina Fuster , Prados de la Torre Esther , Barrios Diana , Jiménez Alfons , Zanoncello Jasmina , Melero Natalia Rodrigo , Carolis Carlo , Izquierdo Luis , Aguilar Ruth , Moncunill Gemma , Ruiz-Comellas Anna
Published: October 2022

This study evaluated the persistence of IgM, IgA, and IgG to SARS-CoV-2 spike and nucleocapsid antigens up to 616 days since the onset of symptoms in a longitudinal cohort of 247 primary health care workers from Barcelona, Spain, followed up since the start of the pandemic. The study also assesses factors affecting antibody levels, including comorbidities and the responses to variants of concern as well as the frequency of reinfections. Despite a gradual and significant decline in antibody levels with time, seropositivity to five SARS-CoV-2 antigens combined was always higher than 90% over the whole study period. In a subset of 23 participants who had not yet been vaccinated by November 2021, seropositivity remained at 95.65% (47.83% IgM, 95.65% IgA, 95.65% IgG). IgG seropositivity against Alpha and Delta predominant variants was comparable to that against the Wuhan variant, while it was lower for Gamma and Beta (minority) variants and for IgA and IgM. Antibody levels at the time point closest to infection were associated with age, smoking, obesity, hospitalization, fever, anosmia/hypogeusia, chest pain, and hypertension in multivariable regression models. Up to 1 year later, just before the massive roll out of vaccination, antibody levels were associated with age, occupation, hospitalization, duration of symptoms, anosmia/hypogeusia, fever, and headache. In addition, tachycardia and cutaneous symptoms associated with slower antibody decay, and oxygen supply with faster antibody decay. Eight reinfections (3.23%) were detected in low responders, which is consistent with a sustained protective role for anti-spike naturally acquired antibodies. Stable persistence of IgG and IgA responses and cross-recognition of the predominant variants circulating in the 2020–2021 period indicate long-lasting and largely variant-transcending humoral immunity in the initial 20.5 months of the pandemic, in the absence of vaccination.
Notch-associated lncRNAs profiling circuiting epigenetic modification in colorectal cancer
Authors: Emam Omnia , Wasfey Eman F. , Hamdy Nadia M.
Published: October 2022

Background

Colorectal cancer (CRC) is one of the most prevalent digestive cancers, ranking the 2nd cause of cancer-related fatality worldwide. The worldwide burden of CRC is predicted to rise by 60% by 2030. Environmental factors drive, first, inflammation and hence, cancer incidence increase.

Main

The Notch-signaling system is an evolutionarily conserved cascade, has role in the biological normal developmental processes as well as malignancies. Long non-coding RNAs (LncRNAs) have become major contributors in the advancement of cancer by serving as signal pathways regulators. They can control gene expression through post-translational changes, interactions with micro-RNAs or down-stream effector proteins. Recent emerging evidence has emphasized the role of lncRNAs in controlling Notch-signaling activity, regulating development of several cancers including CRC.

Conclusion

Notch-associated lncRNAs might be useful prognostic biomarkers or promising potential therapeutic targets for CRC treatment.

Therefore, here-in we will focus on the role of “Notch-associated lncRNAs in CRC” highlighting “the impact of Notch-associated lncRNAs as player for cancer induction and/or progression.”

Graphical Abstract
Neomorphic DNA-binding enables tumor-specific therapeutic gene expression in fusion-addicted childhood sarcoma
Authors: Hölting Tilman L. B. , Cidre-Aranaz Florencia , Matzek Dana , Popper Bastian , Jacobi Severin J. , Funk Cornelius M. , Geyer Florian H. , Li Jing , Piseddu Ignazio , Cadilha Bruno L. , Ledderose Stephan , Zwilling Jennifer , Ohmura Shunya , Anz David , Künkele Annette , Klauschen Frederick , Grünewald Thomas G. P. , Knott Maximilian M. L.
Published: October 2022

Chimeric fusion transcription factors are oncogenic hallmarks of several devastating cancer entities including pediatric sarcomas, such as Ewing sarcoma (EwS) and alveolar rhabdomyosarcoma (ARMS). Despite their exquisite specificity, these driver oncogenes have been considered largely undruggable due to their lack of enzymatic activity.

Here, we show in the EwS model that – capitalizing on neomorphic DNA-binding preferences – the addiction to the respective fusion transcription factor EWSR1-FLI1 can be leveraged to express therapeutic genes.

We genetically engineered a de novo enhancer-based, synthetic and highly potent expression cassette that can elicit EWSR1-FLI1-dependent expression of a therapeutic payload as evidenced by episomal and CRISPR-edited genomic reporter assays. Combining in silico screens and immunohistochemistry, we identified GPR64 as a highly specific cell surface antigen for targeted transduction strategies in EwS. Functional experiments demonstrated that anti-GPR64-pseudotyped lentivirus harboring our expression cassette can specifically transduce EwS cells to promote the expression of viral thymidine kinase sensitizing EwS for treatment to otherwise relatively non-toxic (Val)ganciclovir and leading to strong anti-tumorigenic, but no adverse effects in vivo. Further, we prove that similar vector designs can be applied in PAX3-FOXO1-driven ARMS, and to express immunomodulatory cytokines, such as IL-15 and XCL1, in tumor entities typically considered to be immunologically ‘cold’.

Collectively, these results generated in pediatric sarcomas indicate that exploiting, rather than suppressing, the neomorphic functions of chimeric transcription factors may open inroads to innovative and personalized therapies, and that our highly versatile approach may be translatable to other cancers addicted to oncogenic transcription factors with unique DNA-binding properties.