bluuebunny/crossref_metadata_2025 huggingface dataset:
NPS from the customer’s perspective: The influence of the recent experience
Authors: Pechter Jonna , Kuusik Andres
Published: November 2023

The Net Promoter Score (NPS) is a popular metric for measuring customer loyalty and is claimed by Reichheld to predict a company’s growth. However, various academic studies provide controversial results regarding its reliability and prediction powers. This study analyzes how respondents answer the likelihood-to-recommend (LTR) question in different predescribed and validated situations. One thousand participants are presented with situation descriptions that consist of previous and recent experiences with a bank and are asked how they would respond to the LTR question after such an experience. The results indicate that respondents do not always give a high score for good experiences, and a low score for bad experiences. However, with a high number of respondents, the different answering approaches even out, and the NPS results are higher for good than for bad experiences. Additionally, we notice that whereas negative experiences are evaluated as low by all respondents, Generation X and Boomers tend to give lower scores for neutral and positive experiences. Those with lower income and basic education give lower scores for neutral experiences. The recent experience influences the customer’s likelihood of recommending more than the previous experiences with the company.
Thermo-economic optimization of an ORC system for a dual-fuel marine engine
Authors: Akman Mehmet , Ergin Selma
Published: November 2023

The Organic Rankine Cycle (ORC) is one of the most promising systems to recover the waste heat sourced from internal combustion engines. In this study, thermodynamic, economic and environmental analyses of the scavenge air cooling water-driven Waste Heat Recovery System (WHRS) based on the organic Rankine cycle are conducted for a dual-fuel marine engine integrated with exhaust gas recirculation (EGR) system. Zero ozone-depleting and low global warming potential working fluids; R245fa, R236ea from hydrofluorocarbons, R600a, R601a from hydrocarbons, R1234ze and R1234yf from hydrofluoroolefins are selected for the low-grade WHRS. In addition to the thermal analyses, the mass and volume of the system along with the safety factors of the working fluids are evaluated to judge the physical applicability of the system for ships. Thermo-economic performances of the fluids are analyzed, optimized and compared under various engine loads, Tier II and Tier III modes to reveal the effects of different engine operating conditions on the parameters. According to the results, scavenge air has a significant amount of waste heat at medium and heavy loads and switching the engine mode remarkably affects the performance of the WHRS. R601a shows the best thermo-economic performance, however, considering the applicability of the system R236ea is the most suitable working fluid for the ORC WHRS. The overall thermal efficiency of the power generation system can be increased by about 2.8%.
Marine diesel engine turbocharger fouling phenomenon risk assessment application by using fuzzy FMEA method
Authors: Ceylan Bulut Ozan
Published: November 2023

Turbocharger fouling phenomenon was analyzed from the risk assessment perspective in this study. The research employed exhaust system and turbocharger equipment of commercial ship that equipped with a Doosan-MAN B&W 6S50 MC-C diesel engine was used as the main research materials, and utilized the fuzzy Failure Mode and Effects Analysis (FMEA) based on the expert system as a methodical approach. The experts revealed different types of turbocharger fouling failure modes (FMs), along with their respective causes and subsequent consequences. Following that, the specialists allocated an O, S, and D score to each FM. Within the framework of fuzzy logic, the process entails the establishment of input and output membership functions, as well as the construction of a fuzzy model incorporating an inference mechanism and a rule base. Based on the analysis findings, the three primary factors are as follows: low cylinder compression pressure with a Fuzzy Risk Priority Number (FRPN) score of 6.95, high main engine fuel oil consumption with a score of 6.92, and high CO, CO2, SOx emissions with a 6.45. The phenomenon of turbocharger fouling, being an inherent occurrence, has significant ramifications on the main engine, the vessel as a whole, and the ecological surroundings. The quantitative results presented in this study provide valuable insights into the risks associated with maritime endeavors. The data generated from this research can be used by stakeholders in the maritime industry to better understand this situation and take proactive measures to mitigate potential risks in the future. Furthermore, the findings of the research provide corroboration for the implementation of predictive maintenance procedures.
Numerical analysis of composite preform structure based on flat cross-linked braiding
Authors: Du Chengjie , Hong Jianhan , Zou Zhuanyong , Liu Shimin , Lu Yaoyao , Shen Wei , Sun Zhuangzhi
Published: November 2023

Composite materials are widely used in aerospace, automotive industry and medical equipment, where most of the structural parts are made of fiber laminates. Rotary braiding is one of the most important methods to prepare composite preforms. The ordinary rotary braided preforms have low porosity and dense yarns, but are single-layer structures after molding, which do not meet the needs of most applications. To solve the problem that traditional laminates are prone to delamination, this paper designs a flat cross-linked braiding process for the preparation of multilayer-interlocking composite panels. The carrier trajectory is analyzed, and the spatial coordinate system of the braided chassis is established by combining the effect of the end traction system on the morphology of the preform yarns. The numerical model of the preform is initially obtained by using cubic B-spline curve fitting, and an algorithm for gathering yarns towards the fabric center is proposed to optimize the numerical model. Experimental samples of flat cross-linked preforms are prepared according to the braiding process, and the reliability of the optimization algorithm is verified by comparing the yarn coordinates of the experimental samples with those of the optimized numerical model.
The Impact of Spiritual Well-Being on the Quality of Life of Cancer Patients: A Cross-Sectional Study
Authors: Jetan Mohamad , Daifallah Aiman , Rabayaa Maha Khalid , Qadri Rana , Nassorah Mahmoud , Nouri Ahmed , Al-Othaman Nihad
Published: November 2023

Background:

Quality of life is a multidimensional concept that involves physical, social, emotional, and functional well-being. Spirituality represents a potentially influential factor in the quality of life. This study aimed to evaluate the quality of life and spirituality among cancer patients.

Methods:

A cross-sectional study was carried out on 354 cancer patients in Palestine. A self-administered questionnaire was used for data collection. The questionnaire was made up of 4 sections: sociodemographic factors, clinical data, FACT-G, and FACIT-sp.

Results:

A total of 354 cancer patients with a mean age of 46.4 ± 15.3 years were enrolled in the study. The spiritual well-being of patients reported in this study was measured by using the median FACIT-Sp total score, and it was 35 (IQR: 29-42). The quality of life of patients was measured using the median of the FACT-G total score, and it was 63 (IQR: 52-85). The FACT-G score was significantly variable based on several factors including age, marital status, cancer type, presence of metastasis, presence of treatment side effects, and the period since diagnosis ( P-value < .05). The FACIT-Sp total score had a significantly strong positive relationship with FACT-G total score ( r = .705, P < .001). Moreover, moderate to strong significant correlations were found between spirituality and quality of life subscales.

Conclusions:

Quality of life among cancer patients is affected by their basic and clinical characteristics and is highly correlated with their spirituality level. Thus, addressing palliative support through spiritual care besides primary clinical treatment is of great importance to improve the quality of life among cancer patients.
Rapid Carotid Screening by Duplex: A Prospective Single Centre Assessment
Authors: Phair Alison S. , Rogers Steven K. , Ghosh Jonathan , Smith Craig J. , McCollum Charles N.
Published: November 2023

Objective

A novel carotid quick scan (CQS) protocol was developed to rapidly screen for carotid atherosclerosis greater than 50% stenosis in a vascular outpatient setting. This study assessed accuracy and time saved.

Material & Methods

The CQS was developed by consensus agreement between vascular surgeons and accredited clinical vascular scientists through a modified Delphi technique. The protocol comprised a rapid B-mode then colour flow transverse sweep of the common and internal carotid arteries, with internal carotid artery velocity assessment. One hundred outpatients attending with peripheral artery disease or abdominal aortic aneurysm were recruited. CQS sensitivity, specificity and accuracy was assessed against a conventional full carotid duplex study, performed to UK and ESVS guidelines.

Results

Twenty four percent of patients (n = 100) had >50% carotid NASCET stenosis. CQS achieved an excellent accuracy of 96.5% in detecting >50% stenosis when compared to full duplex; Cohen’s ƙ = .88, (95%CI .79-.97; P < .001), sensitivity 91.4%, specificity 97.6%, positive predictive value (PPV) 88.9% and negative predictive value (NPV) 98.2%. Median (IQR) time to complete the CQS was 13 sec (±12) per side, compared to 151 sec (±78) per side for the full carotid duplex. In the presence of >50% carotid disease, median CQS time was 25 sec (±31) per side compared to 214 (±104) by full scan.

Conclusion

CQS as a carotid screening tool is rapid, accurate and acceptable to the population and workforce. It would be simple to roll out in all vascular laboratories to reduce the time and cost burden of excluding significant carotid disease in any group.
“Powerful Strangers”: A Reflection on Spirituality and the Chaplain–Doctor Partnership
Authors: Rim Rachel
Published: November 2023

In this piece, Rachel Rim (Chaplain, MDiv) offers a poetic reflection on the nature of spirituality and the unique partnership between chaplains and doctors in the healthcare system, and particularly within the realm of palliative care.
“Violence Across Borders: Venezuelan Women and the Continuum of Violence in Migration and Settlement”
Authors: Obinna Denise N.
Published: November 2023

The ongoing conflict in Venezuela has created significant risks for women and girls. Conflict affected populations often face higher levels of vulnerability and risks of gender-based violence (GBV) at home, in transit and at destination countries. Venezuelan women face GBV at all stages of their journey. Due to their often-irregular or undocumented status in host countries, many women lack legal access to healthcare and work which leaves them vulnerable to exploitation and GBV. Using the continuum of violence model by Kelly (1988; 2012) as well as Menjívar & Walsh (2017; 2019), this work underscores the complex ways in which gender, nationality and legal status interact with each other to shape patterns of migration and settlement. Focusing on the two largest receiving countries in Latin America: Colombia and Peru, this work also outlines how the structural, symbolic and interpersonal nature of GBV crosses borders amid the challenges of conflict, displacement and xenophobia.
Determining a risk-proportionate approach to the validation of statistical programming for clinical trials
Authors: Gamble Carrol , Lewis Steff , Stocken Deborah , Juszczak Edmund , Bradburn Mike , Doré Caroline , Kean Sharon
Published: November 2023

Background

The contribution of the statistician to the design and analysis of a clinical trial is acknowledged as essential. Ability to reconstruct the statistical contribution to a trial requires rigorous and transparent documentation as evidenced by the reproducibility of results. The process of validating statistical programmes is a key requirement. While guidance relating to software development and life cycle methodologies details steps for validation by information systems developers, there is no guidance applicable to programmes written by statisticians. We aimed to develop a risk-based approach to the validation of statistical programming that would support scientific integrity and efficient resource use within clinical trials units.

Methods

The project was embedded within the Information Systems Operational Group and the Statistics Operational Group of the UK Clinical Research Collaboration Registered Clinical Trials Unit network. Members were asked to share materials relevant to validation of statistical programming. A review of the published literature, regulatory guidance and knowledge of relevant working groups was undertaken. Surveys targeting the Information Systems Operational Group and Statistics Operational Group were developed to determine current practices across the Registered Clinical Trials Unit network. A risk-based approach was drafted and used as a basis for a workshop with representation from statisticians, information systems developers and quality assurance managers (n = 15). The approach was subsequently modified and presented at a second, larger scale workshop (n = 47) to gain a wider perspective, with discussion of content and implications for delivery. The approach was revised based on the discussions and suggestions made. The workshop was attended by a member of the Medicines for Healthcare products Regulatory Agency Inspectorate who also provided comments on the revised draft.

Results

Types of statistical programming were identified and categorised into six areas: generation of randomisation lists; programmes to explore/understand the data; data cleaning, including complex checks; derivations including data transformations; data monitoring; or interim and final analysis. The risk-based approach considers each category of statistical programme against the impact of an error and its likelihood, whether the programming can be fully prespecified, the need for repeated use and the need for reproducibility. Approaches to the validation of programming within each category are proposed.

Conclusion

We have developed a risk-based approach to the validation of statistical programming. It endeavours to facilitate the implementation of targeted quality assurance measures while making efficient use of limited resources.
Authentic leadership as a predictor of organizational citizenship behaviour and teachers’ burnout: What's ‘quiet quitting’ got to do with it?
Authors: Tsemach Sigalit , Barth Anat
Published: November 2023

Teachers’ attitudes and behaviours have been studied for the past few decades, but recently, especially due to changes following covid-19, a new concept named ‘quiet quitting’ has emerged. This term refers to the widespread phenomenon of employees setting limits to their employers and insisting on their unwillingness to go beyond job requirements. This study explored the relationships between principals’ authentic leadership (AL) and teachers’ organizational citizenship behaviour (OCB) and burnout, mediated by teachers’ organizational commitment, while distinguishing between the teachers’ level and the school level. One Thousand one hundred and seventy-nine Israeli teachers from 69 schools participated in this study. Results indicate that organizational commitment mediated the relationship between AL and burnout on both the teachers’ and the school level. Organizational commitment mediation regarding the relationship between AL and OCB was confirmed for the teachers’ level only. OCB positively correlated to burnout on the school level only. These findings clarify the concept of ‘quiet quitting’ among teachers. Actually, it seems to be a positive trend serving to reduce burnout among teachers who overwork themselves. These findings can help enlighten school leaders regarding their staff's behaviour as well as the school climate they wish to cultivate.
Yokukansan, a Traditional Japanese Medicine, Suppresses Stress-Induced Sympathetic Activation via Central Responses in Rats
Authors: Yamaguchi Naoko , Maruyama Kenta , Okada Shoshiro
Published: November 2023

Objectives: Yokukansan (YKS) is a traditional Japanese Kampo medicine approved by the Ministry of Health, Labour and Welfare of Japan. Recently, in addition to its indications as a drug treatment, YKS has been shown to have ameliorative effects on various psychological and behavioral responses such as anxiety, aggression, and stress responses. Stress exposure activates not only the hypothalamic–pituitary–adrenal axis but also the sympathetic nervous system. Sympathetic activation in brain regions such as the paraventricular hypothalamic nucleus (PVN) stimulates elevation of plasma catecholamine (noradrenaline and adrenaline) levels. We previously reported that various stress-related neuropeptides and several kinds of stressors, such as restraint stress (RS), increase plasma catecholamine and that brain prostanoids and their synthases mediate these responses in rats. In the present study, to determine if YKS treatment can affect stress-induced sympathetic activation, we examined the effects of YKS treatment on the RS-induced elevation of plasma catecholamine levels and related prostanoid production in the PVN of rats. Methods: YKS (1000 mg/10 mL/kg, p.o.) or vehicle was administered to rats daily for 14 days, and all rats were exposed to RS for 60 min on day 14. Before and during stress exposure on day 14, blood samples and PVN dialysates were collected and analyzed by high-performance liquid chromatography and liquid chromatography-ion trap tandem mass spectrometry, respectively. Results: Our results showed that repeated administration of YKS suppressed the RS-induced increase in plasma adrenaline but not noradrenaline. Furthermore, YKS administration also suppressed the RS-induced elevation of both prostaglandin E2 and thromboxane B2 levels in the PVN. In addition, we found that repeated administration of YKS suppressed the RS-induced increase in serotonin, gamma-aminobutyric acid, and acetylcholine in the PVN. Conclusion: Our results suggest that YKS can ameliorate stress-induced sympathetic activation via inhibition of stress responses in the brain.
Unusual sites of hepatocellular carcinoma metastasis: Case report
Authors: Chaudhry Hunza , Sohal Aalam , Iqbal Humzah , Chaudhary Uzair , Roytman Marina
Published: November 2023

Hepatocellular carcinoma is an increasingly frequent cause of cancer-related death. The majority of patients with hepatocellular carcinoma are asymptomatic. In rare cases, patients may present with symptoms of extrahepatic metastases. Early identification can lead to timely treatment and prevent poor outcomes. We report three cases of patients with hepatocellular carcinoma with unusual sites of metastasis, including clival, mandible, and cardiac involvement.
“Where’s My People?”: An Investigation of the Structure and Content of Black and Latinx College Students’ Ethnic-Racial Identity Narratives
Authors: Rosario R. Josiah , Moffitt Ursula , Rogers Leoandra Onnie
Published: November 2023

As attending college became a normative life experience in the U.S., society developed a cultural narrative about what a “good” college experience looks like. But, for racially minoritized college students, this master narrative often excludes their experiences. Integrating narrative and ethnic-racial identity, the current study investigates how a sample of 11 Black and Latinx students ( M age = 19.73) narrate their lives in college and make meaning of their racial experiences. Participants were prompted to construct their college story as if it were a book with chapters and describe the connections between those chapters. We analyzed students’ college stories and found that they used either chronological or thematic coherence to structure their narratives; this distinction in structure was related to the content of their stories. We discuss the theoretical and practical implications of using a racialized college story narrative to understand ethnic-racial identity for minoritized college students.
Should a Narrow Corridor Be a Contraindication for Performing Oblique Lateral Interbody Fusion Procedure or Not?
Authors: Singhatanadgige Weerasak , Chatareeyagul Panupong , Tanasansomboon Teerachat , Phutrakool Phanupong , Kotheeranurak Vit , Yingsakmongkol Wicharn , Limthongkul Worawat
Published: November 2023

Study Design

Retrospective study.

Objectives

We investigated the effect of corridor width on the postoperative outcomes of patients who underwent the OLIF procedure.

Methods

Patients who underwent OLIF surgery, which included L4-5, between 2015 and 2021 were retrospectively studied. The patients were divided into three groups by the width of the corridor: not more than 10 mm, between 10 and 20 mm, and 20 mm or more. We compared clinical and radiographic outcomes and complications between these groups.

Results

A total of 81 patients were included. There were no significant differences in VAS leg and back pain scores, ODI scores, or complications between each group. The radiographic findings, including cage position, anterior and posterior disc height, segmental Cobb angle, and foraminal height, also showed no significant differences between each group. The only radiographic finding that showed a significant difference between each group was the angle of the cage. We found significantly less degree of angle in the wider than 20 mm group when compared to the other two groups. ( P-value = .01). There was no recorded incidence of major vascular complications.

Conclusions

The width of oblique corridor does not affect clinical outcomes, complications, or radiographic findings, including position of the cage, anterior and posterior disc height, segmental angle, and foraminal height after OLIF procedure, including L4-5 level. Thus, the OLIF procedure can be performed safely even in patients with limited oblique corridors, especially at L4-5.
A Pilot Study to Explore the Improvements in Pulmonary and Cognitive Functions With a Kazoo Intervention Among Middle-Aged and Older Adults in a Rural Community
Authors: Chang Luna , Chen Shu-Chuan , Lin Po-Yu , Lin Hsiu-Pi , Liao Li-Ling , Chao Hui-Chen , Chen Mei-Chun , Chen Mei-Chun , Tsao Yi-Ying
Published: November 2023

Dementia is a leading cause of disability and dependence in older adults worldwide. The aim of this pilot study was to explore the effect of using a kazoo instrument to improve pulmonary function and cognitive reserve in middle-aged and older adults in rural areas. This quasi-experimental study was conducted at two community care stations selected using cluster sampling from a rural district in southern Taiwan. We enrolled 85 middle-aged and older adults who were randomly assigned into self-learner and in-class groups. Both groups received a 6-month kazoo program. Cognitive and pulmonary function were compared before and after the intervention between the two groups. Significantly improved pulmonary function with regards to forced vital capacity ( p < .05) was found in the self-learner group, and significantly improved maximum expiratory flow 75% ( p < .001) was found in both groups. Mini-Mental State Examination scores significantly improved in the self-learner group ( p < .01), but there was no significant change in the in-class group. Our results suggest that community care stations could consider implementing wind instrument programs such as a kazoo to enhance pulmonary function and cognitive reserve in middle-aged and older adults residing in rural areas.
Transitional Care from Hospital to Cardiac Rehabilitation During COVID-19: The Perspectives of Older Adults and Their Healthcare Providers
Authors: Flores-Sandoval Cecilia , Orange Joseph B. , Ryan Bridget L. , Adams Tracey L. , Suskin Neville , McKelvie Robert , Elliott Jacobi , Sibbald Shannon L.
Published: November 2023

Transitional care to cardiac rehabilitation during the pandemic was a complex process for older adults, with additional challenges for decision-making and participation. This study aimed to explore the perspectives of older adults and health providers on transitional care from the hospital to cardiac rehabilitation, focusing on patient participation in decision-making. A qualitative exploratory design was used. Semi-structured interviews were conducted with 15 older adults and 6 healthcare providers. Document analysis and reflexive journaling were used to support triangulation of findings. Six themes emerged from the data, related to insufficient follow-up from providers, the importance of patients’ emotional and psychological health and the support provided by family members, the need for information tailored to patients’ needs and spaces for participation in decision-making, as well as challenges during COVID-19, including delayed medical procedures, rushed discharge and isolating hospital stays. The findings of this study indicated a number of potential gaps in the provision of transitional care services as reported by older adults who had a cardiovascular event, often during the first few weeks post hospital discharge.
‘Caste Census’ to Dismantle ‘Group Inequalities’
Authors: Jayanaik Pradeep Ramavath
Published: November 2023

The caste system in India continues to endure, resulting in around 85% of the people experiencing socio-economic disadvantages. The process of systematic exclusion renders the policy intentions devoid of acknowledgement towards the demands of communities that have been historically marginalised. Conducting a comprehensive census of castes is necessary to foster inclusivity within India, as it enables the recognition and subsequent mitigation of entrenched disparities that persist due to factors such as caste affiliations, religious distinctions, gender disparities, ethnic variations, and racial differences. The transition from a focus on ‘Political Citizenship’ to ‘Social Citizenship’ via the implementation of inclusive policies is paramount in pursuing a more equal and just society.
Modeling the relationships among teacher instruction, learner belief, and learning strategies in Chinese character learning by alphabetic learners
Authors: Yu Mingyang , Chan Yuet Hung Cecilia
Published: November 2023

With the increasing research on self-regulated learning of English as a foreign language, scant attention has been devoted to investigating Chinese as a foreign language (CFL). To partially address this issue, we investigated self-regulated Chinese character learning by alphabetic learners. Using structural equation modeling, we constructed a model of the relationship among teachers’ instructions, learners’ beliefs, and learning strategies based on a survey of 202 CFL learners. The model indicated that teachers’ instructions directly and positively affect learners’ beliefs and learning strategies. However, learners’ beliefs cannot predict what strategies they adopt in character learning. The findings of this study shed light on the effective teaching of Chinese characters to CFL learners. We suggest that in addition to shape-related and pronunciation-related instructions, CFL learners should be provided with more meaning-related instructions and that Chinese character typing should be introduced to facilitate the learners’ use of effective strategies in self-regulated character learning.
Exploring Antenatal Exercise: Knowledge, Attitudes, Practices, and Influencing Factors among Pregnant Women in Libya
Authors: Jahan Alhadi M , Anaiba Salima M
Published: November 2023

Background:

Antenatal exercise is crucial in promoting pregnant women’s health and well-being. However, no research in Libya examined the knowledge, attitudes, and practices of antenatal exercise among pregnant women.

Methods:

This cross-sectional study aimed to explore the knowledge, attitudes, and practices related to antenatal exercise among pregnant women in Libya. A convenience sample of pregnant women (n = 205) receiving prenatal care at Misrata Medical Center and having no contraindication for exercise participated in the study. A self-administered, previously elaborated questionnaire was used to assess participants’ awareness, knowledge, attitudes, and practice of antenatal exercise. Descriptive statistics and binary logistic regression analysis were employed using SPSS version 28.

Results:

The findings revealed that nearly half of the participants demonstrated good knowledge (56.1%) and a positive attitude (47.8%) regarding antenatal exercise. Less than one-third (30.2%) of participants engaged in some form of exercise during pregnancy. The logistic regression results showed that age, income, and practice of exercise before pregnancy significantly contributed to the knowledge score. The analysis indicated that the unemployment status (AOR = 2.42, 95% CI [0.78-6.38], P = .03) and practicing exercise before pregnancy (AOR = 1.97, 95% CI [0.92-4.24], P = .02) were significantly associated with a higher likelihood of engaging in antenatal exercise. The main subjective reasons for pregnant women not engaging in antenatal exercise were lack of time, poor knowledge, fatigue, and worries about harming the baby.

Conclusion:

This study sheds light on the current state of antenatal exercise among pregnant women in Libya and highlights the factors shaping these behaviors. The findings underscore the importance of promoting accurate knowledge, addressing misconceptions, and providing support and resources to overcome barriers and encourage safe and effective antenatal exercise practices in Libya. Future studies should consider employing qualitative or mixed methods research designs to examine antenatal exercise from different perspectives.
Lung functional imaging
Authors: Bayat Sam , Wild Jim , Winkler Tilo
Published: November 2023

Pulmonary functional imaging modalities such as computed tomography, magnetic resonance imaging and nuclear imaging can quantitatively assess regional lung functional parameters and their distributions. These include ventilation, perfusion, gas exchange at the microvascular level and biomechanical properties, among other variables. This review describes the rationale, strengths and limitations of the various imaging modalities employed for lung functional imaging. It also aims to explain some of the most commonly measured parameters of regional lung function. A brief review of evidence on the role and utility of lung functional imaging in early diagnosis, accurate lung functional characterisation, disease phenotyping and advancing the understanding of disease mechanisms in major respiratory disorders is provided.
Relationship between the thrombospondin-1/Toll-like receptor 4 (TSP1/TLR4) pathway and vitamin D levels in obese and normal weight subjects with different metabolic phenotypes
Authors: Khairy Eman Y. , Saad Azza
Published: November 2023

Thrombospondin-1 (TSP1) contributes to obesity-associated inflammation via activating Toll-like receptor 4 (TLR4). The regulatory role of vitamin D on this pathway has been suggested. This study aimed to investigate the relationship between TSP1/TLR4 pathway and vitamin D in obese and normal weight subjects with different metabolic phenotypes. Thirty obese and thirty normal weight men were selected. Anthropometric parameters and serum TSP1, TLR4, TNF-α, vitamin D, and metabolic profile were determined. Metabolic phenotypes of obese and normal weight subjects were determined. Findings revealed enhanced TSP1/TLR4/TNF-α levels and reduced 25(OH)D levels in obese compared to normal weight subjects and metabolically unhealthy compared to metabolically healthy subjects. TSP1 correlated positively with parameters of unhealthy metabolic profile. TSP1, TLR4 and TNF-α levels significantly negatively correlated with vitamin D levels. In conclusion, vitamin D might exert a regulatory role on TSP1/TLR4 pathway, providing a potential mechanism that links hypovitaminosis D with risk of metabolic dysfunction.
Distinct transcriptional responses to fludioxonil in Aspergillus fumigatus and its ΔtcsC and Δskn7 mutants reveal a crucial role for Skn7 in the cell wall reorganizations triggered by this antifungal
Authors: Schruefer Sebastian , Pschibul Annica , Wong Sarah Sze Wah , Sae-Ong Tongta , Wolf Thomas , Schäuble Sascha , Panagiotou Gianni , Brakhage Axel A. , Aimanianda Vishukumar , Kniemeyer Olaf , Ebel Frank
Published: November 2023

Background

Aspergillus fumigatus is a major fungal pathogen that causes severe problems due to its increasing resistance to many therapeutic agents. Fludioxonil is a compound that triggers a lethal activation of the fungal-specific High Osmolarity Glycerol pathway. Its pronounced antifungal activity against A. fumigatus and other pathogenic molds renders this agent an attractive lead substance for the development of new therapeutics. The group III hydride histidine kinase TcsC and its downstream target Skn7 are key elements of the multistep phosphorelay that represents the initial section of the High Osmolarity Glycerol pathway. Loss of tcsC results in resistance to fludioxonil, whereas a Δskn7 mutant is partially, but not completely resistant.

Results

In this study, we compared the fludioxonil-induced transcriptional responses in the ΔtcsC and Δskn7 mutant and their parental A. fumigatus strain. The number of differentially expressed genes correlates well with the susceptibility level of the individual strains. The wild type and, to a lesser extend also the Δskn7 mutant, showed a multi-faceted stress response involving genes linked to ribosomal and peroxisomal function, iron homeostasis and oxidative stress. A marked difference between the sensitive wild type and the largely resistant Δskn7 mutant was evident for many cell wall-related genes and in particular those involved in the biosynthesis of chitin. Biochemical data corroborate this differential gene expression that does not occur in response to hyperosmotic stress.

Conclusions

Our data reveal that fludioxonil induces a strong and TcsC-dependent stress that affects many aspects of the cellular machinery. The data also demonstrate a link between Skn7 and the cell wall reorganizations that foster the characteristic ballooning and the subsequent lysis of fludioxonil-treated cells.
Regulatory effects of Hemin on prevention and rescue of salt stress in rapeseed (Brassica napus L.) seedlings
Authors: Zhao Hui-Min , Zheng Dian-Feng , Feng Nai-Jie , Zhou Guang-Sheng , Khan Aaqil , Lu Xu-Tong , Deng Peng , Zhou Hang , Du You-Wei
Published: November 2023

Background

Salt stress severely restricts rapeseed growth and productivity. Hemin can effectively alleviate salt stress in plants. However, the regulatory effect of Hemin on rapeseed in salt stress is unclear. Here, we analyzed the response and remediation mechanism of Hemin application to rapeseed before and after 0.6% (m salt: m soil) NaCl stress. Experiment using two Brassica napus (AACC, 2n = 38) rapeseed varieties Huayouza 158R (moderately salt-tolerant) and Huayouza 62 (strongly salt-tolerant). To explore the best optional ways to improve salt stress resistance in rapeseed.

Results

Our findings revealed that exogenous application of Hemin enhanced morph-physiological traits of rapeseed and significantly attenuate the inhibition of NaCl stress. Compared to Hemin (SH) treatment, Hemin (HS) significantly improved seedlings root length, seedlings height, stem diameter and accumulated more dry matter biomass under NaCl stress. Moreover, Hemin (HS) significantly improved photosynthetic efficiency, activities of antioxidant enzymes such as superoxide dismutase (SOD), peroxidase (POD), ascorbate peroxidase (APX), and decreased electrolyte leakage (EL) and malondialdehyde (MDA) content, thus resulting in the alleviation of oxidative membrane damage. Hemin (HS) showed better performance than Hemin (SH) under NaCl stress.

Conclusion

Hemin could effectively mitigate the adverse impacts of salt stress by regulating the morph-physiological, photosynthetic and antioxidants traits of rapeseed. This study may provide a basis for Hemin to regulate cultivated rapeseed salt tolerance and explore a better way to alleviate salt stress.
Platelet/Albumin ratio and plateletcrit levels are potential new biomarkers for assessing endoscopic inflammatory bowel disease severity
Authors: Huang Jun , Lu Jie , Jiang Feiyu , Song Tiejun
Published: November 2023

Background

Endoscopy is currently recognized as the gold standard for assessing inflammatory bowel disease (IBD) severity. However, because the procedure is costly and invasive, endoscopy is not suitable for frequently monitoring intestinal inflammation. In this study, our aim was to identify noninvasive, low cost, and convenient biomarkers for identifying endoscopic IBD activity.

Methods

In total, 246 patients with IBD (131 with Ulcerative colitis (UC) and 115 with Crohn’s disease (CD)) and 369 healthy controls were recruited for this retrospective study. IBD activity was evaluated using endoscopic and clinical examinations. The potential of several inflammatory biomarkers, including platelets (PLT), plateletcrit (PCT), albumin (ALB), highly sensitive C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR), and platelet-to-albumin ratio (PLT/ALB) to assess endoscopic IBD activity was evaluated using receiver operating characteristic (ROC) analyses.

Results

PLT/ALB ratio, PLT, ALB, and hs-CRP levels were correlated with Mayo scores in UC patients, while PCT, PLT, fibrinogen (FIB), PLT/ALB ratio, hs-CRP, and ESR levels were correlated with Simple Endoscopic Scores for CD (SES-CD) in CD patients. ROC analyses showed that the area under the curve (AUC) value for the PLT/ALB ratio (0.705) was greater than hs-CRP (0.607) and ESR (0.552) values in UC patients. The AUC value for PCT (0.779) was greater than hs-CRP (0.698) and ESR (0.746) values in CD patients.

Conclusion

PLT/ALB ratio and PCT biomarkers were the most appropriate of all tested inflammatory biomarkers for assessing endoscopic IBD activity in UC and CD patients, respectively.
Quality of life profiles and its association with predictors amongst Chinese older adults in nursing homes: a latent profile analysis
Authors: Liu Chunqin , Luo Qing , Luo Dongyi , Zhou Ying , Feng Xue , Wang Zihan , Xiao Jiajian , Bi Qiulin , Smith Graeme Drummond
Published: November 2023

Background

Recently developments in the field of positive psychology have provided new perspectives for understanding the connection between individual variation in Quality of life (QoL) and positive aspects of human potential, strengths, and resources, commanding increasing attention. This study aimed to examine self-reported quality of life (QoL) profiles and the association of QoL profiles with positive psychosocial characteristics in Chinese older adults.

Methods

A convenient sample of 354 older adults in nursing homes was recruited from Guangdong Province, China, between November 2020 and January 2021. Latent Profile Analysis (LPA) was conducted to explore QoL profiles using the four WHOQOL-BREF domains as input variables. Multinomial logistic regression was performed to explore the association between latent profiles and predictors.

Results

LPA identified three latent QoL profiles: “low QoL with poor psychological health” (18.1%), “moderate QoL” (46.0%) and “high QoL” (35.9%). Frequency of weekly activity, optimism, gratitude, and social support were associated with the increased likelihood of belonging to the moderate-to-high QoL classes. Furthermore, Class 2 (moderate QoL group, reference) was compared with Class3 (high QoL group), higher frequency of weekly physical activity and spending more time on physical activity exhibited higher odds of belonging to high QoL class.

Conclusion

Using the domains of the WHOQOL-BREF scale, the QoL profiles Chinese older adults can be identified. We found that psychosocial variables and demographic characteristic, including lower level of optimism and gratitude, lack of social support, low frequency of physical activity, and shorter activity duration time, heighten the risk for lower levels of QoL. Identifying classification may help focus on those at elevated risk for poor QoL and for developing tailored QoL improvement programs.
Are people living with HIV have a low vulnerability to omicron variant infection: results from a cross-sectional study in China
Authors: Tan Yuting , Wu Songjie , Guo Wei , Liu Jie , Ming Fangzhao , Zou Shi , Tang Weiming , Liang Ke , Yang Junjun
Published: November 2023

Background

A surge of more than 80 million Omicron variant infected cases was reported in China less than a month after the "zero COVID" strategy ended on December 7, 2022. In this circumstance, whether people living with HIV (PLWH) in China experience a similar risk is not clear.

Methods

A cross-sectional study was conducted in the Wuchang District of Wuhan between December 20, 2022, and January 18, 2023 through a self-administered online survey. PLWH and HIV-negative people aged ≥ 18 years old who volunteered for this survey were eligible. The prevalence of Omicron variant infection between PLWH and HIV-negative people was compared, and the factors associated with the Omicron variant infection among PLWH and HIV-negative people were further evaluated, respectively.

Results

In total, 890 PLWH and 1,364 HIV-negative adults from Wuchang District were enrolled. Among these participants, 690 PLWH (77.5%) and 1163 HIV-negative people (85.3%) reported SARS-CoV-2 infection. Gender, chronic disease conditions, and COVID-19 vaccination status significantly differed between the two groups. After adjusting gender, age, comorbidities, and COVID-19 vaccination status, the risk of SARS-CoV-2 infection among PLWH was significantly lower than among HIV-negative people (aOR 0.56, 95%CI 0.42–0.76). Multivariable logistic regression analysis showed that PLWH with older age and detectable HIV-viral load (HIV-VL) had decreased risk of SARS-CoV-2 infection (aOR 0.98, 95%CI 0.96–0.99; aOR 0.59, 95%CI 0.36–0.97). Compared with PLWH receiving one/two doses of COVID-19 vaccines, no significant differences in the risk of SARS-CoV-2 infection were observed among PLWH receiving three doses of inactivated vaccines and four doses of vaccines (three doses of inactivated vaccines plus one dose of inhaled recombinant adenovirus type 5 (AD5)-vectored vaccine). Among HIV-negative people, those receiving four doses of COVID-19 vaccines had a lower risk of SARS-CoV-2 infection than those receiving one/two doses (aOR 0.14, 95%CI 0.08–0.25).

Conclusions

Our study proves that PLWH have a lower risk of Omicron variant infection than HIV-negative people. However, even PLWH with younger age and virological suppression should strengthen the prevention against SARS-CoV-2 infection. Three doses of inactivated vaccines plus one dose of inhaled recombinant AD5-vectored COVID-19 vaccine may provide better protection for HIV-negative people.
Acinetobacter spp. bloodstream infection in hematological patients: a 10-year single-center study
Authors: Li Jia , Feng Xiaomeng , Wang Jieru , Lin Qingsong , Zheng Yizhou , Zhang Fengkui , Mi Yingchang , Zhu Xiaofan , Jiang Erlie , Xiao Zhijian , Wang Jianxiang , Feng Sizhou
Published: November 2023

Purpose

This study investigated the clinical and antimicrobial characteristics of Acinetobacter spp. bloodstream infection (BSI) in hematological patients. Risk factors for 30-day mortality and carbapenem-resistant Acinetobacter spp. (CRA) BSI acquisition were also identified.

Methods

We reviewed forty hematological patients with Acinetobacter spp. BSI in a large Chinese blood disease hospital between 2013 and 2022. The remaining CRA isolates were subjected to whole-genome sequencing.

Results

The 30-day mortality rate was high at 35%. Hematological patients with Acinetobacter spp. BSI often presented with severe conditions and co-infections at multiple sites. All strains were colistin-susceptible and 40.0% were CR. Multivariate analysis identified several risk factors associated with CRA BSI acquisition, including previous exposure to carbapenems within 30 days and CRA colonization. Very severe aplastic anaemia, tetracycline-resistant Acinetobacter spp. BSI, and unresolved neutropenia after infection were closely associated with 30-day mortality. Non-survivors often presented with higher median PCT and CRP levels and severe complications, such as intracranial infection, cardiac dysfunction, respiratory failure, and severe sepsis or septic shock. Our study also identified inappropriate empirical antibiotic therapy as an independent predictor of 30-day mortality (OR: 11.234, 95% CI: 1.261–20.086, P = 0.030). This study was the first to report A. oleivorans as a human pathogen, and to identify its unique oxacillinase, OXA-325.

Conclusion

An environment-originated non-pathogenic species can become pathogenic when the body’s immunity is compromised. Our results also highlighted the importance of improving neutropenia after infection, treating severe organ dysfunction, and administering appropriate empirical antibiotic therapy to reduce mortality in this patient population.
A new contingent screening strategy increased detection rate of trisomy 21 in the first trimester
Authors: Luo Wei , He Bin , Han Daiwen , Yuan Lixing , Tang Jun , Pang Ling , Zou Fene , Zhao Kai , Liu Shanling , Hu Ting
Published: November 2023

Background

Although the traditional contingent screening strategy is effective, there are still undetected low-risk trisomy 21. This study aims to define appropriate cut-off values of serum biochemical markers at low-risk and develop a strategy for sequential prenatal testing associated with first-trimester screening to increase the detection rate of trisomy 21.

Methods

This was a 9-year retrospective analysis of singleton pregnant women who underwent serum biochemical screening or combined first-trimester screening (CFTS) in the first trimester. For the low-risk group, the cut-off values of the serum biochemical markers were adjusted to determine the appropriate detection efficiency. Gravidas with abnormal serum biochemical markers at low-risk were advised to undergo further non-invasive prenatal screening (NIPS), whereas others continued with routine prenatal care.

Results

When cut-off values of free beta subunit of human chorionic gonadotropin (free β-hCG) multiples of the median (MoM) or pregnancy-associated plasma protein A (PAPP-A) MoM were defined with ≥ 2.75 or ≤ 0.5, 7.72% (2,194/28,405) in the serum biochemical screening group and 12.36% (4,005/32,403) in CFTS group could be detected as abnormal results for further NIPS. Finally, 55.56% (5/9) and 85.71% (6/7) of trisomy 21 cases with false-negative results were detected, and the overall detection rate for trisomy 21 was improved by 10.64% (5/47) and 12.77% (6/47), respectively.

Conclusions

The new contingent screening strategy can increase the detection rate of trisomy 21 compared with the traditional contingent screening strategy.