bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety evaluations of anlotinib in patients with advanced non-small cell lung cancer treated with bevacizumab
Authors: Jiang Fenge , Li Junxia , Kong Xiangshuo , Sun Ping , Qu Huajun
Published: September 2022

Objective: The purpose of this study is to evaluate the efficacy and safety of anlotinib in patients with advanced non-small cell lung cancer (NSCLC) who had previously received bevacizumab.

Methods: The participants were histopathologically or cytologically diagnosed advanced NSCLC patients whose disease progressed after at least one type of systemic therapy and who had previously received bevacizumab treatment. The patients were on 3-week administration cycles, including 2 weeks on-treatment (12 mg anlotinib oral route, once a day) and 1 week off-treatment. The primary end point of the trial was overall survival (OS). The secondary end points were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and safety.

Results: As of the data collection deadline (31 March 2021), 30 patients were enrolled in the study and received anlotinib treatment. All patients were included in the data set except one, who withdrew their consent after the start of treatment. The median follow-up period was 12.1 months (range, 3.6–25.0 months), and 29 patients were included in the evaluation of the treatment. Of the 29 patients, no CR cases occurred. In total, three patients (10.2%) showed a PR, 21 (72.4%) had SD, and five patients (17.2%) had PD. The objective response rate (ORR) was 10.2% (3 of 29 patients), and the disease control rate (DCR) was 82.7% (24 of 29 patients). The median progression-free survival (PFS) was 5.6 months (95% CI, 5.0–6.1 months; Figure 2). The median overall survival (OS) was 10.6 months (95% CI, 9.4–11.8 months; Figure 3). The overall tolerance of the anlotinib treatment was high among the enrolled patients. No treatment-related grade four or five toxicities were observed. Of the 29 patients, one patient’s anlotinib administration was reduced to 8 mg/day due to hypertension and headache. Most adverse events (AEs) were grade one or two; the most common AEs were fatigue (51.7%), hypertension (41.3%), hand–foot syndrome (41.4%), anorexia (34.5%) and hypertriglyceridemia (34.5%).

Conclusion: Anlotinib demonstrated favourable activity and manageable toxicity in NSCLC patients who were treated with bevacizumab previously.
An interpretable stacking ensemble learning framework based on multi-dimensional data for real-time prediction of drug concentration: The example of olanzapine
Authors: Zhu Xiuqing , Hu Jinqing , Xiao Tao , Huang Shanqing , Wen Yuguan , Shang Dewei
Published: September 2022

Background and Aim: Therapeutic drug monitoring (TDM) has evolved over the years as an important tool for personalized medicine. Nevertheless, some limitations are associated with traditional TDM. Emerging data-driven model forecasting [e.g., through machine learning (ML)-based approaches] has been used for individualized therapy. This study proposes an interpretable stacking-based ML framework to predict concentrations in real time after olanzapine (OLZ) treatment.

Methods: The TDM-OLZ dataset, consisting of 2,142 OLZ measurements and 472 features, was formed by collecting electronic health records during the TDM of 927 patients who had received OLZ treatment. We compared the performance of ML algorithms by using 10-fold cross-validation and the mean absolute error (MAE). The optimal subset of features was analyzed by a random forest-based sequential forward feature selection method in the context of the top five heterogeneous regressors as base models to develop a stacked ensemble regressor, which was then optimized via the grid search method. Its predictions were explained by using local interpretable model-agnostic explanations (LIME) and partial dependence plots (PDPs).

Results: A state-of-the-art stacking ensemble learning framework that integrates optimized extra trees, XGBoost, random forest, bagging, and gradient-boosting regressors was developed for nine selected features [i.e., daily dose (OLZ), gender_male, age, valproic acid_yes, ALT, K, BW, MONO#, and time of blood sampling after first administration]. It outperformed other base regressors that were considered, with an MAE of 0.064, R-square value of 0.5355, mean squared error of 0.0089, mean relative error of 13%, and ideal rate (the percentages of predicted TDM within ± 30% of actual TDM) of 63.40%. Predictions at the individual level were illustrated by LIME plots, whereas the global interpretation of associations between features and outcomes was illustrated by PDPs.

Conclusion: This study highlights the feasibility of the real-time estimation of drug concentrations by using stacking-based ML strategies without losing interpretability, thus facilitating model-informed precision dosing.
Trypsin inhibitor LH011 inhibited DSS-induced mice colitis via alleviating inflammation and oxidative stress
Authors: Jia Zhenmao , Wang Panxia , Xu Yuansheng , Feng Guodong , Wang Quan , He Xiangjun , Song Yan , Liu Peiqing , Chen Jianwen
Published: September 2022

Background: Ulcerative colitis (UC) is one type of inflammatory bowel disease, characterized by inflammation with infiltration and activation of macrophages in colonic tissue. LH011 is a trypsin inhibitor with potential anti-inflammatory effect.

Purpose: Here, we aim to assay the effects of LH011 on UC and further investigate the potential mechanisms in vitro and in vivo.

Methods: Dextran sulfate sodium (DSS, 3.5%, w/v) was used to induce UC, and lipopolysaccharide (LPS) was used to induce inflammation in RAW 264.7 cells. LH011 was administrated to mice in vivo or to RAW 264.7 cells in vitro at different concentrations. The cytokines (IL-1β, IL-6, and TNF-α) and the changes of NF-κB and Nrf2 pathways were detected.

Results: The results showed that LH011 improved DSS-induced mice colitis, including loss of weight, disease activity index (DAI), and colonic pathological damage. In addition, LH011 inhibited the expressions of IL-1β, IL-6, and TNF-α and strengthened the anti-oxidative capacity. Mechanically, LH011 downregulated the nuclear localization of NF-κB p65 and upregulated the protein expression of Nrf2.

Conclusion: These results demonstrated that LH011 alleviated inflammation and oxidative stress during UC by inhibiting TLR4/NF-κB and activating Nrf2/Keap1/HO-1 signaling pathways.
Eicosanoids in inflammation in the blood and the vessel
Authors: Yamaguchi Adriana , Botta Eliana , Holinstat Michael
Published: September 2022

Polyunsaturated fatty acids (PUFAs) are structural components of membrane phospholipids in cells. PUFAs regulate cellular function through the formation of derived lipid mediators termed eicosanoids. The oxygenation of 20-carbon PUFAs via the oxygenases cyclooxygenases, lipoxygenases, or cytochrome P450, generates a class of classical eicosanoids including prostaglandins, thromboxanes and leukotrienes, and also the more recently identified hydroxy-, hydroperoxy-, epoxy- and oxo-eicosanoids, and the specialized pro-resolving (lipid) mediators. These eicosanoids play a critical role in the regulation of inflammation in the blood and the vessel. While arachidonic acid-derived eicosanoids are extensively studied due to their pro-inflammatory effects and therefore involvement in the pathogenesis of inflammatory diseases such as atherosclerosis, diabetes mellitus, hypertension, and the coronavirus disease 2019; in recent years, several eicosanoids have been reported to attenuate exacerbated inflammatory responses and participate in the resolution of inflammation. This review focused on elucidating the biosynthesis and the mechanistic signaling of eicosanoids in inflammation, as well as the pro-inflammatory and anti-inflammatory effects of these eicosanoids in the blood and the vascular wall.
Metabolization and sequestration of plant specialized metabolites in insect herbivores: Current and emerging approaches
Authors: Jeckel Adriana Moriguchi , Beran Franziska , Züst Tobias , Younkin Gordon , Petschenka Georg , Pokharel Prayan , Dreisbach Domenic , Ganal-Vonarburg Stephanie Christine , Robert Christelle Aurélie Maud
Published: September 2022

Herbivorous insects encounter diverse plant specialized metabolites (PSMs) in their diet, that have deterrent, anti-nutritional, or toxic properties. Understanding how they cope with PSMs is crucial to understand their biology, population dynamics, and evolution. This review summarizes current and emerging cutting-edge methods that can be used to characterize the metabolic fate of PSMs, from ingestion to excretion or sequestration. It further emphasizes a workflow that enables not only to study PSM metabolism at different scales, but also to tackle and validate the genetic and biochemical mechanisms involved in PSM resistance by herbivores. This review thus aims at facilitating research on PSM-mediated plant-herbivore interactions.
Effects of apnoea training on aerobic and anaerobic performance: A systematic review and meta-analysis
Authors: de Asís-Fernández Francisco , Sereno Daniel , Turner Anthony P. , González-Mohíno Fernando , González-Ravé José María
Published: September 2022

Background Trained breath-hold divers have shown physiological adaptations that might improve athletes’ aerobic and anaerobic performance.

Objective This study aimed to systematically review the scientific literature and perform a meta-analysis to assess the effects of voluntary apnoea training on markers of anaerobic and aerobic performance, such as blood lactate and VO2max.

Methods A literature search on three databases (Web of Science, PubMed and SCOPUS) was conducted in March 2022. The inclusion criteria were 1) peer-reviewed journal publication; 2) clinical trials; 3) healthy humans; 4) effects of apnoea training; 5) variables included markers of aerobic or anaerobic performance, such as lactate and VO2max.

Results 545 manuscripts were identified following database examination. Only seven studies met the inclusion criteria and were, therefore, included in the meta-analysis. 126 participants were allocated to either voluntary apnoea training (ApT; n = 64) or normal breathing (NB; n = 63). Meta-analysis on the included studies demonstrated that ApT increased the peak blood lactate concentration more than NB (MD = 1.89 mmol*L−1 [95% CI 1.05, 2.73], z = 4.40, p < 0.0001). In contrast, there were no statistically significant effects of ApT on VO2max (MD = 0.89 ml*kg−1*min−1 [95% CI −1.23, 3.01], z = 0.82, p = 0.41).

Conclusion ApT might be an alternative strategy to enhace anaerobic performance associated with increased maximum blood lactate; however, we did not find evidence of ApT effects on physiological aerobic markers, such as VO2max.

Systematic Review Registration: [PRISMA], identifier [registration number].
Transcriptome profiling shows a rapid variety-specific response in two Andigenum potato varieties under drought stress
Authors: Ponce Olga Patricia , Torres Yerisf , Prashar Ankush , Buell Robin , Lozano Roberto , Orjeda Gisella , Compton Lindsey
Published: September 2022

Potato is a drought-sensitive crop whose global sustainable production is threatened by alterations in water availability. Whilst ancestral Solanum tuberosum Andigenum landraces retain wild drought tolerance mechanisms, their molecular bases remain poorly understood. In this study, an aeroponic growth system was established to investigate stress responses in leaf and root of two Andigenum varieties with contrasting drought tolerance. Comparative transcriptome analysis revealed widespread differences in the response of the two varieties at early and late time points of exposure to drought stress and in the recovery after rewatering. Major differences in the response of the two varieties occurred at the early time point, suggesting the speed of response is crucial. In the leaves and roots of the tolerant variety, we observed rapid upregulation of ABA-related genes, which did not occur until later in the susceptible variety and indicated not only more effective ABA synthesis and mobilization, but more effective feedback regulation to limit detrimental effects of too much ABA. Roots of both varieties showed differential expression of genes involved in cell wall reinforcement and remodeling to maintain cell wall strength, hydration and growth under drought stress, including genes involved in lignification and wall expansion, though the response was stronger in the tolerant variety. Such changes in leaf and root may help to limit water losses in the tolerant variety, while limiting the reduction in photosynthetic rate. These findings provide insights into molecular bases of drought tolerance mechanisms and pave the way for their reintroduction into modern cultivars with improved resistance to drought stress and yield stability under drought conditions.
Comparative RNA-seq analysis reveals a critical role for ethylene in rose (Rosa hybrida) susceptible response to Podosphera pannosa
Authors: Liu Xintong , Fang Peihong , Wang Zicheng , Cao Xiaoqian , Yu Zhiyi , Chen Xi , Zhang Zhao
Published: September 2022

Rose is one of the most important ornamental flowers, accounting for approximately one-third of the world’s cut flower market. Powdery mildew caused by Podosphera pannosa is a devastating fungal disease in rose, mainly infecting the young leaves and causing serious economic losses. Therefore, a study on the mechanism of the fungus infecting the rose leaves and the possibility to improve resistance hereby is interesting and meaningful. Accordingly, we conducted transcriptome sequencing of rose leaves infected by P. pannosa at different time points to reveal the molecular mechanism of resistance to powdery mildew. The high-quality reads were aligned to the reference genome of Rosa chinensis, yielding 51,230 transcripts. A total of 1,181 differentially expressed genes (DEGs) were identified in leaves during P. pannosa infection at 12, 24, and 48 hpi. The transcription factors of ERF, MYB, bHLH, WRKY, etc., family were identified among DEGs, and most of them were downregulated during P. pannosa infection. The Kyoto Encyclopedia of Genes and Genomes analysis showed that the hormone signal transduction pathway, especially ethylene signal-related genes, was consistently showing a downregulated expression during powdery mildew infection. More importantly, exogenous 1-MCP (inhibitor of ethylene) treatment could improve the rose leaves’ resistance to P. pannosa. In summary, our transcriptome of rose leaf infected by powdery mildew gives universal insights into the complex gene regulatory networks mediating the rose leaf response to P. pannosa, further demonstrating the positive role of 1-MCP in resistance to biotrophic pathogens.
Plant recognition by AI: Deep neural nets, transformers, and kNN in deep embeddings
Authors: Picek Lukáš , Šulc Milan , Patel Yash , Matas Jiří
Published: September 2022

The article reviews and benchmarks machine learning methods for automatic image-based plant species recognition and proposes a novel retrieval-based method for recognition by nearest neighbor classification in a deep embedding space. The image retrieval method relies on a model trained via the Recall@k surrogate loss. State-of-the-art approaches to image classification, based on Convolutional Neural Networks (CNN) and Vision Transformers (ViT), are benchmarked and compared with the proposed image retrieval-based method. The impact of performance-enhancing techniques, e.g., class prior adaptation, image augmentations, learning rate scheduling, and loss functions, is studied. The evaluation is carried out on the PlantCLEF 2017, the ExpertLifeCLEF 2018, and the iNaturalist 2018 Datasets—the largest publicly available datasets for plant recognition. The evaluation of CNN and ViT classifiers shows a gradual improvement in classification accuracy. The current state-of-the-art Vision Transformer model, ViT-Large/16, achieves 91.15% and 83.54% accuracy on the PlantCLEF 2017 and ExpertLifeCLEF 2018 test sets, respectively; the best CNN model (ResNeSt-269e) error rate dropped by 22.91% and 28.34%. Apart from that, additional tricks increased the performance for the ViT-Base/32 by 3.72% on ExpertLifeCLEF 2018 and by 4.67% on PlantCLEF 2017. The retrieval approach achieved superior performance in all measured scenarios with accuracy margins of 0.28%, 4.13%, and 10.25% on ExpertLifeCLEF 2018, PlantCLEF 2017, and iNat2018–Plantae, respectively.
Can multi-cropping affect soil microbial stoichiometry and functional diversity, decreasing potential soil-borne pathogens? A study on European organic vegetable cropping systems
Authors: Trinchera Alessandra , Migliore Melania , Warren Raffa Dylan , Ommeslag Sarah , Debode Jane , Shanmugam Sindhuja , Dane Sandra , Babry Joran , Kivijarvi Pirjo , Kristensen Hanne Lakkemborg , Lepse Liga , Salo Tapio , Campanelli Gabriele , Willekens Koen
Published: September 2022

Crop diversification in spatial and temporal patterns can optimize the synchronization of nutrients plant demand and availability in soils, as plant diversity and soil microbial communities are the main drivers of biogeochemical C and nutrient cycling. The introduction of multi-cropping in organic vegetable production can represent a key strategy to ensure efficient complementation mediated by soil microbiota, including beneficial mycorrhizal fungi. This study shows the effect of the introduction of multi-cropping in five European organic vegetable systems (South-West: Italy; North-West: Denmark and Belgium; North-East: Finland and Latvia) on: (i) soil physicochemical parameters; (ii) soil microbial biomass stoichiometry; (iii) crop root mycorrhization; (iv) bacterial and fungal diversity and composition in crop rhizosphere; (v) relative abundance of selected fungal pathogens species. In each site, three cropping systems were considered: (1) crop 1—monocropping; (2) crop 2—monocropping; (3) crop 1—crop 2—intercropping or strip cropping. Results showed that, just before harvest, multi-cropping can increase soil microbial biomass amount and shape microbial community toward a predominance of some bacteria or fungi phyla, in the function of soil nutrient availability. We mainly observed a selection effect of crop type on rhizosphere microbiota. Particularly, Bacteroidetes and Mortierellomycota relative abundances in rhizosphere soil resulted in suitable ecological indicators of the positive effect of plant diversity in field, the first ones attesting an improved C and P cycles in soil and the second ones a reduced soil pathogens' pressure. Plant diversity also increased the root mycorrhizal colonization between the intercropped crops that, when properly selected, can also reduce the relative abundance of potential soil-borne pathogens, with a positive effect on crop productivity in long term.
Identification lodging degree of wheat using point cloud data and convolutional neural network
Authors: Li Yunlong , Yang Baohua , Zhou Shuaijun , Cui Qiang
Published: September 2022

Wheat is one of the important food crops, and it is often subjected to different stresses during its growth. Lodging is a common disaster in filling and maturity for wheat, which not only affects the quality of wheat grains, but also causes severe yield reduction. Assessing the degree of wheat lodging is of great significance for yield estimation, wheat harvesting and agricultural insurance claims. In particular, point cloud data extracted from unmanned aerial vehicle (UAV) images have provided technical support for accurately assessing the degree of wheat lodging. However, it is difficult to process point cloud data due to the cluttered distribution, which limits the wide application of point cloud data. Therefore, a classification method of wheat lodging degree based on dimensionality reduction images from point cloud data was proposed. Firstly, 2D images were obtained from the 3D point cloud data of the UAV images of wheat field, which were generated by dimensionality reduction based on Hotelling transform and point cloud interpolation method. Then three convolutional neural network (CNN) models were used to realize the classification of different lodging degrees of wheat, including AlexNet, VGG16, and MobileNetV2. Finally, the self-built wheat lodging dataset was used to evaluate the classification model, aiming to improve the universality and scalability of the lodging discrimination method. The results showed that based on MobileNetV2, the dimensionality reduction image from point cloud obtained by the method proposed in this paper has achieved good results in identifying the lodging degree of wheat. The F1-Score of the classification model was 96.7% for filling, and 94.6% for maturity. In conclusion, the point cloud dimensionality reduction method proposed in this study could meet the accurate identification of wheat lodging degree at the field scale.
Enhancement of nitrogen use efficiency through agronomic and molecular based approaches in cotton
Authors: Chattha Muhammad Sohaib , Ali Qurban , Haroon Muhammad , Afzal Muhammad Junaid , Javed Talha , Hussain Sadam , Mahmood Tahir , Solanki Manoj K. , Umar Aisha , Abbas Waseem , Nasar Shanza , Schwartz-Lazaro Lauren M. , Zhou Lei
Published: September 2022

Cotton is a major fiber crop grown worldwide. Nitrogen (N) is an essential nutrient for cotton production and supports efficient crop production. It is a crucial nutrient that is required more than any other. Nitrogen management is a daunting task for plants; thus, various strategies, individually and collectively, have been adopted to improve its efficacy. The negative environmental impacts of excessive N application on cotton production have become harmful to consumers and growers. The 4R’s of nutrient stewardship (right product, right rate, right time, and right place) is a newly developed agronomic practice that provides a solid foundation for achieving nitrogen use efficiency (NUE) in cotton production. Cropping systems are equally crucial for increasing production, profitability, environmental growth protection, and sustainability. This concept incorporates the right fertilizer source at the right rate, time, and place. In addition to agronomic practices, molecular approaches are equally important for improving cotton NUE. This could be achieved by increasing the efficacy of metabolic pathways at the cellular, organ, and structural levels and NUE-regulating enzymes and genes. This is a potential method to improve the role of N transporters in plants, resulting in better utilization and remobilization of N in cotton plants. Therefore, we suggest effective methods for accelerating NUE in cotton. This review aims to provide a detailed overview of agronomic and molecular approaches for improving NUE in cotton production, which benefits both the environment and growers.
Loot boxes use, video gaming, and gambling in adolescents: Results from a path analysis before and during COVID-19-pandemic-related lockdown in Italy
Authors: Primi Caterina , Sanson Francesco , Vecchiato Marta , Serra Emilia , Donati Maria Anna
Published: September 2022

Loot Boxes (LBs), i.e., virtual items embedded within video games with numerous features reminiscent of gambling, are increasingly widespread among adolescents. LB use is associated with problem gambling in youth, but few studies have been conducted on the association between LB use and gambling behavior considering adolescents. Thus, the mechanisms underlying this relationship are not clear. As LB use is a significant and positive risk factor for video gaming severity, and video gaming is associated with problem gambling, we hypothesized that LB use would be related to gambling frequency and problem gambling through the intermediary role of video gaming frequency and problem video gaming. We tested our hypothesis before COVID-19-pandemic-related lockdown and during COVID-19-pandemic-related lockdown, in Italy. Study 1 was conducted with 1,078 high school students (39% boys, mean age = 16.46, SD = 1.28) before COVID-19-pandemic-related lockdown, and Study 2 was conducted with 1,204 high school students (57% boys, mean age = 15.62, SD = 0.64) during COVID-19-pandemic-related lockdown. A path analysis was carried out to analyze the significance of indirect effects from LB use to gambling behavior and problem gambling through video gaming and problem video gaming. In both the studies, results showed that LB use exerted significant and positive direct effects on video gaming frequency, problem video gaming, and gambling frequency. Moreover, LB use had indirect significant and positive effects on problem gambling through video gaming frequency, problem video gaming, and gambling frequency. Findings attest that LB use can be related to problem gambling through a greater involvement in videogames. Thus, a specific subtype of young gamblers can develop Gambling Disorder symptoms from the use of LBs and through an intense use of video games. Practical implications for prevention and treatment are discussed.
Can extreme experiences enhance creativity? The case of the underwater nightclub
Authors: Richardson Daniel C. , Tagomori Hosana , Devlin Joseph T.
Published: September 2022

Creativity is a valuable commodity. Research has revealed some identifying characteristics of creative people and some of the emotional states that can bring out the most creativity in all of us. It has also been shown that the long-term experience of different cultures and lifestyles that is the result of travel and immigration can also enhance creativity. However, the role of one-off, extreme, or unusual experiences on creativity has not been directly observed before. In part, that may be because, by their very nature, such experiences are very difficult to bring into the laboratory. Here, we brought the tools and empirical methods of the laboratory into the wild, measuring the psychological effects of a unique multisensory experience: an underwater nightclub. We showed – with fully randomized and experimentally controlled conditions – that such an experience boosted measures of divergent thinking in participants. This demonstrates that one element of creativity can be directly enhanced by unusual situations, and that experimental tools of psychology can be used to investigate a range of consumer experiences.
Enhancing older adult financial decision making through the use of self-evaluation worksheets
Authors: Denburg Natalie L. , Collins Sam M. , Garcia Norma P. , Cole Prescott
Published: September 2022

Financial products and options are frequently complex and difficult for consumers to understand, which, alongside positively oriented sales pitches and predatory practices, may lead to uninformed and hazardous financial decisions. While several legal reforms have been implemented to improve consumers’ understanding of financial products, these modifications have only achieved mixed results. An ongoing challenge is the passive nature of such modifications, giving rise to confirmation bias—noticing the information which confirms one’s belief about a product, while ignoring or not paying enough attention to the potential risks. The aim of this study was to test an implementable form of public policy to help older adults successfully navigate these financial decisions. We tested whether a self-evaluation worksheet (in conjunction with a written disclosure), involving an active manipulation of financial content, would significantly impact older adult participants’ responses in an experimental reverse mortgage scenario. Forty community-dwelling, healthy older adults were randomized to one of two conditions: Control Condition (passive manipulation of financial content) and Manipulation Condition (active manipulation of financial content). In addition to completing a comprehensive neuropsychological examination, participants were administered the Reverse Mortgage Task (RM Task). Results indicated that a simple yet active manipulation—imparting accurate and understandable information regarding a complex financial product that must be further manipulated—led to the following among participants in the Manipulation Condition: (1) declines in mood; (2) superior understanding of the financial product; and (3) reduced intention of purchasing the financial product. In order for older adults to be well informed about reverse mortgages, policies must be put in place to ensure that adequate and accurate information has been not only provided but also actively processed by the individual.
Designing narratives and data visuals in comic form for social influence in climate action
Authors: LC Ray , Song Zijing , Sun Yating , Yang Cheng
Published: September 2022

Climate change is difficult to connect with personally, because people only regard the phenomenon as important if it becomes a perceived threat to themselves. Arguments like statistics and policy debates are extrinsic motivators, which do not necessarily align people’s own intrinsic motives with those of climate action. Instead, narratives and visual communication can influence viewers implicitly by the way they show and reinforce actions and thoughts that align with climate action. In this design study, we used comics created for human-level climate change influence to promote ideas like future-based thinking, sharing of responsibility, and caring for each other. We also created data visuals that illustrate future consequences of climate change for the purpose of averting negative alternative realities. To see whether our design can affect audience perception of climate change on the human level of goals and desires, we showed the comics to readers unfamiliar with the themes of the stories, presenting them as manga about characters and situations. The survey showed that data stories can affect the way naive readers interpret narratives to align with pro-climate attitudes such as sharing and future-vision, and that readers are focused on the human-level of the data and story as opposed to the physical resource level. Speculative fiction and data visuals provide a potentially effective way to influence individuals’ climate change attitudes by showing alternative realities and attributes of collective responsibility and planning-for-the-future as data stories.
Knowledge sharing of health technology among clinicians in integrated care system: The role of social networks
Authors: Zeng Zhichao , Deng Qingwen , Liu Wenbin
Published: September 2022

Promoting clinicians’ knowledge sharing of appropriate health technology within the integrated care system (ICS) is of great vitality in bridging the technological gap between member institutions. However, the role of social networks in knowledge sharing of health technology is still largely unknown. To address this issue, the study aims to clarify the influence of clinicians’ social networks on knowledge sharing of health technology within the ICS. A questionnaire survey was conducted among the clinicians in the Alliance of Liver Disease Specialists in Fujian Province, China. Social network analysis was conducted using NetDraw and UCINET, and the quadratic assignment procedure (QAP) multiple regression was used to analyze the influencing factors of knowledge sharing of health technology. The results showed that the ICS played an insufficient role in promoting overall knowledge sharing, especially inter-institutional knowledge sharing. Trust, emotional support, material support, and cognitive proximity positively influenced knowledge sharing of health technology, while the frequency of interaction and relationship importance had a negative impact on it. The finding extended the research scope of social network theory to the field of healthcare and will bridge the evidence gap in the influence of the clinicians’ social networks on their knowledge sharing within the ICS, providing new ideas to boost knowledge sharing and diffusion of appropriate health technology.
Effectiveness of Taijiquan in treating insomnia: A systematic review and meta-analysis of randomized controlled studies
Authors: Han Dongmiao , Cheng Jinling , Qu Jiayang , Wen Xin , Liu Xuejin , Chen Yanfeng , Wen Youliang , Liu Zicai , Liu Huiyu , Huang Ying
Published: September 2022

Background

Sleep efficiency of <80% based on actigraphy was defined as insomnia as self-reported difficulty falling asleep or waking up at night three to four times per week. It is known that adequate sleep is very important for human wellbeing, affecting people's work and life, insomnia will seriously damage our daily life. There is no recognized non-drug treatment. Studies have found that Taijiquan has a positive effect on insomnia patients. This systematic review and meta-analysis will evaluate the effect of Taijiquan on insomnia.

Methods

To find all randomized controlled trials exploring the effects of Taijiquan on insomnia patients in Chinese and English, eight databases (Pubmed, Embase, Cochrane library, Web of Science, CNKI, CBM, VIP, and Wanfang Data) were searched. The retrieval time is from database construction to October 2021. Searches were conducted in both English and Chinese language. A meta-analysis by mean difference (MD) and 95% confidence interval (CI) was performed with RevMan 5.3. The risk of bias for each study was accounted for according to the Cochrane Handbook. Our primary outcome was Pittsburg Sleep Quality Index. We explored sources of heterogeneity by comparing effect sizes across different types of etiology, country, control group, and intervention type. The protocol was pre-registered with PROSPERO, CRD42021284511.

Results

Twenty-one RCTs published between 2004 and 2021 with 2,022 participants were included in this study. Twenty-one randomized controlled studies showed that Tai Chi significantly improved PSQI scores in patients with cancer, muscle fibrosis, and sub-health insomnia [MD = −1.16, 95% CI (−1.62, −0.71), P < 0.01]; There is insufficient evidence of improvement in patients with cerebrovascular disease [MD = −0.54, 95% CI (−1.58, 0.51), P = 0.31]; 8-form, 10-form or 24-form Yang's Taijiquan had the same effect in improving PSQI [MD = −1.33, 95% CI (−1.85, −0.81), P < 0.01]. When there is no treatment, exercise, exercise and health education as the control, taijiquan has a significant effect on insomnia treatment, and there is no difference in efficacy compared with cognitive behavioral therapy and health education (usual care) alone.

Conclusions

The results of the study showed that Taijiquan significantly improved sleep quality in healthy adults and patients with chronic diseases, which suggests that Taijiquan may be considered as an alternative behavioral therapy in the treatment of insomnia. In the future, more high-quality, well-controlled randomized trials are needed to better inform clinical decisions.
Studies on endoscopic submucosal dissection in the past 15 years: A bibliometric analysis
Authors: Wu Deqing , Jia Mengyu , Zhou Shu , Xu Xiaorong , Wu Meiqin
Published: September 2022

Background and aims

Endoscopic submucosal dissection (ESD) is an advanced minimally invasive technique for en bloc resection of superficial gastrointestinal lesions, which is drawn an increasing attention from its emergence. This bibliometric analysis is to evaluate the origin, current hotspots, and research trends on ESD.

Methods

A total of 2,131 publications on ESD from 2006 to 2020 were obtained from the Web of Science Core Collection (WoSCC) database. Bibliometric visualization analyses of countries/regions, institutes, authors, journals, references and keywords were performed by CiteSpace V.5.8.R3.

Results

The quantity of publications on ESD increased significantly during the past 15 years. Japan occupied the leading position in terms of research power. Professor Yutaka Saito, together with the institute he belongs, the Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan, were the most productive author and institute, respectively. Colorectal ESD led the main thematic concentrations in ESD research. The most prolific journal was Gastrointestinal Endoscopy. European ESD Guideline was the most frequently co-cited reference. Guideline, meta-analysis, endoscopic resection, poly-glycolic acid sheet, Barrett's esophagus, fibrin glue, risk and colorectal neoplasm will be the active research hotspots in the future.

Conclusions

These findings provide the trends and frontiers in the field of ESD, as well as valuable information for clinicians and scientists to discover the future perspectives with potential collaborators.
The behavioral intention to adopt mobile health services: The moderating impact of mobile self-efficacy
Authors: Mensah Isaac Kofi , Zeng Guohua , Mwakapesa Deborah Simon
Published: September 2022

This study explored the moderating impact of mobile self-efficacy on the adoption of mobile health services. The UTAUT was used as the theoretical foundation for this study. The results have indicated that mobile self-efficacy was significant in moderating the impact of both performance expectancy (β = −0.005, p < 0.05) and effort expectancy (β = −010, p < 0.05) on the adoption of mobile health services. In addition, it was revealed to our surprise that both performance (β = 0.521, t = 9.311, p > 0.05) and effort expectancy (β = 0.406, t = 7.577, p > 0.05) do not determine the behavioral intention to use mobile health services. Effort expectancy and behavioral intention to use were also, respectively, not significant in influencing performance expectancy (β = 0.702, t = 12.601, p > 0.05) and intention to recommend the adoption of mobile health services (β = 0.866, t = 13.814, p > 0.05). Mobile self-efficacy, however, was found to significantly predict the citizen's intention to recommend the adoption of mobile health services (β = 0.139, t = 2.548, p < 0.05). The implications of these findings on mobile health are discussed.
Association of extreme precipitation with hospitalizations for acute myocardial infarction in Beijing, China: A time-series study
Authors: Chen Yuxiong , Chang Zhen'ge , Zhao Yakun , Liu Yanbo , Fu Jia , Liu Yijie , Liu Xiaole , Kong Dehui , Han Yitao , Tang Siqi , Fan Zhongjie
Published: September 2022

Background

In the context of global climate changes, increasing extreme weather events have aroused great public concern. Limited evidence has focused on the association between extreme precipitation and hospitalizations for acute myocardial infarction (AMI). Our study aimed to examine the effect of extreme precipitation on AMI hospitalizations.

Methods

Daily AMI hospitalizations, weather variables and air pollution data in Beijing from 2013 to 2018 were obtained. We used a time-series analysis with a distributed lag model to evaluate the association of extreme precipitation (≥95th percentile of daily precipitation) with AMI hospitalizations. Subgroup analysis was conducted to identify the vulnerable subpopulations and further assessed the attributable burden.

Results

Extreme precipitation increased the risk of AMI hospitalizations with significant single-day effects from Lag 4 to Lag 11, and the maximum cumulative effects at Lag 0–14 (CRR = 1.177, 95% CI: 1.045, 1.326). Older people (≥65 years) and females were more vulnerable to extreme precipitation. The attributable fraction and numbers of extreme precipitation on AMI hospitalizations were 0.68% (95% CI: 0.20%, 1.12%) and 854 (95% CI: 244, 1,395), respectively.

Conclusion

Extreme precipitation is correlated with a higher risk of AMI hospitalizations. The elderly (≥65 years) and females are more susceptible to AMI triggered by extreme precipitation.
Paediatric biobanking for health: The ethical, legal, and societal landscape
Authors: Casati Sara , Ellul Bridget , Mayrhofer Michaela Th. , Lavitrano Marialuisa , Caboux Elodie , Kozlakidis Zisis
Published: September 2022

Biobanks play a central role in pediatric translational research, which deals primarily with genetic data from sample-based research. However, participation of children in biobanking has received only limited attention in the literature, even though research in general and in clinical trials in particular have a long history in involving minors. So, we resolved to explore specific challenging ethical, legal, and societal issues (ELSI) in the current pediatric biobanking landscape to propose a way forward for biobanking with children as partners in research. Methodologically, we first established the accessibility and utilization of pediatric biobanks, mainly in Europe. This was supported by a literature review related to children's participation, taking into account not only academic papers but also relevant guidelines and best-practices. Our findings are discussed under five themes: general vulnerability; ethical issues—balancing risks and benefits, right to an open future, return of results including secondary findings; legal issues—capacity and legal majority; societal issues—public awareness and empowerment; and responsible research with children. Ultimately, we observed an on-going shift from the parents'/guardians' consent being a sine-qua-non condition to the positive minor's agreement: confirming that the minor is the participant, not the parent(s)/guardian(s). This ethical rethinking is paving the way toward age-appropriate, dynamic and participatory models of involving minors in decision-making. However, we identified a requirement for dynamic tools to assess maturity, a lack of co-produced engagement tools and paucity of shared best practices. We highlight the need to provide empowerment and capability settings to support researchers and biobankers, and back this with practical examples. In conclusion, equipping children and adults with appropriate tools, and ensuring children's participation is at the forefront of responsible pediatric biobanking, is an ethical obligation, and a cornerstone for research integrity.
Massive health education through technological mediation: Analyses and impacts on the syphilis epidemic in Brazil
Authors: Caitano Alexandre R. , Gusmão Cristine M. G. , Dias-Trindade Sara , Barbalho Ingridy M. P. , Morais Philippi Sedir G. , Caldeira-Silva Gleyson J. P. , Romão Manoel H. , Valentim Janaína L. R. S. , Dias Aline P. , Alcoforado Joaquim L. M. , Oliveira Carlos A. P. , Coutinho Karilany D. , Rêgo Maria C. F. D. , Valentim Ricardo A. M.
Published: September 2022

With syphilis cases on the rise, Brazil declared an epidemic in 2016. To address the consequent public health crisis, the Ministry of Health laid out a rapid response plan, namely, the “Syphilis No!” Project (SNP), a national instrument to fight the disease which encompasses four dimensions: (a) management and governance, (b) surveillance, (c) comprehensive care, and (d) strengthening of educommunication. In the dimension of education, the SNP developed the learning pathway “Syphilis and other Sexually Transmitted Infections (STIs)” to strengthen and promote Health Education. This pathway features 54 Massive Open Online Courses (MOOCs), delivered through the Virtual Learning Environment of the Brazilian Health System (AVASUS). This paper analyzes the impacts of the learning pathway “Syphilis and other STIs” on the response to the epidemic in Brazil, highlighting the educational process of the learning pathway and its social implications from the perspective of the United Nations' 2030 Agenda and its Sustainable Development Goals. Three distinct databases were used to organize the educational data: the learning pathway “Syphilis and other STIs” from AVASUS, the National Registry of HealthCare Facilities from the Brazilian Ministry of Health (MoH), and the Brazilian Occupation Classification, from the Ministry of Labor. The analysis provides a comprehensive description of the 54 courses of the learning pathway, which has 177,732 enrollments and 93,617 participants from all Brazilian regions, especially the Southeast, which accounts for the highest number of enrollees. Additionally, it is worth noting that students living abroad also enrolled in the courses. Data characterization provided a demographic study focused on the course participants' profession and level of care practiced, revealing that the majority (85%) worked in primary and secondary healthcare. These practitioners are the target audience of the learning pathway and, accordingly, are part of the personnel directly engaged in healthcare services that fight the syphilis epidemic in Brazil.
Respectful maternity care among women who gave birth at public hospitals in Hadiya Zone, Southern Ethiopia
Authors: Mengistie Tilahun , Mulatu Teshale , Alemayehu Afework , Yadeta Tesfaye Assebe , Dheresa Merga
Published: September 2022

Background

A compassionate and respectful care during pregnancy and childbirth is one of the essential components of safe motherhood. However, most of the women in developing countries experience disrespectful and abusive maternity care during childbirth. Hence, this study assessed the status of respectful maternity care and associated factors to bridge the gap.

Methodology

Facility-based cross-sectional study was conducted among mothers who delivered in public Hospitals in the Hadiya Zone, South Ethiopia from March 01 to 30, 2020. Data were collected using a pretested questionnaire through face-to-face interviews. Descriptive statistics was computed and multivariable logistic regression was fitted to identify predictors. Adjusted Odds Ratio (AOR) with 95% Confidence Interval was used to show the strength of association and level of significance was declared at P-value < 0.05.

Result

This study showed that 67.8 % (95% CI: 62.4–70.8%) of mothers received respectful maternal care. Being married [AOR: 2.17, 95% CI (1.03–6.93)], Cesarean section delivery [AOR: 2.48, 95% CI (1.03–5.97)], and absence of complications during child birth [AOR: 4.37, 95% CI (1.41–13.56)], were significantly associated with respectful maternity care.

Conclusions

The level of RMC in this study was moderate. Being married, Cesarean section delivery, and absence of complications during child birth were identified predictors of respectful maternity care. Therefore, tailored interventions aimed at improving respectful maternity care should target unmarried women, and women with complications of labor regardless of mode of delivery.
Can supplementary private health insurance further supplement health
Authors: Chen Xinlin , Guo Dandan , Tan Huawei , Zhang Yunfan , Liu Yanchen , Chen Xinlan , Chen Yingchun
Published: September 2022

Background

China advocates a health insurance system with social health insurance (SHI) as the main body and private health insurance (PHI) as the supplement. The study of PHI's complementary role in health is conducive to providing evidence for PHI's policy expansion and encouraging the public to participate in PHI, which is insufficient in China.

Methods

We used the three-wave balanced panel data of the China Health and Retirement Longitudinal Survey (CHARLS). Taking the ownership of supplementary PHI as the independent variable and EQ-5D index scores as the dependent variable, the panel instrumental variable (IV) method was used to analyze the impact of participation in PHI on health. We also assessed the heterogeneity of the health effects of PHI between chronic and non-chronic disease groups and between low- and high-income groups.

Results

The coverage rate of PHI at baseline was 10.53%. The regression results showed that participating in PHI on the basis of SHI could result in an additional 8.21% health gain (p < 0.001). At the same time, PHI had greater health gain for chronic disease population than for healthy population (9.25 vs. 6.24%, p < 0.001), and greater health gain for high-income population than for low-income population (8.32 vs. 5.31%, p < 0.001).

Conclusion

Participating in supplementary PHI can effectively enhance the health status of the insured, and has a more significant effect on patients with chronic diseases. The development of PHI should be further supported, while the health inequality in different income groups should be paid attention to.