bluuebunny/crossref_metadata_2025 huggingface dataset:
Psycho-social and health predictors of loneliness in older primary care patients and mediating mechanisms linking comorbidities and loneliness
Authors: Trtica Ljiljana Majnarić , Volarić Mile , Kurevija Tomislav , Mihaljević Silvio , Dupan Zdravka Krivdić , Wittlinger Thomas
Published: December 2023

Background

Aging is associated with many personal, social, and environmental challenges that increase the risk of loneliness. Loneliness is a painful emotional experience associated with a perceived lack of connection and intimacy. Loneliness accelerates health deterioration, but the presence of chronic health conditions (comorbidities) in older individuals may potentiate the feeling of loneliness. The relationships between health status and loneliness in older individuals have not been assessed in an integrated manner, although it is necessary for planning efficient interventions. The aim of this study was to fill in this knowledge gap, by attempting to create an integrated model of loneliness in older individuals.

Methods

The sample consisted of 189 (58% F) older individuals (> 60 years) (mean ± SD, 78.47 ± 6.65), attendees in Primary Health Care. Different factors associated with loneliness in the older population were assessed, and classified as demographic, environmental, physical (health-related), and psychological, in addition to functional abilities. A set of standard questionnaires was used to assess psychological factors and functional abilities. The hierarchical regression model assessed the effect of particular blocks of factors on status loneliness. The second aim was to analyze how psychological factors mediate associations between health status (comorbidity level) and loneliness.

Results

Indicated that increasing comorbidity, anxiety, lack of positive moods, not having hobbies/activities, low perception of social support, impaired cognitive function, and suppression of emotion expression, are significant predictors of loneliness. Mediation analysis informed us of how to help patients with comorbidities feel less lonely. Interventions that were suggested were those that can reduce anxiety and depression, improve cognitive abilities and emotional regulation control, and enhance social support.

Conclusions

Results can help understand the pathophysiology loops linking poor health status (comorbidity level) of older individuals and loneliness, and have significant potentials from the translational perspectives, as a decision-support tool.
Impact of the Exercise Right for Active Ageing program on physical function in older adults: a quasi-experimental pre-post study
Authors: Ekegren Christina , Skouteris Helen , Ayton Darshini , Soh Sze-Ee
Published: December 2023

Background

The Exercise Right for Active Ageing (ERAA) program was established to improve access to exercise classes for community-dwelling older Australians. The aims of this study were to determine whether older adults, who participated in ERAA exercise classes experienced a change in physical function, and identify factors associated with this change.

Methods

Participants included community-dwelling older adults, aged ≥ 65 years, from every state and territory of Australia. The ERAA program included 12 subsidised, weekly, low- to moderate-intensity exercise classes, delivered by accredited exercise scientists or physiologists (AESs/AEPs). Primary outcomes included the 30 s Sit-to-Stand (STS) and the 3-metre Timed Up and Go (TUG) tests. Secondary outcomes included grip strength, the Chair Sit and Reach test, and waist circumference. Linear mixed-effects regression models were used to evaluate the change in outcomes following program completion, and to determine factors associated with changes in the primary outcomes.

Results

3,582 older adults (77% female) with a median (IQR) age of 72 (69–77) years completed follow-up testing. For all primary and secondary outcomes, there was a statistically significant improvement after program completion (p < 0.001). The STS increased by 2.2 repetitions (95% CI: 2.1, 2.3), the TUG decreased by 0.9 s (95% CI: -1.0, -0.8), right and left grip strength increased by 1.3 kg (95% CI: 1.2, 1.5) and 1.5 kg (95% CI: 1.3, 1.6), respectively, right and left reach increased by 1.7 cm (95% CI: 1.4, 2.0), and waist circumference decreased by 1.2 cm (95% CI: -1.4, -1.1). Greater improvements in STS were observed for participants aged 65–69 years, females, and those with greater socio-economic disadvantage. For the TUG, greater improvements were observed in participants reporting 2 + comorbidities, and residing in outer regional areas and areas with greater socio-economic disadvantage.

Conclusions

Participation of older Australians in the ERAA program, led to statistically significant improvements in physical function. The program reached a large number of older Australians from every state and territory, including those from regional and remote parts of Australia, aged over 85 years, and with high levels of comorbidity, which supports the feasibility and acceptability of AES- and AEP-led exercise classes amongst community-dwelling older Australians.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12623000483651). Registered 12 May 2023 - Retrospectively registered,https://www.anzctr.org.au/ACTRN12623000483651.aspx.
Comparative effectiveness of tocilizumab vs standard care in patients with severe COVID-19-related pneumonia: a retrospective cohort study utilizing registry data as a synthetic control
Authors: Uemura Yukari , Ozaki Ryoto , Shinozaki Tomohiro , Ohtsu Hiroshi , Shimizu Yousuke , Izumi Kazuo , Saito Sho , Matsunaga Nobuaki , Ohmagari Norio
Published: December 2023

Background

The severity of coronavirus disease 2019 (COVID-19) infections has led to the development of several therapeutic agents, with tocilizumab becoming increasingly used to treat patients with COVID-19-related pneumonia. This study compared the use of tocilizumab treatment with the standard of care (SOC) to determine its efficacy against severe COVID-19-related pneumonia in Japan.

Methods

This retrospective cohort study was designed to evaluate the efficacy of tocilizumab in two different databases: the JA42434 single-arm study and COVID-19 Registry Japan (COVIREGI-JP), with a synthetic control group from the COVIREGI-JP cohort as a benchmark for the tocilizumab group. The study’s primary objective was to evaluate the efficacy of tocilizumab in treating severe COVID-19-related pneumonia compared to the SOC among patients included in the above two databases. The SOC group was extracted as the synthetic control group using exact matching and a propensity score matching in sequence per subject. As a secondary objective, the efficacy of tocilizumab compared to the SOC was evaluated exclusively among patients included in the COVIREGI-JP database. In each objective, the primary endpoint was defined as the time to discharge or the status of awaiting discharge.

Results

For the primary endpoint, the hazard ratio (HR) of the tocilizumab group against the SOC group was 1.070 (95% confidence interval [CI]: 0.565–2.028). The median time from Study Day 1 to discharge or the state of awaiting discharge was 15 days in the tocilizumab group and 16 days in the SOC group. The HRs for the secondary endpoints, namely, time to improvement in the clinical state, time to clinical failure, and time to recovery, were 1.112 (95% CI: 0.596–2.075), 0.628 (95% CI: 0.202–1.953), and 1.019 (95% CI: 0.555–1.871), respectively. Similarly, the HR of the primary endpoint for the secondary objective was 0.846 (95% CI: 0.582–1.230).

Conclusions

Tocilizumab did not demonstrate a positive effect on time to discharge or the state of awaiting discharge. Furthermore, no statistically significant differences in other clinical outcomes, such as time to improvement in the clinical state, time to clinical failure, and time to recovery, were observed among the groups.
Incidental multiple myeloma in a patient with neuroretinitis: a case report
Authors: Joo Taesung , Kim Tae Gi , Moon Sang Woong
Published: December 2023

Background

Neuroretinitis is classically defined as a clinical triad of unilateral, painless vision loss, accompanied by optic disc edema and characteristic macular star formation. The causes of neuroretinitis can be categorized as infectious, non-infectious, and idiopathic, therefore differential diagnosis and careful evaluation are required, owing to the various etiologies and masqueraders.

Case presentation

A 54-year-old woman presented to the clinic with blurred vision in both eyes. A complete ophthalmic examination revealed optic disc edema with blurred margins and macular exudates, intraretinal edema in the temporal peripapillary area, and subretinal fluid with neurosensory retinal detachment in the macular area. Systemic laboratory investigations showed no signs of infection or inflammation. However, bone marrow suppression was suspected based on the results of the complete blood count test, and the patient was diagnosed with multiple myeloma.

Conclusion

Although neuroretinitis is rarely accompanied by hematological malignancy, it is important to be mindful of the latter because ophthalmic manifestations are a common feature of hematological malignancies and lesions occur in nearly every ocular structure.
Acceptability of a hypothetical dengue vaccine and the potential impact of dengue vaccination on personal vector control behavior: a qualitative study in Fortaleza, Brazil
Authors: Scott Valerie K. , Pinheiro Maria Suelly Nogueira , Machado Marcia Maria Tavares , Castro Marcia C.
Published: December 2023

Background

Dengue is the most rapidly spreading viral vector-borne disease in the world. Promising new dengue vaccines have contributed to a growing consensus that effective dengue control will require integrated strategies of vaccination and vector control. In this qualitative study, we explored the perspectives of residents of Fortaleza, Brazil on acceptability of a hypothetical safe and effective dengue vaccine, specific drivers of dengue vaccine acceptance or hesitance, and the expected impact of dengue vaccination on their personal vector control practices.

Methods

A total of 43 in-depth interviews were conducted from April to June 2022 with Fortaleza residents from a diverse range of educational and professional backgrounds, with and without recent personal experiences of symptomatic dengue infections. Data were analyzed using the principles of inductive grounded theory methodology.

Results

Our findings indicate that knowledge of dengue transmission, symptoms, and prevention methods was strong across respondents. Respondents described willingness to accept a hypothetical dengue vaccine for themselves and their children, while emphasizing that the vaccine must be demonstrably safe and effective. Respondents expressed diverse perspectives on how receiving a safe and effective dengue vaccine might influence their personal vector control behaviors, relating these behaviors to their perception of risk from other Aedes mosquito-carried infections and beliefs about the role of vector control in maintaining household cleanliness.

Conclusions

Our study findings provide community-level perspectives on dengue vaccination and its potential impact on personal vector control behavior for policymakers and program managers in Fortaleza to consider as new dengue vaccines become available. With the introduction of any new dengue vaccine, community perspectives and emerging concerns that may drive vaccine hesitancy should be continuously sought out. Improved urban infrastructure and efforts to engage individuals and communities in vector control may be needed to optimize the impact of future dengue vaccinations and prevent rising cases of other arboviruses such as Zika and chikungunya.
Birth outcomes and early growth patterns associated with age at adiposity rebound: the Ma’anshan birth cohort (MABC) study
Authors: Zhou Jixing , Teng Yuzhu , Zhang Shanshan , Yang Mengting , Yan Shuangqin , Tao Fangbiao , Huang Kun
Published: December 2023

Objective

Early onset of adiposity rebound (AR) is considered an early indicator of obesity risk. Our objective was to investigate the association of birth outcomes and early physical growth patterns with early AR in children.

Methods

Study subjects (n = 2705) were enrolled from the Ma’anshan birth cohort (MABC). The body mass index (BMI), head circumference, waist circumference, and body fat were collected. Rapid weight gain (RWG) was defined by the change in weight standard-deviation score in the first two years of life. Group-based trajectory modeling (GBTM) was used to determine children’s physical growth trajectories. The age of AR was fitted using fractional polynomial function models.

Results

Children with very high BMI trajectories (RR = 2.83; 95% CI 2.33 to 1.40), rising BMI trajectories (RR = 3.15; 95% CI 2.66 to 3.72), high waist circumference trajectories (RR = 4.17; 95% CI 3.43 to 5.06), and high body fat trajectories (RR = 3.01; 95% CI 2.62 to 3.46) before 72 months of age were at a greater risk of experiencing early AR. Low birth weight (LBW) (RR = 1.86; 95% CI 1.28 to 2.51), preterm birth (PTB) (RR = 1.50; 95% CI 1.17 to 1.93), and small for gestational age (SGA) (RR = 1.37; 95% CI 1.14 to 1.64) associated with increased risk of early AR. Moreover, infants experiencing RWG (RR = 1.59; 95% CI 1.40 to 1.83), low BMI trajectories (RR = 1.27; 95% CI 1.06 to 1.53) and rising BMI trajectories (RR = 1.50; 95% CI 1.22 to 1.84) in the first two years were at higher risk of developing early AR subsequently. Compared to the group with non-early AR, the BMI of children with early AR tended to be lower first (from birth to 6 months of age) and then higher (from 18 to 72 months of age).

Conclusions

Children with overall high BMI, high waist circumference, and high body fat before 72 months of age are more likely to experience early AR, but infants with low BMI trajectories, rising BMI trajectories and infants experiencing RWG in the first two years of life similarly increase the risk of early AR. These results can help to understand the early factors and processes that lead to metabolic risks.
Exploring the microbial diversity and characterization of cellulase and hemicellulase genes in goat rumen: a metagenomic approach
Authors: Thapa Santosh , Zhou Suping , O’Hair Joshua , Al Nasr Kamal , Ropelewski Alexander , Li Hui
Published: December 2023

Background

Goat rumen microbial communities are perceived as one of the most potential biochemical reservoirs of multi-functional enzymes, which are applicable to enhance wide array of bioprocesses such as the hydrolysis of cellulose and hemi-cellulose into fermentable sugar for biofuel and other value-added biochemical production. Even though, the limited understanding of rumen microbial genetic diversity and the absence of effective screening culture methods have impeded the full utilization of these potential enzymes. In this study, we applied culture independent metagenomics sequencing approach to isolate, and identify microbial communities in goat rumen, meanwhile, clone and functionally characterize novel cellulase and xylanase genes in goat rumen bacterial communities.

Results

Bacterial DNA samples were extracted from goat rumen fluid. Three genomic libraries were sequenced using Illumina HiSeq 2000 for paired-end 100-bp (PE100) and Illumina HiSeq 2500 for paired-end 125-bp (PE125). A total of 435gb raw reads were generated. Taxonomic analysis using Graphlan revealed that Fibrobacter, Prevotella, and Ruminococcus are the most abundant genera of bacteria in goat rumen. SPAdes assembly and prodigal annotation were performed. The contigs were also annotated using the DOE-JGI pipeline. In total, 117,502 CAZymes, comprising endoglucanases, exoglucanases, beta-glucosidases, xylosidases, and xylanases, were detected in all three samples. Two genes with predicted cellulolytic/xylanolytic activities were cloned and expressed in E. coli BL21(DE3). The endoglucanases and xylanase enzymatic activities of the recombinant proteins were confirmed using substrate plate assay and dinitrosalicylic acid (DNS) analysis. The 3D structures of endoglucanase A and endo-1,4-beta xylanase was predicted using the Swiss Model. Based on the 3D structure analysis, the two enzymes isolated from goat’s rumen metagenome are unique with only 56–59% similarities to those homologous proteins in protein data bank (PDB) meanwhile, the structures of the enzymes also displayed greater stability, and higher catalytic activity.

Conclusions

In summary, this study provided the database resources of bacterial metagenomes from goat’s rumen fluid, including gene sequences with annotated functions and methods for gene isolation and over-expression of cellulolytic enzymes; and a wealth of genes in the metabolic pathways affecting food and nutrition of ruminant animals.
Efficacy of Kinesio taping in post operative sequalae after surgical removal of mandibular third molars: a split mouth randomized control study
Authors: Patil Sneha , K. Rajanikanth , Bhola Nitin
Published: December 2023

Background

The surgical removal of impacted lower third molars produces a significant degree of trauma to the soft tissue and bony structures of the oral cavity, which can initiate considerable inflammatory reaction. Consequently, patient experiences pain, swelling, hemorrhage, nerve paraesthesia, limited mouth opening etc. The kinesiologic tape (KT) can help with blood and lymphatic circulation and has shown acceptable outcomes in reducing pain and in managing post-operative muscle spasm.

Methodology

The study was aimed to compare the effects of kinesiologic tape on post operative pain, swelling and trismus following surgical removal of mandibular third molar when compared to control group. 15 patients with bilaterally impacted mandibular third molar were included in the split mouth study. One side was randomly assigned as Group A where patient’s face was subjected to Kinesio tape application post extraction. The other was Group B where Kinesio tape was not applied. After extraction each patient was evaluated in terms of post op pain, swelling and trismus in post-op day 1,2 and 7th.

Results

The pain was found to be significantly less (p = 0.042) in group A when compared to group B on the first day. The mean pain was 5.07 in KT group and 6.20 in No KT group on day 2nd. Post OP Swelling was statistically significantly less (p < 0.01) in Group A on 2nd & 3rd day. The postoperative mouth opening was more from the 2nd day in group A with mean of 26.07 mm and 20.33 mm in group B (p < 0.01).

Conclusion

The kinesiologic taping originates from sports medicine, but can also used therapeutically for reducing post operative sequelae as demonstrated in our study. Kinesiologic tape (KT) enables patients to have a comfortable time post-operatively and helps to regain better quality of life.

Trial registration

Registered in Clinical Trial Registry—India.

Registration number—CTRI/2021/05/033359, registration date – 04/05/2021.
Breast cancer survival after mammography dissemination in Brazil: a population-based analysis of 2,715 cases
Authors: Fernandes Juliana O. , Machado Beatriz F. , Cardoso-Filho Cassio , Nativio Juliana , Cabello Cesar , Vale Diama B.
Published: December 2023

Background

This study aims to assess breast cancer survival rates after one decade of mammography in a large urban area of Brazil.

Methods

It is a population-based retrospective cohort of women with breast cancer in Campinas, São Paulo, from 2010 to 2014. Age, vital status and stage were accessed through the cancer and mortality registry, and patients records. Statistics used Kaplan–Meier, log-rank and Cox's regression.

Results

Out of the 2,715 cases, 665 deaths (24.5%) were confirmed until early 2020. The mean age at diagnosis was 58.6 years. Women 50–69 years were 48.0%, and stage I the most frequent (25.0%). The overall mean survival was 8.4 years (8.2–8.5). The 5-year survival (5yOS) for overall, 40–49, 50–59, 60–69, 70–79 years was respectively 80.5%, 87.7%, 83.7%, 83.8% and 75.5%. The 5yOS for stages 0, I, II, III and IV was 95.2%, 92.6%, 89.4%, 71.1% and 47.1%. There was no significant difference in survival in stage I or II (p = 0.058). Compared to women 50–59 years, death's risk was 2.3 times higher for women 70–79 years and 26% lower for women 40–49 years. Concerning stage I, the risk of death was 1.5, 4.1 and 8.6 times higher, and 34% lower, respectively, for stage II, III, IV and 0.

Conclusions

In Brazil, breast cancers are currently diagnosed in the early stages, although advanced cases persist. Survival rates may reflect improvements in screening, early detection and treatment. The results can reflect the current status of other regions or countries with similar health care conditions.
Diosbulbin C, a novel active ingredient in Dioscorea bulbifera L. extract, inhibits lung cancer cell proliferation by inducing G0/G1 phase cell cycle arrest
Authors: Zhu Zhiyu , Liu Yanfen , Zeng Jiangping , Ren Shuyi , Wei Lu , Wang Fei , Sun Xiaoyu , Huang Yufei , Jiang Haiyang , Sui Xinbing , Jin Weiwei , Jin Lijun , Sun Xueni
Published: December 2023

Background

Despite the critical progress of non-small cell lung cancer (NSCLC) therapeutic approaches, the clinical outcomes remain considerably poor. The requirement of developing novel therapeutic interventions is still urgent. In this study, we showed for the first time that diosbulbin C, a natural diterpene lactone component extracted from traditional Chinese medicine Dioscorea bulbifera L., possesses high anticancer activity in NSCLC.

Methods

A549 and NCI-H1299 cells were used. The inhibitory effects of the diosbulbin C on NSCLC cell proliferation were evaluated using cytotoxicity, clone formation, EdU assay, and flow cytometry. Network pharmacology methods were used to explore the targets through which the diosbulbin C inhibited NSCLC cell proliferation. Molecular docking, qRT-PCR, and western blotting were used to validate the molecular targets and regulated molecules of diosbulbin C in NSCLC.

Results

Diosbulbin C treatment in NSCLC cells results in a remarkable reduction in cell proliferation and induces significant G0/G1 phase cell cycle arrest. AKT1, DHFR, and TYMS were identified as the potential targets of diosbulbin C. Diosbulbin C may inhibit NSCLC cell proliferation by downregulating the expression/activation of AKT, DHFR, and TYMS. In addition, diosbulbin C was predicted to exhibit high drug-likeness properties with good water solubility and intestinal absorption, highlighting its potential value in the discovery and development of anti-lung cancer drugs.

Conclusions

Diosbulbin C induces cell cycle arrest and inhibits the proliferation of NSCLC cells, possibly by downregulating the expression/activation of AKT, DHFR, and TYMS.
Physicians’ self-perceived preparedness for clinical supervision of medical students at university and non-university hospitals -results from a Swedish survey
Authors: Pålsson Paul , Hulegårdh Erik , Wahlqvist Mats , Naredi Silvana , Jood Katarina
Published: December 2023

Background

The need for clinical placements outside traditional teaching hospitals for medical students is growing, both due to a decrease in hospital beds and the expansion of medical students. In this survey, distributed to supervisors at university and non-university hospitals, we investigated supervisors’ self-perceived preparedness for the training assignment and searched for factors associated with self-perceived pedagogical knowledge and familiarity with the students’ learning objectives.

Methods

A pilot survey was developed using results from qualitative studies regarding clinical supervision of medical students and included questions on the supervisors’ education and preparation, if they were familiar with the students’ learning objectives, self-perceived pedagogical knowledge, and characteristics of the learning environment. The pilot survey was tested on a smaller group of supervisors. The results from the pilot survey were used to develop an e-survey that was distributed to all hospital employed physicians in Region Västra Götaland.

Results

The survey was completed by 1732 physicians (response rate 43%). Among 517 respondents at the university hospital who reported activity as supervisor, 240 (46%) had attended preparatory supervisor training, 423 (82%) perceived enough pedagogical knowledge for the teaching assignment, and 391 (76%) reported familiarity with the learning objectives. The corresponding proportions at non-university hospitals were 159/485 (33%), 363/485 (75%), and 298/485 (61%), respectively (p ≤ .007 all through, compared to the university hospital). Perceiving that goal description and written information from the course management was sufficient for being able to complete the training assignment showed strong association with both self-perceived pedagogical knowledge and familiarity with the students’ learning objectives.

Conclusions

We found consistent differences between university and non-university hospitals with respect to the supervisors’ self-perceived preparedness for the training assignment. Efforts to convey the learning objectives and support to clinical supervisors are crucial for supervision of students at non-university hospitals.
Rationing of nursing care in Internal Medicine Departments—a cross-sectional study
Authors: Jędrzejczyk Maria , Guzak Beata , Czapla Michał , Ross Catherine , Vellone Ercole , Juzwiszyn Jan , Chudiak Anna , Sadowski Mikołaj , Uchmanowicz Izabella
Published: December 2023

Background

Implicit rationing of nursing care refers to a situation in which necessary nursing care is not performed to meet all of the patients’ needs.

Purpose

To examine the factors influencing the rationing of nursing care, nurses’ assessment of the quality of patient care, and their job satisfaction in Internal Medicine Departments.

Methods

A cross-sectional descriptive study was undertaken. The study included 1164 nurses working in the Internal Medicine Departments in 8 hospitals (Lower Silesia, Poland). The Perceived Implicit Rationing of Nursing Care instrument was used.

Results

Respondents rarely ration nursing care, with a mean score of 1.12 (SD = 0.68). The mean score for quality of patient care was 6.99 (SD = 1.92). In contrast, the mean job satisfaction score was 6.07 points (SD = 2.22). The most important predictors of high rates of rationing of nursing care were work experience of 16–20 years (regression parameter: 0.387) and a Bachelor’s degree in nursing (regression parameter: 0.139). Nurses’ assessment of the quality of patient care ratings were increased by having a Master’s degree in nursing (regression parameter: 0.41), and significantly decreased by work experience of 16–20 years (regression parameter: -1.332). Independent predictors of job satisfaction ratings in both univariate and multivariate analysis were Master’s degree and long-shift working patterns.

Conclusion

The factors that influence an increased level of nursing care rationing on medical wards are nurse seniority, exceeding 16 years and female gender. Obtaining a Master’s degree in nursing indicates improved nurses’ assessment of the quality of patient care.
Job embeddedness and missed nursing care at the operating theatres: the mediating role of polychronicity
Authors: El-Sayed Ahmed Abdelwahab Ibrahim , Asal Maha Gamal Ramadan , Shaheen Rabab Saleh , Abdelaliem Sally Mohammed Farghaly
Published: December 2023

Background

Perioperative missed nursing care is a serious issue that can compromise patient safety and quality of care. However, little is known about the factors that influence perioperative missed nursing care.

Aim

This study aimed to examine the effects of job embeddedness and polychronicity on perioperative missed nursing care as well as to test the mediating role of polychronicity on the relationship between job embeddeness and perioperative missed nursing care.

Method

This was a cross-sectional correlational study that used a convenience sample of 210 operating room nurses from nine hospitals in Egypt. Data were collected using self-administered questionnaires that measured job embeddedness, polychronicity, and perioperative missed nursing care. Structural equation modeling was used to test the hypothesized relationships among the variables.

Results

The findings demonstrated a significant negative and moderate association between missed perioperative care and both nurses’ job embeddedness and polychronicity. Moreover, there was a moderately positive and significant correlation between polychronicity and job embeddedness. Path analysis revealed a significant positive causal effect between job embeddedness and polychronicity. The results of mediation revealed that the indirect effect of job embeddedness on missed care through polychronicity was statistically significant; suggesting that polychronicity partially mediated this relationship.

Conclusion

This study sheds light on the intricate relationship between nurses’ job embeddedness, missed care, and polychronicity in the operating theater context. By enhancing job embeddedness and fostering polychronicity among nurses, healthcare organizations can reduce perioperative missed care and ultimately improve patient care outcomes in this critical healthcare setting.
Emergency department care experiences among people who use substances: a qualitative study
Authors: Rajab Dana , Fujioka Jamie K. , Walker Melanie , Bartels Susan A. , MacKenzie Meredith , Purkey Eva
Published: December 2023

Background

People who use substances (PWUS) encounter significant barriers to accessing care for their complex health needs. As a result, emergency departments (EDs) often become the first point of healthcare access for many PWUS and are a crucial setting for the study of health inequities. This study aimed to understand the ED healthcare experiences of PWUS with the intent of informing ways of improving the delivery of equitable care.

Methods

This qualitative study was part of a larger cross-sectional, mixed-methods study that examined ED experiences among diverse underserved and equity-deserving groups (EDGs) within Kingston, Ontario, Canada. Participants shared and self-interpreted a story about a memorable ED or UCC visit within the preceding 24 months. Data from participants who self-identified as having substance use experiences was analyzed through inductive thematic analysis.

Results

Of the 1973 unique participants who completed the survey, 246 participants self-identified as PWUS and were included in the analysis. Most participants were < 45 years of age (61%), male (53%), and white/European (57%). 45% identified as a person with a disability and 39% frequently struggled to make ends meet. Themes were determined at the patient, provider, and system levels. Patient: history of substance use and experience of intersectionality negatively influenced participants’ anticipation and perception of care. Provider: negative experiences were linked to assumption making, feelings of stigma and discrimination, and negative perceptions of provider care. Whereas positive experiences were linked to positive perceptions of provider care. System: timeliness of care and the perception of inadequate mental health resources negatively impacted participants’ care experience. Overall, these themes shaped participants’ trust of ED staff, their desire to seek care, and their perception of the care quality received.

Conclusions

PWUS face significant challenges when seeking care in the ED. Given that EDs are a main site of healthcare utilization, there is an urgent need to better support staff in the ED to improve care experiences among PWUS. Based on the findings, three recommendations are proposed: (1) Integration of an equity-oriented approach into the ED, (2) Widespread training on substance use, and (3) Investment in expert resources and services to support PWUS.
Functionalized MoS2-nanosheets with NIR-Triggered nitric oxide delivery and photothermal activities for synergistic antibacterial and regeneration-promoting therapy
Authors: Mu Zhixiang , Jin Ting , Chu Tengda , Lu Hongyang , Chen Yuanqi , Li Sisi , Zeng BaiRui , Huang Chen , Lei Kezheng , Cai Xiaojun , Deng Hui , Hu Rongdang
Published: December 2023

Bacterial infection in skin and soft tissue has emerged as a critical concern. Overreliance on antibiotic therapy has led to numerous challenges, including the emergence of multidrug-resistant bacteria and adverse drug reactions. It is imperative to develop non-antibiotic treatment strategies that not only exhibit potent antibacterial properties but also promote rapid wound healing and demonstrate biocompatibility. Herein, a novel multimodal synergistic antibacterial system (SNO-CS@MoS2) was developed. This system employs easily surface-modified thin-layer MoS2 as photothermal agents and loaded with S-nitrosothiol-modified chitosan (SNO-CS) via electrostatic interactions, thus realizing the combination of NO gas therapy and photothermal therapy (PTT). Furthermore, this surface modification renders SNO-CS@MoS2 highly stable and capable of binding with bacteria. Through PTT’s thermal energy, SNO-CS@MoS2 rapidly generates massive NO, collaborating with PTT to achieve antibacterial effects. This synergistic therapy can swiftly disrupt the bacterial membrane, causing protein leakage and ATP synthesis function damage, ultimately eliminating bacteria. Notably, after effectively eliminating all bacteria, the residual SNO-CS@MoS2 can create trace NO to promote fibroblast migration, proliferation, and vascular regeneration, thereby accelerating wound healing. This study concluded that SNO-CS@MoS2, a novel multifunctional nanomaterial with outstanding antibacterial characteristics and potential to promote wound healing, has promising applications in infected soft tissue wound treatment.
Mesenchymal stem cells-derived extracellular vesicles protect against oxidative stress-induced xenogeneic biological root injury via adaptive regulation of the PI3K/Akt/NRF2 pathway
Authors: Fu Haojie , Sen Lin , Zhang Fangqi , Liu Sirui , Wang Meiyue , Mi Hongyan , Liu Mengzhe , Li Bingyan , Peng Shumin , Hu Zelong , Sun Jingjing , Li Rui
Published: December 2023

Xenogeneic extracellular matrices (xECM) for cell support have emerged as a potential strategy for addressing the scarcity of donor matrices for allotransplantation. However, the poor survival rate or failure of xECM-based organ transplantation is due to the negative impacts of high-level oxidative stress and inflammation on seed cell viability and stemness. Herein, we constructed xenogeneic bioengineered tooth roots (bio-roots) and used extracellular vesicles from human adipose-derived mesenchymal stem cells (hASC-EVs) to shield bio-roots from oxidative damage. Pretreatment with hASC-EVs reduced cell apoptosis, reactive oxygen species generation, mitochondrial changes, and DNA damage. Furthermore, hASC-EV treatment improved cell proliferation, antioxidant capacity, and odontogenic and osteogenic differentiation, while significantly suppressing oxidative damage by activating the phosphatidylinositol 3-kinase (PI3K)/Akt pathway and nuclear factor erythroid 2 (NFE2)-related factor 2 (NRF2) nuclear translocation via p62-associated Kelch-like ECH-associated protein 1 (KEAP1) degradation. Inhibition of PI3K/Akt and Nrf2 knockdown reduced antioxidant capacity, indicating that the PI3K/Akt/NRF2 pathway partly mediates these effects. In subcutaneous grafting experiments using Sprague–Dawley rats, hASC-EV administration significantly enhanced the antioxidant effect of the bio-root, improved the regeneration efficiency of periodontal ligament-like tissue, and maximized xenograft function. Conclusively, therefore, hASC-EVs have the potential to be used as an immune modulator and antioxidant for treating oxidative stress-induced bio-root resorption and degradation, which may be utilized for the generation and restoration of other intricate tissues and organs.

Graphic Abstract
Psychosocial factors, dentist-patient relationships, and oral health-related quality of life: a structural equation modelling
Authors: Song Youngha , Luzzi Liana , Brennan David
Published: December 2023

Background

Psychosocial factors and dentist-patient relationships (DPR) have been suggested to be associated with oral health outcomes. This study aimed to test a conceptual model which hypothesised relationships among psychosocial factors, DPR variables, and oral health-related quality of life (OHRQoL) in the ‘distal-to-proximal’ framework.

Methods

A total of 12,245 adults aged 18 years or over living in South Australia were randomly sampled for the study. Data were collected from self-complete questionnaires in 2015–2016. The outcome variable of Oral Health Impact Profile was used to measure OHRQoL. Psychosocial domain consisted of psychological well-being, social support, and health self-efficacy. DPR domain included trust in dentists, satisfaction with dental care, and dental fear. The hypothesised model was tested using the two-step approach in structural equation modelling.

Results

Data were analysed from 3767 respondents after the screening/preparing process (adjusted valid response rate 37.4%). In the first step of the analysis, confirmatory factor analyses produced acceptable measurement models for each of the six latent variables (GFI = 0.95, CFI = 0.98, RMSEA = 0.04). The final structural model indicated that better well-being, higher self-efficacy, and more satisfaction were associated with lower oral health impact (β = − 0.12, − 0.07, − 0.14, respectively) whereas fear was positively associated (β = 0.19). Among intermediates, support was positively associated with satisfaction within a small effect size (β = 0.06) as compared to self-efficacy with trust (β = 0.22). The invariance of the final model was also confirmed on participants’ SES and dental service characteristics except the variable of ‘last dental visit’.

Conclusions

Psychosocial factors and DPR variables were associated with oral health impact in both direct and indirect paths. The framework of ‘distal-to-proximal’ actions is empirically supported from psychosocial factors via DPR variables to OHRQoL.
Polyamines: their significance for maintaining health and contributing to diseases
Authors: Xuan Mengjuan , Gu Xinyu , Li Juan , Huang Di , Xue Chen , He Yuting
Published: December 2023

Polyamines are essential for the growth and proliferation of mammalian cells and are intimately involved in biological mechanisms such as DNA replication, RNA transcription, protein synthesis, and post-translational modification. These mechanisms regulate cellular proliferation, differentiation, programmed cell death, and the formation of tumors. Several studies have confirmed the positive effect of polyamines on the maintenance of health, while others have demonstrated that their activity may promote the occurrence and progression of diseases. This review examines a variety of topics, such as polyamine source and metabolism, including metabolism, transport, and the potential impact of polyamines on health and disease. In addition, a brief summary of the effects of oncogenes and signaling pathways on tumor polyamine metabolism is provided.
Altered splicing machinery in lung carcinoids unveils NOVA1, PRPF8 and SRSF10 as novel candidates to understand tumor biology and expand biomarker discovery
Authors: Blázquez-Encinas Ricardo , García-Vioque Víctor , Caro-Cuenca Teresa , Moreno-Montilla María Trinidad , Mangili Federica , Alors-Pérez Emilia , Ventura Sebastian , Herrera-Martínez Aura D. , Moreno-Casado Paula , Calzado Marco A. , Salvatierra Ángel , Gálvez-Moreno María A. , Fernandez-Cuesta Lynnette , Foll Matthieu , Luque Raúl M. , Alcala Nicolas , Pedraza-Arevalo Sergio , Ibáñez-Costa Alejandro , Castaño Justo P.
Published: December 2023

Background

Lung neuroendocrine neoplasms (LungNENs) comprise a heterogeneous group of tumors ranging from indolent lesions with good prognosis to highly aggressive cancers. Carcinoids are the rarest LungNENs, display low to intermediate malignancy and may be surgically managed, but show resistance to radiotherapy/chemotherapy in case of metastasis. Molecular profiling is providing new information to understand lung carcinoids, but its clinical value is still limited. Altered alternative splicing is emerging as a novel cancer hallmark unveiling a highly informative layer.

Methods

We primarily examined the status of the splicing machinery in lung carcinoids, by assessing the expression profile of the core spliceosome components and selected splicing factors in a cohort of 25 carcinoids using a microfluidic array. Results were validated in an external set of 51 samples. Dysregulation of splicing variants was further explored in silico in a separate set of 18 atypical carcinoids. Selected altered factors were tested by immunohistochemistry, their associations with clinical features were assessed and their putative functional roles were evaluated in vitro in two lung carcinoid-derived cell lines.

Results

The expression profile of the splicing machinery was profoundly dysregulated. Clustering and classification analyses highlighted five splicing factors: NOVA1, SRSF1, SRSF10, SRSF9 and PRPF8. Anatomopathological analysis showed protein differences in the presence of NOVA1, PRPF8 and SRSF10 in tumor versus non-tumor tissue. Expression levels of each of these factors were differentially related to distinct number and profiles of splicing events, and were associated to both common and disparate functional pathways. Accordingly, modulating the expression of NOVA1, PRPF8 and SRSF10 in vitro predictably influenced cell proliferation and colony formation, supporting their functional relevance and potential as actionable targets.

Conclusions

These results provide primary evidence for dysregulation of the splicing machinery in lung carcinoids and suggest a plausible functional role and therapeutic targetability of NOVA1, PRPF8 and SRSF10.
Association between human herpesvirus infection and cervical carcinoma: a systematic review and meta-analysis
Authors: Zhang Han , Cai Shunli , Xia Yuan , Lin Yangxuan , Zhou Guozhong , Yu Yinghui , Feng Min
Published: December 2023

Background

Cervical cancer (CC) is one of the most common gynecologic tumors among women around the world. Although the etiological role of human papillomavirus (HPV) in CC is well established, other factors in CC carcinogenesis remains unclear. Here, we performed a systematic review and meta-analysis to explore the association between infections of human herpesvirus (HHVs) and CC risk.

Methods

Embase and PubMed databases were utilized to search the relevant studies. The revised JBI Critical Appraisal Tool was used to assess the quality of the included studies. Prevalence and odds ratios (ORs) with 95% confidence intervals (CI) were calculated to evaluate the association between viral infection and CC or precancerous cervical lesions (PCL).

Results

Totally 67 eligible studies involving 7 different HHVs were included in meta-analysis. We found an increased risk of CC or PCL that was associated with the overall infection of HHVs (CC, OR = 2.74, 95% CI 2.13–3.53; PCL, OR = 1.95, 95% CI 1.58–2.41). Subgroup analysis showed a trend towards positive correlations between herpes simplex virus type 2 (HSV-2) infection and CC (OR = 3.01, 95% CI 2.24 to 4.04) or PCL (OR = 2.14, 95% CI 1.55 to 2.96), and the same is true between Epstein-Barr virus (EBV) infection and CC (OR = 4.89, 95% CI 2.18 to 10.96) or PCL (OR = 3.55, 95% CI 2.52 to 5.00). However, for HSV-1 and cytomegalovirus (HCMV), there was no association between viral infection and CC or PCL. By contrast, the roles of HHV-6, HHV-7, and Kaposi sarcoma–associated herpesvirus (KSHV) in cervical lesions were unclear due to the limited number of studies.

Conclusions

This study provided evidence that HHVs infection as a whole increase the risk of CC incidence. In addition, some types of HHVs such as EBV and HSV-2 may serve as potential targets in the development of new interventions or therapeutic strategies for cervical lesions.
Whole mount multiplexed visualization of DNA, mRNA, and protein in plant-parasitic nematodes
Authors: Sperling Alexis L. , Eves-van den Akker Sebastian
Published: December 2023

Background

Plant-parasitic nematodes compromise the agriculture of a wide variety of the most common crops worldwide. Obtaining information on the fundamental biology of these organisms and how they infect the plant has been restricted by the ability to visualize intact nematodes using small molecule stains, antibodies, or in situ hybridization. Consequently, there is limited information available about the internal composition of the nematodes or the biology of the effector molecules they use to reprogram their host plant.

Results

We present the Sperling prep - a whole mount method for nematode preparation that enables staining with small molecules, antibodies, or in situ hybridization chain reaction. This method does not require specialized apparatus and utilizes typical laboratory equipment and materials. By dissociating the strong cuticle and interior muscle layers, we enabled entry of the small molecule stains into the tissue. After permeabilization, small molecule stains can be used to visualize the nuclei with the DNA stain DAPI and the internal structures of the digestive tract and longitudinal musculature with the filamentous actin stain phalloidin. The permeabilization even allows entry of larger antibodies, albeit with lower efficiency. Finally, this method works exceptionally well with in situ HCR. Using this method, we have visualized effector transcripts specific to the dorsal gland and the subventral grand of the sugar beet cyst nematode, Heterodera schachtii, multiplexed in the same nematode.

Conclusion

We were able to visualize the internal structures of the nematode as well as key effector transcripts that are used during plant infection and parasitism. Therefore, this method provides an important toolkit for studying the biology of plant-parasitic nematodes.
Iron as an emerging therapeutic target in critically ill patients
Authors: Grange Coralie , Lux François , Brichart Thomas , David Laurent , Couturier Aymeric , Leaf David E. , Allaouchiche Bernard , Tillement Olivier
Published: December 2023

The multiple roles of iron in the body have been known for decades, particularly its involvement in iron overload diseases such as hemochromatosis. More recently, compelling evidence has emerged regarding the critical role of non-transferrin bound iron (NTBI), also known as catalytic iron, in the care of critically ill patients in intensive care units (ICUs). These trace amounts of iron constitute a small percentage of the serum iron, yet they are heavily implicated in the exacerbation of diseases, primarily by catalyzing the formation of reactive oxygen species, which promote oxidative stress. Additionally, catalytic iron activates macrophages and facilitates the growth of pathogens. This review aims to shed light on this underappreciated phenomenon and explore the various common sources of NTBI in ICU patients, which lead to transient iron dysregulation during acute phases of disease. Iron serves as the linchpin of a vicious cycle in many ICU pathologies that are often multifactorial. The clinical evidence showing its detrimental impact on patient outcomes will be outlined in the major ICU pathologies. Finally, different therapeutic strategies will be reviewed, including the targeting of proteins involved in iron metabolism, conventional chelation therapy, and the combination of renal replacement therapy with chelation therapy.