bluuebunny/crossref_metadata_2025 huggingface dataset:
Policy Reform on the Qualification Pathway of Internationally Educated Nurses in Greenland and Its Relationship With the Danish System: A Qualitative Discourse Analysis
Authors: Cubelo Floro
Published: April 2024

The nursing profession in Greenland, particularly in rural and remote areas, faces challenges due to geographical limitation and a lack of interdisciplinary collaboration. The registration process and status of internationally educated nurses (IENs) in Greenland are unclear. This article aimed to analyze existing policies and propose recommendations for an independent registration process for IENs in Greenland. A qualitative discourse analysis was used to critically discuss existing policies and regulations governing nursing registration in Greenland. Relevant legislation, government reports, and official documents were reviewed. Legislative regulations protect the title of registered nurse in both Greenland and Denmark. To work in Greenland, an IEN must have a residence permit. With recent health agreements between Greenland and Denmark, both countries have streamlined the permit acquisition process for foreign healthcare professionals, making it more accessible. However, the process of acquiring a license to work as a registered nurse for IENs lacks clarity. Policy reform is needed to establish a group of diverse nurse experts under the National Board of Health responsible for the assessment and registration of IEN qualifications. There is also a need for a bridging education program or national licensure examination which could facilitate faster IEN recognition. Mutual recognition of nurse licenses between Greenland and Denmark should be established to ensure efficient healthcare delivery and maintain professional standards. Embracing IENs can address nursing shortages and improve healthcare services in Greenland.
Study on the Role and Mechanism of SLC3A2 in Tumor-Associated Macrophage Polarization and Bladder Cancer Cells Growth
Authors: Wu Peishan , Zhao Lingna , Kong Guangqi , Song Bo
Published: April 2024

Background: Solute carrier family 3 member 2 (SLC3A2) is highly expressed in various types of cancers, including bladder cancer (BLCA). However, the role and mechanism of SLC3A2 in the onset and progression of BLCA are still unclear. Methods: The interfering plasmid for SLC3A2 was constructed and transfected into BLCA cells. Cell proliferation, invasion, and migration abilities were assessed to evaluate the impact of SLC3A2 silencing on BLCA cell growth. M1 and M2 macrophage polarization markers were detected to evaluate macrophage polarization. The levels of reactive oxygen species (ROS), lipid peroxidation, and Fe2+, as well as the expression of ferroptosis-related proteins, were measured to assess the occurrence of ferroptosis. Ferroptosis inhibitors were used to verify the mechanism. Results: The experimental results showed that SLC3A2 was highly expressed in BLCA cell lines. The proliferation, invasion, and migration of BLCA cells were reduced after interfering with SLC3A2. Interference with SLC3A2 led to increase the expression of M1 macrophage markers and decreased the expression of M2 macrophage markers in M0 macrophages co-cultured with tumor cells. Additionally, interference with SLC3A2 led to increased levels of ROS, lipid peroxidation, and Fe2+, downregulated the expression of solute carrier family 7 member11 (SLC7A11) and glutathione peroxidase 4 (GPX4), while upregulated the expression of acyl-coA synthetase long chain family member 4 (ACSL4) and transferrin receptor 1 (TFR1) in BLCA cells. However, the impact of SLC3A2 interference on cell proliferation and macrophage polarization was impeded by ferroptosis inhibitors. Conclusion: Interference with SLC3A2 inhibited the growth of BLCA cells and the polarization of tumor-associated macrophages by promoting ferroptosis in BLCA cells.
Physical activity advice for children and young people
Authors: Hunt Dr Ian , Al-Zubaidi Dr Hussain
Published: April 2024

Unfortunately, only 47.2% of children and young people in the UK are currently meeting the chief medical officer’s physical activity guidelines of 60 minutes daily, with 30.1% of children doing less than 30 minutes daily. Reduced physical activity in children is a significant contributor to childhood obesity, a growing paediatric pandemic with 1-in-3 children overweight or obese by the time they leave primary school. The long-term health implications of this and the additional burden on health services are already widely apparent. It is important for GPs and primary care staff to understand the current UK recommendations and evidence on childhood physical activity to empower their support of early engagement of children with measures to improve levels of physical activity. An understanding of childhood obesity is also important. At the other end of the spectrum elite children’s sport is becoming increasingly competitive and injuries in developing children can lead to lifelong complications and injury recurrence. It is, therefore, important to understand how much and what types of exercise and training are safe in the paediatric population.
The ‘demographic winter’ in Italy: Crisis factors, problematic issues and policy actions
Authors: Blangiardo Gian Carlo
Published: April 2024

Demographic issues are becoming key to the debate on the future of Europe, and of Italy in particular, which has the lowest birth rate in Europe but is among the top-ranked countries for demographic ageing. The general improvement of living conditions and the ageing of large cohorts cannot be supported by the economic activity of the younger generations, which calls into question the security of certain aspects of the social pact, such as the provision of pensions and health care.

While encouraging an awareness among Italians of the trends and problems they will have to deal with, all national actors must cooperate to ensure the recovery of the birth rate, and to harness the economic benefits of incoming migrants and the experiences of older people. It is equally necessary to meet the needs of young people and enhance their social role. Only through such cooperation will it be possible to create a favourable climate for actions that will allow us to control and direct these demographic phenomena and not to suffer from them.
Chinese Migrants in Metropolitan Cities Abroad: Reconsidering Agency, Interactions, and Belonging
Authors: Gransow Bettina
Published: April 2024

At the interface of Chinese diaspora studies, migration studies, and urban studies, this introduction argues for a shift towards city-based migration studies. The city is understood here not as a self-contained social cosmos, but as a globally and socially embedded urban level that opens up a more flexible perspective on the unfolding of migration processes at the micro, meso, and macro levels. It begins with a brief overview of recent trends in Chinese diaspora studies, global migration and urbanisation trends, and debates in critical geography on multi-scale urban theories. Then, it raises the question of the empirical feasibility of such an approach and argues for conceptualising migrants’ agency as a starting point for migration research, rather than pursuing a policy-driven, normative approach. Finally, it presents the five empirical contributions to this Special Issue. They are based on fieldwork in Paris, Berlin, Manchester (UK), Mexico City, Lagos, Gaborone, and Windhoek.
Time’s Gifting
Authors: Bussey Marcus , Kristoffersson Cecilia
Published: April 2024

This poem is a reflection on the contradictions inherent to futures work. Pasts, presents and futures fold in on each other and this is reflected in the deliberately tribal image offered by Kristoffersson. In both image and poem lies biography and memory both personal and also epochal. Time is sticky and we must deal with that as best we can.
Spine tuberculosis with an intercurrent active pulmonary location in a high incidence country: A rare case report
Authors: El Harras Yahya , Imrani Kaoutar , Faraj Chaymae , Moatassim Billah Nabil , Nassar Ittimade
Published: April 2024

Spinal tuberculosis usually presents as destroyed contiguous vertebral bodies associated with intervertebral discs and paravertebral or psoas abscesses. Atypical forms are uncommonly reported. Vertebral involvement without disk destruction is a rare form that improves satisfactorily after appropriate medical management. We report the case of a 36-year-old male who had spine tuberculosis without disk involvement, associated with intercurrent active pulmonary location with good clinical improvement after treatment and follow-up imaging showing spectacular regression of bone lesions. By reporting this case, we also review the literature on this rare form of tuberculosis.
Behavioral Therapy for People With Diabetes Who Smoke: A Scoping Review
Authors: Sammut Roberta , Grech Joseph , Polosa Riccardo , Campagna Davide , Di Ciaula Agostino , Dugal Tabinda , Kenge Andre , Misra Anoop , Abbas Raza Syed , Russo Cristina , Somasundaram Noel , Walicka Magdalena , Phoung Le Dinh , Prezzavento Graziella Chiara , Casu Mirko , La Rosa Giusy Rita Maria , Caponnetto Pasquale
Published: April 2024

Background:

Tobacco smoking exacerbates diabetes-related complications; its prevalence is notwithstanding substantial. Persons with diabetes face a number of barriers and challenges to quitting such as multiple lifestyle restrictions; tailored interventions are required for smoking cessation.

Objective:

To identify research on behavioral interventions for smoking cessation in diabetes.

Methods:

Studies had to be randomized controlled trials, quasiexperimental or systematic reviews. The behavioral interventions included were: the 5As, Cognitive-Behavioral Therapy, Motivational Interviewing, Contingency Management, Health Coaching and Counselling, as compared to standard care. The outcomes were self-reported and/or biochemically verified smoking cessation. CINAHL Complete, MEDLINE Complete, the Cochrane databases of systematic reviews and randomized controlled trials, PsychInfo and PubMed Central were searched until July, 2023. Keywords used included diabetes, smoking cessation and each of the behavioral interventions included.

Results:

1615 papers were identified. Three studies on the 5As/brief advice, 4 on Motivational Intervention and 1 on counseling were retained. The results on the 5As and Motivational Interviewing were conflicting. More intensive interventions appear to be more successful in achieving smoking cessation in smokers with diabetes.

Conclusions:

Future research should focus on the continued development and evaluation of structured smoking cessation interventions based on the 5As, Motivational interviewing and Cognitive Behavioral Therapy.
The Value of Political Connections of Developers in Residential Land Leasing: Case of Chengdu, China
Authors: Liu Xuan , Zhu Chunwu , Kong Minghui , Yin Lirong , Zheng Wenfeng
Published: April 2024

The graduate approach applied in China for the economic transition poses the risk of continued government influence on the market. The land reform and the following adjustment in China have introduced a seemingly complete market for residential land. However, a widely practiced coalition between the local developmental states and developers might impact residential land leasing in a more hidden way. Taking central Chengdu as the study area, this study takes the enterprise ownership and affiliations as two explanatory factors that impact the land leasing prices and builds an MGWR model to evaluate the premium of political connections for the developers to obtain the land. The result gives a clue to the local protectionism and preference for state-owned enterprises that might exist in land leasing in Chengdu. It is proved in this study that the average purchase price by state-owned enterprises is 8.9% lower than the prices that private enterprises could enjoy, and the average land leasing price by local enterprises is 14.2% lower than that enjoyed by non-local enterprises. The preceding conceptual and empirical discussion in this study advocates for a review and rethinking of the public sector’s intervention in China’s land market. In-depth analyses of the factors that define the land leasing behaviors of the local government are needed.
Escalation on Kihon Checklist Scores Preceding the Certification of Long-Term Care Need in the Older Population in Japan. A 9-Year Retrospective Study
Authors: Kitazawa Kazuki , Tsuchiya Kenji , Hirao Kazuki , Furukawa Tomomi , Tozato Fusae , Iwaya Tsutomu , Mitsui Shinichi
Published: April 2024

Objectives

The Kihon Checklist (KCL) is valuable for predicting long-term care (LTC) certification. However, the precise association between KCL scores and the temporal dynamics of LTC need certification remains unclear. This study clarified the characteristic trajectory of KCL scores in individuals certified for LTC need.

Methods

The KCL scores spanning from 2011 to 2019 were obtained from 5630 older individuals, including those certified for LTC need in November 2020, in Iiyama City, Nagano, Japan. We analyzed the KCL score trajectories using a linear mixed model, both before and after propensity score matching.

Results

Throughout the 9-year observation period, the KCL scores consistently remained higher in the certified group compared to the non-certified group. Notably, a significant score increase occurred within the 3 years preceding LTC certification.

Discussion

Our findings highlight the effectiveness of continuous surveillance using the KCL in identifying individuals likely to require LTC within a few years.
Regional Inequalities in Oral Frailty and Social Capital
Authors: Yamamoto T. , Mochida Y. , Irie K. , Altanbagana N. U. , Fuchida S. , Aida J. , Takeuchi K. , Fujita M. , Kondo K.
Published: April 2024

Introduction:

Oral frailty leads to poor nutritional status, which, in turn, leads to frailty. This cross-sectional study aimed to determine regional differences in the prevalence of oral frailty and to identify factors associated with oral frailty using 3-level multilevel models.

Methods:

This study comprised 165,164 participants aged ≥65 y without long-term care requirements in the Japan Gerontological Evaluation Study. The dependent variable was oral frailty, which was calculated based on age, number of teeth, difficulty in eating tough foods, and choking. The individual-level independent variables included sociodemographics, present illness, social participation, frequency of meeting friends, and social capital. The local district-level independent variable was social capital (n = 1,008) derived from exploratory factor analyses. The municipality-level independent variable was population density (n = 62). Three-level multilevel Poisson regression analysis was performed to calculate the prevalence ratios (PRs).

Results:

The prevalence of oral frailty in municipalities ranged from 39.9% to 77.6%. Regarding district-level factors, higher civic participation was significantly associated with a lower probability of oral frailty. At the municipality level, the PR of the rural-agricultural area was 1.17 (95% confidence interval, 1.11–1.23) (reference: metropolitan).

Conclusion:

These results highlight the usefulness of oral frailty prevention measures in encouraging social participation in rural areas.

Knowledge Transfer Statement:

The results of the present study showed regional differences in oral frailty. In particular, rural-agricultural areas show higher prevalence rates of oral frailty than those in metropolitan cities. Promoting measures of social participation among older adults may help prevent oral frailty in rural areas.
Adolescent Cancer Survivors and Their Parents’ Experiences With the Transition Off Treatment to Survivorship: A Qualitative Interview Study
Authors: Larsen Elna Hamilton , Wahl Astrid Klopstad , Ruud Ellen , Mellblom Anneli Viktoria , Ålykkja Anette , Lie Hanne Cathrine
Published: April 2024

Background: Transitioning from active cancer treatment to survivorship represents a vulnerable yet underresearched phase for adolescents and their families. Knowledge of their support needs, the challenges they experience, and how they manage them are useful to inform tailored follow-up care. Thus, we aimed to explore their transition experiences. Method: We interviewed 15 adolescents (12–19 years) who had transitioned off of treatment 1 to 47 months prior at Oslo University Hospital’s Department of Paediatric Haematology and Oncology and their biological parents ( n = 16). The interviews were analyzed using inductive, reflexive thematic analysis inspired by Braun and Clarke. NVivo-12 was used for data management. Results: Four main themes were identified: (a) consequences of cancer beyond transition, (b) transition back to normalcy, (c) survivorship competence, and (d) changes in roles and relationships. The families described happiness and relief but also said that the lingering effects of cancer treatment had a profound impact on day-to-day living. The adolescents expressed closeness with and dependency on their parents, and they perceived family and friends as essential for social readjustment. Discussion: Although adolescent survivors and their parents described a wide variety of strategies for returning to “normalcy,” their perspectives also illustrate ongoing psychosocial and educational support needs that changed over time. Our findings indicate a need for improved preparation for and support through the transition. Nurses are well positioned to provide continuous and structured transition support tailored to the needs of the individual survivors and their families.
Seismic capacity models for earth dams and their use in developing fragility curves
Authors: He Jingwen , Rathje Ellen M.
Published: April 2024

This article develops seismic capacity models for earth dams and demonstrates how the proposed seismic capacity models may be used to develop seismic fragility curves that predict the probability of damage as a function of ground shaking intensity. Developing earth dam fragility curves requires two major components: (1) a seismic capacity model that predicts the probability of a damage state given the relative settlement (RS) and (2) an engineering demand model that predicts the RS as a function of ground motion intensity. While seismic demand models for earth dams have been studied by various researchers, there is a scarcity of seismic capacity models. This article focuses first on developing seismic capacity relationships using a dataset of earthquake case histories of dam performance. Different from previously developed relationships, only the damage description for each dam is used when assigning the damage state, which results in statistical variability in the capacity relationship between the damage state and RS. The fragility curve development is demonstrated by combining the seismic capacity relationships with a seismic demand model for RS derived from nonlinear, dynamic finite element analyses for a 20-m generic dam geometry subjected to a suite of earthquake motions from the NGA-West2 database.
Compressed earthen blocks using alluvial clays from Mbam: performance comparison using statistical analysis of cement vs heat-stabilized blocks
Authors: Enock Embom Christophe , Nyemb Bayamack Joël Fabrice , Ngo'o Ze Arnaud , Mache Jacques Richard , Mbey Jean Aimé , Onana Vincent Laurent
Published: April 2024

In the present study, a comparison of the thermal-insulation and mechanical performances of cement and heat-stabilized compressed earthen blocks (CEBs) was carried out to determine the factors which influence those properties. The raw clays used consist mainly of kaolinite, orthoclase and quartz. The mechanical strength increased with increase in both the amount of cement added and the firing temperature. However, the responses are better for cement-stabilized CEBs. The thermal insulation of fired bricks is greater than that of cement-stabilized bricks. This difference was related to the decrease in porosity and the formation of continuous-surface. The decrease in thermal insulation is mainly related to the formation of continuous-surface in cement-stabilized CEBs, whereas in the fired CEBs, it is due to the modification of pore volume. The mineralogy of the raw clays is statistically correlated to porosity and continuous-surface development that were confirmed as the main factors in the modification of both the mechanical strength and the thermal insulation. In cement-stabilization, the decrease in insulation is due to the development of continuous surface, while for heat-stabilization, mineral transformations during the sintering reduced continuous-surface formation and the insulation was controlled by both radiation and reduced surface conduction. The influence of the mineralogy of the raw material shows that clay content favours the insulation in fired bricks obtained at T ≤ 1000°C, while sand contents favour densification. In contrast, clay contents reduce the mechanical response of cement-stabilized material due to limited cement–clay interactions. In general, the mechanical response is more favourable in cement stabilization, while thermal insulation is better in fired bricks.
Airborne indoor allergen serine proteases and their contribution to sensitisation and activation of innate immunity in allergic airway disease
Authors: Ouyang Xuan , Reihill James A. , Douglas Lisa E.J. , Martin S. Lorraine
Published: April 2024

Common airborne allergens (pollen, animal dander and those from fungi and insects) are the main triggers of type I allergic disorder in the respiratory system and are associated with allergic rhinitis, allergic asthma, as well as immunoglobulin E (IgE)-mediated allergic bronchopulmonary aspergillosis. These allergens promote IgE crosslinking, vasodilation, infiltration of inflammatory cells, mucosal barrier dysfunction, extracellular matrix deposition and smooth muscle spasm, which collectively cause remodelling of the airways. Fungus and insect (house dust mite and cockroaches) indoor allergens are particularly rich in proteases. Indeed, more than 40 different types of aeroallergen proteases, which have both IgE-neutralising and tissue-destructive activities, have been documented in the Allergen Nomenclature database. Of all the inhaled protease allergens, 85% are classed as serine protease activities and include trypsin-like, chymotrypsin-like and collagenolytic serine proteases. In this article, we review and compare the allergenicity and proteolytic effect of allergen serine proteases as listed in the Allergen Nomenclature and MEROPS databases and highlight their contribution to allergic sensitisation, disruption of the epithelial barrier and activation of innate immunity in allergic airways disease. The utility of small-molecule inhibitors of allergen serine proteases as a potential treatment strategy for allergic airways disease will also be discussed.
An unexpected case of tetanus in a fully immunized 20-year-old female: a case report
Authors: Okuda Mitsutoshi , Morizane Atsushi , Asaba Sunao , Tsurui Saika , Tsuno Ryutaro , Hatakenaka Mariko , Sugimura Tomoko , Saisaka Yuichi
Published: April 2024

Background

Widespread vaccinations have significantly decreased the number of tetanus cases in developed countries. Today, most cases of tetanus affect the elderly and those with inadequate immunization in developed countries such as Japan. As vaccinations were believed to be nearly 100% effective in preventing tetanus, tetanus in young, immunized individuals were considered unlikely. However, unexpected tetanus infection has been reported in young adequately immunized individuals.

Case

We herein describe a 20-year-old immunized female who visited our emergency department with trismus and painful muscle spasms that started after receiving a puncture wound to her right foot. A physical examination revealed an elevated body temperature (38°C), trismus, muscle spasms in her right leg and neck, and a puncture wound at the sole of her right foot. Following the development of dyspnea after admission to the intensive care unit, the patient was intubated and mechanically ventilated. She fully recovered after six days in intensive care.

Conclusion

The present case serves as a stark reminder that tetanus may still occur in young, immunized individuals. Patients with a history of immunization may have a better prognosis than those with no immunizations.
Constructed Rice Tracers Identify the Major Virulent Transcription Activator-Like Effectors of the Bacterial Leaf Blight Pathogen
Authors: Liu Linlin , Li Ying , Wang Qi , Xu Xiameng , Yan Jiali , Wang Yong , Wang Yijie , Shah Syed Mashab Ali , Peng Yongzheng , Zhu Zhangfei , Xu Zhengyin , Chen Gongyou
Published: April 2024

Xanthomonas oryzae pv. oryzae (Xoo) injects major transcription activator-like effectors (TALEs) into plant cells to activate susceptibility (S) genes for promoting bacterial leaf blight in rice. Numerous resistance (R) genes have been used to construct differential cultivars of rice to identify races of Xoo, but the S genes were rarely considered. Different edited lines of rice cv. Kitaake were constructed using CRISPR/Cas9 gene-editing, including single, double and triple edits in the effector-binding elements (EBEs) located in the promoters of rice S genes OsSWEET11a, OsSWEET13 and OsSWEET14. The near-isogenic lines (NILs) were used as tracers to detect major TALEs (PthXo1, PthXo2, PthXo3 and their variants) in 50 Xoo strains. The pathotypes produced on the tracers determined six major TALE types in the 50 Xoo strains. The presence of the major TALEs in Xoo strains was consistent with the expression of S genes in the tracers, and it was also by known genome sequences. The EBE editing had little effect on agronomic traits, which was conducive to balancing yield and resistance. The rice-tracers generated here provide a valuable tool to track major TALEs of Xoo in Asia which then shows what rice cultivars are needed to combat Xoo in the field.
Assessment of neuropathic pain management knowledge, attitudes, and practices among urology trainees and consultants in prostate cancer care: a survey-based study
Authors: Sinkila O. , Matjomane N. , Cronje T. , Mathabe K.
Published: April 2024

Background

Effective neuropathic pain management is crucial in improving the quality of life for patients with prostate cancer. There is an abundance of research about cancer pain and guidelines that have been developed by World Health Organization including the analgesia stepladder, yet patients with cancer pain are still sub optimally analgesed. This is due to a variety of both patient and physician factors which include: lack of knowledge on the use of adjuvant medication, fear of addiction and poor characterization of the type of pain. This study intended to assess the knowledge, attitudes, and practices of urology trainees and consultants in the the context of neuropathic pain in prostatecancer care.

Methods

The study involved 91 urologists, comprising of junior registrars, medical officers and experienced specialists who are members of the South African Urological Association (SAUA). Data was collected through a 25-question web-based survey. The survey covered: demographic information, knowledge, attitudes, and practices related to cancer pain management.

Results

The study revealed that a significant proportion of urologists assessed neuropathic pain reactively, with only 8% of respondents being familiar with screening scales. Approximately, one-third preferred referrals, and 74% expressed confidence in self-treatment. Concerns regarding opioid prescription were observed in 40.4% of respondents. Furthermore, the usage of adjuvant medications was limited, with only 35% proficiently combining analgesia and adjuvants. Notably, 65% continued to escalate analgesic monotherapy.

Conclusion

Effective neuropathic pain management in prostate cancer care necessitates a multidisciplinary approach, comprehensive assessment and expertise in adjuvant medication usage. The discrepancies observed among urologists are likely due to variations in experience levels. The study identifies knowledge gaps and suboptimal practices in neuropathic pain management among urologists. Addressing these issues through education, awareness, and interdisciplinary collaboration is imperative to enhance patient outcomes and improve the quality of life for individuals with prostate cancer. This study underscores the need for improved education and interdisciplinary collaboration among urologists in managing neuropathic pain among prostate cancer patients. Enhancing these aspects is essential to achieve better patient outcomes and overall quality of life.
PPanG: a precision pangenome browser enabling nucleotide-level analysis of genomic variations in individual genomes and their graph-based pangenome
Authors: Liu Mingwei , Zhang Fan , Lu Huimin , Xue Hongzhang , Dong Xiaorui , Li Zhikang , Xu Jianlong , Wang Wensheng , Wei Chaochun
Published: April 2024

Graph-based pangenome is gaining more popularity than linear pangenome because it stores more comprehensive information of variations. However, traditional linear genome browser has its own advantages, especially the tremendous resources accumulated historically. With the fast-growing number of individual genomes and their annotations available, the demand for a genome browser to visualize genome annotation for many individuals together with a graph-based pangenome is getting higher and higher. Here we report a new pangenome browser PPanG, a precise pangenome browser enabling nucleotide-level comparison of individual genome annotations together with a graph-based pangenome. Nine rice genomes with annotations were provided by default as potential references, and any individual genome can be selected as the reference. Our pangenome browser provides unprecedented insights on genome variations at different levels from base to gene, and reveals how the structures of a gene could differ for individuals. PPanG can be applied to any species with multiple individual genomes available and it is available at https://cgm.sjtu.edu.cn/PPanG.
Identifying mitigation strategies of comprehensive health centers against dust hazard: a qualitative study in Iran
Authors: Sarani Arezoo , Tavan Asghar , Bahaadinbeigy Kambiz , Aminzadeh Mohsen , Moradi Seyed Mobin , Khademipour Gholamreza , Farahmandnia Hojjat
Published: April 2024

Background

Exposure to dust can disrupt healthcare services and severely affect all activity domains of the health system. The aim of this study was to explore mitigation strategies for comprehensive health centers against dust hazard.

Method

The present study was conducted using a qualitative design with a conventional content analysis approach in 2023. The participants in this study were managers and staff of comprehensive health centers and experts in health in disasters and emergencies in Kerman, Bam, Regan, and Ahvaz. Data were collected through interviews. Data collection continued until data saturation. The collected data were analyzed based on the steps proposed by Graneheim and Lundman. Participants’ statements, after recording and transcribing, were categorized into semantic units. Data were analyzed by using MAXQDA software version 2020.

Results

The analysis of the data with 23 participants revealed 106 Codes, 13 sub- categories and 5 main categories including: (A) reducing the impact of dust hazards, (B) management functions, (C) empowerment and performance improvement, (D) maintaining and promoting safety, and (E) Inter-sectoral coordination to implement mitigation strategies.

Conclusion

The findings showed that the mitigation strategies and solutions can be used by health policymakers and planners to reduce the impact of dust hazard, empower and motivate healthcare staff, develop training protocols to enhance risk perception of the staff and members of the community, create the necessary infrastructure for adoption of effective mitigation strategies in healthcare centers to create resilience and continue service delivery.
Multimorbidity in middle-aged women and COVID-19: binary data clustering for unsupervised binning of rare multimorbidity features and predictive modeling
Authors: Benny Dayana , Giacobini Mario , Costa Giuseppe , Gnavi Roberto , Ricceri Fulvio
Published: April 2024

Background

Multimorbidity is typically associated with deficient health-related quality of life in mid-life, and the likelihood of developing multimorbidity in women is elevated. We address the issue of data sparsity in non-prevalent features by clustering the binary data of various rare medical conditions in a cohort of middle-aged women. This study aims to enhance understanding of how multimorbidity affects COVID-19 severity by clustering rare medical conditions and combining them with prevalent features for predictive modeling. The insights gained can guide the development of targeted interventions and improved management strategies for individuals with multiple health conditions.

Methods

The study focuses on a cohort of 4477 female patients, (aged 45-60) in Piedmont, Italy, and utilizes their multimorbidity data prior to the COVID-19 pandemic from their medical history from 2015 to 2019. The COVID-19 severity is determined by the hospitalization status of the patients from February to May 2020. Each patient profile in the dataset is depicted as a binary vector, where each feature denotes the presence or absence of a specific multimorbidity condition. By clustering the sparse medical data, newly engineered features are generated as a bin of features, and they are combined with the prevalent features for COVID-19 severity predictive modeling.

Results

From sparse data consisting of 174 input features, we have created a low-dimensional feature matrix of 17 features. Machine Learning algorithms are applied to the reduced sparsity-free data to predict the Covid-19 hospital admission outcome. The performance obtained for the corresponding models are as follows: Logistic Regression (accuracy 0.72, AUC 0.77, F1-score 0.69), Linear Discriminant Analysis (accuracy 0.7, AUC 0.77, F1-score 0.67), and Ada Boost (accuracy 0.7, AUC 0.77, F1-score 0.68).

Conclusion

Mapping higher-dimensional data to a low-dimensional space can result in information loss, but reducing sparsity can be beneficial for Machine Learning modeling due to improved predictive ability. In this study, we addressed the issue of data sparsity in electronic health records and created a model that incorporates both prevalent and rare medical conditions, leading to more accurate and effective predictive modeling. The identification of complex associations between multimorbidity and the severity of COVID-19 highlights potential areas of focus for future research, including long COVID and intervention efforts.
Perceptions and beliefs of general practitioners on their role in the cancer screening programmes in the Netherlands: a mixed-methods study
Authors: Bongaerts Thomas H.G. , Büchner Frederike L. , Nierkens Vera , Crone Matty R. , Guicherit Onno R. , Numans Mattijs E.
Published: April 2024

Background

In the Netherlands, population-based cancer screening programmes (CSPs) are organized aiming at cervical, breast and colorectal cancer. For a CSP to be effective, high participation rates are essential; however, there is an alarming downward trend, including wide regional variation in screening uptake. General practitioner (GP) involvement can have a stimulating effect on screening participation. Current GP involvement is however, limited, varies between the programmes and has changed over time. Unexplored is what GPs think of their role(s) in the CSPs. The aim of this study was therefore to map the perceptions and beliefs of GPs regarding their current and future role in the Dutch CSPs.

Methods

A mixed-methods sequential explanatory study was conducted in the Leiden/The Hague area of the Netherlands, between the end of 2021 and 2022. A questionnaire was developed and distributed among 110 GPs. The aggregated results obtained from the questionnaires served as starting points for conducting semi-structured interviews, with purposefully selected GPs. With this sequential approach we aimed to further enhance the understanding of the questionnaire data, and delved into the topics that emerged from the questionnaire responses.

Results

In total, 46 GPs completed the online questionnaire (response rate 42%). Subsequent five semi-structured comprehensive interviews were conducted. GPs indicated that they frequently encounter the CSP in their daily practice and consider it important. They also emphasised it is important that GPs remain closely involved with the CSPs in the future. Nevertheless, GPs also repeatedly mentioned that they are not eager to take on more logistical/organizational tasks. They are however willing to empower CSPs in a positive manner.

Conclusion

GPs were generally positive about the CSPs and their current role within these programmes. Nevertheless, several options have been proposed to improve the CSPs, especially to increase screening uptake for populations in a socioeconomically disadvantaged position. Since it is of utmost importance to screen those who are most at risk of developing the screening-specific tumours, efforts should be made to achieve this goal.
Fructose malabsorption and fructan malabsorption are associated in patients with irritable bowel syndrome
Authors: Sia Twan , Tanaka Riki O. , Mousad Albert , Narayan Aditya P. , Si Kristen , Bacchus Leeon , Ouerghi Hind , Patel Aashka , Patel Arnav , Cunningham Evan , Epstein Taylor , Fu Jerry , Liu Stanley , Khuda Raisa , McDonald Paige , Mallik Shibani , McNulty Joanna , Pan Michelle , Leung John
Published: April 2024

Background

Food malabsorption and intolerance is implicated in gastrointestinal symptoms among patients with irritable bowel syndrome (IBS). Key triggers include fructose and fructan. Prior studies examined fructose and fructan malabsorption separately in IBS patients. None have concurrently assessed both within the same patient group. We aimed to investigate the association between fructose and fructan malabsorption in the same patients with IBS using hydrogen breath testing (HBT).

Methods

We retrospectively identified patients with IBS who underwent fructose and fructan HBTs and abstracted their results from the electronic medical record. Fructose and fructan HBTs were performed by administering a 25 g fructose solution or 10 g fructan solution, followed by breath hydrogen readings every 30 min for 3 h. Patients were positive for fructose or fructan malabsorption if breath hydrogen levels exceeded 20 ppm.

Results

Of 186 IBS patients, 71 (38.2%) were positive for fructose malabsorption and 91 (48.9%) were positive for fructan malabsorption. Of these patients, 42 (22.6%) were positive for fructose malabsorption and fructan malabsorption. Positive fructose HBT readings were significantly associated with positive fructan HBT readings (p = 0.0283). Patients positive for fructose malabsorption or fructan malabsorption had 1.951 times higher odds of testing positive for the other carbohydrate.

Conclusions

Our results reveal a clinically significant association between fructose malabsorption and fructan malabsorption in patients with IBS. Fructan malabsorption should be assessed in patients with fructose malabsorption, and vice versa. Further studies are required to identify the mechanisms underlying our findings.
Follow-up SARS-CoV-2 serological study of a health care worker cohort following COVID-19 booster vaccination
Authors: Hönning Alexander , Tomczyk Sara , Hermes Julia , Grossegesse Marica , Hofmann Natalie , Michel Janine , Neumann Markus , Nitsche Andreas , Hoppe Berthold , Eckmanns Tim , Schmidt-Traub Hajo , Zappel Kristina
Published: April 2024

Background

Studies have shown that Omicron breakthrough infections can occur at higher SARS-CoV-2 antibody levels compared to previous variants. Estimating the magnitude of immunological protection induced from COVID-19 vaccination and previous infection remains important due to varying local pandemic dynamics and types of vaccination programmes, particularly among at-risk populations such as health care workers (HCWs). We analysed a follow-up SARS-CoV-2 serological survey of HCWs at a tertiary COVID-19 referral hospital in Germany following the onset of the Omicron variant.

Methods

The serological survey was conducted in January 2022, one year after previous surveys in 2020 and the availability of COVID-19 boosters including BNT162b2, ChAdOx1-S, and mRNA-1273. HCWs voluntarily provided blood for serology and completed a comprehensive questionnaire. SARS-CoV-2 serological analyses were performed using an Immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA). Antibody levels were reported according to HCW demographic and occupational characteristics, COVID-19 vaccination and SARS-CoV-2 infection history, and multivariate linear regression was used to evaluate these associations.

Results

In January 2022 (following the fourth COVID-19 wave in Germany including the onset of the Omicron variant), 1482/1517 (97.7%) HCWs tested SARS-CoV-2 seropositive, compared to 4.6% in December 2020 (second COVID-19 wave). Approximately 80% had received three COVID-19 vaccine doses and 15% reported a previous laboratory-confirmed SARS-CoV-2 infection. SARS-CoV-2 IgG geometric mean titres ranged from 335 (95% Confidence Intervals [CI]: 258–434) among those vaccinated twice and without previous infection to 2204 (95% CI: 1919–2531) among those vaccinated three times and with previous infection. Heterologous COVID-19 vaccination combinations including a mRNA-1273 booster were significantly associated with the highest IgG antibody levels compared to other schemes. There was an 8-to 10-fold increase in IgG antibody levels among 31 HCWs who reported a SARS-CoV-2 infection in May 2020 to January 2022 after COVID-19 booster vaccination.

Conclusions

Our findings demonstrate the importance of ongoing COVID-19 booster vaccination strategies in the context of variants such as Omicron and despite hybrid immunity from previous SARS-CoV-2 infections, particularly for at-risk populations such as HCWs. Where feasible, effective types of booster vaccination, such as mRNA vaccines, and the appropriate timing of administration should be carefully considered.
The application of plasma circRAD18 in the prediction of gestational diabetes mellitus (GDM) and its adverse effects
Authors: Ni Nanying , Li Lina , Xiao Mei , Yu Fengqin
Published: April 2024

Background

In cancer biology, circRAD18 promotes glucose metabolism, potentially indicating its involvement in glucose metabolism-related disorders, such as gestational diabetes mellitus (GDM). The present study investigated the predictive role of circRAD18 in GDM and its potential adverse effects.

Methods

A total of 482 women who intended to get pregnant in short-term were enrolled. For those who successfully conceived, plasma samples were collected and followed up until delivery to monitor the occurrence of GDM and its associated adverse events. The accumulation of circRAD18 in plasma was analyzed using RT-qPCR. GDM-free curves and ROC curves were plotted to assess the predictive value of plasma circRAD18 for GDM.

Results

After admitting 482 female patients, 388 of them achieved pregnancy within half a year. During the follow-up period, 52 cases were diagnosed with GDM. Compared to non-GDM group (n = 336), the GDM group (n = 52) had a lower accumulation level of circRAD18 on the day of pregnancy confirmation. In addition, low levels of circRAD18 accumulation on that day distinguished potential GDM patients from non-GDM cases. The 388 cases were divided into high and low circRAD18 level groups (n = 194). GDM-free curve analysis showed that patients in the low circRAD18 level group had a higher incidence of GDM compared to the high level group (43/194 vs. 9/194). A close association was found between low levels of plasma circRAD18 and hypertension, but not premature delivery, intrauterine death, malformation, intrauterine infection, miscarriage, macrosomia or intrauterine distress.

Conclusion

The reduction in the accumulation of plasma circRAD18 is predictive of GDM and hypertension in pregnant women.
Modulating DNA damage response in uveal melanoma through embryonic stem cell microenvironment
Authors: Zhang Yingxu , Zheng Jinbiao , Chen Minyu , Zhao Shulun , Ma Ruiqian , Chen Wenwei , Liu Jiahui
Published: April 2024

Background

Uveal melanoma (UVM) is the most common primary intraocular tumor in adults, with a median survival of 4–5 months following metastasis. DNA damage response (DDR) upregulation in UVM, which could be linked to its frequent activation of the PI3K/AKT pathway, contributes to its treatment resistance. We have reported that embryonic stem cell microenvironments (ESCMe) can revert cancer cells to less aggressive states through downregulation of the PI3K signaling, showing promise in modulating the DDR of UVM.

Methods

Since nonhomologous end joining (NHEJ) is the main DNA repair mechanism in UVM, this study utilized gene expression analysis and survival prognosis analysis to investigate the role of NHEJ-related genes in UVM based on public databases. Xenograft mouse models were established to assess the therapeutic potential of ESC transplantation and exposure to ESC-conditioned medium (ESC-CM) on key DNA repair pathways in UVM. Quantitative PCR and immunohistochemistry were used to analyze NHEJ pathway-related gene expression in UVM and surrounding normal tissues. Apoptosis in UVM tissues was evaluated using the TUNEL assay.

Results

PRKDC, KU70, XRCC5, LIG4 and PARP1 showed significant correlations with UM progression. High expression of PRKDC and XRCC5 predicted poorer overall survival, while low PARP1 and XRCC6 expression predicted better disease-free survival in UVM patients. ESCMe treatment significantly inhibited the NHEJ pathway transcriptionally and translationally and promoted apoptosis in tumor tissues in mice bearing UVM. Furthermore, ESC transplantation enhanced DDR activities in surrounding normal cells, potentially mitigating the side effects of cancer therapy. Notably, direct cell-to-cell contact with ESCs was more effective than their secreted factors in regulating the NHEJ pathway.

Conclusions

Our results suggest that NHEJ-related genes might serve as prognostic markers and therapeutic targets in UVM. These findings support the therapeutic potential of ESC-based therapy in enhancing UVM sensitivity to radiochemotherapy and improving treatment outcomes while minimizing damage to healthy cells.