bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary screening of biomarkers in HAPE based on quasi-targeted metabolomics
Authors: Lin Xue , Dai Chongyang , Chen Zhi , Zhang Tongzuo , Pu Xiaoyan
Published: March 2023

High altitude pulmonary edema (HAPE) is a serious threat to the physical and mental health of people who quickly enter high plateaus, deserves more attention and in-depth research. In our study, through the detection of various physiological indexes and other phenotypes in a HAPE rat model, the HAPE group showed a significant decrease in oxygen partial pressure and oxygen saturation, and a significant increase in pulmonary artery pressure and lung tissue water content. The lung histomorphology showed characteristics such as pulmonary interstitial thickening and inflammatory cell infiltration. We applied quasi-targeted metabolomics to compare and analyze the components of metabolites in arterial–veinous blood in control rats and HAPE rats. Using kyoto Encyclopedia of Genes Genomes (KEGG) enrichment analysis and two machine algorithms, we speculate that after hypoxic stress and comparing arterial blood and venous blood products in rats, the metabolites were richer, indicating that normal physiological activities, such as metabolism and pulmonary circulationhad a greater impact after hypoxic stress; D-mannoseDOWN, oxidized glutathioneDOWN, glutathione disulfideDOWN, and dehydrocholic acidDOWN in arterial blood play key roles in predicting the occurrence of HAPE; in venous blood, L-leucineDOWN, L-thyroxineDOWN, and cis-4-hydroxy- D-prolineDOWN may have key roles, which can be considered biomarkers of HAPE. This result provides a new perspective for the further diagnosis and treatment of plateau disease and lays a strong foundation for further research.
Usefulness of cultivar-level calibration of AquaCrop for vegetables depends on the crop and data availability
Authors: Coudron Willem , De Frenne Pieter , Verheyen Kris , Gobin Anne , Boeckaert Charlotte , De Cuypere Tim , Lootens Peter , Pollet Sabien , De Swaef Tom
Published: March 2023

As a result of climate change, climatic extremes are expected to increase. For high-value crops like vegetables, irrigation is a potentially economically viable adaptation measure in western Europe. To optimally schedule irrigation, decision support systems based on crop models like AquaCrop are increasingly used by farmers. High value vegetable crops like cauliflower or spinach are grown in two distinct growth cycles per year and, additionally, have a high turnover rate of new varieties. To successfully deploy the AquaCrop model in a decision support system, it requires a robust calibration. However, it is not known whether parameters can be conserved over both growth periods, nor whether a cultivar dependent model calibration is always required. Furthermore, when data are collected from farmers’ fields, there are constraints in data availability and uncertainty. We collected data from commercial cauliflower and spinach fields in Belgium in 2019, 2020 and 2021 during different growing periods and of different cultivars. With the use of a Bayesian calibration, we confirmed the need for a condition or cultivar specific calibration for cauliflower, while for spinach, splitting the data per cultivar or pooling the data together did not improve uncertainty on the model simulations. However, due to uncertainties arising from field specific soil and weather conditions, or measurement errors from calibration data, real time field specific adjustments are advised to simulations when using AquaCrop as decision support tool. Remotely sensed or in situ ground data may be invaluable information to reduce uncertainty on model simulations.
Physiological, biochemical, and metabolic changes in diploid and triploid watermelon leaves during flooding
Authors: He Nan , Umer Muhammad Jawad , Yuan Pingli , Wang Weiwei , Zhu Hongju , Lu Xuqiang , xing Yan , Gong Chengsheng , Batool Raufa , Sun Xiaowu , Liu Wenge
Published: March 2023

Background

Flooding is a major stress factor impacting watermelon growth and production globally. Metabolites play a crucial role in coping with both biotic and abiotic stresses.

Methods

In this study, diploid (2X) and triploid (3X) watermelons were investigated to determine their flooding tolerance mechanisms by examining physiological, biochemical, and metabolic changes at different stages. Metabolite quantification was done using UPLC-ESI-MS/MS and a total of 682 metabolites were detected.

Results

The results showed that 2X watermelon leaves had lower chlorophyll content and fresh weights compared to 3X. The activities of antioxidants, such as superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT), were higher in 3X than in 2X. 3X watermelon leaves showed lower O2 production rates, MDA, and hydrogen peroxide (H2O2) levels in response to flooding, while higher ethylene production was observed. 3X had higher levels of dehydrogenase activity (DHA) and ascorbic acid + dehydrogenase (AsA + DHA), but both 2X and 3X showed a significant decline in the AsA/DHA ratio at later stages of flooding. Among them, 4-guanidinobutyric acid (mws0567), an organic acid, may be a candidate metabolite responsible for flooding tolerance in watermelon and had higher expression levels in 3X watermelon, suggesting that triploid watermelon is more tolerant to flooding.

Conclusion

This study provides insights into the response of 2X and 3X watermelon to flooding and the physiological, biochemical, and metabolic changes involved. It will serve as a foundation for future in-depth molecular and genetic studies on flooding response in watermelon.
Photoacclimation and entrainment of photosynthesis by fluctuating light varies according to genotype in Arabidopsis thaliana
Authors: Burgess Alexandra J. , Retkute Renata , Murchie Erik H.
Published: March 2023

Acclimation of photosynthesis to light intensity (photoacclimation) takes days to achieve and so naturally fluctuating light presents a potential challenge where leaves may be exposed to light conditions that are beyond their window of acclimation. Experiments generally have focused on unchanging light with a relatively fixed combination of photosynthetic attributes to confer higher efficiency in those conditions. Here a controlled LED experiment and mathematical modelling was used to assess the acclimation potential of contrasting Arabidopsis thaliana genotypes following transfer to a controlled fluctuating light environment, designed to present frequencies and amplitudes more relevant to natural conditions. We hypothesize that acclimation of light harvesting, photosynthetic capacity and dark respiration are controlled independently. Two different ecotypes were selected, Wassilewskija-4 (Ws), Landsberg erecta (Ler) and a GPT2 knock out mutant on the Ws background (gpt2-), based on their differing abilities to undergo dynamic acclimation i.e. at the sub-cellular or chloroplastic scale. Results from gas exchange and chlorophyll content indicate that plants can independently regulate different components that could optimize photosynthesis in both high and low light; targeting light harvesting in low light and photosynthetic capacity in high light. Empirical modelling indicates that the pattern of ‘entrainment’ of photosynthetic capacity by past light history is genotype-specific. These data show flexibility of photoacclimation and variation useful for plant improvement.
Water use efficiency responses to fluctuating soil water availability in contrasting commercial sugar beet varieties
Authors: Barratt Georgina E. , Murchie Erik H. , Sparkes Debbie L.
Published: March 2023

Many areas of sugar beet production will face hotter and drier summers as the climate changes. There has been much research on drought tolerance in sugar beet but water use efficiency (WUE) has been less of a focus. An experiment was undertaken to examine how fluctuating soil water deficits effect WUE from the leaf to the crop level and identify if sugar beet acclimates to water deficits to increase WUE in the longer term. Two commercial sugar beet varieties with contrasting upright and prostrate canopies were examined to identify if WUE differs due to contrasting canopy architecture. The sugar beet were grown under four different irrigation regimes (fully irrigated, single drought, double drought and continually water limited) in large 610 L soil boxes in an open ended polytunnel. Measurements of leaf gas exchange, chlorophyll fluorescence and relative water content (RWC) were regularly undertaken and stomatal density, sugar and biomass yields and the associated WUE, SLW and Δ13C were assessed. The results showed that water deficits generally increase intrinsic (WUEi) and dry matter (WUEDM) water use efficiency but reduce yield. Sugar beet recovered fully after severe water deficits, as assessed by leaf gas exchange and chlorophyll fluorescence parameters and, except for reducing canopy size, showed no other acclimation to drought, and therefore no changes in WUE or drought avoidance. Spot measurements of WUEi, showed no differences between the two varieties but the prostrate variety showed lower Δ13C values, and traits associated with more water conservative phenotypes of a lower stomatal density and greater leaf RWC. Leaf chlorophyll content was affected by water deficit but the relationship with WUE was unclear. The difference in Δ13C values between the two varieties suggests traits associated with greater WUEi may be linked to canopy architecture.
Nitric oxide promotes adventitious root formation in cucumber under cadmium stress through improving antioxidant system, regulating glycolysis pathway and polyamine homeostasis
Authors: Niu Lijuan , Tang Yunlai , Zhu Bo , Huang Zhenfu , Wang Dan , Chen Qiyang , Yu Jian
Published: March 2023

Cadmium (Cd) as a potentially toxic heavy metal that not only pollutes the environment but also interferes with plant growth. Nitric oxide (NO) regulates plant growth and development as well as abiotic stress response. However, the mechanism underpinning NO-induced adventitious root development under Cd stress remains unclear. In this study, cucumber (Cucumis sativus ‘Xinchun No. 4’) was used as the experimental material to investigate the effect of NO on the development of adventitious roots in cucumber under Cd stress. Our results revealed that, as compared to Cd stress, 10 μM SNP (a NO donor) could considerably increase the number and length of adventitious roots by 127.9% and 289.3%, respectively. Simultaneously, exogenous SNP significantly increased the level of endogenous NO in cucumber explants under Cd stress. Our results revealed that supplementation of Cd with SNP significantly increased endogenous NO content by 65.6% compared with Cd treatment at 48 h. Furthermore, our study indicated that SNP treatment could improve the antioxidant capacity of cucumber explants under Cd stress by up-regulating the gene expression level of antioxidant enzymes, as well as reducing the levels of malondialdehyde (MDA), hydrogen peroxide (H2O2) and superoxide anion (O2.-) to alleviate oxidative damage and membrane lipid peroxidation. Application of NO resulted in a decrease of the O2.-, MDA, and H2O2 level by 39.6%, 31.4% and 60.8% as compared to Cd-alone treatment, respectively. Besides that, SNP treatment significantly increased the expression level of related genes involved in glycolysis processes and polyamine homeostasis. However, application of NO scavenger 2-(4-carboxy -2-phenyl)-4, 4, 5, 5-tetramethy limidazoline -1-oxyl -3-oxide (cPTIO) and the inhibitor tungstate significantly reversed the positive role of NO in promoting the adventitious root formation under Cd stress. These results suggest that exogenous NO can increase the level of endogenous NO, improve antioxidation ability, promote glycolysis pathway and polyamine homeostasis to enhance the occurrence of adventitious roots in cucumber under Cd stress. In summary, NO can effectively alleviate the damage of Cd stress and significantly promote the development of adventitious root of cucumber under Cd stress.
A mitochondrion-associated PPR protein, WBG1, regulates grain chalkiness in rice
Authors: Wu Mingming , Cai Maohong , Zhai Rongrong , Ye Jing , Zhu Guofu , Yu Faming , Ye Shenghai , Zhang Xiaoming
Published: March 2023

Rice kernel quality has vital commercial value. Grain chalkiness deteriorates rice’s appearance and palatability. However, the molecular mechanisms that govern grain chalkiness remain unclear and may be regulated by many factors. In this study, we identified a stable hereditary mutant, white belly grain 1 (wbg1), which has a white belly in its mature grains. The grain filling rate of wbg1 was lower than that of the wild type across the whole filling period, and the starch granules in the chalky part were oval or round and loosely arranged. Map-based cloning showed that wbg1 was an allelic mutant of FLO10, which encodes a mitochondrion-targeted P-type pentatricopeptide repeat protein. Amino acid sequence analysis found that two PPR motifs present in the C-terminal of WBG1 were lost in wbg1. This deletion reduced the splicing efficiency of nad1 intron 1 to approximately 50% in wbg1, thereby partially reducing the activity of complex I and affecting ATP production in wbg1 grains. Furthermore, haplotype analysis showed that WBG1 was associated with grain width between indica and japonica rice varieties. These results suggested that WBG1 influences rice grain chalkiness and grain width by regulating the splicing efficiency of nad1 intron 1. This deepens understanding of the molecular mechanisms governing rice grain quality and provides theoretical support for molecular breeding to improve rice quality.
Factors associated with changes in healthy lifestyle behaviors among hematological cancer patients during the COVID-19 pandemic
Authors: Zomerdijk Nienke , Jongenelis Michelle I. , Collins Ben , Turner Jane , Short Camille E. , Smith Andrew , Huntley Kathryn
Published: March 2023

Background

There is a paucity of research examining the effects of the COVID-19 pandemic on the healthy lifestyle behaviors of hematological cancer patients. We examined changes in healthy lifestyle behaviors since the pandemic and identified factors associated with these changes among members of this high-risk population.

Methods

Hematological cancer patients (n = 394) completed a self-report online survey from July to August 2020. The survey assessed pandemic-related changes in exercise, alcohol consumption, and consumption of fruit, vegetables, and wholegrains. Information relating to several demographic, clinical, and psychological factors was also collected. Factors associated with changes in healthy lifestyle behaviors were analyzed using logistic regression.

Results

Just 14% of patients surveyed reported exercising more during the pandemic (39% exercised less). Only a quarter (24%) improved their diet, while nearly half (45%) reported eating less fruit, vegetables, and wholegrains. Just over a quarter (28%) consumed less alcohol (17% consumed more alcohol). Fear of contracting COVID-19 and psychological distress were significantly associated with reduced exercise. Younger age was significantly associated with both increased alcohol consumption and increased exercise. Being a woman was significantly associated with unfavorable changes in diet and being married was significantly associated with decreased alcohol consumption.

Conclusion

A substantial proportion of hematological cancer patients reported unfavorable changes in healthy lifestyle behaviors during the pandemic. Results highlight the importance of supporting healthy lifestyle practices among this particularly vulnerable group to ensure health is optimized while undergoing treatment and when in remission, particularly during crisis times like the COVID-19 pandemic.
Path of intuitive compassion to transform conflicts into enduring peace and prosperity: Symmetry across domains of reiterated prisoner's dilemma, dyadic active inference, and Mahayana Buddhism
Authors: Ho S. Shaun , Nakamura Yoshio , Swain James E.
Published: March 2023

Conflicts are increasingly intensified among the members of the community, making it almost impossible to extend compassion—defined as a wish to relieve others from suffering—from one side to the other, especially when both sides believe that “life is a battle of us the good vs. them the evil.” Is compassion even relevant to conflicts? The answer depends on how a conflict is framed in one's perception. If a conflict is perceived in a frame of zero-sum competition, then compassion is meaningless in such a “tug-of-war” mindset. Conversely, if perceived in a non-zero-sum frame—as demonstrated in reiterated prisoner's dilemma (rPD) in which two players may interdependently render win–win, lose–lose, win–lose, or lose–win scenarios by their actions—then compassion can help achieve the most preferable outcomes for all in a “dyadic dance” mindset. In this article, we present a path of intuitive compassion by pointing to symmetry across three distinct domains of rPD, dyadic active inference, and Mahayana Buddhism. In each of these domains, conflicts serve as points of bifurcation on a bidirectional path, and compassion as a conflict-proof commitment to carrying out the best strategies—even if assessed for one's own sake only—that consistently produce optimal payoffs in rPD, minimal stress in dyadic active inference, and limitless joy of ultimate enlightenment in Mahayana Buddhism. Conversely, a lack of compassion is caused by invalid beliefs that obscure the nature of reality in these domains, causing conflicts to produce even more conflicts. These invalid beliefs are produced by mistakes of over-reduction, over-separation, and over-compression in the mind, and therefore, a person's mindset is overly compressed from a multidimensional frame to a one-dimensional frame. Taken together, intuitive compassion is not about how to balance one's self-serving goals with altruistic ones. Rather, it is a conflict-proof commitment to transforming conflicts into enduring peace and prosperity according to the ultimate nature of reality. The work presented here may serve as a preliminary science-informed introduction to a genre of time-tested compassion meditations, i.e., lojong mind training, for the world laden with conflicts, starting from the conflicts in close relationships to those in geopolitics.
Change and convergence of innovation efficiency among listed health companies in China: Empirical study based on the DEA–Malmquist model
Authors: Han Yanqi , Hua Minghui , Huang Malan , Li Jin , Cheng Shixiong , Wei Xihang
Published: March 2023

This study investigates the present situation of and changing trend in the innovation efficiency of health industry enterprises in China. Based on panel data for 192 listed health companies in China from 2015 to 2020, we analyse innovation efficiency using the DEA–Malmquist index and test convergence using σ-convergence and β-convergence models. From 2016 to 2019, comprehensive average innovation efficiency increased from 0.6207 to 0.7220 and average innovation efficiency decreased significantly in 2020. The average Malmquist index was 1.072. Innovation efficiency in China as a whole, North China, South China, and Northwest China showed σ-convergence. Except for the Northwest region, absolute β-convergence was evident, and in China as a whole, North China, Northeast China, East China, and South China, conditional β-convergence was evident. Overall innovation efficiency of these companies has increased annually but needs further improvement, and the COVID-19 pandemic has had a great negative impact on it. Innovation efficiency and trends in it vary across regions. Furthermore, we should pay attention to the impacts of innovation infrastructure and government scientific and technological support on innovation efficiency.
Drivers of behaviors: How do city pilots shape residential energy-related emissions through perceptions?
Authors: Xing Hua , Li Xiangyang
Published: March 2023

Residential energy consumption, as a major source of emissions in cities, is also a policy priority for the construction of low-carbon cities. The occurrence of residential energy saving and emissions mitigation behaviors is closely related to low-carbon perceptions. Against this background, cities make efforts to shape residential low-carbon perceptions. In order to investigate residential energy consumption and carbon emissions, this study takes low-carbon city pilots as the policy context and establishes the difference-in-difference model on Chinese prefecture-level cities. Theory of planned behavior is utilized to analyze the influence mechanism of residential low-carbon perceptions. Results indicated that (1) low-carbon city pilots can decrease residential energy-related emissions and pass a variety of robustness tests. Multiple pilot eligibility and policy lag would reinforce policy effects. (2) Mechanism analysis shows that low-carbon city pilots can strengthen residential behavioral attitudes, establish subjective norms, and adjust perceived behavioral control. All three mechanisms together shape residential low-carbon perceptions, which consequently promote energy-related emissions mitigation behaviors. (3) Due to differences in geographic location and city size, there is heterogeneity for the policy effects of low-carbon city pilots. For the future research, it is necessary to expand the scope of residential energy-related emissions, find out the potential influencing factors, and track the policy effects in long-term.
Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study
Authors: Stephenson Callum , Malakouti Niloufar , Nashed Joseph Y. , Salomons Tim , Cook Douglas J. , Milev Roumen , Alavi Nazanin
Published: March 2023

Background

Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder with current psychotherapeutic treatments, while somewhat effective, yielding low accessibility and scalability. A lack of knowledge regarding the neural pathology of OCD may be hindering the development of innovative treatments. Previous research has observed baseline brain activation patterns in OCD patients, elucidating some understanding of the implications. However, by using neuroimaging to observe the effects of treatment on brain activation, a more complete picture of OCD can be drawn. Currently, the gold standard treatment is cognitive behavioral therapy (CBT). However, CBT is often inaccessible, time-consuming, and costly. Fortunately, it can be effectively delivered electronically (e-CBT).

Objectives

This pilot study implemented an e-CBT program for OCD and observed its effects on cortical activation levels during a symptom provocation task. It was hypothesized that abnormal activations could be attenuated following treatment.

Methods

OCD patients completed a 16-week e-CBT program administered through an online platform, mirroring in-person content. Treatment efficacy was evaluated using behavioral questionnaires and neuroimaging. Activation levels were assessed at the resting state and during the symptom provocation task.

Results

In this pilot, seven participants completed the program, with significant improvements (p < 0.05) observed between baseline and post-treatment for symptom severity and levels of functioning. No statistically significant (p = 0.07) improvement was observed in the quality of life. Participants had mostly positive qualitative feedback, citing accessibility benefits, comprehensive formatting, and relatable content. No significant changes in cortical activation were observed between baseline and post-treatment.

Conclusion

This project sheds light on the application of e-CBT as a tool to evaluate the effects of treatment on cortical activation, setting the stage for a larger-scale study. The program showed great promise in feasibility and effectiveness. While there were no significant findings regarding changes in cortical activation, the trends were in agreeance with previous literature, suggesting future work could provide insight into whether e-CBT offers comparable cortical effects to in-person psychotherapy. Applying a greater knowledge of the neural mechanisms of action in OCD can help develop novel treatment plans in the future.
Predicting life satisfaction based on the emotion words in self-statement texts
Authors: Song Mengyao , Zhao Nan
Published: March 2023

Measuring people's life satisfaction in real time on a large scale is quite valuable for monitoring and promoting public mental health; however, the traditional questionnaire method cannot fully meet this need. This study utilized the emotion words in self-statement texts to train machine learning predictive models to identify an individual's life satisfaction. The SVR model was found to have the best performance, with the correlation between predicted scores and self-reported questionnaire scores achieving 0.42 and the split-half reliability achieving 0.939. This result demonstrates the possibility of identifying life satisfaction through emotional expressions and provides a method to measure the public's life satisfaction online. The word categories selected through the modeling process were happy (PA), sorrow (NB), boredom (NE), reproach (NN), glad (MH), aversion (ME), and N (negation + positive), which reveal the specific emotions in self-expression relevant to life satisfaction.
Barriers to adequate nutrition care for child malnutrition in a low-resource setting: Perspectives of health care providers
Authors: Elhady Ghada Wahby , Ibrahim Sally kamal , Abbas Enas S. , Tawfik Ayat Mahmoud , Hussein Shereen Esmat , Salem Marwa Rashad
Published: March 2023

Introduction

Several studies in developing countries found that more need-based training is required for health care providers (HCPs) in child malnutrition management.

Methods

An exploratory cross-sectional study was conducted to explore barriers to providing adequate nutrition care as perceived by the healthcare providers (HCPs) in the child malnutrition clinic at a Children's University Hospital in Egypt. Participants were selected using the purposive sampling technique. Five out of seven HCPs in the clinic were included (two male physicians, one female physician, and two female nurses). Qualitative data were collected through in-depth interviews. The interview guide consisted of semi-structured open-ended questions. Quantitative data were the resulting scores from the scoring system used to assess the understandability and actionability of the patient education materials (PEMs) that are available in the clinic. The Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) for the scoring. Statistical analysis: The thematic content analysis technique was employed for qualitative data. The percent score was generated for the PEM actionability and understandability for quantitative data.

Results

Most common child malnutrition conditions encountered by HCPs were nutritional deficiencies. Barriers to the delivery of adequate nutrition care to children were physician-centered: limited nutrition education in the medical school, health system-centered: an insufficient number of HCPs, lack of nutritional supplements, lack of patient education materials (PEMs) that suit the characteristics of the served community, lack of updated standard of practice (SOP) and guidelines, inadequate nutrition training of HCPs, and insufficient time for each patient, and caregivers-centered: the low socioeconomic status and false cultural, nutritional beliefs.

Conclusion

There are different barriers to adequate nutrition care for child malnutrition in low-resource healthcare settings. Mainly nutritional deficiencies. Most of the barriers were health system-related in the form of insufficient resources (shortage of workforce; concerning the high caseload, nutritional supplements, and PEMs) and inadequate management of resources (lack of skill-based training, lack of updated SOP and guidelines, and lack of properly designed PEMs that facilitate communication with the target caregivers).
Latency period of aristolochic acid-induced upper urinary tract urothelial carcinoma
Authors: Jhuang Jing-Rong , Chiu Po-Chun , Hsieh Tung-Che , Chen Chung-Hsin , Pu Yeong-Shiau , Lee Wen-Chung
Published: March 2023

Purpose

Aristolochic acid (AA) is a carcinogen in upper urinary tract urothelial carcinoma (UTUC). This study investigated the latency period between AA exposure and UTUC development.

Materials and methods

This population-based cohort study was designed using record linkage of the National Health Insurance Research Database (NHIRD), Taiwan Cancer Registry Dataset, and cause-of-death data in Taiwan. Those aged 40–79 years were enrolled in this study. Patients who died or had renal insufficiency or UTUC before 2005 were excluded. The doses of AA exposure and rates of comorbidities between 2000 and 2005 were obtained. The Cox proportion hazard model was used to estimate the risk of UTUC between 2005 and 2016. In addition, the Cox model with time-varying coefficient of AA was used to measure the latency period of UTUC.

Results

Of the 752,232 participants enrolled from the NHIRD, 520,871 (68.29%), 210,447 (27.59%), and 31,415 (4.12%) were exposed to cumulative AA doses of 0–1 mg, 1–150 mg, and >150 mg, respectively. A total of 1,147 (0.15%) patients were diagnosed with UTUC between 2005 and 2016. The latency periods of UTUC in middle-aged (40–59 years old) men with cumulative AA doses of 1–150 mg and middle-aged women with cumulative AA doses of 1–150 mg and >150 mg were 8, 9, and 7 years, respectively. Among the aged (60–79 years) individuals, no time-varying effect was observed, and the latency period could not be measured.

Conclusion

A decreased risk of UTUC was observed after the ban on AA in Taiwan, especially in middle-aged women with moderate to high doses of AA exposure and men with moderate doses of AA exposure. The latency period of UTUC varies with age, the dose of AA exposure, and sex.
Burnout and associative emotional status and coping style of healthcare workers in COVID-19 epidemic control: A cross-sectional study
Authors: Yang Cece , Wang Xunqiang , Zhang Xing , Liu Wenping , Wang Chengmin
Published: March 2023

Objective

The aim of this study was to evaluate the prevalence of burnout, clinical anxiety, depression, and insomnia and to estimate the associations of adverse emotional status, coping style, and level of self-efficacy with burnout of healthcare workers in the Shenzhen Longgang District Frontline District Headquarters of COVID-19 epidemic control, China.

Methods

In this cross-sectional study, 173 staff completed the anonymous questionnaires of the Maslach Burnout Inventory, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7), Insomnia Severity Index (ISI), General Self-efficacy Scale, and Simplified Coping Style Questionnaire electronically (https://www.wjx.cn/) in June 2022. Hierarchical logistic regression was used to explore the associated factors of burnout in this study.

Results

The prevalence of burnout in our participants (defined as high emotional exhaustion or high depersonalization) was 47.40%, and reduced personal accomplishment was 92.49%. The prevalence of clinically significant depression (the cutoff score of ≥15), anxiety (the cutoff score of ≥10), and insomnia (the cutoff score of ≥15) was 11.56, 19.08, and 19.08%, respectively. There was a degree of overlap between burnout and other measures of adverse mental status, most notably for anxiety (odds ratio, 27.049; 95% CI, 6.125–117.732; p < 0.001). Hierarchical logistic regression demonstrated that burnout was strongly associated with anxiety (OR = 23.889; 95% CI, 5.216–109.414; p < 0.001) and negative coping style (OR = 1.869; 95% CI, 1.278–2.921; p < 0.01) independently.

Conclusion

Medical staff involved in COVID-19 epidemic control in the post-epidemic era were at high risk of burnout, and most of them were in low personal accomplishment. Reducing anxiety and improving coping style by medical management institutions from the system level may be effective in alleviating burnout in healthcare workers.
Cost-effectiveness analysis of a hand hygiene monitoring system in a tertiary pediatric hospital in Mexico
Authors: Salinas-Escudero Guillermo , Rosa-Zamboni Daniela De la , Carrillo-Vega María Fernanda , Gamiño-Arroyo Ana Estela , Toledano-Toledano Filiberto , Ortega-Riosvelasco Fernando , Granados-García Víctor , Villa-Guillén Mónica , Garduño-Espinosa Juan
Published: March 2023

Background

An automated hand-hygiene monitoring system (AHHMS) was implemented in October 2019 at the Hospital Infantil de México Federico Gómez (HIMFG), a tertiary pediatric referral hospital, in four of the hospital wards with the highest rates of Healthcare Associated Infections (HAIs). The clinical and economic impact of this system had not yet been assessed prior to this study. This study aimed to evaluate if the AHHMS is a cost-effective alternative in reducing HAIs in the HIMFG.

Methodology

A full cost-effectiveness economic assessment was carried out for the hospital. The alternatives assessed were AHHMS implementation vis-a-vis AHHMS non-implementation (historical tendency). The outcomes of interest were infection rate per 1,000 patient-days and cost savings as a result of prevented infections. Infection rate data per 1,000 patient-days (PD) were obtained from the hospital's Department of Epidemiology with respect to the AHHMS. As regards historical tendency, an infection-rate model was designed for the most recent 6-year period. Infection costs were obtained from a review of available literature on the subject, and the cost of the implemented AHHMS was provided by the hospital. The assessment period was 6 months. The incremental cost-effectiveness ratio was estimated. Costs are reported in US Dollars (2021). Univariate sensitivity and threshold analysis for different parameters was conducted.

Results

The total estimated cost of the AHHMS alternative represented potential savings of $308,927–$546,795 US Dollars compared to non-implementation of the system (US$464,102 v. US$773,029–$1,010,898) for the period. AHHMS effectiveness was reflected in a diminished number of infections, 46–79 (−43.4–56.7%) compared to non-implementation (60 v. 106-139 infections).

Conclusion

The AHHMS was found to be a cost-saving alternative for the HIMFG given its cost-effectiveness and lower cost vis-a-vis the alternate option. Accordingly, the recommendation was made of extending its use to other areas in the hospital.
Associations between short-term PM2.5 exposure and daily hospital admissions for circulatory system diseases in Ganzhou, China: A time series study
Authors: You Xiaojie , Cao Xiuyu , Guo You , Wang Dongming , Qiu Weihong , Zhou Chuanfei , Zhou Min , Chen Weihong , Zhang Xiaokang
Published: March 2023

Objective

Previous epidemiological studies have shown that both long-term and short-term exposure to fine particulate matters (PM2.5) were associated with the morbidity and mortality of circulatory system diseases (CSD). However, the impact of PM2.5 on CSD remains inconclusive. This study aimed to investigate the associations between PM2.5 and circulatory system diseases in Ganzhou.

Methods

We conducted this time series study to explore the association between ambient PM2.5 exposure and daily hospital admissions for CSD from 2016 to 2020 in Ganzhou by using generalized additive models (GAMs). Stratified analyses were also performed by gender, age, and season.

Results

Based on 201,799 hospitalized cases, significant and positive associations were found between short-term PM2.5 exposure and hospital admissions for CSD, including total CSD, hypertension, coronary heart disease (CHD), cerebrovascular disease (CEVD), heart failure (HF), and arrhythmia. Each 10 μg/m3 increase in PM2.5 concentrations was associated with a 2.588% (95% confidence interval [CI], 1.161%–4.035%), 2.773% (95% CI, 1.246%–4.324%), 2.865% (95% CI, 0.786%–4.893%), 1.691% (95% CI, 0.239%–3.165%), 4.173% (95% CI, 1.988%–6.404%) and 1.496% (95% CI, 0.030%–2.983%) increment in hospitalizations for total CSD, hypertension, CHD, CEVD, HF, and arrhythmia, respectively. As PM2.5 concentrations rise, the hospitalizations for arrhythmia showed a slow upward trend, while other CSD increased sharply at high PM2.5 levels. In subgroup analyses, the impacts of PM2.5 on hospitalizations for CSD were not materially changed, although the females had higher risks of hypertension, HF, and arrhythmia. The relationships between PM2.5 exposure and hospitalizations for CSD were more significant among individuals aged ≤65 years, except for arrhythmia. PM2.5 had stronger effects on total CSD, hypertension, CEVD, HF, and arrhythmia during cold seasons.

Conclusion

PM2.5 exposure was positively associated with daily hospital admissions for CSD, which might provide informative insight on adverse effects of PM2.5.
COVID-19 surveillance: Large decrease in clinical notifications and epidemiological investigation questionnaires for laboratory-confirmed cases after the 2nd epidemic wave, Portugal March 2020–July 2021
Authors: Ricoca Peixoto Vasco , Vieira André , Aguiar Pedro , Sentis Alexis , Carvalho Carlos , Rhys Thomas Daniel , Abrantes Alexandre , Nunes Carla
Published: March 2023

Introduction

In Portugal, COVID-19 laboratory notifications, clinical notifications (CNs), and epidemiological investigation questionnaires (EI) were electronically submitted by laboratories, clinicians, and public health professionals, respectively, to the Portuguese National Epidemiological Surveillance System (SINAVE), as mandated by law. We described CN and EI completeness in SINAVE to inform pandemic surveillance efforts.

Methods

We calculated the proportion of COVID-19 laboratory-notified cases without CN nor EI, and without EI by region and age group, in each month, from March 2020 to July 2021. We tested the correlation between those proportions and monthly case counts in two epidemic periods and used Poisson regression to identify factors associated with the outcomes.

Results

The analysis included 909,720 laboratory-notified cases. After October 2020, an increase in the number of COVID-19 cases was associated with a decrease in the submissions of CN and EI. By July 2021, 68.57% of cases had no associated CN nor EI, and 96.26% had no EI. Until January 2021, there was a positive correlation between monthly case counts and the monthly proportion of cases without CN nor EI and without EI, but not afterward. Cases aged 75 years or older had a lower proportion without CN nor EI (aRR: 0.842 CI95% 0.839–0.845). When compared to the Norte region, cases from Alentejo, Algarve, and Madeira had a lower probability of having no EI (aRR;0.659 CI 95%0.654–0.664; aRR 0.705 CI 95% 0.7–0.711; and aRR 0.363 CI 95% 0.354–0.373, respectively).

Discussion

After January 2021, CN and EI were submitted in a small proportion of laboratory-confirmed cases, varying by age and region. Facing the large number of COVID-19 cases, public health services may have adopted other registry strategies including new surveillance and management tools to respond to operational needs. This may have contributed to the abandonment of official CN and EI submission. Useful knowledge on the context of infection, symptom profile, and other knowledge gaps was no longer adequately supported by SINAVE. Regular evaluation of pandemic surveillance systems' completeness is necessary to inform surveillance improvements and procedures considering dynamic objectives, usefulness, acceptability, and simplicity.
Supporting the future of medicine: Student mental health services in medical school
Authors: Hale Elijah W. , Davis Rachel A.
Published: March 2023

Background

Mental health issues are common among United States medical students, and the AAMC has established recommendations for student mental health services provided by medical schools. Few studies directly compare mental health services at medical schools across the United States and, to our knowledge, none analyze how well schools adhere to the established AAMC recommendations.

Objective

To determine whether mental health services at United States medical schools adhere to established guidelines.

Methods

From October 2021 to March 2022, we obtained student handbooks and policy manuals from 77% of the accredited LCME United States medical schools. The AAMC guidelines were operationalized and placed into a rubric format. Each set of handbooks was independently scored against this rubric. A total of 120 handbooks were scored and the results were compiled.

Results

Rates of comprehensive adherence were very low, with only 13.3% of schools displaying adherence to the full set of AAMC guidelines. Partial adherence was higher, with 46.7% of schools meeting at least one of three guidelines. Portions of guidelines whose requirements reflected a standard for LCME accreditation displayed a higher rate of adherence.

Conclusion

The low rates of adherence across medical schools, as measured by handbooks and Policies & Procedures manuals, represents an opportunity to improve the mental health services within United States allopathic schools. An increase in adherence could be a step towards improving the mental health of United States medical students.
Soundscape structure in forests surrounded by protected and productive areas in central Costa Rica
Authors: Retamosa Izaguirre Mónica , Barrantes Madrigal Jimy
Published: March 2023

Ecosystems are under a multitude of pressures, including land-use change, overexploitation, pollution, and climate change. Most studies, resources, and conservation efforts are allocated to protected areas, while anthropogenic activities in their surroundings may affect them in ways that are poorly understood. We evaluated soundscape structure in forests surrounded by protected or productive areas in central Costa Rica. We sampled soundscapes in 91 recording sites in Grecia Forest Reserve and Poas Volcano National Park, and surrounding areas with productive activities (predominantly agricultural and urban). We classified sampling sites into three clusters according to landscape entropy, forest amount, and fragmentation surrounding recording points: more fragmented, more conserved, and intermediate. The conserved cluster showed higher acoustic diversity or entropy, but lower acoustic complexity, shorter duration of sounds in all frequency ranges, and lower amount of energy in the biological frequency bands than the fragmented cluster. We additionally found a positive significant relationship between the amount of forest and acoustic entropy or diversity indices, but a negative relationship with acoustic activity or energy indices. Indices, such as spectral and temporal entropy, the entropy of spectral variance, and total entropy, seemed to be a better fit than acoustic complexity and bioacoustic indices as indicators of habitat conservation in this study. Acoustic indices revealed that the surrounding matrices of protected areas have an impact on acoustic environments. We encourage researchers and decision-makers to carefully interpret acoustic indices when evaluating habitats showing a higher value in acoustic energy or activity because this might not necessarily reflect either a high level of biodiversity or habitat conservation. Also, we highlight the importance of preserving undisturbed forested matrices around protected areas, as they are important for maintaining acoustic diversity.
Research on the flow characteristics identification of steam turbine valve based on FCM-LSSVM
Authors: Hao Xiaoguang , Jin Fei , Wang Bin , Zhang Qinghao , Wu Chuang , Sun Hao
Published: March 2023

Due to aging and deformation of the through-flow path and system modifications, the flow characteristics of the turbine inlet valve often deviate from the design value, which affects the unit load control accuracy and operational stability. In order to obtain the actual valve flow characteristics of the turbine and thus improve the FM performance, an FCMLSSVM model is proposed in this paper to identify the valve flow characteristics. First, FCM clustering is proposed to classify the historical operating data of the plant and obtain a wide range of variable operating conditions. Then, using least squares support vector machine (LSSVM), the relationship between turbine input and output variables was modeled in each condition cluster, with integrated valve position command, speed, and real power generated as input variables and actual steam inlet flow as output variables. Using a 330 MW turbine unit as an application example, the established FCM-LSSVM model was validated for the valve flow characteristics of the turbine. The results show that the model can obtain accurate valve flow characteristics without conducting tests on the turbine. The method can save a lot of labor and material resources in doing the characteristic test, and after comparison, the proposed method can identify the flow characteristics more accurately among the existing neural network identification methods, which can provide technical support to improve the unit frequency regulation characteristics and improve the accuracy of valve operation.
Intimate partner sexual violence during pregnancy and its associated factors in Northwest Ethiopian women
Authors: Azene Zelalem Nigussie , Merid Mehari Woldemariam , Taddese Asefa Adimasu , Andualem Zewudu , Amare Nakachew Sewnet , Taye Birhan Tsegaw
Published: March 2023

Background

Violence against women is a global problem. In pregnant women, it is a particular concern as a virtue of the additional risks to the unborn child. Of different acts of violence, sexual violence shares the major contribution that results in short and long-term physical, sexual, reproductive, and mental health problems of pregnant women. Little is known about sexual violence during pregnancy in Ethiopia.

Objective

this study aimed to assess the proportion and factors associated with intimate partners' sexual violence against pregnant women in Northwest Ethiopia.

Methods

A cross-sectional study was conducted among 409 pregnant women in Debre Markos town from March to April 2018. The study participants were selected using a systematic random sampling technique. A pre-tested and validated questionnaire was used. Binary logistic regression analyses were done to identify associated factors and the adjusted odds ratio (AOR) with its 95 % confidence interval (CI) at a p-value of <0.05 was used to declare a significant association.

Result

Of 409 pregnant women, 19.8% have experienced sexual violence by their intimate partner during their current pregnancy. Accordingly, the major intimate partner sexual violence during pregnancy was having unwanted sexual intercourse due to fear from the partner (13.4%), being forced to do something sexual that is degrading or humiliating (13.0%), and being physically forced to have sexual intercourse (9.8%). Living with her partner/husband (AOR: 3.73, 95% CI: 1.30, 10.69), uneducated educational status of partner (AOR: 2.43, 95% CI: 1.06, 5.56), and frequency of alcohol consumption (AOR: 3.20, 95% CI: 1.24, 8.26) were factors associated with increased occurrence of intimate partner sexual violence during pregnancy.

Conclusion

The proportion of sexual violence against pregnant women by their intimate partner(s) was found to be common in our study. Socio-demographic and behavioral-related factors were risk factors for sexual violence. As a result, preventive strategies and interventions centering on the empowerment of those facing the greatest barriers to reproductive freedom require a shift from traditional ways of thinking.