bluuebunny/crossref_metadata_2025 huggingface dataset:
AM1241 inhibits chondrocyte inflammation and ECM degradation through the Nrf2/HO-1 and NF-κB pathways and alleviates osteoarthritis in mice
Authors: Zou Zhuan , Pan Songmu , Sun Changzheng , Wei Jiyong , Xu Yi , Xiao Kaizhen , Zhao Jinmin , Gu Ronghe
Published: January 2025

Background

This study aimed to investigate the impact of AM1241 on lipopolysaccharide (LPS)-induced chondrocyte inflammation in mice and its potential mechanism for improving osteoarthritis (OA).

Methods

The OA mice model was established employing the refined Hulth method. The impact of different concentrations of AM1241 on mice chondrocyte activity was detected using CCK-8. Changes in the levels of LPS-induced inflammatory factors and cartilage extracellular matrix (ECM) degradation in chondrocytes were determined by western blot, RT-qPCR, ELISA, and immunofluorescence assays, respectively. The specific action modes and binding sites of AM1241 with NEMO/IκB kinases (IKKs) in the NF-κB pathway and Keap1 protein in the Nrf2 pathway were predicted via molecular docking and molecular dynamics simulation, and the NF-κB and Nrf2 pathways were detected using western blot and immunofluorescence. In vivo, the impact of AM1241 on OA mice was analyzed through safranin-fast green staining, IHC staining, Mankin score, and microCT.

Results

AM1241 inhibited the levels of LPS-induced transforming growth factor-β (TGF-β1), tumor necrosis factor-α (TNF-α), interleukin 6 (IL-6), matrix metalloproteinase-13 (MMP-13), and a disintegrin and metalloproteinase with thrombospondin motif 5 (ADAMTS-5) and diminished the degradation of type II collagen and Aggrecan. For the mechanism, AM1241 regulated the NF-kB and Nrf2/HO-1 signaling pathways by binding to NEMO/IKKβ and Keap1 target proteins and suppressed the activation of the NF-κB signaling pathway by activating the Nrf2 in chondrocytes. In vivo, AM1241 inhibited bone anabolism, mitigated articular cartilage hyperplasia and wear, and reduced the Mankin score in mice, thereby hindering the development of OA.

Conclusion

AM1241 inhibited activation of the NF-κB signaling pathway via activating Nrf2. It suppressed the expression of inflammation factors and the degradation of ECM in vitro, and improved OA in mice in vivo, suggesting its potential as an effective drug candidate for the treatment of OA. The remarkable efficacy of AM1241 in alleviating murine OA positions it as a potential therapeutic strategy in the clinical management of OA diseases.
The prevalence of frailty among older adults with maintenance hemodialysis: a systematic
Authors: Li Juanjuan , Xiao Wenyi , Wang Lijuan , Zhang Miao , Ge Yurong
Published: January 2025

Background

To evaluate the epidemiological data on the prevalence of frailty and prefrailty in individuals aged 60 years or older on MHD patients.

Methods

PubMed, Web of Science, Embase, CNKI, WanFang, CBM, and VIP were searched from inception to February 2023 using combinations of subject words and free words. The methodological quality of all the selected studies was assessed using the Joanna Briggs Institute Critical Appraisal of Epidemiological Studies Checklist and Newcastle‒Ottawa Cohort Quality Assessment Scale. Random effects meta-analysis was used to pool estimates from different studies. Subgroup analysis and meta-regression were performed to explore potential sources of heterogeneity.

Results

Of the 4,190 documents retrieved, 16 observational studies involving 2,446 participants from 8 countries were included in this systematic review. Among older adults receiving MHD, the overall prevalence of frailty and prefrailty was 41% (95% CI = 34–49%) and 37% (95% CI = 26–48%), respectively, with considerable heterogeneity. The pooled prevalence of frailty was greater among individuals aged > 70 years (45%) than among those aged ≤ 70 years (37%). However, subgroup analyses indicated that the confidence intervals for the age group overlap substantially.

Conclusion

Our research showed that the prevalence of frailty and prefrailty in older patients with MHD are high.

Trial registration

The PROSPERO registration number for this study was CRD42023442569.
Prognostic role of the pathological status following neoadjuvant chemoradiotherapy and surgery in esophageal squamous cell carcinoma
Authors: Duan Xiaofeng , Yue Jie , Wang Shangren , Zhao Fangdong , Zhang Wencheng , Qie Shuo , Jiang Hongjing
Published: January 2025

Background

In this study, we retrospectively examined the prognostic significance of the pathological status of esophageal squamous cell carcinoma (ESCC) patients following neoadjuvant chemoradiotherapy (NCRT) and surgery.

Methods

Data of patients with cT2-4aN0-3 stage ESCC who underwent NCRT and esophagectomy during 2014–2022 were reviewed retrospectively. Survival differences were compared according to revised TN (rTN) stage (ypT0N0, ypT + N0, ypT0N+, and ypT + N+) using univariate and Cox regression analyses.

Results

Of the 136 patients (59.1 ± 7.2 y) included in this study, 123 (90.4%) were males. There were 39 (28.7%) patients with ypT0N0 disease, 49 (36.0%) ypT + N0, 11 (8.1%) ypT0N+, and 37 (27.2%) ypT + N+. Additionally, 126 patients had a median follow-up period of 30 (1–90) months. The 5-year overall survival was 81.6% in ypT0N0 group, 53.1% for ypT + N0, 50.0% for ypT0N+, and 18.6% for ypT + N+ (p < 0.001) and 5-year disease-free survival was 70.1% for ypT0N0, 39.7% for ypT + N0, 33.3% for ypT0N+, and 18.4% for ypT + N+ (p < 0.001). The ypT + N0 and ypT0N + groups showed no significant differences in survival (p > 0.05). In Cox regression analysis, ypT stage and rTN stage showed an independent association with OS (p = 0.026 and 0.001, respectively). During the follow-up period, 69 (54.8%) patients developed recurrence, with ypT0N0 patients experiencing fewer local and distant recurrences compared to other groups (p < 0.001).

Conclusion

In ESCC patients, the ypT0N0 status after NCRT predicts prolonged survival, but this reduces significantly when nodal metastases or residual primary lesions are present.
Metabolic studies of Ogataea polymorpha using nine different corn steep liquors
Authors: Wahjudi Sekar Mayang W. , Engel Dominik , Büchs Jochen
Published: January 2025

Background

In the fermentation industry, the demand to replace expensive complex media components is increasing for alternative nutrient sources derived from waste or side streams, such as corn steep liquor (CSL). However, the use of CSL is associated with common problems of side products, such as batch-to-batch variations and compositional inconsistencies. In this study, to detect batch-to-batch variations in CSL for Ogataea polymorpha cultivations, a “fingerprinting” system was developed by employing the Respiration Activity Monitoring System designed for shake flasks (RAMOS) and 96-well microtiter plates (µTOM).

Results

At 2.5 g d.s./L CSL and 5 g/L glucose, a limitation by a secondary substrate, other than the carbon source, was observed. For this specific CSL medium, this limitation was caused by ammonium nitrogen and could be removed through targeted supplementation of ammonium sulphate. Under ammonium nitrogen limitation, O. polymorpha showed a change in morphology and developed a different cell size distribution. Increasing CSL storage times impaired O. polymorpha cultivation results. It was speculated that this observation is caused by micronutrient precipitation as sulfide salts. Through targeted nutrient supplementation, these limiting microelements were identified to be copper, iron and zinc.

Conclusions

This study shows the versatility of CSL as an alternative nutrient source for O. polymorpha cultivations. “Fingerprinting” of CSL batches allows for early screening. Fermentation inconsistencies can be eliminated by selecting the better performing CSL batches or by supplementing and improving an inferior CSL prior to large-scale productions.
Enhancing work environments and reducing turnover intention: a multicenter longitudinal cohort study on differentiated nursing practices in Dutch hospitals
Authors: van Kraaij Julia , de Vries Neeltje , Wessel Hanna , Vermeulen Hester , van Oostveen Catharina ,   RN2Blend Consortium, Schoonhoven Lisette , Stalpers Dewi , Lalleman Pieterbas , Martini Dieke , Schalkwijk Hugo , Spits Jet , Bal Roland , Goossens Lucas , Wallenburg Iris , Felder Martijn , Kuijper Syb , Miedema Nienke
Published: January 2025

Background

Addressing the growing challenge of nurse retention requires coordinated actions at national and global levels to improve recruitment, retention policies, and investments in the nursing work environment. The nursing work environment, defined as the "organizational characteristics of a work setting that facilitate or constrain professional nursing practice", is critical in influencing whether nurses decide to leave their jobs. This study investigates the impact of differentiated nursing practices – which involved tailoring roles and responsibilities based on nurses’ training, skills, and experience in Dutch hospitals – and investigated their impact on the nursing work environment and turnover intention (i.e., nurses’ intentions to leave their organization). We also explored whether the work environment mediates this relationship.

Methods

A multicenter longitudinal cohort study was conducted across 19 Dutch hospitals between 2019 and 2023. Nursing professionals participated via digital surveys administered before (T0) and after (T1) differentiated nursing practices were introduced. The nursing work environment was assessed using the Practice Environment Scale of the Nursing Work Index. A multilevel analysis with a random intercept and fixed slope was used to evaluate the impact of differentiated nursing practices on the work environment and on nurses' turnover intentions.

Results

We received 5411 responses to our questionnaire – 4259 at T0 and 1152 at T1. Results showed that, while the overall work environment improved, particularly in the dimensions of staffing and resource adequacy, collegial nurse–physician relationships, and participation in hospital affairs, there were no significant improvements in nursing foundation for quality of care or nurse managers' ability, leadership, and support of nurses. Additionally, differentiated nursing practices did not significantly impact turnover intention, nor did the work environment mediate this relationship.

Conclusions

This study is the first to explore the unique effects of practice differentiation on turnover intention mediated by the work environment. The findings suggest that, while differentiated practices can enhance certain aspects of the work environment, a more systemic and integrated approach is required for sustained improvements. Future research should include longer term studies to fully understand the complex relationship and accompanying mechanisms between differentiated nursing practices, the nursing work environment, and turnover intention.

Trial registration

Clinical trial number not applicable.
Immobilization of Paenibacillus polymyxa with biopolymers to enhance the production of 2,3-butanediol
Authors: Joshi Jnanada , Langwald Sarah Vanessa , Kruse Olaf , Patel Anant
Published: January 2025

Background

Paenibacillus polymyxa, is a Gram-positive, plant growth promoting bacterium, known for producing 98% optically pure 2,3-butanediol, an industrially valuable chemical for solvents, plasticizers and resins. Immobilization of Paenibacillus polymyxa has been proposed to improve the cell stability and efficiency of the fermentation process, reduce contamination and provide easy separation of butanediol in the culture broth as compared to conventional bioprocesses. This research aimed to explore the potential of Paenibacillus polymyxa with immobilization technique to produce 2,3-butanediol.

Results

We investigated different immobilization methods with natural biopolymers like alginate, chitosan and carrageenan-chitosan-based immobilization. These methods were further investigated for their immobilization efficiency and yield in 2,3-butanediol production. Carrageenan-chitosan beads enabled a higher cell concentration and demonstrated superior cell retention to calcium-alginate-chitosan beads. Carrageenan-chitosan immobilization preserved 2,3-butanediol production in bacteria and increased the product formation rate.

Conclusion

Carrageenan-chitosan immobilization enables non-pathogenic Paenibacillus polymyxa to be a capable 2,3-butanediol producer with increased product formation rate, which has not been previously reported. This novel strategy offers promising alternative to traditional fermentation processes using pathogenic strains and can be further applied in co-cultivations for metabolite production, wastewater management and bioremediation.
Mind the G(ap): bridging prevention needs and approaches for GHB/GBL users and their social environment
Authors: Bendau Antonia , Roediger Lukas , Piest Andrea , Schmolke Rüdiger , Ahrend Katharin , Petzold Moritz Bruno , Michnevich Twyla , Betzler Felix
Published: January 2025

Background

Gamma-hydroxybutyrate (GHB) and its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (BD) have become a significant concern due to the increase in their recreational use and the high risks associated with it (e.g., overdose, addiction, life-threatening withdrawal syndromes). However, targeted prevention and treatment strategies are lacking, and little is known about the specific needs of users regarding supportive approaches.

Methods

To address this gap, a mixed-methods longitudinal study was conducted with two waves of online data collection (11/2022–01/2023; 11/2023–01/2024) in Germany. The adult convenience sample (N = 2,196, with n = 240 participating in the follow-up) was mostly connected to Berlin’s nightlife scene and included GHB/GBL/BD users and their (non-user) social environment. Perceptions and needs regarding prevention and harm-reduction, reasons and measures of decreasing use, and the impact of GHB/GBL/BD use were analyzed both quantitatively and qualitatively.

Results

Education, harm reduction strategies, and specialized support options were welcomed by users and non-users, while restrictive approaches were viewed negatively, particularly by heavy users. Many participants expressed a desire to reduce GHB/GBL/BD use, driven primarily by health concerns, immediate use risks, and addiction, but only few participants had previously accessed preventive/therapeutic services. The follow-up showed little change in perceptions and experiences over time.

Conclusions

The findings underscore the need for comprehensive and integrative prevention and treatment strategies for GHB/GBL/BD use, with harm reduction approaches prioritized over restrictions. They provide a crucial foundation for future research and interventions and emphasize the necessity of adequately addressing the growing issues related to GHB/GBL/BD use.

Trial registration

The study protocol was pre-registered with the German registry for clinical studies (Deutsches Register Klinischer Studien; drks.de/search/de/trial/DRKS00030608) on October 28, 2022.
Combined effects of reflexology massage and respiratory relaxation on pain following chest tube removal in heart surgery patients
Authors: Bahramian Zainab , Kazemi Majid , Vazirinejad Reza , Hasani Hadi
Published: January 2025

Background and aim

Removing the chest tube in cardiac patients after surgery is one of the worst experiences of hospitalization in the intensive care units. Various pharmacological and non-pharmacological methods are available to control pain in these patients. This study aimed to investigate the combined effect of reflexology massage and respiratory relaxation on pain following chest tube removal in cardiac surgery patients of Shahid Beheshti Hospital in Shiraz, Iran, in 2023.

Methods

This was a double-blind randomized clinical trial performed on 140 patients who underwent heart surgery and had a chest tube in Shiraz, Iran. The samples were randomly divided into four groups: 1- control group, 2- respiratory relaxation group, 3- foot reflex massage group, and 4- a combination of respiratory relaxation and reflexology massage. To collect data, two demographic questionnaires, and a visual analog scale were used.

Results

The participants of the four groups were not meaningfully different in terms of age, BMI, duration of surgical operation, gender, job, education, place of residency, number of chest tubes, history of operation (P = 0.99, 0.31, 0.06, 0.81, 0.97, 0.96, 0.17, 0.10, 0.89 respectively). The mean scores of pain intensity during chest tube removal, and 15 min after chest tube removal were not statistically different among the four groups of study (P = 0.15, 0.54 respectively); However, just after chest tube removal, the mean scores of pain intensity differed meaningfully among four groups (P = 0.008).

Conclusion

The results showed that reflexology massage and respiratory relaxation both reduce pain immediately after chest tube removal in heart surgery patients. Also, the combination of these two techniques was more effective in reducing patients’ average pain.
Application of deep learning model based on unenhanced chest CT for opportunistic screening of osteoporosis: a multicenter retrospective cohort study
Authors: Huang Chengbin , Wu Dengying , Wang Bingzhang , Hong Chenxuan , Hu Jiasen , Yan Zijian , Chen Jianpeng , Jin Yaping , Zhang Yingze
Published: January 2025

Introduction

A large number of middle-aged and elderly patients have an insufficient understanding of osteoporosis and its harm. This study aimed to establish and validate a convolutional neural network (CNN) model based on unenhanced chest computed tomography (CT) images of the vertebral body and skeletal muscle for opportunistic screening in patients with osteoporosis.

Materials and methods

Our team retrospectively collected clinical information from participants who underwent unenhanced chest CT and dual-energy X-ray absorptiometry (DXA) examinations between January 1, 2022, and December 31, 2022, at four hospitals. These participants were divided into a training set (n = 581), an external test set 1 (n = 229), an external test set 2 (n = 198) and an external test set 3 (n = 118). Five CNN models were constructed based on chest CT images to screen patients with osteoporosis and compared with the SMI model to predict the performance of osteoporosis patients.

Results

All CNN models have good performance in predicting osteoporosis patients. The average F1 score of Densenet121 in the three external test sets was 0.865. The area under the curve (AUC) of Desenet121 in external test set 1, external test set 2, and external test set 3 were 0.827, 0.859, and 0.865, respectively. Furthermore, the Densenet121 model demonstrated a notably superior performance compared to the SMI model in predicting osteoporosis patients.

Conclusions

The CNN model based on unenhanced chest CT vertebral and skeletal muscle images can opportunistically screen patients with osteoporosis. Clinicians can use the CNN model to intervene in patients with osteoporosis and promptly avoid fragility fractures.

Critical relevance statement

The CNN model based on unenhanced chest CT vertebral and skeletal muscle images can opportunistically screen patients with osteoporosis. Clinicians can use the CNN model to intervene in patients with osteoporosis and promptly avoid fragility fractures.

Key Points

The application of unenhanced chest CT is increasing.

Most people do not consciously use DXA to screen themselves for osteoporosis.

A deep learning model was constructed based on CT images from four institutions.

Graphical Abstract
Fluoroscopy-guided aspiration of the acutely dislocated total hip arthroplasty: a feasible, high-yield, and safe procedure
Authors: Flores Dyan V. , Felemban Abdullah , Hodgdon Taryn , Beaulé Paul , Grammatopolous George , Rakhra Kawan S.
Published: January 2025

Objective

To determine the feasibility, yield, and safety of fluoroscopic-guided aspiration of the acutely dislocated total hip arthroplasty (AD-THA).

Materials and methods

IRB-approved, retrospective review of fluoroscopic-guided aspirations of AD-THA (January 2005–December 2023) was performed. Data from electronic charts and fluoroscopy images/reports were obtained. Positive yield was defined as spontaneous aspirate or saline rinse adequate for microbiology analysis. Sub-analysis by needle target (acetabular cup or femur) was performed for spontaneous aspiration rate, aspirate volume and fluoroscopy time. Differences between groups were analyzed with unpaired, t-test (2-tail) and between proportions with Fisher’s exact test, with significance p < 0.05.

Results

Aspiration of 20 AD-THA in 19 patients (12 female, mean age (SD) of 73 years (16)) targeted the acetabular cup in 45% (9/20) or femur in 55% (11/20) of cases. Positive yield was obtained in 95% (19/20), with spontaneous aspirate in 75% (15/20) and saline rinse in 20% (4/20) of cases; in 5% (1/20), no diagnostic sample was obtained. Spontaneous aspirate mean volume (SD, range) for all cases was 8.3 mL (6.9, 0.2–25), and higher when targeting the acetabular cup 11.2 mL (6.9, 5–25) versus the femur 4.0 mL (4.4, 0.2–12) (p = 0.026). The rate of spontaneous aspiration was higher for the acetabular cup 100% (9/9) versus the femur 55% (6/11) (p = 0.038). The mean fluoroscopy time (SD, range) for all cases was 43 s (25, 19–102), and shorter for targeting the acetabular cup 32 s (16, 19–75) versus the femur 56 s (28, 28–102) (p = 0.034). No immediate complications occurred in all aspirations.

Conclusion

Fluoroscopy-guided aspiration of AD-THA is a feasible, high-yield, and safe procedure. Targeting the acetabular cup results in a higher rate of spontaneous aspirate, larger aspiration volume, and lower fluoroscopy time.

Critical relevance statement

Although technically more challenging, radiologists should feel confident aspirating the acutely dislocated total hip arthroplasty (AD-THA) under fluoroscopic guidance.

Key Points

Total hip arthroplasty (THA) infection can be evaluated with synovial fluid aspiration.

Fluoroscopic-guided aspiration of the dislocated THA is feasible, high-yield, and safe.

Targeting of the acetabular cup is recommended over the femoral prosthetic component.

Acetabular cup targeting gives larger, spontaneous aspirates with lower fluoroscopy time.

Graphical Abstract
Ultra-low dose dual-layer detector spectral CT for pulmonary nodule screening: image quality and diagnostic performance
Authors: Ding Li , Chen Mingwang , Li Xiaomei , Wu Yuting , Li Jingxu , Deng Shuting , Xu Yikai , Chen Zhao , Yan Chenggong
Published: January 2025

Objectives

To investigate the image quality and diagnostic performance with ultra-low dose dual-layer detector spectral CT (DLSCT) by various reconstruction techniques for evaluation of pulmonary nodules.

Materials and methods

Between April 2023 and December 2023, patients with suspected pulmonary nodules were prospectively enrolled and underwent regular-dose chest CT (RDCT; 120 kVp/automatic tube current) and ultra-low dose CT (ULDCT; 100 kVp/10 mAs) on a DLSCT scanner. ULDCT was reconstructed with hybrid iterative reconstruction (HIR), electron density map (EDM), and virtual monoenergetic images at 40 keV and 70 keV. Quantitative and qualitative image analysis, nodule detectability, and Lung-RADS evaluation were compared using repeated one-way analysis of variance, Friedman test, and weighted kappa coefficient.

Results

A total of 249 participants (mean age ± standard deviation, 50.0 years ± 12.9; 126 male) with 637 lung nodules were included. ULDCT resulted in a significantly lower mean radiation dose than RDCT (0.3 mSv ± 0.0 vs. 3.6 mSv ± 0.8; p < 0.001). Compared with RDCT, ULDCT EDM showed significantly higher signal-noise-ratio (44.0 ± 77.2 vs. 4.6 ± 6.6; p < 0.001) and contrast-noise-ratio (26.7 ± 17.7 vs. 5.0 ± 4.4; p < 0.001) with qualitative scores ranked higher or equal to the average. Using the regular-dose images as a reference, ULDCT EDM images had a satisfactory nodule detection rate (84.6%) and good inter-observer agreements compared with RDCT (κw > 0.60).

Conclusion

Ultra-low dose dual-layer detector CT with 91.2% radiation dose reduction achieves sufficient image quality and diagnostic performance of pulmonary nodules.

Critical relevance statement

Dual-layer detector spectral CT enables substantial radiation dose reduction without impairing image quality for the follow-up of pulmonary nodules or lung cancer screening.

Key Points

Radiation dose is a major concern for patients requiring pulmonary nodules CT screening.

Ultra-low dose dual-layer detector spectral CT with 91.2% dose reduction demonstrated satisfactory performance.

Dual-layer detector spectral CT has the potential for lung cancer screening and management.

Graphical Abstract
Estimated prevalence of post-intensive care cognitive impairment at short-term and long-term follow-ups: a proportional meta-analysis of observational studies
Authors: Ho Mu-Hsing , Lee Yi-Wei , Wang Lizhen
Published: January 2025

Objective

Evidence of the overall estimated prevalence of post-intensive care cognitive impairment among critically ill survivors discharged from intensive care units at short-term and long-term follow-ups is lacking. This study aimed to estimate the prevalence of the post-intensive care cognitive impairment at time to < 1 month, 1 to 3 month(s), 4 to 6 months, 7–12 months, and > 12 months discharged from intensive care units.

Methods

Electronic databases including PubMed, Cochrane Library, EMBASE, CINAHL Plus, Web of Science, and PsycINFO via ProQuest were searched from inception through July 2024. Studies that reported on cognitive impairment among patients discharged from intensive care units with valid measures were included. Data extraction and risk of bias assessment were performed independently for all included studies according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines. Newcastle–Ottawa Scale was used to measure risk of bias. Data on cognitive impairment prevalence were pooled using a random-effects model. The primary outcome was pooled estimated proportions of prevalence of the post-intensive care cognitive impairment.

Results

In total, 58 studies involving 347,940 patients were included. The pooled post-intensive care cognitive impairment prevalence rates at the follow-up timepoints < 1 month, 1–3 month(s), 4–6 months, 7–12 months, > 12 months were 49.8% [95% Prediction Interval (PI), 39.9%–59.7%, n = 19], 45.1% (95% PI, 34.8%–55.5%, n = 23), 47.9% (95% PI, 35.9%–60.0%, n = 16), 28.3% (95% PI, 19.9%–37.6%, n = 19), and 30.4% (95% PI, 18.4%–43.9%, n = 7), respectively. Subgroup analysis showed that significant differences of the prevalence rates between continents and study designs were observed.

Conclusions

The prevalence rates of post-intensive care cognitive impairment differed at different follow-up timepoints. The rates were highest within the first three months of follow-up, with a pooled prevalence of 49.8% at less than one month, 45.1% at one to three months, and 47.9% at three to six months. No significant differences in prevalence rates between studies that only included coronavirus disease 2019 survivors. These fundings highlight the need for further research to develop targeted interventions to prevent or manage cognitive impairment at short-term and long-term follow-ups.
A protocol to study the effect of targeted parental education intervention to identify early childhood development disorder – multisite interventional study
Authors: Kanniappan Vadivelan , Muthuperumal Prakash , Venkataraman P. , Murugesan Anuradha , Chinnasami Balaji , Muthiah Manikumar , Sethuraman Subramanian , J. R. Abishek , Suresh Shrisruthi , Nambirajan Murali Krishnan , G. Angeline Grace , T. S. Veeragoudhaman , Deivasigamani Kuberan
Published: January 2025

Background

In India, approximately 3.5 million children are affected by Developmental Delay (DD), often stemming from preterm births. These delays contribute to neurological and motor development delays, placing a significant financial burden on families. Maternal unemployment rates are also elevated in such cases. Delayed Developmental Milestones identification, often due to a lack of parental awareness, further compounds these challenges. This study introduces a multiphasic approach aimed at educating antenatal women on monitoring neurological maturation, with the overarching objective of assessing the effectiveness of a targeted multi-method parental education intervention in improving parents’ knowledge and early detection of developmental disorders in early childhood.

Methods

Antenatal women will be assigned to intervention or control groups. The intervention group will undergo specialized training in a multiphasic study, while the control group will receive routine care. A meticulously developed intervention module for early detection of neurodevelopmental disorders will empower mothers to monitor their newborns for potential deficits. Outcomes will be assessed through questionnaires, analyzing knowledge improvement and early identification of DD using statistical methods such as chi-square tests. The study involves three phases: preparatory, implementation, and evaluation, aiming to empower mothers to detect developmental concerns early and improve maternal awareness of child development. The study was approved by the SRM Institutional Ethical Committee with the reference number 8688/IEC/2023.

Discussion

This study will identify DD and improve parental awareness by providing tools for early detection thereby empowers parents to identify developmental concerns early. The study supports policy goals to reduce the burden of DD, enhance early intervention, and improve long-term outcomes for children. It is anticipated that this intervention will complement existing health policies, contributing to better child health and developmental outcomes in India.

Trial registration

Trail is registered under Clinical Trails Registry - India (CTRI/2024/04/065008) registered on 01 April 2024.
Systematic review on the effects of exercise with and without breakfast consumption on cognitive performance in healthy adults
Authors: Hsieh Shu-Shih , Tian Yu , Cheng Chun-Yuan , Chen Yung-Chih
Published: January 2025

Background

The objective of this systematic review was to review the current evidence on the effects of acute exercise with and without morning breakfast consumption on cognitive performance.

Methods

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and is registered in the International Prospective Register of Systematic Reviews (CRD42023396125). Studies were included if they investigated effects of acute exercise with and without preceding morning breakfast on cognitive performance measured during and following exercise in healthy adults. Eligible studies from 5 electronic databases, PubMed, Scopus, MEDLINE, Web of Science, and Embase, with no limitations on years and dates of publications to retrieve maximal number of literature (literature search and screen were completed on 13 December 2024). Study quality was assessed using the Physiotherapy Evidence Database scale (PEDro).

Results

A total of 3018 studies were screened. Five studies, involving 70 participants (42 women, aged between 18 and 50 years) in total (sample size per study: 10–24), were eligible for inclusion in this review. The synthesised results based on 5 identified studies with healthy adults showed that there was no indication that effects of exercise on cognitive performance (e.g., processing speed, inhibitory control) are altered by breakfast skipping and/or consumption (e.g., different portion, macronutrients, and contents). The included studies had a mean PEDro score of 4.0 (scored between 3 and 5), suggesting ‘fair’ methodological quality.

Conclusion

The synthesised results showed that there was no indication that effects of exercise on cognitive performance (e.g., processing speed, inhibitory control) are altered by morning breakfast consumption or macronutrients and contents of breakfast in healthy adults. However, the synthesised results should be interpreted cautiously, given the limited evidence and the heterogeneity in methodology with mostly involved young and healthy adults. Further investigation regarding interactive effects of breakfast and exercise on cognition, especially in individuals with metabolic disease or medical conditions, is warranted.
The periplasmic protein HslJ is the first-line of defense against oxidative stress in Acinetobacter baumannii
Authors: Scribano Daniela , Pasqua Martina , Limongi Dolores , Nencioni Lucia , Palamara Anna Teresa , Ambrosi Cecilia
Published: January 2025

Background

Acinetobacter baumannii poses a significant threat globally, causing infections primarily in healthcare settings, with high mortality rates. Its adaptability to antibiotic resistance and tolerance to various stresses, including reactive oxygen species (ROS), contribute to its persistence in healthcare environments. Previous evidence suggested that the periplasmic heat shock protein, HslJ-like protein (ABUW_2868), could be involved in oxidative stress defense in A. baumannii. In this study, we demonstrate the pivotal function of HslJ as the first line of defense against oxidative damage induced by hydrogen peroxide (H2O2).

Methods

An isogenic site-specific hslJ mutant of A. baumannii AB5075 was used to evaluate its sensitivity to H2O2, survival rate in human macrophages, biofilm, cell surface hydrophobicity, and motility. Additionally, the hslJ expression profile was measured under stress conditions and its OxyR-dependent regulation was assessed both in vitro and in a heterologous host.

Results

Herein, we report that HslJ is under the positive regulatory control of OxyR, which upregulates its expression in response to imipenem (IMP) and H2O2, thereby underscoring its importance in A. baumannii survival strategy. In addition, our findings revealed that the hslJ mutant displayed abrogated surface-associated motility accompanied by increased cell surface hydrophobicity (CSH), indicating also a role in maintaining cell membrane properties.

Conclusions

This comprehensive understanding of HslJ multifaceted role not only enriches our knowledge of A. baumannii stress response mechanisms but also provides valuable insights for developing targeted strategies to eradicate this deadly resilient pathogen in healthcare settings.
Monetary policy shocks and multi-scale positive and negative bubbles in an emerging country: the case of India
Authors: Cepni Oguzhan , Gupta Rangan , Nel Jacobus , Nielsen Joshua
Published: January 2025

We employ the Multi-Scale Log-Periodic Power Law Singularity Confidence Indicator (MS-LPPLS-CI) approach to identify positive and negative bubbles in the short-, medium, and long-term for the Indian stock market, using weekly data from November 2003 to December 2020. We use a nonparametric causality-in-quantiles approach to analyze the predictive impact of monetary policy shocks on bubble indicators. We find, in general, strong evidence of predictability across the entire conditional distribution for the two monetary policy shock factors, with stronger impacts for negative bubbles. Our findings have critical implications for the Reserve Bank of India, academics, and investors.
Harmonized technical standard test methods for quality evaluation of medical fluorescence endoscopic imaging systems
Authors: Liu Bodong , Guo Zhaojun , Yang Pengfei , Ye Jian’an , He Kunshan , Gao Shen , Chi Chongwei , An Yu , Tian Jie
Published: January 2025

Fluorescence endoscopy technology utilizes a light source of a specific wavelength to excite the fluorescence signals of biological tissues. This capability is extremely valuable for the early detection and precise diagnosis of pathological changes. Identifying a suitable experimental approach and metric for objectively and quantitatively assessing the imaging quality of fluorescence endoscopy is imperative to enhance the image evaluation criteria of fluorescence imaging technology. In this study, we propose a new set of standards for fluorescence endoscopy technology to evaluate the optical performance and image quality of fluorescence imaging objectively and quantitatively. This comprehensive set of standards encompasses fluorescence test models and imaging quality assessment protocols to ensure that the performance of fluorescence endoscopy systems meets the required standards. In addition, it aims to enhance the accuracy and uniformity of the results by standardizing testing procedures. The formulation of pivotal metrics and testing methodologies is anticipated to facilitate direct quantitative comparisons of the performance of fluorescence endoscopy devices. This advancement is expected to foster the harmonization of clinical and preclinical evaluations using fluorescence endoscopy imaging systems, thereby improving diagnostic precision and efficiency.
Advances in oral dissolving film research in the food field
Authors: Li Yue , Zhao Min , Zhao Ming-Yue , Li Bin , Tian Jin-Long
Published: January 2025

Oral dissolving film (ODF) emerges as a novel active substance delivery system, offering portability, safety, and compliance. ODF presents superior gastrointestinal absorption compared to conventional food products, making it ideal for providing nutrition and medication support to vulnerable populations such as children, the elderly, and individuals with dysphagia. With promising applications in pharmaceuticals and especially food industry, ODFs offer a highly absorbable method for delivering nutritious and healthy foods. This review underscores the potential of orally dissolving films in active substance delivery, outlining their advantages over traditional oral delivery methods and their current market status. Additionally, the review discusses the formulation procedure, production methods, and quality evaluation methods for film dosage forms of ODFs. Lastly, it examines the limitations of ODFs and speculates on their future trends in the food industry. This study serves as a valuable reference for the development and utilization of orally dissolving films in the food sector.

Graphical Abstract
Social and Legal Needs in Patients and Families With Cancer: Interaction With Patient-Level Financial Toxicity
Authors: Anant Shruti , Jiang Changchuan , Doran Joanna , Gany Francesca , Gupta Arjun , Rocque Gabrielle B. , Knight Louise K. , Hussaini S.M. Qasim
Published: January 2025

Adverse financial burden and its effect on patients resulting from the costs associated with cancer care, both direct and indirect, is known as financial toxicity. This review explores the interplay between financial toxicity and key social and legal needs in cancer care. Drawing from the WHO's framework and the ASCO's policy statement on social determinants of health, we propose a conceptual model that discusses five key needs—housing insecurity, food insecurity, transportation and access barriers, employment disruptions, and psychosocial needs—which interact with, and are affected by financial toxicity, and adversely influence patients' well-being and adherence to treatment. We review literature addressing the scope of each of these key needs, their effect on patients with cancer, and how each increases the overall burden of cancer treatment. There is an emphasis on both the patient and the caregiver as one unit navigating through cancer treatment together. The aim is to guide interventions at the patient-provider, institutional, and policy levels that alleviate financial toxicity and improve overall care delivery for patients and caregivers by addressing underappreciated social and legal needs.
Βέλτιστος σχεδιασμός συστημάτων ηλεκτρικής ενέργειας με διασυνδέσεις συνεχούς ρεύματος και μεγάλη διείσδυση ανανεώσιμων πηγών ενέργειας
Authors: Συλλιγνάκης Ιωάννης
Published: January 2025

Τα ηλεκτρικά ενεργειακά δίκτυα είναι δυναμικά και συνεχώς αναπτυσσόμενα. Αφενός οι διασυνδέσεις τους, αφετέρου οι νέες τεχνολογίες ελέγχου σε όλα τα επίπεδα (παραγωγής, μεταφοράς και διανομής), αλλαζουν διαρκώς τα δεδομένα για τις ανάγκες μελέτης και σχεδιασμού για ανάπτυξη τους. Προς αυτήν την κατέυθυνση, της μελέτης και σχεδιασμού, έχουν αναπτυχθεί πολλές εφαρμογές προσομοίωσης που λαμβάνουν υποψην τα νέα δεδομένα. Οι περισσότερες εφαρμογές είναι εμπορικές, και κάνουν χρήση μοντέλων των συνιστωσών των δικτύων, είτε κλειστού τύπου, είτε τυποποιημένων. Κίνητρο της παρούσας διατριβής ήταν η ανάπτυξη μεθοδολογίας και αντίστοιχου λογισμικού ανοιχτού κώδικα, για τον βέλτιστο σχεδιασμό συστημάτων ηλεκτρικής ενέργειας (ΣΗΕ) με διασυνδέσεις και παρουσία σημαντικής παραγωγής ανανεώσιμων πηγών ενέργειας (ΑΠΕ). Σε σχέση με εμπορικά πακέτα λογισμικού προσομοίωσης, η παρούσα διατριβή παρουσιάζει την ανάπτυξη ελεύθερου κώδικα, για βέλτιστο σχεδιασμό των υπό εξέταση συστημάτων. Στη διατριβή αυτή έγινε χρήση υφιστάμενων λογισμικών (MATLAB MATPOWER, MATDYN) και πάνω σε αυτά αναπτύχθηκαν επιπλέον μοντέλα, όπως μετατροπείς HVDC, γραμμές μεταφοράς ΣΡ και ΑΠΕ. Τα μοντέλα αυτά μπορούν εύκολα να τροποποιηθούν κατάλληλα ανάλογα με τις ανάγκες της μελέτης. Για τις ανάγκες της βελτιστοποίησης έγινε χρήση της μεθευριστικής μεθόδου Particle Swarm Optimization (PSO), με τις απαραίτητες τροποποιήσεις. Η πιο σημαντική προσθήκη στην προτεινόμενη μέθοδο, είναι η ενσωμάτωση κριτηρίων βραχυπρόθεσμης μεταβατικής ευστάθειας στα αποτελέσματα της βελτιστοποίησης. Υιοθετώντας κριτήρια ευτάθειας τάσης και συχνότητας, εξετάζονται οι βελτιστες λύσεις του εξεταζόμενου προβλήματος βελτιστοποίησης. Τέτοια σφάλματα είναι βραχυκύκλωματα, διακοπές γραμμής, απώλεια παραγωγής (συμβατικής θερμικής γεννήτριας). Η μεθοδολογία εξετάστηκε σε κατάλληλα τροποποιημένα δίκτυα όπως τα ΙΕΕΕ 9-bus, ΙΕΕΕ-24bus, το απλοποιημένο σύστημα Ελλάδας-Κρήτης-Κύπρου κ.α. Αναπτύχθηκε επίσης κατάλληλη, φιλική προς τον χρήστη διεπαφή, με δυνατότητα προσομοίωσης ηλεκτρικού δικτύου.
Η βιωματική Μάθηση κατά την Ενδουπηρεσιακή Εκπαίδευση στα Ψυχοπαιδαγωγικά Κέντρα: Μια Ποιοτική Μελέτη
Authors: Παππάς Νικόλαος
Published: January 2025

Η παρούσα έρευνα μελετά και διερευνά τη συμβολή της βιωματικής μάθησης στην απόκτηση νέων γνώσεων και ικανοτήτων στο πλαίσιο εφαρμογής βιωματικών τεχνικών σε προγράμματα ενδοεπιχειρησιακής εκπαίδευσης. Ο ερευνητής, μέσω συνεντεύξεων και στη βάση της ποιοτικής προσέγγισης, απευθύνθηκε σε δείγμα είκοσι (20) εργαζόμενων σε Ψυχοπαιδαγωγικά Κέντρα, προκειμένου να καταγραφούν και να αναλυθούν οι απόψεις και οι αντιλήψεις τους σχετικά με τη βιωματική μάθηση και ακολούθως, να διερευνηθεί η ενδεχόμενη αλλαγή των γνώσεων και απόψεών τους οι οποίες προσδίδουν αποτελεσματικότητα στην εργασία τους. Στην έρευνα αναδεικνύεται ο υψηλός βαθμός αποδοχής αλλά και εφαρμογής βιωματικών μορφών μάθησης, κυρίως μέσα από δραστηριότητες και μορφές συμμετοχικής δράσης στο πλαίσιο των δραστηριοτήτων που εφαρμόζονται στο χώρο εργασίας. Καταγράφεται η ενεργητική συμμετοχή των ερωτώμενων σε προγράμματα που αξιοποιούν βιωματικές τεχνικές καθώς και ο στοχασμός πάνω στις αλλαγές που συντελούνται στο επίπεδο των απόψεων, των αντιλήψεων και των ικανοτήτων τους στο χώρο εργασίας.
Development and validation of an interprofessional collaborative educational module on the self-management of foot for individuals with type II diabetes mellitus in India
Authors: Prabhath Sushma , Ramanathan Harihara Prakash , Kamath M Ganesh , Karkada Gagana , Handady Ganesh , Mohammed Ciraj Ali , Maiya Arun G.
Published: January 2025

Background Insufficient awareness of foot self-care among diabetic individuals results in diabetic foot ulcers especially in the Indian population considering its varied ethnicity and lifestyle practices. The management of diabetes and diabetic foot ulcers therefore demands a well-coordinated approach that involves multiple healthcare providers (HCPs). The present study aims to develop and validate an interprofessional collaborative (IPC) educational program involving HCPs to efficiently oversee and instruct the public on appropriate strategies for self-managing diabetic foot health in the Indian population. Methods The research group worked on creating an educational module titled ‘An Interprofessional Collaborative Educational Module on Self-Management of Foot for Individuals with Type II Diabetes Mellitus.’ The objective of this module was to promote the adoption of proper practices in self-managing foot health for individuals with type 2 diabetes mellitus. A panel of 13 experts participated in a two-stage validation process using the Delphi method to assess the module and its educational resources. Subsequently, the module was tested on a group of 30 participants, i.e., individuals with diabetes, with its efficacy evaluated through conversation analysis and in-depth interviews. Results The three-month-long module included three sessions • 1: Diabetes and its health implications • 2: Diabetic foot and self-management • 3: Interprofessional education in diabetic foot care The mode of content delivery was via Whatsapp, and the educational resources, in the form of pamphlets, flowcharts, handouts, case-based cartoons, and videos on diabetes, including diabetic foot, its risks, and self-management, were shared regularly. All participating experts consensually validated the module and educational resources. Analysis of in-depth interviews revealed that the module immensely benefitted the participants and helped them improve their knowledge and practices of foot care in diabetes. Conclusions The study highlights the importance of developing and validating IPC educational modules tailored to diabetic foot care. It can aid in enhancing adherence to proper diabetic foot care practices. By promoting collaborative care approaches, these educational resources can contribute to better preventive practices, potentially reducing the risk of complications like foot ulcers and amputations in individuals with diabetes.
The Privacy of a Court Painter: Michel Sittow and his Journeys to the Courts of Isabella of Castile, Christian II of Denmark, and Margaret of Austria
Authors: Rojewski Oskar J. , Bruun Mette Birkedal
Published: January 2025

The painter Michel Sittow worked for at least three courts: Castile,Denmark, and the Habsburg’s Low Countries. His presence and, tosome extent, his status and activities are documented in scatteredindications in financial sources and inventories. Examining thoseprimary sources, this article pursues two lines of inquiry. Firstly, wetrace Sittow’s trajectory and the connection of his artworks to thesethree periods of his life. Secondly, we deploy the painter’s case toponder material and immaterial courtly boundaries that would haveconstituted different degrees and forms of privacy at court. Finally,this dual examination shows that he may indeed have posed a threatto the privacy of some of his royal employers.