bluuebunny/crossref_metadata_2025 huggingface dataset:
Oxy-fuel and air atmosphere combustions of Zingiber officinalis biomass residues: Performances, dynamics, flue gas emissions, mechanisms, and ash properties
Authors: Zhang Xiaogang , Jia Dajie , Song Shuxiang , Yang Ruzhu , Evrendilek Fatih , Zeng Wu , Li Yaohuang , Dong Shuyu , liu jingyong
Published: September 2023

This study aimed to turn a better understanding of the combustion dynamics of ginger (Zb) residues into operationally optimal conditions. Thermogravimetric analysis revealed that the primary degradation range of Zb was between 144–432 °C. Under the same heating rate, the N2/O2 atmosphere was more favorable for the Zb combustion than was the CO2/O2 atmosphere. The emissions of functional groups in both atmospheres remained similar and mostly occurred between 150 and 550 °C. Based on the multi-objective optimization of the best-fit neural networks, the maximum energetic performance and minimum gas emissions consistently occurred in the range of 575-1000 ℃ in the CO2/O2 atmosphere. The propensity for slagging and scaling was significantly higher in the N2/O2 atmosphere than in the CO2/O2 atmosphere. The Zb ash exhibited higher alkalinity due to the presence of alkali metals, a lower melting temperature, and other characteristics associated with slagging. The combustion in both atmospheres followed a stochastic nucleation mechanism, suggesting high reactivity of the reaction system and positive and favorable progression of the reaction. This study provides valuable insights into the operationally optimal combustion dynamics of Zb, shedding light on how to best control and valorize its gas-to-ash byproducts.
Earthworm-assisted Bioremediation in a Clayey Soil Contaminated by Biodiesel.
Authors: Immich Gabriel , Visentin Caroline , Braun Adeli Beatriz , Reginatto Cleomar , Thomé Antônio
Published: September 2023

The Success in bioremediation techniques depends on factors such as site characteristics, environmental factors, contaminant nature (temperature, pH, nutrients), presence of suitable biodegradable genes, the contamination nature, etc. Earthworms can aid in these on these factors, through their biological, chemical and physical characteristics, they aerate the soil, improve the nutritional status and help to release the contaminants binding in the soil particles, besides, they help the degrading microorganisms’ dispersion. Biodiesel is a contaminant widely used in the fuel industry, and its production is encouraged. Thus, the aim of this study is analyzed the efficiency of an earthworm species (Eudrilus eugeniae) to remediated a residual clayey soil contaminated with biodiesel, with and without assistance for biostimulated native microorganisms. Therefore, a clay soil was contaminated with biodiesel (24 g / kg) and the ability of the earthworms of the species (Eudrilus eugeniae) to degrade biodiesel with or without biostimulation (cattle manure) for a period of 90 days was analyzed. Earthworms and cow dung have proved to be efficient for remediation processes. Providing 100% degradation at the end of 90 days for "biostimulation and earthworm" and "biostimulation, microorganisms and earthworm" samples. Thus, the use of earthworms contributes to a faster remediation process and, together with microorganisms, they are a more sustainable solution for application in areas contaminated with fuels.
Unveiling the Multifaceted Associations between Work, Psychosocial Risks, and Musculoskeletal Disorders in the Italian workforce
Authors: Tecco Cristina Di , Adamo Giovanna , Russo Fabrizio , Iavicoli Sergio
Published: September 2023

Background
Musculoskeletal diseases (MSDs) pose a significant occupational health challenge and are the leading cause of disability worldwide. These conditions can adversely affect health, quality of life, productivity and result in substantial social and public costs. Psychosocial risk factors have been identified as having a causal link or worsening various MSDs. Given the advancements in technology and digitalization that may lead to new work tasks and organizational changes, MSDs and psychosocial risks have become top priorities for Occupational Safety and Health (OSH) initiatives. This study investigates the association between occupational characteristics, exposure to work-related psychosocial risks, and MSDs in a large cohort of Italian workers.
Methods:
The study draws upon data from a cross-sectional national survey, INSuLa-2, conducted in 2019 by the Italian Workers' Compensation Authority (INAIL). The survey involved 8,000 Italian workers, representing the national workforce population. The data analysis focused on variables related to psychosocial risks and MSDs, encompassing sociodemographic and occupational characteristics, psychosocial risks, and health-related aspects.
Results:
The study population had a mean age of 43.3 ± 11.5 years, with a majority of males (55.5%). The manufacturing/primary industry/mining/utilities sector was the most prevalent occupational sector (25.0%), with blue-collar workers (46.2%) and employees (43.1%) being the most common occupational groups. Participants reported a high prevalence of psychosocial risks, including elevated levels of violence and harassment (43.0%) and job insecurity (44.4%). Among MSDs, back pain was the most prevalent (45.3%), followed by shoulder, neck, and/or upper limb pain (39.4%), and lower limb pain (32.1%). Age, female gender, low educational level, and a BMI higher than 30 were identified as significant risk factors for experiencing MSDs. Occupational sectors with higher risks of MSDs included agriculture, fishing, hunting, healthcare, and social assistance. Furthermore, blue-collar workers were found to have a higher likelihood of experiencing MSDs compared to employees.
Conclusion:
This study provides insights into the association between occupational characteristics, psychosocial risk factors, and MSDs in a substantial cohort of Italian workers. The findings suggest that workers exposed to psychosocial risks in the workplace face an increased risk of MSDs. Consequently, the prevention of MSDs and psychosocial risks should be integrated into workplace health and safety programs to enhance employee health, well-being, and productivity.
Long-term outcomes by bone marrow B-cell depletion from the R2W trial of bortezomib with cyclophosphamide and rituximab in Waldenstrőm macroglobulinaemia
Authors: Auer Rebecca , de Tute Ruth , Counsell Nicholas , Clifton-Hadley Laura , D'Sa Shirley , Pratt Guy , Campbell Gavin , Campbell Lauren , Sadler Ross , Townsend William , Popova Bilyana , Smith Paul , Schofield Oliver , Owen Roger
Published: September 2023

There remains a lack of consensus as to the most appropriate primary therapy in Waldenstrőm macroglobulinemia (WM). We evaluated a novel bortezomib-based combination and developed a sensitive WM-specific flow cytometry assay (limit of detection 0.004% of leucocytes) to assess bone marrow (BM) response. Sixty treatment-naïve WM patients were enrolled into this phase II trial and randomised (2:1) to receive cyclophosphamide and rituximab with either bortezomib (BCR) or fludarabine (FCR). The primary objective was to assess the overall response rate (ORR) in eligible patients receiving BCR (N=41). An ORR of 97.6% (95%CI: 87.1-99.9) was observed; 27 (65.9%) patients remain alive without progression after 62.6 months median follow-up, with 2- and 3-year progression-free survival (PFS) rates of 92.7% (95%CI: 79.0-97.6) and 80.5% (95%CI: 64.8-89.7). Persistent WM B-cells were demonstrable in 19/38 patients at the end of treatment (median 0.24%, range 0.02-11.2%). PFS was markedly longer in patients with BM B-cell depletion (<0.004%) compared to those who had persistent BM B-cells detectable at end of treatment (HR=0.06, 95%CI:0.01-0.47, p<0.001), and remained independently associated after adjusting for baseline risk stratification or investigator-assessed response. BCR is a tolerable, highly efficacious regimen for treatment-naïve WM patients. BM B-cell depletion is independently associated with patient outcomes.
Can nonfinancial disclosure (NFD) benefit companies? - Evidence from the 2016 Hong Kong “Comply or Explain” mandatory environmental, social, and governance (ESG) disclosure policy
Authors: Xu Juan , Kaneko Shinji , Goto Daisaku
Published: September 2023

This empirical study investigates whether mandatory nonfinancial disclosure (NFD) impacts financial performance using the Hong Kong 2016 “Comply or Explain” mandatory ESG disclosure policy. We use a total of 4712 observations from balanced panel data obtained from combined sources: Refinitiv and manually collected databases from 2013 to 2020. We employ the difference-in-difference (DID) as an identification strategy to explore the average treatment effect on the treated (ATET) of mandatory ESG disclosure policy. The treatment group is dual-listed companies (A/H shares) from Hong Kong, and the control group is domestic-list-only companies (A shares) from Mainland China. The results suggest that a mandatory ESG disclosure policy positively affects corporate financial performance (Tobin’s Q). From heterogeneity analysis, we also find that mandatory disclosure varies across ownership status, economic development regions and industrial sectors. We find that Hong Kong’s 2016 "Comply or Explain" mandatory ESG disclosure policy positively impacts corporate financial performance. Our findings demonstrate the effectiveness of regulatory-driven nonfinancial information disclosure on corporate financial performance.
Carefix hexaxial spatial frame versus Ilizarov circular external fixator in treating high-energy tibial shaft fractures：a retrospective study
Authors: Zhao Zhiming , Chen Xu , Guo Feng , Liu Yabin , Shi Bowen , Ji Guoqi , Cai Chengkuo , Shu Hengsheng
Published: September 2023

Background: External fixation has become an effective technique for treating the high-energy tibial shaft fractures (HETSFs) , which is usually accompanied by significant surrounding soft tissue damage. This study aimed to explore the differences of clinical outcomes of HETSFs with the treatment of Carefix hexaxial spatial frame (CHSF) or Ilizarov circular external fixator (ICEF).
Methods: 46 patients suffering HETSFs that were treated between January 2019 and July 2022 by CHSF or ICEF were divided into two groups: CHSF group and ICEF group. There were 38 males and 8 females with age range of 20 to 65 years. The characteristics data, operation time, external fixation time, bone union time, final radiological outcomes, complications and clinical outcomes were recorded. The minimum follow-up was 12 months.The clinical outcomes were evaluated by the Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) at the final follow-up.
Results: 46 patients with HETSFs were evaluated, including 26 patients in CHSF group and 20 patients in ICEF group in this study. The mean operation time in CHSF group (85.9±11.5 min) was shorter than that in ICEF group (95.8±4.2 min) (P<0.001). All patients achieved complete bone union. Mean external fixation time was (26.0±3.8) weeks for CHSF group and (26.5±4.1weeks) for ICEF group (P>0.05). Translation and angulation in lateral view for CHSF group were all less than that for ICEF group (P<0.001). At the final follow-up, no significant differences were found between the two groups concerning the ASAMI scores and complication rate (P>0.05).
Conclusion: In terms of final clinical outcomes, there is no statistically significant difference between CHSF and ICEF in treating HETSFs. Nevertheless, CHSF is superior to ICEF in aspects of operation time and tibial fracture reduction.
Organic Molecules are Deterministically Assembled across River Corridor Sediments
Authors: Stegen James , Garayburu-Caruso Vanessa , Danczak Robert , Chu Rosalie , Goldman Amy , McKever Sophia , Renteria Lupita , Toyoda Jason , Consortium WHONDRS
Published: September 2023

Dissolved organic matter (DOM) is central to ecosystem function. A fundamental challenge is understanding the processes leading to variation in the chemistry of organic molecules that comprise DOM. Here we study these processes in variably inundated riverbed sediments, as an understudied, yet ubiquitous component of rivers. Using null-model approaches adopted from community ecology, we found that within-site variation in environmental conditions caused non-random (i.e., deterministic) shifts in DOM chemistry. Deterministic shifts were observed across diverse biomes, though the strength of determinism varied substantially. We found that the strength of determinism decreased with increasing sediment moisture, but in the form of a constraint space. Many systems fell below the upper constraint boundary, however. We propose a conceptual model based on our results and other publications in which DOM assemblages are hypothesized to be increasingly deterministic across the continuum from the river water column to saturated sediment pore spaces to unsaturated and dry soils/sediments.
Impaired reinforcement learning and behavioral activation/inhibition systems in internet addiction
Authors: Chen Jin , Xie Ze-Yuan , Chen Tian-Zhen , Lu Jian-Xia , Zeng Ning-Ning , Zheng Hui
Published: September 2023

Background
The goal of this study is to examine whether goal-directed control and learning rate are more closely associated with internet addiction (IA) and analyze maladaptive behavior in IA through reinforcement learning processes and personality traits by looking at the personality traits of people with IA, thereby validating its alternative for diagnosing and measuring IA.
Methods
A total of sixty-one participants with IA and sixty-one healthy participants completed the Internet Addiction Test (IAT), the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scale, and the two-step Markov decision task. Through hybrid modeling and multivariate regression, the relationship between reinforcement learning parameters, personality traits, and IA scores was analyzed.
Results
Significant impairment in goal-directed system was observed in the IA group, although this impairment did not correlate with the degree of IA. In comparison to the healthy control group, the IA group exhibited a significantly higher learning rate, which was positively correlated with the severity of IA and reward sensitivity. Furthermore, the BIS score and learning rate were predictive of IAT scores.
Conclusions
Maladaptive behavior in IA can be attributed partially to deficits in goal-directed system and an elevated learning rate. Individuals with a higher BIS sensitivity are more likely to experience IA. Incorporating behavioral modeling parameters and personality factors might aid in IA diagnosis.
Safety and effectiveness of atrial fibrillation ablation in patients aged ≥80 years: a retrospective study
Authors: Sakamoto Yusuke , Osanai Hiroyuki , Tanaka Yuki , Hiramatsu Shotaro , Arai Kenji , Watanabe Takashi , Ohguchi Shiou , Nakashima Yoshihito , Asano Hiroshi , Ajioka Masayoshi
Published: September 2023

Background
Catheter ablation is the first-line treatment for atrial fibrillation (AF). Although the efficacy and safety of this procedure have been reported in older patients, this might diminish with age. Therefore, this study aimed to determine the safety and effectiveness of AF ablation in patients aged ≥ 80 years.
Methods
We retrospectively analyzed the features of ablation and the subsequent clinical course and outcomes of 100 patients with AF aged ≥ 80 years who underwent ablation between July 2019 and December 2021 at Tosei General Hospital, Seto, Aichi, Japan.
Results
The average duration of AF was 6.0 ± 9.5 months, and 83% of the patients were symptomatic. Approximately 30% of the patients developed heart failure, with 15% requiring hospitalization within 1 year before ablation. Postablation, 93% of patients remained free of AF, and none required postoperative hospitalization due to heart failure. However, several complications were observed, including cardiac tamponade, hematoma at the access site, and postoperative bradycardia. Notably, an enlarged left atrial diameter before ablation was a predictor of complications.
Conclusions
In patients aged ≥ 80 years, AF ablation therapy demonstrated a high nonrecurrence rate and altered progression of heart failure. Although the incidence of complications was relatively low, caution should be exercised when older patients with enlarged left atrial diameters undergo AF ablation.
Grading Reflective Essays: The Construct Validity and Reliability of a Newly Developed Tool- GRE-9
Authors: Makarem Nisrine N , Rahme Diana V , Brome Dayana , Saab Bassem R
Published: September 2023

Background
The main objective of this study is to assess the construct validity and reliability of the Grading Reflective Essays-9 (GRE-9).
Methods
This study took place in a major tertiary academic medical center in Beirut, Lebanon. 104 reflective essays written by years 1–3 residents in the department of Family Medicine at the American University of Beirut Medical Center (AUBMC) were graded by 2 trained raters who independently scored the essays using GRE-9. GRE-9 scores were then correlated with scores on communication skills OSCE stations and in-training examinations to investigate, respectively, convergent and divergent validity. One of the 2 raters scored the essays twice one month apart to assess the reliability of the GRE-9 using intra rater reliability and internal consistency.
Results
There was a weak, non-significant correlation between GRE-9 score and In training examination (ITE) score (r = − .213, p = .395). There was a moderate, non-significant correlation between GRE-9 scores and the Objective structured clinical examination (OSCE) communication station scores (r = − .412 p = .162). The correlation coefficient between trails 1 and 2 was significant (r = .832, p = .000). Intra class correlation coefficient (ICC) analysis demonstrated almost perfect intra-rater agreement (0.819; 95% CI: 0.741–0.875) of the test ratings over time.
Conclusions
GRE-9, is a short, concise, easy-to-use reliable grading tool for reflective essays that has demonstrated moderate to substantial intra-rater reliability and evidence of divergent validity. The study found non-significant correlations between reflective writing scores OSCE communication scores demonstrating a lack of relationship between reflective writing and this measure of performance.
WeChat mini program in laboratory biosafety education among medical students at Guangzhou Medical University: a mixed method study of feasibility and usability
Authors: Li QianJun , Zhao JingJing , Yan RuiChao , Gao QiJian , Yao Zhen , Li Xue , Liang Ying , Wen ShiHao , Yang LiJuan
Published: September 2023

Background
Laboratory biosafety should be a priority in all healthcare institutions. An engaging and tailored training program will ensure that students are prepared for their careers as professionals so that they can perform their duties in a safe and effective manner. As the most popular social application in China, WeChat has become a powerful tool for delivering interventions and can be used for health education. The objective of the present study was to assess the feasibility and usability of a WeChat mini program in laboratory biosafety education for medical laboratory students at Guangzhou Medical University (GMU).
Methods
The WeChat mini program "WeMed" was developed and extensively evaluated using a mixed method approach. A convergent design was undertaken to assess feasibility and usability among second-year undergraduate students at GMU between November 2022 and June 2023. In the quantitative strand, two evaluations were conducted via online surveys from students (n = 67) after a four-week study period. The System Usability Scale (SUS) was used to evaluate usability, while self-developed questions were used to assess feasibility. In the qualitative strand, fourteen semi-structured interviews were conducted to confirm the findings. A reflexive thematic analysis was utilized to analyze the qualitative data.
Results
An adequate SUS score (M = 68.17, SD = 14.39) was obtained in the quantitative strand. Based on the results, the acceptability of the WeMed program is in the marginal high range, and the grade scale is in class D. This finding was further supported by the positive experiences shared by students highlighting the usability and feasibility of the WeMed program in the qualitative strand.
Conclusion
The WeMed program proves to be a valuable supplementary learning strategy for medical laboratory students, empowering them with essential knowledge and skills in laboratory biosafety. WeMed's emphasis on laboratory biosafety contributes to a culture of safety and compliance in medical laboratories. Medical laboratory students could better prepared to adhere to safety protocols and guidelines, contributing to a safer working environment for themselves and others.
The mediating and moderating role of rumination and cognitive reappraisal between perceived stress and prenatal depression: a multicenter cross-sectional study in southeast China
Authors: Wang Yuying , Fang Fan , Yang Yuan , Liu Wenting , Gao Yaqin , Chen Yuqi , Liu Haiyan , Huang Fanyan , Chen Yu
Published: September 2023

Background
Prenatal depression is one of the most prevalent psychiatric disorders among maternal. Perceived stress plays an important role in the onset of prenatal depression, however, the underlying mechanisms between them are not well understood. We aimed to explore the mechanisms from rumination(risk factors) and cognitive reappraisal(protective factors) perspectives, which may be used to design interventions to improve prenatal depression.
Methods
A multicenter cross-sectional survey of 1055 maternal were enrolled using a convenience sampling method from June 2020 to January 2021 and was conducted in five hospitals in Guangzhou, southeastern China. A moderated mediation model was performed to examine the role of rumination(Ruminative Responses Scale, RRS), and cognitive reappraisal(Emotional Regulation Questionnaire, ERQ) in the relationship between perceived stress(Perceived Stress Scale 10, PSS-10) and prenatal depression(Edinburgh Postpartum Depression Scale, EPDS).
Results
The prevalence of prenatal depression was 37.53%. There was a significant correlation among perceived stress, rumination, cognitive reappraisal, and prenatal depression(all P < 0.001). Rumination played a partial mediating role in the relationship between perceived stress and prenatal depression, accounting for 58.92% of the total effect. Moreover, the indirect effect of rumination in this link was moderated by cognitive reappraisal. This mediation effect was stronger for pregnant women with lower levels of cognitive reappraisal(P < 0.001).
Conclusions
The study provides powerful evidences through a large maternal sample for the mediating role of rumination and the moderating role of cognitive reappraisal between perceived stress and prenatal depression. Ongoing clinical care and targeted interventions may need to carry out from the perspective of rumination according to the different cognitive levels of maternal.
The role of vitamin D status on treatment outcome among HIV- infected children receiving care in Kisumu County, Kenya
Authors: Asamuka Maurice Songoreh , Ogonda Lilian , Onyango Calleb George , Guyah Bernard
Published: September 2023

Background: Kenya has a paediatric HIV burden of nearly 140,000 children, of which only 48% of those on antiretroviral therapy (ART) have achieved the desired viral suppression possibly due to vitamin D deficiency. We explored the influence of vitamin D levels on treatment outcome.
Method: We performed a cross-sectional study of 196 participants aged 3 – 14 years; among them 98 HIV infected who received treatment between 2019 - 2020 in Jaramogi Oginga Odinga Teaching and Referral Hospital, Kenya. The exposure was vitamin D levels, including deficient (<20 ng/ml), insufficient (≥20 - <30 ng/ml), and sufficient (30 – 50ng/ml). The outcome was optimal immune recovery (CD4 ≥ 500 cells/mm3) and optimal viral suppression (viral load ≤ 200 copies/ml). We compared difference in means for each vitamin D category between HIV infected and uninfected using independent t-test, multiple comparisons of vitamin D levels among age categories using ANOVA and post hoc test and Pearson correlation to correlate vitamin D levels, CD4 and viral load of HIV infected children.
Results: Compared with HIV uninfected, HIV infected recorded mean age ± standard deviation of10.65±2.17 years with 39(39.8%) males vs. 6.68±2.81 years with 52(53.1%) males p<0.001; and the difference in vitamin D mean levels was statistically significant [28.21 ± 6.39 infected vs.30.88 ± 6.62 uninfected] t = 2.94, df =194, p = 0.004, 95%CI (0.90 – 4.59). Among age categories, mean vitamin D varied significantly F (2,193) = 10.68, p =0.001; with higher levels observed between 1-4 years category {mean difference 4.64ng/ml, p = 0.02, [95%CI 1.49 – 7.78]} and 5-9 years category {mean difference 4.33ng/ml, p = 0.001, [95%CI 1.89 – 6.38]} as compared to 10 – 14 years respectively.
Additionally, children with optimal immune recovery recorded higher proportion of vitamin D deficiency and insufficiency (12.24% and 42.86%) as compared with sub optimally recovered 1.02% and 4.08%); while children with optimal viral suppression recorded higher proportion of vitamin D deficiency and insufficiency (8.16% and 30.61%) as compared with sub optimally suppressed (5.1% and 16.3%).
Conclusion: Infections with HIV suppresses levels of vitamin D, but this has no influence on CD4 counts and viral load status in children receiving ART.
Quality Indicators for Enhanced Recovery After Surgery (ERAS) Nursing in Cervical Cancer Patients: A Qualitative Study from the Perspectives of Patients and Nurses
Authors: Luo Yanxia , Ye Minshan , Chen Yiteng , Wang Xindi , Lin Huahong , Ruan Weiqing
Published: September 2023

Background
The quality of nursing of cervical cancer Enhanced Recovery After Surgery care (ERAS) is closely associated with cervical cancer patients and gynaecological nursing staff. However, there is limited previous research on the opinions and views of these two groups regarding the quality indicators. This study aimed to explore the standards and requirements of nursing quality in cervical cancer ERAS care from the perspectives of cervical cancer patients and nursing staff.
Methods
A descriptive qualitative study was conducted using one-on-one semi-structured interviews between January 2023 and April 2023 with seven cervical cancer patients and twelve gynaecological nursing staff from a tertiary hospital in Guangzhou, China. The interviews were audio-recorded and analysed using thematic analysis.
Results
Using the structure-process-outcome model as a reference, seven themes were identified, namely: (1) Optimisation and allocation of human resources; (2) Equipment and environmental support; (3) Improvement of the ERAS institutional system; (4) Enhancement of team expertise and professional ethics; (5) Improvement of health education efficiency; (6) Patients’ psychological state and care; (7) Patients’ outcome reporting and auditing.
Conclusion
This study reveals nursing measures valued by patients and nursing staff in cervical cancer ERAS care, which can be used to assess and enhance the nursing quality of cervical cancer ERAS care.
Experiences of returning to work in schizophrenic patients after treatment: a longitudinal qualitative study
Authors: Song Jin , Zhang Yu-xin , Qin Meng-nan , Ren Jia-xin , Jia Yan-nan , Yu Hong , Zhou Yu-qiu
Published: September 2023

Background: Returning to work (RTW) has always been regarded as one of the important indicators to evaluate the therapeutic effect of patients with schizophrenia, which plays a positive role in improving the quality of life and mental symptoms of patients with schizophrenia.The existing studies on RTW in schizophrenic patients are mostly focused on intervention measures, and the qualitative research on RTW is very limited. The purpose of this study was to evaluate the experience of the RTW after treatment in schizophrenic patients.
Method: A longitudinal qualitative study was conducted involving 24 patients with schizophrenia in China. The interviews were held at three time-points during their RTW process, (1) when patients had improved and were close to discharge, (2) within one month post-discharge, and (3) six months post-discharge. The interview recordings were transcribed by the research team, and transcripts were independently analyzed by two independent coders using reflexive thematic analysis.
Results：A total of 24 patients with schizophrenia participated in 72 personal interviews. The thematic framework based on the experience of schizophrenic patients reveals a three-phases of the process of RTW: improved, being at a loss, and job crisis. The study identified one theme of the first phase：the expectation and optimism. Two themes in the second phase: (1) psychological distress of upcoming work; (2 expectation of assistance pre-work. And four themes in the third phase: (1）tremendous pressure of RTW; (2）lack of medical and social support; (3) social status and interpersonal relationships change; (4) high level of financial pressure.
Conclusion: The experience of RTW is a dynamic process with great challenges in each phase，schizophrenic patients have been deeply affected by what they have experienced. There is an urgent need to ensure that existing community and social support is integrated into daily care，and follow-up mental health services and disease information should be accessible to support schizophrenic patients to RTW successful. The findings of this study also suggest relevant departments and employers should be aware of the barriers to RTW for people with schizophrenia, and take certain measures to change the current situation.
Feed intake and in vitro dry matter digestibility in dairy cows fed different levels of dried Moringa oleifera leaves and Medicago sativa hay as a supplement to Chloris gayana hay
Authors: Alarape Omolara Latifat , Migwi Perminus K. , Ondiek James O.
Published: September 2023

The effect of supplementing Rhodes grass hay with different levels of dried Moringa (Moringa oleifera) leaves and Lucerne hay on feed intake and in vitro digestibility were studied using lactating dairy cows. Nine lactating Holstein-Friesian cows with initial body weight of 444 ± 39.7 kg were randomly assigned to three experimental treatments using a Randomised Complete Block Design (RCBD). Rhodes grass hay was fed ad libitum while Moringa leaves and Lucerne hay were supplemented at the ratio 0:10 in T1, 5:5 in T2 and 10:0 in T3 respectively. Moringa supplementation increased (p˂0.05) the DM intake of the basal diet (13.7 kg DM/day) and the total DM intake (15.3 kg DM/day). The Moringa-supplemented treatment (T3) produced the highest gas (8.93 ml/200mg DM) at 24 hr, has the highest SCFA (0.19 ml/200mg DM) and ME (6.86 MJ/kg DM) but the least organic matter digestibility (20.7%) when compared to the control. The results showed that the use of dried Moringa leaves as a protein supplement to low quality diets improved the DM intake and the digestibility of the diet which can lead to an increase in dairy productivity.
Interprofessional Identity Development: Awareness as the Beginning of Change
Authors: Cantaert Gabriël Rafaël , Lauwerier Emelien , Reinders Jan-Jaap , Goyvaerts Silke , Vaes Lena , d’Hooghe Yorinde , Mertens Fien , Slaghmuylder Yaël , Oosterwijck Jessica Van , Pype Peter
Published: September 2023

Background: Developing an interprofessional identity (IPI) generates an intrinsic motivation for interprofessional collaboration owing to pro-diversity beliefs that mitigate identity threat within dynamic teams. However, personal experiences and contextual changes such as the transition into practice may decrease this openness and, as such, disrupt the complementarity between an individual’s professional and IPI. This study explores the construct of readiness-to-change as a missing link in strengthening IPI by revisiting the contested Readiness for Interprofessional Learning Scale (RIPLS).
Methods: A pragmatic constructionist stance combining quantitative and qualitative approaches was adopted to determine the meaning and utility of a translated Dutch version of the RIPLS in an undergraduate university context. The validity and reliability were evaluated by analyzing cross-disciplinary data obtained from a cross-sectional (n=3311) and two prepost studies (n=330/n=89). In addition, a content analysis was performed by means of a coding frame and on the basis of interviews with teachers (n=2) and trainees (n=6) in health sciences.
Results: Exploratory factor analysis, informed by the content analysis, led to a hypothesized one-factor model comprising 8 items with factor loadings between .512 and .697 and explaining 35.35% of the total variance (eigenvalue=3.463), which was relabeled the Awareness of Interprofessional Learning Scale (AIPLS). Confirmatory factor analysis with posttest data (n=456) showed excellent model fit (SRMR=.018, RMSEA=.068, CFI=.969, TLI=.957) and factor loadings (.62-.77), while both the unidimensional and 4-dimensional RIPLS’ structure showed very poor (SRMS=.071/RMSEA=.083) to reasonable (SRMS=.059/RMSEA=.067) model fit. Additionally, the AIPLS has a high coefficient omega (.81), moderate stability (ICC=.725) and confirmed convergent validity.
Conclusions: The comprehensive approach adopted in this study led us to reject the RIPLS as a multidimensional instrument as the subscales showed considerable overlap and did not reflect the construct of readiness. Instead, the AIPLS measures interprofessional awareness, which is vital in the first stages in developing readiness, allowing us to reinterpret past research and to revisit the scale’s applicability in a theory-driven way. Moreover, we consider interprofessional awareness to be the beginning of change because it is a precursor of self-efficacy, openness and commitment, which may prove to be missing links to leverage in the delivery of interprofessional education.
PD-1 inhibitors combined with paclitaxel and cisplatin in first-line treatment of esophageal squamous cell carcinoma (ESCC): a network meta-analysis
Authors: Zhao Jia , Zhang Simeng , Guo Xiaoyu , li Ce , Yang Bowen , Qu Xiujuan , Wang Shuo
Published: September 2023

Background
The combination of PD-1 inhibitors with paclitaxel/cisplatinum (PD-1 + TP) and fluoropyrimidine/cisplatinum (PD-1 + FP) both have been shown to improve overall survival (OS) and progression-free survival (PFS) in patients with previously untreated, advanced esophageal squamous cell carcinoma (ESCC). However, there is no consensus on which chemotherapy regimen combined with PD-1 has better efficacy. To address this important issue in the first-line treatment of patients with esophageal squamous cell carcinoma, we conducted a network meta-analysis.
Methods
Data were collected from eligible studies searched in Medline, Web of Science, Pubmed, the Cochrane Library and Embase. Pooled Hazard Ratio (HR) for OS, and PFS, Odds Ratio (OR) for objective response rate (ORR) and ≥ 3grade treatment-related adverse events (≥ 3TRAEs) were estimated to evaluate the efficacy of PD-1 inhibitors combined with TP or FP.
Results
Five RCTs and one retrospective study involving 3685 patients and evaluating 4 treatments were included in this network meta-analysis. Compared to other treatments, PD-1 + TP was better. For PFS, the HRs for PD-1 + TP compared to PD-1 + FP, TP and FP were 0.59 (0.44, 0.80), 0.56 (0.51, 0.61) and 0.45 (0.37, 0.56) respectively. For OS, PD-1 + TP was also a better treatment compared to other treatments, the HRs were 0.74 (0.56, 0.96), 0.64 (0.57, 0.71), 0.53 (0.43, 0.67) respectively. For ORR, there was no significant difference between PD-1 + TP and PD-1 + FP, ORs were 1.2 (0.69, 2.11). Compare with TP and FP, PD-1 + TP has a obvious advantage, ORs were 2.5 (2.04, 3.04) and 2.95 (1.91, 4.63). For ≥ 3TRAEs, PD-1 + TP compared to other treatments, OR were 1.34 (0.74, 2.46) and 1.13 (0.92, 1.38) and 2.23 (1.35, 3.69).
Conclusion
PD-1 + TP significantly improved both PFS and OS compared to PD-1 + FP. Taking into account both efficacy and safety, PD-1 + TP may be a superior first-line treatment option for esophageal squamous cell carcinoma.
The unintended consequences of decarbonizing the China Southern Power Grid
Authors: Galelli Stefano , Jin Xiaoyu , Chowdhury Kamal , Cheng Chuntian
Published: September 2023

Decarbonizing the electricity sector requires massive investments in generation and transmission infrastructures that may impact both water and land resources. Characterizing these effects is key to ensure a sustainable energy transition. Here, we identify and quantify the unintended consequences of decarbonizing the China Southern Power Grid, China’s second-largest grid. We show that reaching carbon neutrality by 2060 is feasible; yet, doing so requires converting 40,000 km2 of land to support solar and wind as well as tapping on rivers to build 32 GW of hydropower. The impact of wind and solar development would span across multiple sectors, since crop and grassland constitute 90% of the identified sites. The construction of new dams would carry major externalities and trickle down to nearby countries, as most dams are located in transboundary rivers. Curbing the international footprint of this decarbonization effort would require additional investments (12 billion USD) in carbon capture technologies.
Natural disasters and technological upgrading measured by changes in demand for ICT labour: Estimating the impacts with text
Authors: Campos-González Jorge
Published: September 2023

Extensive literature has studied the economic impact of natural disasters. However, specific impacts on labour markets have received less attention. Using a massive earthquake (> 8.0 Mw) that struck Chile in 2010 and proprietary data from a Chilean online job board (4,136 job postings published between 2008 and 2012), we examine changes in demand for Information and Communications Technologies, ICT, related labour as a proxy for technological upgrading, by assuming that ICT and related technologies drive much of the technical change in production. We implement a structural topic model to discover and estimate the difference in the prevalence of ICT and Construction labour. Our results show that ICT labour does not change. In contrast, Construction labour significantly differed after the disaster, suggesting that reconstruction activities led to employment differences. Our results suggest that there was no substantive technological replacement following the earthquake.
JEL Classification: J20, Q54, O33
Facile Assembly of Flexible Symmetric Micro-Supercapacitors with Wide Working Voltage Window
Authors: Li Min , Han Xiangguang , Zhao Libo , Jia Chen , Li Zhikang , Xie Jiaqi , Luo Guoxi , Yang Ping , Boukherroub Rabah , Türker Yurdanur , Özkaynak Mert , Dönmez Koray , Jiang Zhuangde
Published: September 2023

With the upcoming flourishing development of intelligent robots and wearable electronics, demands for high-performance flexible energy storage devices are increasing. In this study, flexible symmetric micro-supercapacitors (MSCs) that could work in wide working voltage window were demonstrated by combining laser-direct-writing graphene (LG) electrodes with phosphoric acid-non-ionic surfactant liquid crystal (PA-NI LC) gel electrolyte. To increase the flexibility and enhance the conformal ability with anisotropic surfaces of the MSC devices, after the interdigitated LG formation on polyimide (PI) film surface, they were further transferred onto a flexible, stretchable and transparent polydimethylsiloxane (PDMS) substrate, which displayed favorable flexibility and mechanical characteristics in the bending test. Furthermore, the electrochemical performance of symmetric MSCs with various electrode widths (300, 400, 500 and 600 μm) was appraised. The findings disclosed that the symmetric MSC devices could be conducted in a large voltage range (0-1.5 V), and the one with 300-μm electrode width (MSC-300) exhibited the largest areal capacitance of 2.3 mF×cm-2 at 0.07 mA×cm-2 and areal (volumetric) energy density of 0.72 μWh×cm-2 (35.9 mWh×cm-3) at 55.07 μW×cm-2 (2753.5 mW×cm-3), along with favorable mechanical and cycling stability. After charging for ~20 s, two MSC-300 devices connected in series could supply energy to a calculator to operate for ~130 s, suggesting the practical application potential as energy storage device.
Enzyme-Instructed Peptide Self-Assembly as A Cell Membrane Lichen Activating Macrophage-Mediated Cancer Immunotherapy
Authors: Cai Yanbin
Published: September 2023

Targeted immunomodulation for reactivating innate cells, especially macrophages, holds great promise to complement current adaptive immunotherapy. Nevertheless, there is still a lack of high-performance inhibitors for blocking macrophage phagocytosis checkpoints in immune quiescent solid tumors so far. Herein, a peptide-antibody combo-supramolecular in situ assembled CD47 and CD24 bi-target inhibitor (PAC-SABI) is described, which undergoes biomimetic surface propagation like lichens on cancer cell membranes through ligand-receptor binding and enzyme-triggered reactions. Primarily, the PAC-SABIs demonstrate specific avidity for the overexpressed CD24 on the cancer cell surface with anti-CD24 monoclonal antibody (mAb). Subsequently, they exhibit alkaline phosphatase-catalyzed rapid dephosphorylation of phosphopeptides, constructing a three-dimensional nanofiber network and reinstating blockade of CD47 signaling. By concurrent inhibition of CD47 and CD24 signaling, PAC-SABIs stimulate macrophage phagocytosis and initiate T cell antitumor response. Remarkably, compared with anti-CD24 mAb, PAC-SABIs enhance the phagocytic ability of macrophages by 3–4 times in vitro and in vivo while facilitating infiltration of CD8+ T cells into 4T1 tumors. Moreover, combining PAC-SABIs with anti-PD-1 therapy effectively suppressed 4T1 tumor growth in murine models, surmounting other treatment groups with a 60-day survival rate of 57%. The in vivo construction of PAC-SABI-based nanoarchitectonics provides an efficient platform for bridging innate and adaptive immunity to maximize therapeutic potency.
Genetically divergent shallow and mesophotic Stephanocoenia intersepta coral populations across Florida Keys National Marine Sanctuary
Authors: Eckert Ryan , Sturm Alexis , Carreiro Ashley , Klein Allison , Voss Joshua
Published: September 2023

Population genetic analyses can provide useful data on species’ regional connectivity and diversity which can inform conservation and restoration efforts. In this study, we quantified the genetic connectivity and diversity of Stephanocoenia intersepta corals from shallow (<30 m) to mesophotic (30–45 m) depths across Florida Keys National Marine Sanctuary. We generated single nucleotide polymorphism (SNP) markers to identify genetic structuring of shallow and mesophotic S. intersepta populations. We uncovered four distinct genetic lineages with varying levels of depth-specificity. Shallow lineages exhibited lower heterozygosity and higher inbreeding relative to depth-generalist lineages found predominantly on mesophotic reefs. Estimation of recent genetic migration rates demonstrated that mesophotic populations are more prolific sources than shallow populations, particularly in the Lower Keys and Tortugas Bank. Additionally, we compared endosymbiotic Symbiodiniaceae communities among S. intersepta populations using the ITS2 region and SymPortal analysis framework, identifying symbionts from the genera Symbiodinium, Breviolum, and Cladocopium. Symbiodiniaceae communities varied significantly across depth and location and exhibited significant, but weak correlation with host population structure and genotype. Together, these data demonstrate that despite population genetic structuring across depth, mesophotic populations may provide refuge for shallow populations moving forward and remain important contributors to the overall genetic diversity of this species throughout the region. This study highlights the importance of including mesophotic as well as shallow coral populations in population genetic assessments and informs future science-based management, conservation, and restoration efforts within Florida Keys National Marine Sanctuary.
Mettl1-dependent m7G tRNA modification is essential for maintaining spermatogenesis and fertility in Drosophila melanogaster
Authors: Saito Kuniaki
Published: September 2023

N7-methylguanosine (m7G) in the variable loop region of tRNA is catalyzed by METTL1/WDR4 heterodimer and stabilizes target tRNA. Here, we reveal essential functions of Mettl1 in Drosophila fertility. Knockout of Mettl1 (Mettl1-KO) lost the elongated spermatids and mature sperm, which was fully rescued by a Mettl1-transgene expression, but not a catalytic-dead Mettl1 transgene. This demonstrates that Mettl1-dependent m7G is required for spermatogenesis. Mettl1-KO resulted in a loss of m7G modification on a subset of tRNAs and a decreased level of tRNA expression. Strikingly, overexpression of the translational elongation factor, EF1α1, which can compete with the rapid tRNA decay (RTD) pathway in S. cerevisiae, significantly counteracted the sterility of Mettl1-KO males, supporting a critical role of m7G modification of tRNAs in spermatogenesis. Ribosome profiling showed that Mettl1-KO led to the ribosome stalling at codons decoded by tRNAs that were reduced in expression. Mettl1-KO also significantly reduced the translation efficiency of genes involved in elongated spermatid formation and sperm stability. These findings reveal a developmental role for m7G tRNA modifications and indicate that m7G modification-dependent tRNA stability differs among tissues.
Prevalence and Predictors of Erectile Dysfunction among Filipino men: A cross-sectional study
Authors: De Guzman Sagie
Published: September 2023

Objective: This study aimed to estimate the prevalence and predictors of Erectile Dysfunction (ED) among Filipino men 18 years and older using a cross-sectional survey design.Methods: A sample of N = 1, 246 men was recruited from multiple regions across the Philippines using social media platform. The International Index of Erectile Function (IIEF) questionnaire was administered to assess the degree of ED. Additional demographic data were collected to evaluate the impact of variables such as age, educational level, civil status, and sexual orientation on the prevalence of ED.Results: The overall prevalence of ED among Filipino men was found to be 78.8%. Age is an independent significant predictor (ß= .289, t = 6.65, p < .001), with young adult men aged 18–39 showing a higher prevalence (45.3%) compared with middle-aged, 40–64 years (26.3%). Factors such as age, educational level, and civil status were also significantly associated with higher rates of ED. Interestingly, social and cultural variables, such as marital status and educational level, showed varying influences on the prevalence rates.Conclusions: This study is one of the first comprehensive investigations into the prevalence of ED among Filipino men. The findings not only fill a critical gap in the existing literature but also offer sociocultural insights that may be crucial for future interventions and public health planning. The primary care providers are at the best position to screen and assess young and middle-aged Filipino men for ED to prompt early management and timely referral. Further studies are needed to investigate the facilitators and barriers of health-seeking behaviors among Filipino men concerning ED.