bluuebunny/crossref_metadata_2025 huggingface dataset:
Physiological-based cord clamping in very preterm infants: the Aeration, Breathing, Clamping 3 (ABC3) trial—statistical analysis plan for a multicenter randomized controlled trial
Authors: Willemsen Sten P. , Knol Ronny , Brouwer Emma , van den Akker Thomas , DeKoninck Philip L. J. , Lopriore Enrico , Onland Wes , de Boode Willem P. , van Kaam Anton H. , Nuytemans Debbie H. , Reiss Irwin K. M. , Hutten G. Jeroen , Prins Sandra A. , Mulder Estelle E. M. , Hulzebos Christian V. , van Sambeeck Sam J. , van der Putten Mayke E. , Zonnenberg Inge A. , te Pas Arjan B. , Vermeulen Marijn J.
Published: March 2024

Background

Mortality, cerebral injury, and necrotizing enterocolitis (NEC) are common complications of very preterm birth. An important risk factor for these complications is hemodynamic instability. Pre-clinical studies suggest that the timing of umbilical cord clamping affects hemodynamic stability during transition. Standard care is time-based cord clamping (TBCC), with clamping irrespective of lung aeration. It is unknown whether delaying cord clamping until lung aeration and ventilation have been established (physiological-based cord clamping, PBCC) is more beneficial. This document describes the statistical analyses for the ABC3 trial, which aims to assess the efficacy and safety of PBCC, compared to TBCC.

Methods

The ABC3 trial is a multicenter, randomized trial investigating PBCC (intervention) versus TBCC (control) in very preterm infants. The trial is ethically approved. Preterm infants born before 30 weeks of gestation are randomized after parental informed consent.

The primary outcome is intact survival, defined as the composite of survival without major cerebral injury and/or NEC. Secondary short-term outcomes are co-morbidities and adverse events assessed during NICU admission, parental reported outcomes, and long-term neurodevelopmental outcomes assessed at a corrected age of 2 years.

To test the hypothesis that PBCC increases intact survival, a logistic regression model will be estimated using generalized estimating equations (accounting for correlation between siblings and observations in the same center) with treatment and gestational age as predictors. This plan is written and submitted without knowledge of the data.

Discussion

The findings of this trial will provide evidence for future clinical guidelines on optimal cord clamping management at birth.

Trial registration

ClinicalTrials.gov NCT03808051. Registered on 17 January 2019.
Development of a CRISPR/Cas9-mediated gene-editing method to isolate a mutant of the unicellular green alga Parachlorella kessleri strain NIES-2152 with improved lipid productivity
Authors: Kasai Yuki , Takagi Satsuki , Ota Shuhei , Ishii Kotaro , Takeshita Tsuyoshi , Kawano Shigeyuki , Harayama Shigeaki
Published: March 2024

Background

Previously, we isolated a mutant of Parachlorella kessleri named strain PK4 that accumulated higher concentrations of lipids than the wild-type strain. Resequencing of the PK4 genome identified mutations in three genes which may be associated with the high-lipid phenotype. The first gene, named CDMT1, encodes a protein with a calcium-dependent membrane association domain; the second gene, named DMAN1, encodes endo-1,4-β-mannanase, while the third gene, named AATPL1, encodes a plastidic ATP/ADP antiporter-like protein.

Results

To determine which of these mutant genes are directly responsible for the phenotype of strain PK4, we delivered Cas9-gRNA ribonucleoproteins targeting each of the three genes into the wild-type cells by electroporation and successfully disrupted these three genes separately. The lipid productivity in the disruptants of CDMT1 and DMAN1 was similar to and lower than that in the wild-type strain, while the disruptants of AATPL1 exhibited > 30% higher lipid productivity than the wild-type strain under diurnal conditions.

Conclusions

We succeeded in improving the lipid productivity of P. kessleri by CRISPR/Cas9-mediated gene disruption of AATPL1. The effective gene-editing method established in this study will be useful to improve Parachlorella strains for industrial applications.
Integrating a self-directed ultrasound curriculum for the internal medicine clerkship
Authors: Signor Emily , Gerstenberger John , Cotton Jennifer , Colbert-Getz Jorie , Lappé Katie
Published: March 2024

Background

Incorporating ultrasound into the clinical curriculum of undergraduate medical education has been limited by a need for faculty support. Without integration into the clinical learning environment, ultrasound skills become a stand-alone skill and may decline by the time of matriculation into residency. A less time intensive ultrasound curriculum is needed to preserve skills acquired in preclinical years. We aimed to create a self-directed ultrasound curriculum to support and assess students’ ability to acquire ultrasound images and to utilize ultrasound to inform clinical decision-making.

Methods

Third year students completed the self-directed ultrasound curriculum during their required internal medicine clerkship. Students used Butterfly iQ+ portable ultrasound probes. The curriculum included online modules that focused on clinical application of ultrasound as well as image acquisition technique. Students were graded on image acquisition quality and setting, a patient write-up focused on clinical decision-making, and a multiple-choice quiz. Student feedback was gathered with an end-of-course survey. Faculty time was tracked.

Results

One hundred and ten students participated. Students averaged 1.79 (scale 0–2; SD = 0.21) on image acquisition, 78% (SD = 15%) on the quiz, and all students passed the patient write-up. Most reported the curriculum improved their clinical reasoning (72%), learning of pathophysiology (69%), and patient care (55%). Faculty time to create the curriculum was approximately 45 h. Faculty time to grade student assignments was 38.5 h per year.

Conclusions

Students were able to demonstrate adequate image acquisition, use of ultrasound to aid in clinical decision-making, and interpretation of ultrasound pathology with no in-person faculty instruction. Additionally, students reported improved learning of pathophysiology, clinical reasoning, and rapport with patients. The self-directed curriculum required less faculty time than prior descriptions of ultrasound curricula in the clinical years and could be considered at institutions that have limited faculty support.
Resistance exercising on unstable surface leads to Pupil Dilation
Authors: Claußen Lisa , Heidelbach Tabea
Published: March 2024

Background

Chronic resistance training and acute resistance exercises improve physical performance and can enhance cognitive performance. However, there is still uncertainty about the mechanism(s) responsible for cognitive improvement following resistance training and exercise. Recent findings suggest that resistance exercise has metabolic as well as cognitive demands, which potentially activate similar neural circuitry associated with higher-order cognitive function tasks. Exercising on unstable devices increases the coordinative and metabolic demands and thus may further increase cognitive activation during resistance exercise. The measurement of pupil diameter could provide indications of cognitive activation and arousal during resistance exercise. Pupil dilation is linked to the activity in multiple neuromodulatory systems (e.g., activation of the locus coeruleus and the release of the neurotransmitter norepinephrine (LC-NE system)), which are involved in supporting processes for executive control. Therefore, the purpose of this study was to compare the cognitive activation measured by pupil diameter during an acute bout of resistance exercise on stable and unstable surfaces.

Methods

18 participants (23.5 ± 1.5 years; 10 females) performed ten kettlebell squats in a preferred repetition velocity in stable and unstable (BOSU® Balance Trainer) ground conditions. Pupil diameter was recorded with eye tracking glasses (SMI ETG) during standing (baseline) and during squatting. Raw pupil data were cleaned of artifacts (missing values were linearly interpolated) and subjected to a subtractive baseline correction. A student t-test was used to compare mean pupil diameter between ground conditions.

Results

The mean pupil diameter was significantly greater during squats in the unstable condition than in the stable condition, t (17) = -2.63, p =.018, Cohen’s dZ = -0.62; stable: 0.49 ± 0.32 mm; unstable: 0.61 ± 0.25 mm).

Conclusion

As indicated by pupil dilation, the use of unstable devices can increase the cognitive activation and effort during acute bouts of resistance exercise. Since pupil dilation is only an indirect method, further investigations are necessary to describe causes and effects of neuromodulatory system activity during resistance exercise. Resistance training with and without surface instability can be recommended to people of all ages as a physically and cognitively challenging training program contributing to the preservation of both physical and cognitive functioning.
Canopy gap impacts on soil organic carbon and nutrient dynamic: a meta-analysis
Authors: Tong Ran , Ji Biyong , Wang G. Geoff , Lou Chenyang , Ma Cong , Zhu Nianfu , Yuan Wenwen , Wu Tonggui
Published: March 2024

Key message

The forest canopy gaps, formed by natural or anthropogenic factors, have been found to reduce soil carbon content and increase nutrient availability. The magnitudes of these effects have been observed to increase with gap age and size, and are largely influenced by changes in temperature, precipitation, and solar radiation.

Context

Local studies have illustrated the influence of canopy gaps on the spatial heterogeneity of soil carbon and nutrients, playing a pivotal role in driving forest regeneration and succession. Nevertheless, it remains largely unknown whether the response of soil carbon and nutrient content to gap formation is consistent across forest ecosystems at global scale.

Aims

The aim of this paper is to assess the homogeneity of the observed responses of soil carbon and nutrients following gap formation among a wide array of forest ecosystems and climatic regions.

Methods

We performed a meta-analysis synthesizing 2127 pairwise observations from 52 published articles to quantify the changes in in soil physical, chemical, and microbial variables resulting from gap creation in natural forests and plantations spanning tropical to boreal regions.

Results

Canopy gaps resulted in significant decrease of soil organic carbon (Corg) and microbial carbon (Cmic). The concentrations of ammonium (NH4+), nitrate (NO3−), and available phosphorus (available P) increased following gap creation. These changes mainly occurred in the growing season and in the mineral soil layer, becoming more pronounced with increasing gap age and size. The change in Corg was negatively regulated by mean annual precipitation, and was associated with the changes in Nt and Nmic. The change in NH4+ was positively regulated by mean annual temperature, and was associated with the changes in available P and oxidoreductases (Ox-EEAs). The model explaining the change in soil carbon content exhibited a higher explanatory power than the one accounting for changes in soil nutrient availability.

Conclusion

The results indicated that forest canopy gaps resulted in a reduction in soil carbon content and an increase in nutrient availability. These findings contribute to a better understanding of the role of small-scale disturbances as drivers of forest ecosystem succession.
Inter-provenance variability and phenotypic plasticity of wood and leaf traits related to hydraulic safety and efficiency in seven European beech (Fagus sylvatica L.) provenances differing in yield
Authors: Kurjak Daniel , Petrík Peter , Konôpková Alena Sliacka , Link Roman M. , Gömöry Dušan , Hajek Peter , Liesebach Mirko , Leuschner Christoph , Schuldt Bernhard
Published: March 2024

Key message

Seven European beech provenances differing largely in growth performance were grown at two common garden sites in Germany and Slovakia. The intra-specific variability of most traits was explained more by phenotypic plasticity than inter-provenance variability, and efficiency-related traits showed a higher phenotypic plasticity than safety-related traits.

Context

To maintain climate-resilient future forests, replicated common-garden experiments are suited for developing assisted migration strategies for key tree species.

Aims

We analysed the magnitude of inter-provenance variability and phenotypic plasticity for 12 functional traits of European beech (Fagus sylvatica L.) and analysed whether the climate at the place of origin left an imprint. Moreover, we asked whether growth is unrelated to xylem safety and to what extent the foliar, xylem and growth-related traits are coordinated.

Methods

Terminal branches were collected from 19-year-old and 22-year-old trees of seven European beech provenances planted at two common garden sites in Germany and Slovakia, respectively. Three hydraulic, three wood anatomical and four foliar traits were measured and related to two growth-related variables.

Results

At the two sites, the same pair of provenances showed the highest and lowest growth. Nevertheless, a high degree of phenotypic plasticity was observed, as all traits differed significantly between sites after accounting for provenance effects, with hydraulic safety-related traits showing the lowest and efficiency-related traits the highest plasticity. There was no evidence for inter-provenance variability in xylem embolism resistance (P50) or the foliar carbon isotope signature (δ13C), a proxy for intrinsic water use efficiency (iWUE), and both were unrelated to growth. P50 was positively correlated with the lumen-to-sapwood area ratio and vessel density.

Conclusions

Because of the lacking trade-off between embolism resistance and growth, highly productive provenances can be selected without reducing the drought tolerance of the branch xylem. However, as xylem safety is only one element of a trees’ drought response, it may be beneficial to select provenances with other more conservative drought adaptations such as smaller vessel lumen areas for increasing xylem safety and small supported total leaf areas for reduction of total transpiration.
Technological turbulence as hindrance between factors influencing readiness of senior management and implementing blockchain technology in Jordanian Islamic banks: a structural equation modeling approach
Authors: Alnsour Ibrahim Radwan
Published: March 2024

The purpose of the study was to identify the factors that influence senior management for adopting blockchain technology in the banking industry in general and Islamic banking in particular. Furthermore, the research addressed the moderating role of technological turbulence as it holds a significant hindering role. This study employed the analytical approach, and the data were collected through questionnaires distributed to several senior management employees in both the Jordan Islamic Bank and the Islamic Arab Bank. The research instrument was developed and confirmed by the experts in the field. For identifying the significance of the variables incorporated in the researchers applied structural equation modeling technique. The findings revealed that economic efficiency, bank security, customer expectations, education, training and preparation all are significant predictors of readiness for implementing blockchain technology in the Islamic banks in Jordan. The study concluded that blockchain technology should be adopted by all Islamic banks because of its advantages and also the management needs to be educated regarding the same; they should be provided appropriate training.
Joint analysis of interaction and psychological characteristics in english teaching based on multimodal integration
Authors: Li Chao
Published: March 2024

The intersection of psychology and English teaching is profound, as the application of psychological principles not only guides specific English instruction but also elevates the overall quality of teaching. This paper takes a multimodal approach, incorporating image, acoustics, and text information, to construct a joint analysis model for English teaching interaction and psychological characteristics. The novel addition of an attention mechanism in the multimodal fusion process enables the development of an English teaching psychological characteristics recognition model. The initial step involves balancing the proportions of each emotion, followed by achieving multimodal alignment. In the cross-modal stage, the interaction of image, acoustics, and text is facilitated through a cross-modal attention mechanism. The utilization of a multi-attention mechanism not only enhances the network’s representation capabilities but also streamlines the complexity of the model. Empirical results demonstrate the model’s proficiency in accurately identifying five psychological characteristics. The proposed method achieves a classification accuracy of 90.40% for psychological features, with a commendable accuracy of 78.47% in multimodal classification. Furthermore, the incorporation of the attention mechanism in feature fusion contributes to an improved fusion effect.
The double-edged sword of becoming a caregiver: dynamic impact on four dimensions of well-being in Norway
Authors: Methi Fredrik , Nes Ragnhild Bang , Skirbekk Vegard , Hansen Thomas
Published: March 2024

Background

Becoming a caregiver can be a transformative journey with profound, multifaceted implications for well-being. However, existing research predominantly emphasizes the negative aspects of caregiving, paying less attention to the positive sides. This study aims to explore the impact of transitioning into a caregiving role on various well-being indicators, such as negative hedonic, positive hedonic, eudaimonic, and social well-being.

Methods

We use Norwegian panel data (2019–2021) and employ a combination of nearest-neighbour matching and a difference-in-differences approach to analyse well-being trajectories among new caregivers (n = 304) and non-caregivers (n = 7822). We assess ten items capturing the dimensions of negative hedonic (anxiousness, sadness, and worriedness), positive hedonic (happiness and life satisfaction), eudaimonic (contributing to others’ happiness, engagement, and meaning), and social (strong social relations and loneliness) well-being.

Results

Our results show a general increase in negative hedonic well-being and a decline in positive hedonic well-being for new caregivers. These impacts are larger for caregivers providing daily care, compared to those providing weekly and monthly care, and for those providing care inside rather than outside their own household. We observe only minor differences regarding gender and age. Interestingly, we also notice neutral or beneficial changes for eudaimonic aspects of well-being; of note, caregivers generally experience an increased sense of contributing to others’ happiness.

Conclusion

Our study reveals that adopting a caregiving role often leads to significant psychosocial challenges, especially in intensive caregiving situations. However, it also uncovers potential positive influences on eudaimonic aspects of well-being. Future research should explore underlying explanatory mechanisms, to inform strategies that enhance caregivers’ well-being.
Impressions of Guangzhou city in Qing dynasty export paintings in the context of trade economy: a color analysis of paintings based on k-means clustering algorithm
Authors: Ao Jinghui , Ye Ziying , Li Weicong , Ji Shanshan
Published: March 2024

Study on export paintings has gradually shifted from artistic form to cultural connotation, with an emphasis on cross-cultural communication. Although the economic and social dimensions of their artistic value have been explored, few studies delve into the connection between Qing-era Guangzhou's trade culture and its color characteristics. Utilizing the HSV color model and the k-means algorithm, this study analyzes the color traits of 35 export paintings depicting Guangzhou landscapes and works from the "Thirteen-houses commercial zone," revealing Qing-era Guangzhou's urban impressions and Sino-Western artistic interactions. Key findings include: (1) the hue pixel range in Guangzhou export paintings primarily spans 10°–60° and 120°–250° (dominated by red and yellow-green), saturation values range from 1–82% (primarily low saturation), and value values range from 11–94% (with a wide variance); (2) compared to traditional Chinese paintings, the transformation from pure color (正色) → inter-color (间色) → projection-perspective and light source illustrates both the blending of Eastern and Western artistic cultures and a diminishing influence of traditional ceremonial culture; (3) in contrast with Western artworks, some Guangzhou export paintings display a Westernization trend in color structures, evident in vibrant colors and stark chiaroscuro contrasts. As bespoke art commodities, export paintings microscopically reflect Guangzhou's unique trade culture and socio-political dynamics. The shifts in color schemes, integration of realistic styles, and human-centric characteristics unveil the intricate interplay between quasi-realism and transcendental aesthetics in Qing-era Guangzhou, as well as the nuanced dynamics between social capital and art within a global trade network.
Three-dimensional deviation analysis and digital visualization of shape change before and after conservation treatment of historic kiln site
Authors: Jo Young Hoon , Kim Young Hwan , Lee Hae Soon
Published: March 2024

The Gangjin Celadon Kiln, after its excavation in 1982, was relocated and restored in 1987 and subjected to primary conservation treatment in 2007. However, many problems such as soil disintegration and cavitation occurred in the kiln until recently. In this study, the shape changes due to the conservation treatment in 2020, which was performed to maintain the original shape of the kiln site, were recorded via three-dimensional (3D) scanning, and numerical analysis was conducted to ensure continuous monitoring and preventive conservation. From the results of this study, the locations and ranges of shape changes before and after the conservation treatment of the kiln site were identified through root-mean-square (RMS) deviation analysis and visualization, and the ranges of reinforcement and soil mulch removal were quantified through the deviations at different points. In particular, the most noticeable shape changes occurring from the conservation treatment on the kiln site with 11.2 m long and 16.7° slope were around 15 mm, and many relative changes of 40 mm or more were also observed. In addition, a reinforcement of approximately 40 mm thickness at the least and a flattening were prominently evident on the floor of the working space; the inside of the combustion chamber was visualized with a reinforcement of at least about 50 mm. Damage caused by natural or artificial factors is expected because two extensive conservation treatments were applied in 2007 and 2020 to the kiln sites. Therefore, short-term monitoring using periodic 3D scanning and time-series data comparisons is necessary for the identification of the point of shape change and the determination of major damaged areas so that a mid- to long-term monitoring plan can be established based on the findings of such observations. In addition, predictive modeling research is mandated to detect areas in the entire kiln site that exhibit a greater probability of deterioration based on the available shape change data.
Combined application of N-fixing PGPB and rice straw mulch compensates N immobilization by straw, improving crop growth
Authors: Mazuecos-Aguilera Ismael , Salazar Sergio , Hidalgo-Castellanos Javier , Ortiz-Liébana Noemí , López-Bornay Pedro , González-Andrés Fernando
Published: March 2024

Background

Rice straw, often treated as waste, provides many benefits to crops when used as a mulch. However, straw degradation promotes nitrogen immobilisation due to its high C:N ratio, causing N competition between soil microorganisms and the crop. Currently, sustainable practices to remedy nitrogen immobilisation are hardly being implemented. In microcosm conditions we assessed whether the inoculation with N-fixers could offset the transient nitrogen deficiency caused by straw mulch, thereby harnessing the benefits of straw while mitigating its negative impact on nitrogen depletion and exerting a synergistic effect on crop growth.

Results

Inoculation with N-fixers increased the nitrogen content in the soil (the increase ranged from 14% up to 90% for NH4+ and from 20% to 60% for NO3−) and, in most cases, also the nitrogen content in the plant (ranging from 10% to 15% increase), compared to the non-inoculated control. Therefore, inoculation would compensate for the lack of nitrogen caused by nitrogen immobilisation, and this resulted in an increased biomass production by the crop compared with the uninoculated control (the increase ranged from 25% to 85%). In addition, inoculation with N-fixers did not lead to a permanent change in the bacterial community composition, whereas straw addition increased the biodiversity of the soil microbiome.

Conclusions

The results obtained in microcosm conditions are a first indication that complementing straw mulching with the inoculation of N-fixers could avoid the transient N immobilisation produced during straw degradation. Thus, the benefits of the combination would be a yield increase, while improving the biodiversity of the soil microbiome, stabilising soil temperatures and increasing water soil content.

Graphical Abstract
Successful subtotal gastrectomy and hepatectomy for HER2-positive gastric cancer with liver metastasis after trastuzumab-based chemotherapy: a case report
Authors: Hirase Yuki , Arigami Takaaki , Kawasaki Yota , Matsushita Daisuke , Shimonosono Masataka , Tsuruda Yusuke , Sasaki Ken , Yamasaki Yoichi , Hagihara Takahiko , Noma Hidetoshi , Higashi Michiyo , Kurahara Hiroshi , Ohtsuka Takao
Published: March 2024

Background

Conversion surgery (CS) after chemotherapy is weakly recommended as a promising tool for improving prognoses in patients with unresectable gastric cancer. Moreover, several investigators have demonstrated the clinical efficacy of subtotal gastrectomy (sTG) with a small remnant stomach for the nutritional status and surgical outcome compared with total gastrectomy. Here, we report a patient with liver metastasis from human epidermal growth factor receptor 2 (HER2)-positive gastric cancer who underwent sTG and hepatectomy after trastuzumab-based chemotherapy.

Case presentation

An 84-year-old male patient was diagnosed with HER2-positive gastric cancer with a single liver metastasis. He was treated with eight courses of trastuzumab in combination with S-1 and oxaliplatin as first-line chemotherapy. The primary tumor and liver metastasis shrank significantly. The metastatic liver lesion’s reduction rate was 65%. According to the Response Evaluation Criteria in Solid Tumors, the patient had a partial response. Therefore, he underwent an sTG with D2 lymphadenectomy and partial hepatectomy of segment 2. Histopathological examination revealed a grade 3 histological response without lymph node metastases from the primary tumor. No viable cancer cells were observed in the resected liver specimens. The patient received adjuvant chemotherapy with S-1. The postoperative quality of life (QOL) evaluated using the Postgastrectomy Syndrome Assessment Scale-45 was maintained, and the patient was still alive 8 months after the CS without recurrence.

Conclusions

An sTG with a small remnant stomach might be clinically useful for preventing a decline in QOL and improving prognoses in patients with stage IV gastric cancer after chemotherapy.
Tremella fuciformis beverage improves glycated hemoglobin A1c and waist circumference in overweight/obese prediabetic subjects: a randomized controlled trial
Authors: Gitsomboon Sawika , Ratanapornsompong Ganista , Ongphiphadhanakul Boonsong , Thongpradit Supranee , Chanprasertyothin Suwannee , Chailurtkit La-or , Nimitphong Hataikarn
Published: March 2024

Background

Prediabetes is increasing worldwide. Previous studies have demonstrated the potential of β-glucan derived from oat or barley to lower blood glucose, body weight, and plasma lipid levels. These findings offer a potentially attractive strategy for reducing the risk of diabetes in prediabetic individuals. However, the effects of β-glucan from Tremella fuciformis on glucose metabolism and anthropometric measurements in humans have yet to be studied. We hypothesized that β-glucan from Tremella fuciformis may improve metabolic parameters in subjects with prediabetes. This study aimed to investigate the effects of a once-daily beverage containing Tremella fuciformis (snow mushroom) on anthropometric measurements, metabolic biomarkers, and insulin sensitivity in overweight/obese subjects with prediabetes.

Methods

In this double-blind RCT, 56 participants were randomly assigned to receive either a Tremella fuciformis beverage or placebo daily for 12 weeks. All parameters were assessed at baseline and after the intervention.

Results

After 12 weeks, participants in the intervention group exhibited significant improvements in glycated hemoglobin A1c (HbA1C; 6.03 ± 0.26% at baseline vs. 5.96 ± 0.25% at 12 weeks, p = 0.047, Cohen’s d = 0.39) and waist circumference (95.2 ± 12.51 cm at baseline vs. 93.46 ± 11.48 cm at 12 weeks, p = 0.022, Cohen’s d = 0.45). There were no adverse events reported.

Conclusion

This exploratory study demonstrated that Tremella fuciformis beverage consumption may improve HbA1C and waist circumference in overweight/obese prediabetic individuals. Further research, including larger-scale RCTs and mechanistic studies, is needed to confirm these findings and optimize the therapeutic potential of Tremella fuciformis derivatives in managing prediabetes and preventing type 2 diabetes.

Trial registration

Registered in Thai Clinical Trials Registry (14/07/2021, TCTR20210714004).
Docosahexaenoic acid (DHA) impairs hypoxia-induced cellular and exosomal overexpression of immune-checkpoints and immunomodulatory molecules in different subtypes of breast cancer cells
Authors: Maralbashi Sepideh , Aslan Cynthia , Kahroba Houman , Asadi Milad , Soltani-Zangbar Mohammad Sadegh , Haghnavaz Navideh , Jadidi Farhad , Salari Farhad , Kazemi Tohid
Published: March 2024

Background

Tumor cells express immune-checkpoint molecules to suppress anti-tumor immune responses. In part, immune evasion takes place by secreting exosomes bearing immune-checkpoint and immunomodulatory molecules and their inducing and/or regulating agents e.g., microRNAs (miRs). This study aimed to evaluate the effects of omega-3 fatty acid, docosahexaenoic acid (DHA), on the expression of some selected immune-checkpoint and immunomodulatory molecules and their regulating miRs under both normoxic and hypoxic conditions in triple negative (TNBC) invasive and triple positive non-invasive breast cancer cell lines.

Methods

MDA-MB-231 and BT-474 cells were treated with 100 µM DHA under hypoxic and normoxic conditions for 24 h. Exosomes were isolated by ultracentrifuge and confirmed by electron microscope and anti-CD9, -CD63, -CD81 immunoblotting. Total RNA from cells and exosomes were extracted and expression of CD39, CD73, CD47, CD80, PD-L1, B7-H3, B7-H4 genes and their related miRs were evaluated by quantitative Real-time PCR.

Results

This study showed significant over-expression of immune-checkpoint and immunomodulatory molecules under hypoxic condition. Treatment with DHA resulted in a significant decrease in immune-checkpoint and immunomodulatory molecule expression as well as an upregulation of their regulatory miRNA expression.

Conclusion

DHA supplementation may be utilized in breast cancer therapy for down-regulation of cellular and exosomal immune escape-related molecules.
Time-varying spillovers in high-order moments among cryptocurrencies
Authors: Azimli Asil
Published: March 2024

This study uses high-frequency (1-min) price data to examine the connectedness among the leading cryptocurrencies (i.e. Bitcoin, Ethereum, Binance, Cardano, Litecoin, and Ripple) at volatility and high-order (third and fourth orders in this paper) moments based on skewness and kurtosis. The sample period is from February 10, 2020, to August 20, 2022, which captures a pandemic, wartime, cryptocurrency market crashes, and the full collapse of a stablecoin. Using a time-varying parameter vector autoregressive (TVP-VAR) connectedness approach, we find that the total dynamic connectedness throughout all realized estimators grows with the time frequency of the data. Moreover, all estimators are time dependent and affected by significant events. As an exception, the Russia–Ukraine War did not increase the total connectedness among cryptocurrencies. Analysis of third- and fourth-order moments reveals additional dynamics not captured by the second moments, highlighting the importance of analyzing higher moments when studying systematic crash and fat-tail risks in the cryptocurrency market. Additional tests show that rolling-window-based VAR models do not reveal these patterns. Regarding the directional risk transmissions, Binance was a consistent net transmitter in all three connectedness systems and it dominated the volatility connectedness network. In contrast, skewness and kurtosis connectedness networks were dominated by Litecoin and Bitcoin and Ripple were net shock receivers in all three networks. These findings are expected to serve as a guide for portfolio optimization, risk management, and policy-making practices.
Association of pre-migration socioeconomic status and post-migration mental health in Syrian refugees in Lebanon: a descriptive sex-stratified cross-sectional analysis
Authors: Lange Saskia , Glatz Toivo , Eiset Andreas Halgreen
Published: March 2024

Background

Refugee populations present with high levels of psychological distress, which may vary among sociodemographic characteristics. Understanding the distribution across these characteristics is crucial to subsequently provide more tailored support to the most affected according to their specific healthcare needs. This study therefore seeks to investigate the association between pre-migration socioeconomic status (SES) and post-migration mental health separately for male and female Syrian refugees in Lebanon.

Methods

In a cross-sectional study, a cluster randomized sample of 599 refugees from Syria were recruited between 2016 and 2019 within 12 months after they fled to Lebanon. Logistic regression was used to determine the association between self-reported pre-migration SES and levels of anxiety and depressive symptoms assessed on the Hopkins Symptoms Checklist-25 (HSCL-25) scale, both for the entire sample and stratified by sex. To assess the informative value of self-reported SES, its correlation with education variables was tested. All analyses were conducted in R version 4.3.

Results

Using complete cases, 457 participants (322 female, 135 male) were included in the analyses. Females showed on average more symptoms of anxiety (Median: 2.5) and depression (Median: 2.4) than males (Median: 2.10 and 2.07, respectively). Below average SES was associated with significantly higher odds for mental illness compared to average SES (anxiety: OR 4.28, 95% CI [2.16, 9.49]; depression: OR 1.85, 95% CI [1.06, 3.36]). For anxiety, differences between SES strata were larger for males than females. The self-reported SES measure showed only a weak positive correlation with education.

Conclusions

This study adds additional descriptive data highlighting mental health differences in Syrian refugees in Lebanon, whereby below average SES is associated with worse mental health outcomes compared to average SES. These findings demand further research into the underlying mechanisms. Improving our understanding of the observed differences will provide valuable insights that can contribute to the future development of targeted measures.
Blood levels of glial fibrillary acidic protein for predicting clinical progression to Alzheimer’s disease in adults without dementia: a systematic review and meta-analysis protocol
Authors: Nihashi Takashi , Sakurai Keita , Kato Takashi , Kimura Yasuyuki , Ito Kengo , Nakamura Akinori , Terasawa Teruhiko
Published: March 2024

Background

There is urgent clinical need to identify reliable prognostic biomarkers that predict the progression of dementia symptoms in individuals with early-phase Alzheimer’s disease (AD) especially given the research on and predicted applications of amyloid-beta (Aβ)-directed immunotherapies to remove Aβ from the brain. Cross-sectional studies have reported higher levels of cerebrospinal fluid and blood glial fibrillary acidic protein (GFAP) in individuals with AD-associated dementia than in cognitively unimpaired individuals. Further, recent longitudinal studies have assessed the prognostic potential of baseline blood GFAP levels as a predictor of future cognitive decline in cognitively unimpaired individuals and in those with mild cognitive impairment (MCI) due to AD. In this systematic review and meta-analysis, we propose analyzing longitudinal studies on blood GFAP levels to predict future cognitive decline.

Methods

This study will include prospective and retrospective cohort studies that assessed blood GFAP levels as a prognostic factor and any prediction models that incorporated blood GFAP levels in cognitively unimpaired individuals or those with MCI. The primary outcome will be conversion to MCI or AD in cognitively unimpaired individuals or conversion to AD in individuals with MCI. Articles from PubMed and Embase will be extracted up to December 31, 2023, without language restrictions. An independent dual screening of abstracts and potentially eligible full-text reports will be conducted. Data will be dual-extracted using the CHeck list for critical appraisal, data extraction for systematic Reviews of prediction Modeling Studies (CHARMS)-prognostic factor, and CHARMS checklists, and we will dual-rate the risk of bias and applicability using the Quality In Prognosis Studies and Prediction Study Risk-of-Bias Assessment tools. We will qualitatively synthesize the study data, participants, index biomarkers, predictive model characteristics, and clinical outcomes. If appropriate, random-effects meta-analyses will be performed to obtain summary estimates. Finally, we will assess the body of evidence using the Grading of Recommendation, Assessment, Development, and Evaluation Approach.

Discussion

This systematic review and meta-analysis will comprehensively evaluate and synthesize existing evidence on blood GFAP levels for prognosticating presymptomatic individuals and those with MCI to help advance risk-stratified treatment strategies for early-phase AD.

Trial registration

PROSPERO CRD42023481200.
Cross-cultural adaptation and psychometric properties of the Thai version of the patient-reported outcomes measurement information system short form– depression 8a in individuals with chronic low back pain
Authors: Sansatan Ruetaichanok , Kanlayanaphotporn Rotsalai , Jensen Mark P. , Correia Helena , Janwantanakul Prawit
Published: March 2024

Background

The study aimed to cross-culturally adapt the Patient-Reported Outcomes Measurement Information System Short Form v1.0 - Depression 8a (PROMIS SF v1.0 - Depression 8a) into Thai and evaluate its psychometric properties in individuals with chronic low back pain (CLBP).

Methods

The PROMIS SF v1.0– Depression 8a was translated and cross-culturally adapted into Thai using the Functional Assessment of Chronic Illness Therapy translation methodology. Two hundred and sixty-nine individuals with CLBP completed the Thai version of PROMIS SF v1.0– Depression 8a (T-PROMIS-D-8a) scale and a set of measures assessing validity criterion domains. Structural validity, internal consistency, and test-retest reliability at a 7-day interval of the T-PROMIS-D-8a scale were computed and its construct validity was evaluated by computing correlations with the Thai version of Patient Health Questionnaire-9 (T-PHQ-9), Numeric Rating Scale of pain intensity (T-NRS), and Fear Avoidance Beliefs Questionnaire (T-FABQ).

Results

Data from 269 participants were analyzed. Most participants were women (70%), and the sample had a mean age of 42.5 (SD 16.6) years. The findings supported the unidimensionality, internal consistency (Cronbach’s alpha = 0.94), and test-retest reliability (ICC [2,1] = 0.86) of the T-PROMIS-D-8a. A floor effect was observed for 16% of the sample. Associations with the T-PHQ-9, T-NRS, and T-FABQ supported the construct validity of the T-PROMIS-D-8a.

Conclusions

The T-PROMIS-D-8a was successfully translated and culturally adapted. The findings indicated that the scale is reliable and valid for assessing depression in Thai individuals with CLBP.
Examining interrater agreement between self-report and proxy-report responses for the quality of life-aged care consumers (QOL-ACC) instrument
Authors: Hutchinson Claire , Khadka Jyoti , Crocker Matthew , Lay Kiri , Milte Rachel , Whitehirst David GT , Engel Lidia , Ratcliffe Julie
Published: March 2024

Background

Quality of life is an important quality indicator for health and aged care sectors. However, self-reporting of quality of life is not always possible given the relatively high prevalence of cognitive impairment amongst older people, hence proxy reporting is often utilised as the default option. Internationally, there is little evidence on the impact of proxy perspective on interrater agreement between self and proxy report.

Objectives

To assess the impacts of (i) cognition level and (ii) proxy perspective on interrater agreement using a utility instrument, the Quality of Life-Aged Care Consumers (QOL-ACC).

Methods

A cross-sectional study was undertaken with aged care residents and family member proxies. Residents completed the self-report QOL-ACC, while proxies completed two proxy versions: proxy-proxy perspective (their own opinion), and proxy-person perspective (how they believe the resident would respond). Interrater agreement was assessed using quadratic weighted kappas for dimension-level data and concordance correlation coefficients and Bland-Altman plots for utility scores.

Results

Sixty-three residents (22, no cognitive impairment; 41, mild-to-moderate cognitive impairment) and proxies participated. In the full sample and in the mild-to-moderate impairment group, the mean self-reported QOL-ACC utility score was significantly higher than the means reported by proxies, regardless of perspective (p < 0.01). Agreement with self-reported QOL-ACC utility scores was higher when proxies adopted a proxy-person perspective.

Conclusion

Regardless of cognition level and proxy perspective, proxies tend to rate quality of life lower than residents. Further research is needed to explore the impact of such divergences for quality assessment and economic evaluation in aged care.
Consanguinity, complex diseases and congenital disabilities in the Souss population (Southern Morocco): a cross-sectional survey
Authors: Dahbi Noura , El khair Abderrazak , Cheffi Khadija , Habibeddine Lamiaa , Talbi Jalal , Hilali Abderraouf , El ossmani Hicham
Published: March 2024

Background

Several studies showed that the perpetuation of consanguinity increases homozygosity and homogenizes the population's gene pool. This allows the expression of recessive deleterious mutations and increases the prevalence of genetic disorders and birth defects. Despite the reported negative health effects, consanguinity is still practiced in Morocco. This study aimed to evaluate the prevalence and socio-demographic determinants of consanguinity in the Souss region and to assess the association of this type of union with congenital disabilities and complex diseases. To meet this aim, a survey based on a cross-sectional approach was conducted between January 2019 and January 2020 among 520 randomly selected participants in the Souss region.

Results

The findings revealed a high prevalence of consanguinity of 28.46%, with first-cousin unions accounting for 16.15% of all marriages. According to multivariate logistic regression analysis, early age at first marriage, men’s occupation, endogamy, and parental consanguinity were predictive factors for consanguineous unions in the study population. Moreover, the results revealed a significant association between consanguinity and the incidence of physical disabilities (OR = 3.753; [95% CI 1.398–10.074]), mental retardation (OR = 5.219; [95% CI 1.545–17.631]), deafness-mutism (OR = 4.262; [95% CI 1.004–18.089]) and cardiovascular diseases (OR = 2.167; [95% CI 1.036–4.530]). However, no significant association was found between consanguinity and diabetes, cancer, asthma, epilepsy, and psychiatric disorders.

Conclusion

Overall, our results suggest a high practice of consanguinity in the Souss population, associated with social, economic, and cultural factors. Consanguineous unions were associated with a high incidence of mental retardation, physical disabilities, deafness-mutism, and cardiovascular diseases. In this population, where marriage between relatives is highly preferred, awareness programs are not sufficient, and genetic studies on consanguinity-related diseases are necessary to provide specific premarital screening and thus increase the efficiency of genetic counseling.
Value of different CTO scoring systems in predicting procedural success in coronary chronic total occlusion intervention in Egyptian patients
Authors: AlAshry Ahmed Mohammed Ali , Nagiub Muhammed Nagy , Ismael Magdy Farouk Ahmed , Alghonaimy Wesam
Published: March 2024

Background

Chronic total occlusion (CTO) lesions in coronary arteries pose a significant challenge for coronary interventionists, often leading to referrals for coronary artery bypass graft surgery (CABG). Successful percutaneous coronary intervention (PCI) for CTOs requires accurate assessment of procedural potential. This study, comprising 100 Egyptian patients aged 37–81, compares the predictive efficacy of various CTO scoring systems in PCI success determination. Patients with CTO in at least one coronary artery, planned for elective PCI based on objective evidence of ischemia, were included. Experienced operators performed PCI, recording procedural variables, and assessing complications. Logistic regression analysis revealed an inverse linear relationship between success rates and score values across all systems.

Results

Although, the predictive capacity of the scores was similar, with slight differences. The Euro CTO (CASTLE) score10 exhibited superior predictive efficacy, followed by the CL score9, while PROGRESS8 and J-CTO7 scores showed lower significance. ORA CTO11 score demonstrated intermediate predictive ability, and PROGRESS score8 had the least predictive value.

Conclusion

The CASTLE score10 proved most effective in predicting PCI success for CTO cases in Egyptian patients, with operators advised to choose scoring systems based on experience and case characteristics. Proper planning remains crucial for optimizing success rates in CTO PCI procedures, irrespective of the scoring system employed.