bluuebunny/crossref_metadata_2025 huggingface dataset:
Depression and anxiety symptoms among patients receiving maintenance hemodialysis: a single center cross-sectional study
Authors: Ye Wei , Wang Lizhen , Wang Yu , Wang Chengjun , Zeng Jingyi
Published: December 2022

Background

To investigate depression and anxiety and related factors among patients receiving maintenance hemodialysis (MHD).

Methods

This cross-sectional study included patients underwent MHD in 3/2022 at Jinshan Hospital affiliated to Fudan University. Depression and anxiety levels of patients were assessed using Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively. SF-36 was used to assess patients’ quality of life. Multiple linear regression analysis was used to determine the variables associated with the scores of BDI/BAI.

Results

A total of 103 patients were included, 71 cases (68.93%) and 38 cases (36.89%) with depression and anxiety, respectively. The scores of almost all domains of the SF-36 showed a declining trend with increasing depression or anxiety among patients on MHD. Higher Charlson Comorbidity Index (CCI) (β =0.066, 95%CI: 0.016-0.116,P = 0.010), lower educational status (β = − 0.139, 95%CI: − 0.243- -0.036,P = 0.009), and number of oral medications (β =0.177, 95%CI: 0.031-0.324,P = 0.018) were significantly associated with higher BDI scores. Longer dialysis duration (β =0.098, 95%CI: 0.003-0.193,P = 0.044) and number of oral medications (β =4.714, 95%CI: 1.837-7.590,P = 0.002) were significantly associated with higher BAI scores.

Conclusions

Depression and anxiety may be likely to occur among patients undergoing MHD and impact their quality of life. Higher CCI, lower educational status and usage of multiple oral medications may be associated with depression, whereas longer dialysis duration and multiple oral medications may be associated with anxiety in MHD patients.
Normal parameters for diagnostic transcranial magnetic stimulation using a parabolic coil with biphasic pulse stimulation
Authors: Jitsakulchaidej Pimthong , Wivatvongvana Pakorn , Kitisak Kittipong
Published: December 2022

Background

TMS is being used to aid in the diagnosis of central nervous system (CNS) illnesses. It is useful in planning rehabilitation programs and setting appropriate goals for patients. We used a parabolic coil with biphasic pulse stimulation to find normal values for diagnostic TMS parameters.

Objectives

1. To determine the normal motor threshold (MT), motor evoked potentials (MEP), central motor conduction time (CMCT), intracortical facilitation (ICF), short-interval intracortical inhibition (SICI), and silent period (SP) values. 2. To measure the MEP latencies of abductor pollicis brevis (APB) and extensor digitorum brevis (EDB) at various ages, heights, and arm and leg lengths.

Study design

Descriptive Study.

Setting

Department of Rehabilitation Medicine, Chiang Mai University, Thailand.

Subjects

Forty-eight healthy participants volunteered for the study.

Methods

All participants received a single diagnostic TMS using a parabolic coil with biphasic pulse stimulation on the left primary motor cortex (M1). All parameters: MT, MEP, CMCT, ICF, SICI, and SP were recorded through surface EMGs at the right APB and EDB. Outcome parameters were reported by the mean and standard deviation (SD) or median and interquartile range (IQR), according to data distribution. MEP latencies of APB and EDB were also measured at various ages, heights, and arm and leg lengths.

Results

APB-MEP latencies at 120% and 140% MT were 21.77 ± 1.47 and 21.17 ± 1.44 ms. APB-CMCT at 120% and 140% MT were 7.81 ± 1.32 and 7.19 ± 1.21 ms. APB-MEP amplitudes at 120% and 140% MT were 1.04 (0.80–1.68) and 2.24 (1.47–3.52) mV. EDB-MEP latencies at 120% and 140% MT were 37.14 ± 2.85 and 36.46 ± 2.53 ms. EDB-CMCT at 120% and 140% MT were 14.33 ± 2.50 and 13.63 ± 2.57 ms. EDB-MEP amplitudes at 120% and 140% MT were 0.60 (0.38–0.98) and 0.95 (0.69–1.55) mV. ICF amplitudes of APB and EDB were 2.26 (1.61–3.49) and 1.26 (0.88–1.98) mV. SICI amplitudes of APB and EDB were 0.21 (0.13–0.51) and 0.18 (0.09–0.29) mV. MEP latencies of APB at 120% and 140% MT were different between heights < 160 cm and ≥ 160 cm (p < 0.001 and p < 0.001) and different between arm lengths < 65 and ≥ 65 cm (p = 0.022 and p = 0.002).

Conclusion

We established diagnostic TMS measurements using a parabolic coil with a biphasic pulse configuration. EDB has a higher MT than APB. The 140/120 MEP ratio of APB and EDB is two-fold. The optimal MEP recording for APB is 120%, whereas EDB is 140% of MT. CMCT by the F-wave is more convenient and tolerable for patients. ICF provides a twofold increase in MEP amplitude. SICI provides a ¼-fold of MEP amplitude. SP from APB and EDB are 121.58 ± 21.50 and 181.01 ± 40.99 ms, respectively. Height and MEP latencies have a modest relationship, whereas height and arm length share a strong positive correlation.
Cardiac dysfunction and high-sensitive C-reactive protein are associated with troponin T elevation in ischemic stroke: insights from the SICFAIL study
Authors: Montellano Felipe A. , Kluter Elisabeth J. , Rücker Viktoria , Ungethüm Kathrin , Mackenrodt Daniel , Wiedmann Silke , Dege Tassilo , Quilitzsch Anika , Morbach Caroline , Frantz Stefan , Störk Stefan , Haeusler Karl Georg , Kleinschnitz Christoph , Heuschmann Peter U.
Published: December 2022

Background

Troponin elevation is common in ischemic stroke (IS) patients. The pathomechanisms involved are incompletely understood and comprise coronary and non-coronary causes, e.g. autonomic dysfunction. We investigated determinants of troponin elevation in acute IS patients including markers of autonomic dysfunction, assessed by heart rate variability (HRV) time domain variables.

Methods

Data were collected within the Stroke Induced Cardiac FAILure (SICFAIL) cohort study. IS patients admitted to the Department of Neurology, Würzburg University Hospital, underwent baseline investigation including cardiac history, physical examination, echocardiography, and blood sampling. Four HRV time domain variables were calculated in patients undergoing electrocardiographic Holter monitoring. Multivariable logistic regression with corresponding odds ratios (OR) and 95% confidence intervals (CI) was used to investigate the determinants of high-sensitive troponin T (hs-TnT) levels ≥14 ng/L.

Results

We report results from 543 IS patients recruited between 01/2014–02/2017. Of those, 203 (37%) had hs-TnT ≥14 ng/L, which was independently associated with older age (OR per year 1.05; 95% CI 1.02–1.08), male sex (OR 2.65; 95% CI 1.54–4.58), decreasing estimated glomerular filtration rate (OR per 10 mL/min/1.73 m2 0.71; 95% CI 0.61–0.84), systolic dysfunction (OR 2.79; 95% CI 1.22–6.37), diastolic dysfunction (OR 2.29; 95% CI 1.29–4.02), atrial fibrillation (OR 2.30; 95% CI 1.25–4.23), and increasing levels of C-reactive protein (OR 1.48 per log unit; 95% CI 1.22–1.79). We did not identify an independent association of troponin elevation with the investigated HRV variables.

Conclusion

Cardiac dysfunction and elevated C-reactive protein, but not a reduced HRV as surrogate of autonomic dysfunction, were associated with increased hs-TnT levels in IS patients independent of established cardiovascular risk factors.

Registration-URL: https://www.drks.de/drks_web/; Unique identifier: DRKS00011615.
Perceived COVID-19 threat, perceived healthcare system inequities, personal experiences of healthcare discrimination and their associations with COVID-19 preventive behavioral intentions among college students in the U.S.
Authors: Sherchan Juliana S. , Fernandez Jessica R. , Qiao Shan , Kruglanski Arie W. , Forde Allana T.
Published: December 2022

College students are often reluctant to follow U.S. preventive guidelines to lower their risk of COVID-19 infection, despite an increased risk of transmission in college settings. Prior research suggested that college students who perceived greater COVID-19 severity and susceptibility (i.e., COVID-19 threat) were more likely to engage in COVID-19 preventive behaviors, yet there is limited research examining whether perceived COVID-19 threat, perceived U.S. healthcare system inequities, and personal experiences of healthcare discrimination collectively influence college students’ COVID-19 preventive behaviors. This study identified latent classes of perceived COVID-19 threat, perceived U.S. healthcare system inequities, and personal experiences of healthcare discrimination, examined whether latent classes were associated with COVID-19 preventive behavioral intentions, and assessed whether latent class membership varied across racial/ethnic groups.

Students from the University of Maryland, College Park (N = 432) completed the Weighing Factors in COVID-19 Health Decisions survey (December 2020-December 2021). Latent class analysis identified latent classes based on perceived COVID-19 threat, perceived U.S. healthcare system inequities, and personal experiences of healthcare discrimination. Regression analyses examined associations between the latent classes and COVID-19 preventive behavioral intentions (i.e., social distancing, mask-wearing, COVID-19 vaccination) and whether latent class membership varied across racial/ethnic groups.

Students in Latent Class 1 (27.3% of the sample) had high perceived COVID-19 threat and U.S. healthcare system inequities and medium probability of experiencing personal healthcare discrimination. Students in Latent Class 1 had higher social distancing, mask-wearing, and vaccination intentions compared to other latent classes. Compared to Latent Class 4 (reference group), students in Latent Class 1 had higher odds of identifying as Hispanic or Latino, Non-Hispanic Asian, Non-Hispanic Black or African American, and Non-Hispanic Multiracial versus Non-Hispanic White.

Latent classes of higher perceived COVID-19 threat, perceived U.S. healthcare system inequities, and personal experiences of healthcare discrimination were associated with higher COVID-19 preventive behavioral intentions and latent class membership varied across racial/ethnic groups. Interventions should emphasize the importance of COVID-19 preventive behaviors among students who perceive lower COVID-19 threat.
Impact of weekday and weekend mobility and public policies on COVID-19 incidence and deaths across 76 large municipalities in Colombia: statistical analysis and simulation
Authors: Jason Jamie S. , Bowser Diana M. , Harker Roa Arturo , Contreras Ceballos Diana C. , Muñoz Santiago , Sombrio Anna G. , Shepard Donald S.
Published: December 2022

Background

Despite widespread restrictions on residents’ mobility to limit the COVID-19 pandemic, controlled impact evaluations on such restrictions are rare. While Colombia imposed a National Lockdown, exceptions and additions created variations across municipalities and over time. 

Methods

We analyzed how weekend and weekday mobility affected COVID-19 cases and deaths. Using GRANDATA from the United Nations Development Program (UNDP) we examined movement in 76 Colombian municipalities, representing 60% of Colombia's population, from March 2, 2020 through October 31, 2020. We combined the mobility data with Colombia’s National Epidemiological Surveillance System (SIVIGILA) and other databases and simulated impacts on COVID-19 burden. 

Results

During the study period, Colombians stayed at home more on weekends compared to weekdays. In highly dense municipalities, people moved less than in less dense municipalities. Overall, decreased movement was associated with significant reductions in COVID-19 cases and deaths two weeks later. If mobility had been reduced from the median to the threshold of the best quartile, we estimate that Colombia would have averted 17,145 cases and 1,209 deaths over 34.9 weeks, reductions of 1.63% and 3.91%, respectively. The effects of weekend mobility reductions (with 95% confidence intervals) were 6.40 (1.99–9.97) and 4.94 (1.33–19.72) times those of overall reductions for cases and deaths, respectively.

Conclusions

We believe this is the first evaluation of day-of-the week mobility on COVID-19. Weekend behavior was likely riskier than weekday behavior due to larger gatherings and less social distancing or protective measures. Reducing or shifting such activities outdoors would reduce COVID-19 cases and deaths.
Minimally invasive trans-superior articular process percutaneous endoscopic lumbar discectomy with robot assistance
Authors: Wang Zongjiang , Tan Ying , Fu Kai , Meng Zhaowu , Wang Liang
Published: December 2022

Background

To compare the clinical outcomes of patients with lumbar disc herniation treated with robot-assisted percutaneous endoscopic lumbar discectomy (r-PELD) or conventional PELD under fluoroscopy guidance (f-PELD).

Methods

Our study group included 55 patients, 22 in the r-PELD group and 33 in the f-PELD group. The following clinical and surgical outcomes were compared between the two groups: the visual analog scale for radiculopathy pain; Oswestry Disability Index; intraoperative volume of blood loss; frequency of fluoroscopy used during the procedure; and MacNab classification. The follow-up period was 6–8 months.

Results

Compared with f-PELD, r-PELD was associated with a lower volume of intraoperative blood loss and frequency of fluoroscopy (p < 0.01). There were no differences in complications, MacNab classification, postoperative disability and leg pain, and duration of hospitalization between the two groups.

Conclusion

Based on our findings, r-PELD provides a safe and effective alternative to conventional PELD for the treatment of lumbar disc herniations, with the accuracy for placement of punctures lowering radiation exposure.
Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis
Authors: Murahashi Makoto , Ntege Edward Hosea , Higa Masaru , Maruyama Nobuyuki , Kawano Toshihiro , Shimizu Yusuke , Nakamura Hiroyuki
Published: December 2022

Background

The coexistence of calcium pyrophosphate dihydrate crystal deposition (CPP) and synovial chondromatosis (SC) in the temporomandibular joint (TMJ) is rarely reported. CPP disease (CPPD) is complex arthritis synonymous with excessive pyrophosphate production and variable aberrations in mineral and organic phase metabolism of the joint cartilage, leading to local inundated CPP and crystal deposition of partially deciphered predispositions. Meanwhile, SC is a rare benign synovial joint proliferative disease of unclear etiology and has a low risk of malignant transformation. However, SC manifests severe joint disability and dysfunction because of connective tissue metaplasia of the synovial membrane, which forms cartilaginous nodules with or without calcifications or ossifications. These nodules often detach and form intra-articular loose bodies and very rarely within extraarticular spaces.

Case presentation

We report the case of a 61-year-old man to expand the body of literature on these unusual coexisting arthropathies of the TMJ. The patient presented to our hospital in 2020 with complaints of pain in the right TMJ and trismus for over 6 months. Radiographic assessments of the TMJ provided a preoperative provisional diagnosis of SC. However, the histopathology of the open biopsy revealed tumor-like lesions comprising several deposits of rhomboid and rod-shaped crystals that displayed positive birefringence in polarized light, confirming a coexistence of CPPD. A second-stage operation was performed for the complete removal of the loose bodies and chalk-like lesions including synovectomy. No evidence of recurrence was recorded after a follow-up of nearly 1.5 years.

Conclusions

Isolated CPPD and SC of the TMJ are prevalent in the literature however, monoarticular coexistence of these diseases is rare, due to the lack of consistency in the diagnostic criteria in clinical practice. Moreover, optimal treatment depends on several considerations. This report delineated the molecular etiopathology and underscored the need for continued deciphering of the causal mechanisms of coexisting CPPD and SC of the TMJ. In addition, the importance of confirmatory testing for accurate diagnosis, and appropriate management of these diseases were discussed.
Therapeutic effects of magnesium and vitamin B6 in alleviating the symptoms of restless legs syndrome: a randomized controlled clinical trial
Authors: Jadidi Ali , Rezaei Ashtiani Alireza , Khanmohamadi Hezaveh Ali , Aghaepour Seyed Mohamad
Published: December 2022

Background and objective

Restless legs syndrome/Willis-Ekbom Disease (RLS/WED) is one of the most prevalent sleep disorders. There are contradicting data about the effectiveness of magnesium and vitamin B6 in alleviating the symptoms of this condition. Therefore, this study aimed to assess the efficacy of magnesium and vitamin B6 in alleviating the symptoms of RLS/WED.

Methods

A single-blind study was conducted on individuals with this illness for at least three months. Randomly, 75 patients were assigned into three groups: magnesium, vitamin B6, and placebo. The experimental group received daily doses of 40 mg vitamin B6 or 250 mg magnesium oxide. While others in the control group merely received a placebo. Patients’ disease severity and sleep quality were evaluated three times using standard questionnaires (at the beginning of the study, one and two months after therapy). Utilizing SPSS22 software and the ANOVA, t-test, and repeated measure tests, statistical analysis was conducted.

Results

The mean and standard deviation of sleep quality and disease severity at the beginning of the trial and throughout the first month following the intervention did not differ statistically between the three groups. In the second month following the intervention, the mean and standard deviation of sleep quality and disease severity were significantly different (P = 0.001).

Conclusion

Taking magnesium and vitamin B6 supplements can reduce the severity of symptoms of RLS/WED patients and improve their sleep quality.
Spiritual leadership among nursing educators: a correlational cross-sectional study with psychological capital
Authors: Abou Zeid Mennat-Allah G. , El-Ashry Ayman Mohamed , Kamal Manar Ahmed , Khedr Mahmoud Abdelwahab
Published: December 2022

Background

Spiritual leadership is the most positive leadership style accepted by positive organizational behavior scholars that contributes to psychological capital. Spiritual leadership could be a critical organizational resource for followers. The study aims to examine the levels of spiritual leadership and psychological capital among nursing educators and determine the relationship between spiritual leadership and psychological capital among nurse educators.

Methods

A cross-sectional design was applied using two tools: spiritual leadership and psychological capital scales. Over 3 months, data were collected from 213 nursing educators.

Results

The spiritual leadership level is moderate to high (49.8 and 38.5%). The psychological capital level is high (63.4%). The association between spiritual leadership and psychological capital is a strong, positive, and highly significant correlation (R-value = 0.63, P = 0.001). The regression analysis predicted that male participants were expected to have more spiritual leadership and psychological capital than females.

Conclusion

It can be concluded and validated how important it is to develop and practice spiritual leadership to foster followers’ psychological capital.

Implications of nursing management

as nursing leaders must have spiritual competencies to promote workplace spirituality on the daily agenda as a foundational area in management.
Health system barriers influencing timely breast cancer diagnosis and treatment among women in low and middle-income Asian countries: evidence from a mixed-methods systematic review
Authors: Afaya Agani , Ramazanu Sheena , Bolarinwa Obasanjo Afolabi , Yakong Vida Nyagre , Afaya Richard Adongo , Aboagye Richard Gyan , Daniels-Donkor Silas Selorm , Yahaya Ahmed-Rufai , Shin Jinhee , Dzomeku Veronica Millicent , Ayanore Martin Amogre , Alhassan Robert Kaba
Published: December 2022

Background

Globally, breast cancer is the most common cancer type and the leading cause of cancer mortality among women in developing countries. A high prevalence of late breast cancer diagnosis and treatment has been reported predominantly in Low- and Middle-Income Countries (LMICs), including those in Asia. Thus, this study utilized a mixed-methods systematic review to synthesize the health system barriers influencing timely breast cancer diagnosis and treatment among women in Asian countries.

Methods

We systematically searched five electronic databases for studies published in English from 2012 to 2022 on health system barriers that influence timely breast cancer diagnosis and treatment among women in Asian countries. The review was conducted per the methodology for systematic reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, while health system barriers were extracted and classified based on the World Health Organization (WHO)‘s Health Systems Framework. The mixed-methods appraisal tool was used to assess the methodological quality of the included studies.

Results

Twenty-six studies were included in this review. Fifteen studies were quantitative, nine studies were qualitative, and two studies used a mixed-methods approach. These studies were conducted across ten countries in Asia. This review identified health systems barriers that influence timely breast cancer diagnosis and treatment. The factors were categorized under the following: (1) delivery of health services (2) health workforce (3) financing for health (4) health information system and (5) essential medicines and technology. Delivery of health care (low quality of health care) was the most occurring barrier followed by the health workforce (unavailability of physicians), whilst health information systems were identified as the least barrier.

Conclusion

This study concluded that health system factors such as geographical accessibility to treatment, misdiagnosis, and long waiting times at health facilities were major barriers to early breast cancer diagnosis and treatment among Asian women in LMICs. Eliminating these barriers will require deliberate health system strengthening, such as improving training for the health workforce and establishing more healthcare facilities.
“Frustrated with the whole system”: a qualitative framework analysis of the issues faced by people accessing health services for chronic pain
Authors: Hopkins Ria E. , Degenhardt Louisa , Campbell Gabrielle , Farnbach Sara , Gisev Natasa
Published: December 2022

Background

Chronic non-cancer pain (CNCP) is complex and often requires multimodal management comprising of both pharmacological and non-pharmacological treatments. To inform delivery of CNCP management, it is important to understand how current health services providing non-pharmacological treatments are accessed by exploring the experiences of people attempting to access services. In doing so, this study sought to explore the underlying drivers of service access barriers.

Methods

This study explored the experiences of Australians accessing services for CNCP using semi-structured telephone interviews undertaken between 01 October 2020 and 31 March 2021. Thematic analysis was guided by Levesque et al.’s 2013 conceptual framework of access to health care, with emerging themes mapped to five dimensions of accessibility and corresponding abilities of consumers: Approachability/Ability to perceive; Acceptability/Ability to seek; Availability and Accommodation/Ability to reach; Affordability/Ability to pay; and Appropriateness/Ability to engage.

Results

The 26 participants (aged 24–78 years, 22 female) reported accessing a range of services including general practitioners (GP), allied health services, and specialised pain clinics, for a variety of conditions. Three themes were mapped to accessibility dimensions (in brackets): ‘GP as guide or gatekeeper’ (Approachability); ‘Outside of my control’ (Availability and Accommodation; Affordability); and ‘Services aren’t always good enough’ (Appropriateness). A fourth identified theme illustrated how participants responded to encountering these barriers: ‘Leading my own pain management’. Participant experiences suggest problems with the translation of contemporary pain management principles into practice, including continued application of biomedical health models as opposed to the biopsychosocial model, and demonstrate systemic issues with service delivery, including a lack of benchmarking of specialised services.

Conclusions

The identified themes highlight several evidence-to-practice gaps in the delivery of health services for people with CNCP in Australia. To address these gaps, there is a need for improved clinician training, increased investment in specialised pain services, and development of clear primary care pathways for CNCP management for evidence-based multimodal pain management to be accessible and equitable.
High-density lipoprotein subclasses and cardiovascular disease and mortality in type 2 diabetes: analysis from the Hong Kong Diabetes Biobank
Authors: Jin Qiao , Lau Eric S. H. , Luk Andrea O. , Tam Claudia H. T. , Ozaki Risa , Lim Cadmon K. P. , Wu Hongjiang , Chow Elaine Y. K. , Kong Alice P. S. , Lee Heung Man , Fan Baoqi , Ng Alex C. W. , Jiang Guozhi , Lee Ka Fai , Siu Shing Chung , Hui Grace , Tsang Chiu Chi , Lau Kam Piu , Leung Jenny Y. , Tsang Man-wo , Cheung Elaine Y. N. , Kam Grace , Lau Ip Tim , Li June K. , Yeung Vincent T. , Lau Emmy , Lo Stanley , Fung Samuel , Cheng Yuk Lun , Chow Chun Chung , Yu Weichuan , Tsui Stephen K. W. , Huang Yu , Lan Hui-yao , Szeto Cheuk Chun , So Wing Yee , Jenkins Alicia J. , Chan Juliana C. N. , Ma Ronald C. W. ,   the Hong Kong Diabetes Biobank Study Group
Published: December 2022

Objective

High-density lipoproteins (HDL) comprise particles of different size, density and composition and their vasoprotective functions may differ. Diabetes modifies the composition and function of HDL. We assessed associations of HDL size-based subclasses with incident cardiovascular disease (CVD) and mortality and their prognostic utility.

Research design and methods

HDL subclasses by nuclear magnetic resonance spectroscopy were determined in sera from 1991 fasted adults with type 2 diabetes (T2D) consecutively recruited from March 2014 to February 2015 in Hong Kong. HDL was divided into small, medium, large and very large subclasses. Associations (per SD increment) with outcomes were evaluated using multivariate Cox proportional hazards models. C-statistic, integrated discrimination index (IDI), and categorial and continuous net reclassification improvement (NRI) were used to assess predictive value.

Results

Over median (IQR) 5.2 (5.0–5.4) years, 125 participants developed incident CVD and 90 participants died. Small HDL particles (HDL-P) were inversely associated with incident CVD [hazard ratio (HR) 0.65 (95% CI 0.52, 0.81)] and all-cause mortality [0.47 (0.38, 0.59)] (false discovery rate < 0.05). Very large HDL-P were positively associated with all-cause mortality [1.75 (1.19, 2.58)]. Small HDL-P improved prediction of mortality [C-statistic 0.034 (0.013, 0.055), IDI 0.052 (0.014, 0.103), categorical NRI 0.156 (0.006, 0.252), and continuous NRI 0.571 (0.246, 0.851)] and CVD [IDI 0.017 (0.003, 0.038) and continuous NRI 0.282 (0.088, 0.486)] over the RECODe model.

Conclusion

Small HDL-P were inversely associated with incident CVD and all-cause mortality and improved risk stratification for adverse outcomes in people with T2D. HDL-P may be used as markers for residual risk in people with T2D.
Cucurbitacins as potential anticancer agents: new insights on molecular mechanisms
Authors: Varela Carla , Melim Catarina , Neves Beatriz G. , Sharifi-Rad Javad , Calina Daniela , Mamurova Assem , Cabral Célia
Published: December 2022

Since ancient times, plants have been an extensive reservoir of bioactive compounds with therapeutic interest for new drug development and clinical application. Cucurbitacins are a compelling example of these drug leads, primarily present in the plant kingdom, especially in the Cucurbitaceae family. However, these natural compounds are also known in several genera within other plant families. Beyond the Cucurbitaceae family, they are also present in other plant families, as well as in some fungi and one shell-less marine mollusc. Despite the natural abundance of cucurbitacins in different natural species, their obtaining and isolation is limited, as a result, an increase in their chemical synthesis has been developed by researchers. Data on cucurbitacins and their anticancer activities were collected from databases such as PubMed/MedLine, TRIP database, Web of Science, Google Scholar, and ScienceDirect and the information was arranged sequentially for a better understanding of the antitumor potential. The results of the studies showed that cucurbitacins have significant biological activities, such as anti-inflammatory, antioxidant, antimalarial, antimicrobial, hepatoprotective and antitumor potential. In conclusion, there are several studies, both in vitro and in vivo reporting this important anticancer/chemopreventive potential; hence a comprehensive review on this topic is recommended for future clinical research.
Clinicopathological features and genomic profiles of a group of secretory breast carcinomas in which progressive cases have more complex genomic features
Authors: Lei Ting , Yang Yuyan , Shi Yongqiang , Deng Xu , Peng Yan , Wang Hui , Chen Tongbing
Published: December 2022

Background

Secretory breast carcinoma (SBC) is a rare malignant breast neoplasm with distinct histological features, including solid, microcystic, tubular, and rarely papillary structures, traditionally characterized by a t (12;15) (p13:q25) translocation, which usually leads toETV6-NTRK3fusion, suggesting an early event in tumorigenesis. Due to the rarity of this disease, very few genome sequencing studies have been performed on a series of cases, especially progressive cases.

Methods

Seven lesions from 5 patients diagnosed at the Third Affiliated Hospital of Soochow University from 2007 to 2021 were included. Clinicopathological features and prognosis/survival data were collected. Next-generation DNA sequencing was performed on six of the seven lesions.

Results

In total, 3/7 (42.9%) lesions demonstrated estrogen receptor (ER) expression, including weak, moderate to strong staining, and no lesion demonstrated progesterone receptor (PR) expression. There were no cases of human epidermal growth factor (HER2) overexpression, and the Ki-67 index was low. S-100 and pan-TRK protein were diffusely positively expressed in all cases. All lesions were characterized by a t(12;15) (p13:q25) translocation, leading toETV6-NTRK3fusion confirmed by fluorescence in situ hybridization (FISH). The sequencing results showed thatETV6-NTRK3fusion was the main driver of early tumorigenesis, while SBC with invasive biological behavior had more complex genomic variation in whichTERTpromoter mutation was detected.

Conclusions

Immunohistochemical staining of a biomarker panel, including ER, PR, HER2, Ki-67, S-100 and pan-TRK, can be used as an auxiliary diagnostic tool, and FISH detection can be used as a diagnostic tool.ETV6-NTRK3gene fusion involving multiple sites may drive tumorigenesis, while mutations in theTERTpromoter region may be a factor driving tumor progression.
Isolation, bioassay and 3D-QSAR analysis of 8-isopentenyl flavonoids from Epimedium sagittatum maxim. as PDE5A inhibitors
Authors: Li Juntao , Wu Yue , Yu Xinxin , Zheng Xinyu , Xian Jiechen , Li Senjie , Shi Wanyin , Tang Yun , Chen Zhe-Sheng , Liu Guixia , Yao Shen , Xu Jian , Zheng Xiangwei
Published: December 2022

Background

As known, inhibition of phosphodiesterase 5 (PDE5) has the therapeutic effect on male erectile dysfunction (ED), and the processed folium of Epimedium sagittatum Maxim. (PFES) characterized by 8-isopentenyl flavonoids is a famous herb for treating ED. However, the main flavonoids inhibitory activities, structure–activity relationship (SAR) and signaling pathway have been not systematically studied so that its pharmacodynamic mechanism is unclear.

Methods

We aimed to initially reveal the PFES efficacy mechanism for treating ED. For the first time, 6 main 8-isopentenyl flavonoids (1–6) from PFES were isolated and identified. Then based on HPLC detection, we proposed a novel method to screen inhibitors among them. We further analyze the three-dimensional quantitative structure–activity relationship (3D-QSAR) for those inhibitors.

Results

The results were verified by cellular effects of the screened flavonoids. Among 6 compounds, Icariin: (1), 2-Oʹʹrhamnosylicaridide II (2) and Baohuoside I (3) were identified with significant activities (IC50 = 8.275, 3.233, 5.473 μM). Then 3D-QSAR studies showed that the replacement of C8 with bulky steric groups as isopentenyl, C3 with positive charge groups and C4' with a hydrogen bond acceptor substituent could increase inhibitory effects. In contrast, the substitution of C7 with bulky steric groups or hydrophilic groups tended to decrease the efficacies. And compounds 1, 2, 3 could increase cGMP level and decrease cytoplasmic Ca2+ of rat corpus cavernosum smooth muscle cells (CCSMCs)by activating PKG.

Conclusion

8-isopentenyl flavonoids could be the main pharmacodynamic substances of PFES in the treatment for ED, and some had significant PDE5A1 inhibitory activities so as to activate cGMP/PKG/Ca2+ signaling pathway in CCSMCs, that was related to the substituents at the key sites such as C8, C3, C4ʹ and C7 in the characteristic compounds.
Internalized stigma and associated factors among people with mental illness at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia, 2021
Authors: Sori Lamesa Melese , Sema Faisel Dula , Tekle Masho Tigabe
Published: December 2022

Background

Internalized stigma has been found to be high among people with mental illness (PWMI) and it results in poor treatment outcome, increased disability and high economic burden. So, this study was designed to determine the prevalence and associated factors of high internalized stigma among PWMI attending psychiatric follow-up at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia, 2021.

Methods

A cross-sectional study was conducted among PWMI (n = 365), and internalized stigma was measured by using internalized stigma of mental illness 29 (ISMI-29) scale. The data was entered in to EPI DATA software (4.6.0.2) and analyzed by Statistical Package for Social Sciences version 20. A binary logistic regression was used to identify factors associated with internalized stigma and reported with 95% confidence interval (CI). P-value < 0.05 was considered as statistically significant.

Results

The prevalence of high internalized stigma was found to be 27.9% (95% CI 23.1–32.6). A male gender (AOR = 0.332; 95% CI 0.175–0.629), occupation, specifically government employee (AOR = 0.309; 95% CI 0.118–0.809), life time substance use (AOR = 3.561; 95% CI 1.867–6.793), low self-esteem (AOR = 8.313; 95% CI 3.641–18.977), and history of hospitalization (AOR = 4.236; 95% CI 1.875, 9.570) were factors significantly associated with higher internalized stigma.

Conclusion

The result of this study showed that there was an intermediate prevalence of high internalized stigma among PWMI at University of Gondar Comprehensive Specialized Hospital. The hospital needs to take immediate action to fight internalized stigma by focusing on females, people with low self-esteem, individuals with history of lifetime substance use, and people who have history of hospital admission.
Joint antenna selection and waveform design for coexistence of MIMO radar and communications
Authors: Zhang Xuan , Wang Xiangrong , Wang Xianghua
Published: December 2022

As the problem of spectral congestion is becoming severe, the coexistence between two primary spectrum users, radar and communications, has spurred extensive research interest. To reduce the mutual interferences between the two functions, MIMO radar waveform design needs to consider the compatibility in both spectral and spatial domains, where the former is achieved by null forming in the frequency domain and the latter is achieved by shaped beampattern synthesis. Additionally, high power efficiency and low system overhead are two desirable characteristics for MIMO radar system design. To this end, we first introduce a new realistic waveform constraint, peak-to-valley-power-ratio (PVPR) constraint per antenna to improve the power efficiency. Then, combined with PVPR constraint, we propose a switchable individual antenna power control scheme to jointly optimize waveforms and antenna locations. We adopt a max–min beampattern matching criterion and impose the $$\ell _{2,1}$$

ℓ

2
,
1

-norm penalty on the waveform matrix to promote the sparsity of the array. To solve the resultant non-smooth and non-convex problem, we develop a modified alternating directions method of multipliers, where a surrogate subproblem over primal variables is solved instead of the original problem, and its local convergence is analyzed. Finally, numerical experiments demonstrate the effectiveness and superiority of the proposed method over counterparts, especially obtaining the lowest sidelobe level and deeper spectral nulls using much fewer antennas.
Real-life Data on the Effect of Medical Therapy for Amiodarone-induced Thyrotoxicosis on CV Events and Hospitalizations
Authors: Cappellani Daniele , Marconcini Giulia , Manetti Luca , Bartalena Luigi , Bogazzi Fausto
Published: December 2022

Context

Patients with amiodarone-induced thyrotoxicosis (AIT) often receive initial therapy for thyrotoxicosis in several different medical settings before admission to a referral center.

Objective

This work aimed to determine whether first-line medical therapy (ie, therapies for thyrotoxicosis at first diagnosis of AIT) affects the outcome of AIT patients.

Methods

A single-center historical-prospective cohort study was conducted on 313 AIT patients. Clinical and biochemical data were collected at first diagnosis, at a referral center, and during the course of AIT. Primary outcomes were cardiovascular (CV) events and hospitalizations. First-line therapies were considered appropriate when they included glucocorticoids for type 2 AIT and methimazole for type 1 AIT at the approved dose, either alone (optimal medical therapy, OMT) or in combination (right-dose combination therapy, RCT). Other therapies were considered not appropriate, including no therapy. Duration of exposure to thyrotoxicosis was the time from first diagnosis of AIT to its remission.

Results

A total of 34.5% patients received appropriate therapies (28.1% OMT, 6.4% RCT), whereas the remaining (65.5%) received inappropriate therapies. CV events and hospitalizations were more frequent in patients who received inappropriate therapies (33.2% vs 4.5%, and 24.9% vs 6.5%, respectively; P < .0001 for both). Appropriate therapies reduced serum thyroid hormone concentrations (P = .018) from first diagnosis to referral, unlike the inappropriate therapies. The duration of exposure to thyrotoxicosis was longer in patients receiving inappropriate therapies and was a risk factor for arrhythmias (hazard ratio [HR] 1.004; P = .0008), major acute CV events (HR 1.004; P = .020), and hospitalizations (HR 1.006; P < .0001).

Conclusion

The first medical therapy of AIT influences the exposure time to thyrotoxicosis and the occurrence of CV events and hospitalizations.
Nurse prescribing in Poland: legislative history, trends over time and physicians’ attitudes
Authors: Cianciara Dorota , Wrześniewska-Wal Iwona , Kobuszewski Bartosz , Ruiz Mariusz , Augustynowicz Anna
Published: December 2022

A 2016 a legislative amendment authorized nurses and midwives in Poland to independently prescribe medical drugs and issue prescriptions for the purposes of continuation of treatment previously ordered by a physician. The legislative process was far from perfect, with nurses and midwives voicing their doubts just as well as doctors. Material and methods: Content analysis of documents from the legislative process was conducted, as well as a questionnaire survey among physicians concerning the exercise of these new right in places where doctors work and doctors’ attitudes on the matter. The survey was done in 2017 and 2019, with 547 and 471 physicians participating, respectively. Statistical analysis employed Pearson’s chi-squared test with grouped variables. Results: The main stated reason behind the legalization of nurse and midwife prescribing was the desire to reduce the queues of people waiting for health-care services. Between 2017 and 2019 an insignificant increase in the exercise of these rights occurred, especially in respect of supplementary prescription, i.e. for the purposes of continuation of treatment. The percentage of physicians with a positive attitude to these rights was found to have increased in these years. No variables explicitly linked to a positive attitude were identified. Conclusions: the full, successful and safe use of this opportunity requires continued research into the subject and its conditions, both quantitative and qualitative, as well as appropriate management of the change process on the basis of such data.
Immunomosuppressive Effect of Ziziphus Lotus L. (Desf.) Fruit’s Extract on Neutrophil Bactericidal Activity and on in Vivo Humoral Immune Response in Mice.
Authors: Bendiar Salma , El Faqer Othman , Benjelloun Naima , Hsseini Souada , Bellaoui Hicham , Rais Samira , Zaid Younes , Mtairag El Mostafa , Oudghiri Mounia
Published: December 2022

Background: The fruit of Ziziphus Lotus L. (ZL) is rich in bioactive components. It is known for its high content in polyphenols which gives it its immunomodulatory, antioxidant, and antimicrobial properties. Objective: The intent of the current study was to evaluate, in vivo, the effect of the aqueous extract of ZL fruit’s pulp on humoral immune response as well as its effect on neutrophils’ bactericidal activities, hemolytic and antioxidant and activities. Methods: The antioxidant activity of ZL’s aqueous extract’s was evaluated using DPPH. Hemmagglutination titer assay was used to evaluate the effect of the extract on humoral immune response. ZL extract’s hemolytic activity was assessed by enumerating hemoglobin rates. The effect of ZL extract on the bactericidal activity of Neutrophils was evaluated using MTT colorimetric assay. Results / Discussion: A significant (P<0.05) immunosuppressive effect on humoral immunity (6-fold) was observed. Significant suppression (P<0.05) of the bactericidal activity of neutrophils treated with 0.5 and 1 g/ml of the extract was observed compared to untreated neutrophils. The extract exhibited a high antioxidant activity determined by DPPH test with an IC50 value 10-fold higher (P<0.05) than the IC50 of ascorbic acid. The highest hemolytic activity was found with the lowest concentration of the extract while the higher concentrations tested seem to have an anti-hemolytic activity with a dose dependent effect. Conclusion: The aqueous extract of ZL’s fruit pulp possesses an immunosuppressive activity on both the innate and adaptive immunity responses. Our results demonstrate an anti-oxidative activity as well as an ability to decrease neutrophil bactericidal hemolytic activities as well as humoral immune responses.
Formulation and Physical Stability Test of Red Fruit Oil (Pandanus conoideus Lam.) Emulgel Using Carbopol 940 Base as Wound Treatment
Authors: Inayatilah Fidia Rizkiah , Mas’udah Lailatul , Dwi Atmaja Ria Ramadhani , Rahmayanti Mayu , Ma’arif Burhan , Sugihantoro Hajar
Published: December 2022

Red fruit ( Lam.) contains high levels of fatty acids, α-tocopherol, and β-carotene which can accelerate wound healing. Red fruit oil (RFO) is formulated as an emulgel because it is comfortable to use, has high penetration, and has a low risk of irritation. Emulgel RFO must meet the standards for physical properties and stability of topical preparations.The purpose of this study was to determine the effect of variations in RFO concentration on the physical properties and physical stability of the RFO emulgel. Emulgel was made with various RFO concentrations of 5% w/v (F1), 10% w/v (F2), and 15% w/v (F3). Then there was a physical evaluation and tested for physical stability after storage for 28 days at room temperature (30ºC±2ºC). Variations in RFO concentration decreased dispersion and adhesion values in the evaluation of physical qualities. In the 28-day storage stability test, variations in RFO concentration decreased the pH value, dispersion and increased adhesion. Emulgel RFO before and after the cycling test did not change. After performing the mechanical test, all the RFO emulgels did not occur in phase separation. It can be concluded that the variation of RFO concentration affects the physical properties, namely, dispersion and adhesion. However, it did not affect the organoleptic, homogeneity, and pH of the emulgel. After 28-day storage, variations in RFO concentration significantly affected pH, spreadability, and adhesion, while homogeneity and organoleptic had no significant effect. Variations in RFO concentration did not affect the stability of the cycling test and mechanical test.
Phytochemical Comparison Study for Evaluating the Hypolipidemic Effect Between Two Iraqi Pepper Spp in the Rats Model.
Authors: Alshammaa Dhuha A. , Alshamma Zainab A. A. , Amer Ammar
Published: December 2022

Hypercholesterolemia is a predominant risk factor for atherosclerosis and cardiovascular disease (CVD). The World Health Organization (WHO), ) recommended reducing the intake of cholesterol and saturated fats. On the other hand, limited evidence is available on the benefits of vegetables in the diet to reduce these risk factors, so this research was conducted to compare the hypolipidemic effect between the extracts of two different types of Iraqi peppers, the fruit of the genus Capsicum traditionally known as red pepper extract (RPE), and Piper nigrum as black pepper extract (BPE), respectively, in different parameters and histology of the liver of the experimental animals. The red pepper was extracted by ethyl acetate, while the black pepper was extracted by 90% ethanol, then each extract was concentrated for further analysis. Reversed-phase high-performance liquid chromatography (RP-HPLC) results confirm the presence of a high percentage of alkaloids responsible for hypolipidemic activity studied against hypercholesterolemic rats divided into five rats into six groups for ten weeks. We measured different parameters such as the lipid profile, the oxidized low-density lipoprotein (LDL), and the serum level of the most important parameters of the kidney and liver function tests. We also compared body weight after ten weeks. This study showed a slight or nonsignificant decrease in cholesterol, TG, very low-density lipoprotein VLDL, low-density lipoprotein LDL, and oxidized LDL with a considerable increase in high-density lipoprotein HDL in group V (high-fat diet + black pepper extract). Study results were improved by histological changes induced in liver tissue. In conclusion, the results focused on consuming these vegetables and reducing cholesterol levels, as it is considered a risk factor for cardiovascular disease (CVD).