bluuebunny/crossref_metadata_2025 huggingface dataset:
Team experiences of the root cause analysis process after a sentinel event: a qualitative case study
Authors: Liepelt Silje , Sundal Hildegunn , Kirchhoff Ralf
Published: July 2023

Background
Root cause analysis (RCA) is a systematic approach, typically involving several stages, used in healthcare to identify the underlying causes of a medical error or sentinel event. This study focuses on how members of a Norwegian RCA team experience aspects of an RCA process and whether it complies with the Norwegian RCA method.
Method
Based on a sentinel event in which a child died unexpectedly during childbirth in a Norwegian hospital in 2021, the following research questions are addressed: 1. What was the RCA team’s experience of the RCA process? 2. Was there compliance with the Norwegian RCA method in this case? A case study was chosen out of the desire to understand complex social phenomena and to allow in-depth focus on a case.
Results
The result covered three main themes. The first theme related to the hospital’s management system and aspects of the case that made it challenging to follow all recommendations in the Norwegian RCA guidelines. The second theme encompassed external and internal assessment. The RCA team was composed of members with methodological and medical expertise. However, the police’s involvement in the case made it complex for the team to carry out the process. The third and final theme covered intrapersonal challenges RCA team members faced. Team members experienced various challenges during the RCA process, including being neutral, dealing with role-related challenges, grappling with ambivalence, and managing the additional time burden and resource constraints. As anticipated in the RCA guidelines, the team’s ability to remain neutral was tested.
Conclusion
The findings of this study can help stakeholders better comprehend how an inter-professional RCA teamwork intervention can affect a healthcare organization and enhance the teamwork experience of healthcare staff while facilitating improvements in work processes and patient safety. Additionally, these results can guide stakeholders in creating, executing, utilizing, and educating others about RCA processes.
Pregnancy and Plaque Brachytherapy Treatment of Uveal Melanoma：A Retrospective Study
Authors: Wu Hao-Tian , Liu Yue-Ming , Dong Li , Zhang Rui-Heng , Zhou Wen-Da , Li He-Yan , Wei Wen-Bin
Published: July 2023

Background
To examine whether pregnancy affects the prognosis of uveal melanoma (UM) patients undergoing plaque brachytherapy (PBT) and if PBT has any effect on the outcome of such pregnancy.
Methods
We conducted a single-center retrospective study at the Beijing Tongren Hospital on the population of women with childbearing age who were diagnosed with uveal melanoma and underwent iodine-125 plaque brachytherapy. The outcome of each pregnancy and the status of the fetus was followed-up. Survival analysis were performed using Kaplan-Meier method, with the metastasis and death as endpoints.
Results
13 patients with 13 full-term pregnancies and 96 non-pregnant women with matched age and tumor size were included. In pregnant group, two patients developed metastasis, one of which died shortly after delivery; local recurrence of UM occurred in 2 patients after or during delivery, and 2 other patients developed secondary glaucoma due to radiation retinopathy. None of the other pregnant patients reported any signs of disease progression. In the control group, 18 metastasis cases including 12 deaths were documented. Pregnant patients and matched control subjects showed no statistical difference in both Metastasis-free survival (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.15–2.86; P = 0.576) and overall survival (HR: 0.48, 95% CI: 0.06–3.66; P = 0.464). All pregnant patients carried the pregnancy to term and delivered healthy babies with no report of placental or infant metastases to date.
Conclusion
Pregnancy exerted no adverse effects on the prognosis of UM patients who receive PBT. While PBT had no significant effect on maternal fertility, and did not show teratogenic effect on the fetus so far, long-term effects require further follow-up studies.
A Pan-Cancer Analysis Reveals OAS2 as a Biomarker for Cancer Prognosis and Immunotherapy
Authors: Jia Huizhen , Liu Xiaojuan , Wang Zhifu , Zhang Wei , Chen Xiaofan
Published: July 2023

Background:Although immunotherapy with immune checkpoint inhibitor has emerged as a remarkably effective treatment modality, it benefits only a small proportion of patients. Oligoadenylate Synthetase 2 (OAS2) has been implicated in various cancers, while the relationship between OAS2 expression, immune cell infiltration, and patient prognosis in pan-cancer remains unclear.Methods:We conducted an analysis of OAS2 in pan-cancers using databases such as TCGA, GTEx, UALCAN, cBioPortal, TIMER2.0, TIDE, and GDSC2.Results:OAS2 exhibited different expression patterns between cancer and adjacent normal tissues, with significant impacts on the prognosis of various cancers. High OAS2 expression correlated with poor overall survival (OS) and disease-specific survival (DSS) in low-grade glioma (LGG), pancreatic adenocarcinoma (PAAD), and testicular germ cell tumors (TGCT). Conversely, upregulated OAS2 expression was associated with favorable OS and disease-free survival (DFS) in ovarian cancer (OV) and skin cutaneous melanoma (SKCM). OAS2 expression was positively associated with B cell, CD4+ T cell, and CD8+ T cell infiltration in most cancers, except for LGG. Notably, in SKCM, OAS2 expression positively correlated with activated natural killer (NK) cell infiltration and inversely correlated with resting NK cell infiltration. Co-expression analyses indicated close associations between OAS2 and several common immune checkpoints. Higher OAS2 gene expression correlated with longer overall survival (OS) and progression-free survival (PFS) under immune checkpoint blockade (ICB) immunotherapy in two clinical cohorts.Conclusion:OAS2 is a promising biomarker for evaluating cancer prognosis, particularly in SKCM. Its association with immune factors and modulation of immune cell infiltration suggest its predictive potential for ICB immunotherapy.
Long-lasting household damage from Cyclone Idai increases malaria risk in rural western Mozambique
Authors: Searle Kelly M. , Earland Dominique E. , Francisco Albino , Novela Anisio , Muhiro Vali , Ferrão João
Published: July 2023

Cyclone Idai in 2019 was one of the worst tropical cyclones recorded in the Southern Hemisphere. The storm caused catastrophic damage and led to a humanitarian crisis in Mozambique. The affected population suffered a cholera epidemic on top of housing and infrastructure damage and loss of life. The housing and infrastructure damage sustained during Cyclone Idai still has not been addressed in all affected communities. This is of grave concern because storm damage results in poor housing conditions which are known to increase the risk of malaria. Mozambique has the 4th highest malaria prevalence in sub-Saharan Africa and is struggling to control malaria in most of the country. We conducted a community-based cross-sectional survey in Sussundenga Village, Manica Province, Mozambique in December 2019-February 2020. We found that most participants (64%) lived in households that sustained damage during Cyclone Idai. The overall malaria prevalence was 31% measured by rapid diagnostic test (RDT). When controlling for confounding variables, the odds of malaria infection was nearly 3-fold higher in participants who lived in households damaged by Cyclone Idai nearly a year after the storm. This highlights the need for long-term disaster response to improve the efficiency and success of malaria control efforts.
Development of novel hybrid 3D-printed degradable artificial joints incorporating electrospun pharmaceutical- and growth factor-loaded nanofibers for small joint reconstruction
Authors: Hsu Yung-Heng , Chou Ying-Chao , Chen Chao-Lin , Yu Yi-Hsun , Lu Chia-Jung , Liu Shih-Jung
Published: July 2023

Background
Small joint reconstruction remains a challenge and can lead to prosthesis-related complications, mainly because of the suboptimal performance of the silicone materials used and adverse host reactions. In this study, we developed hybrid three-dimensionally printed polycaprolactone (PCL) artificial joints and electrospun drug- and biomolecule-loaded poly(lactic-co-glycolic acid) nanofibers for small joint reconstruction.
Methods
The mechanical properties of the degradable joints and the drug discharge patterns of the nanofibers were evaluated. Moreover, he drug discharge patterns in vivo and the efficacy of the hybrid joint/nanofibers were assessed using a rabbit knee joint model.
Results
The empirical data showed that 3D-printed PCL joints exhibited good mechanical and fatigue properties. The drug-eluting nanofibers sustainably released teicoplanin, ceftazidime, and ketorolac in vitro for over 30, 19, and 30 d, respectively. Furthermore, the nanofibers discharged high levels of bone morphogenetic protein-2 and connective tissue growth factors for more than 30 d. An in vivo animal test showed that nanofiber-loaded joints released high concentrations of antibiotics and analgesics in the rabbit model for 28 d. The animals in the drug-loaded degradable joint group showed greater activity counts than those in the surgery-only group.
Conclusions
The experimental data of this study illustrated that degradable joints with sustained discharge of biomolecules may be utilized in small joint arthroplasty.
Clinical and multiparametric MRI features for differentiating uterine carcinosarcoma from endometrioid adenocarcinoma
Authors: Chen Xiaodan , Guo Qingyong , Chen Xiaorong , Zheng Wanjing , Kang Yaqing , cao dairong
Published: July 2023

Introduction The purpose of our study was to differentiate uterine carcinosarcoma (UCS) from endometrioid adenocarcinoma (EAC) by the multiparametric magnetic resonance imaging (MRI) features.
Methods We retrospectively evaluated clinical and MRI findings in 17 patients with UCS and 34 patients with EAC proven by histologically. The following clinical and pathological features were evaluated: age, post- or pre-menopausal, clinical presentation, invasion depth, FIGO stage, lymphaticmetastasis. The following MRI features were evaluated: tumor dimension, cystic degeneration or necrosis, hemorrhage, signalintensity (SI) on T2-weighted images (T2WI), relative SI of lesion to myometrium on T2WI, T1WI, DWI, ADCmax, ADCmin, ADCmean (RSI-T2, RSI-T1, RSI-DWI, RSI-ADCmax, RSI-ADCmin, RSI-ADCmean), ADCmax, ADCmin, ADCmean, the maximum, minimum and mean relative enhancement (RE) of lesion to myometrium on the arterial and venous phases (REAmax, REAmin, REAmean, REVmax, REVmin, REVmean). Receiver operating characteristic (ROC) analysis and the area under the curve (AUC) were used to evaluate prediction ability.
Results The mean age of UCS was higher than EAC. UCS occurred more often in the postmenopausal patients. UCS and EAC did not significantly differ in depth of myometrial invasion, FIGO stage and lymphatic metastasis. The anterior-posterior and transverse dimensions were significantly larger in UCS than EAC. Cystic degeneration or necrosis and hemorrhage were more likely occurred in UCS than EAC. The tumor on T2WI was more heterogeneous in UCS. The RSI-T2, ADCmax, ADCmean, RSI-ADCmax and RSI-ADCmean of UCS were significantly higher than EAC. The REAmax, REAmin, REAmean, REVmax, REVmin and REVmean of UCS were all higher than EAC. The AUCs were 0.72, 0.71, 0.86, 0.96, 0.89, 0.84, 0.73, 0.97, 0.88, 0.94, 0.91, 0.69 and 0.80 for the anterior-posterior, transverse dimensions, RSI-T2, ADCmax, ADCmean, RSI-ADCmax, RSI-ADCmean, REAmax, REAmin, REAmean, REVmax, REVmin and REVmean, respectively. Our study showed that REAmax threshold value of 0.23 can differentiate UCS from EAC with 94% sensitivity, 88% specificity, and 0.97AUC.
Discussion Multiparametric MRI features may be utilized as a biomarker to distinguish UCS from EAC.
Knowledge does not explode but increases linearly over time
Authors: Wang Xinbing , Kang Huquan , Fu Luoyi , Ding Jiaxin , Liang Shiyu , Wang Jianghao , Zhou Lei , Zhou Chenghu
Published: July 2023

ChatGPT and GPT-4 have raised debates regarding the progress of knowledge in large language models 1-3. The notion of "knowledge explosion" has been controversial in various variations since the 19th century 4-8. Despite numerous indications to the contrary 9-11, conclusive evidence on knowledge growth is lacking 12. Here, we evaluated knowledge as a collective thinking structure within citation networks by analyzing large-scale datasets containing 213 million publications (1800–2020) and 7.6 million patents (1976–2020). We found that knowledge did not explode but grew linearly over time in naturally formed citation networks that expanded exponentially. Our theoretical analysis established that the knowledge never exceeds the size of the network, revealing the limitation of knowledge development. Moreover, our results showed that the knowledge expansion rate shifted at certain inflection points, implying quantitative-driven qualitative changes. Leaps near inflection points may instigate a "knowledge explosion" delusion, allowing us to reconcile the spreading of the misconception. Inflection points in knowledge growth exhibited similar characteristics to the emergent ability of artificial intelligence 13, furnishing fresh insights into the singularities and emergence in complex systems. Overall, our findings reveal a slow pace of knowledge compared to data, reacquainting us with the progress of knowledge over time.
EGFR protein editing by serine hydroxymethyl transferase SHMT2
Authors: Chin Y. Eugene , Du Juanjuan , Zeng Yuan-yuan , Li Xue , Huang Fang , Zhou Chuanzan , Zi Rui-dong , Liu Lu-ying , Luo Jianyuan , Zhao Ting
Published: July 2023

The epidermal growth factor receptor (EGFR), a transmembrane tyrosine kinase, relies on phosphorylation for signal transduction1,2. It is known that the EGFR gene often harbors activating mutations for protein sequence change, leading to constitutive phosphorylation and activation of the EGFR protein in various cancers3. This study reveals that EGFR proteins, isolated from lung cancer tissues or cell lines, possess multiple glycine-to-serine (G>S) protein sequence modifications, which are not associated with EGFR gene mutations. These EGFR proteins enlist Serine Hydroxymethyl Transferase 2 (SHMT2) to induce glycine hydroxymethylation, resulting in G>S/GS>SG protein sequence editing. SHMT2 catalyzes the protein editing predominantly within the GS-islands of the EGFR protein, utilizing either free serine amino acids present within cells or the serine residue adjacent to glycine residue as the hydroxymethyl group donor. The G>S/GS>SG editing within GS islands G719S720, G810S811, and G1103S1104 causes significantly amplify of EGFR signaling activity, stimulates cancer cell growth, and induces drug resistance. In lung cancer cells, depletion of SHMT2 or inhibition with SHIN1 suppresses glycine hydroxymethylation, eliminating EGFR protein G>S/GS>SG editing and reducing resistance to EGFR-targeting drugs. Our findings not only identify a novel form of protein mutation through directly editing, but also underscore the importance of protein editing driving EGFR activation, thereby presenting potential avenues for EGFR-targeted therapy.
Beyond chronological age: Exploring how different future time perspective influences the health tourism intention
Authors: Liao Caisheng , Xiao Huiqing , Li Zhao
Published: July 2023

Background Health tourism is growing steadily and become an extremely popular component of modern tourism. This study constructed a theoretical model to examine the influential relationships between future time perspective (FTP), health awareness, involvement, and health tourism intention.
Methods This study was conducted among people with normal cognitive function and at least 15 years of age and collected empirical data by means of a questionnaire. The main method of operation was to distribute online questionnaires to collect data on two of the most popular social media (WeChat and QQ) platforms in China. The data was analyzed primarily using SPSS 26.0 and AMOS 26.0.
Results The effect of different dimensions of FTP on health tourism intentions differed. However, limited future time perspective (LFTP) positively influenced health tourism intentions, while open-ended future time perspective (OFTP) did not have a significant effect on health tourism intentions. Involvement and health awareness not only directly influence health tourism intentions, but also mediate the relationship between FTP (OFTP and LFTP) and health tourism intentions respectively.
Conclusions The results show that This study revealed the mechanism of the role of factors other than chronological age and health tourism intentions, suggesting that health tourism companies should pay more attention to subjective factors other than chronological age. According to the findings, the theoretical and managerial implications of the study are discussed, and directions for future research are provided.
A collision tumor of nasopharyngeal carcinoma and primary mantle cell lymphoma in the nasopharynx: A case report and review of the literature
Authors: Jiang Meng , Yuan Xiao-ping , Zhang Hong , Li Chuang-quan , Mao Yong-lin , Chen Wei-liang
Published: July 2023

Background
Nasopharyngeal carcinoma (NPC) is more common in men aged 40 to 59 years, and radiotherapy is an effective treatment. Nasopharyngeal lymphoma (NPL) is rare, and the coexistence of mantle cell lymphoma (MCL) and NPC in the nasopharynx is even rarer. No reports to date have described a collision tumor of NPC and MCL occurring within the same nasopharyngeal mass. We herein report the successful treatment of a unique case of synchronous coexistence of NPC and MCL occurring in the nasopharynx of a Chinese man.
Case presentation:
A 58-year-old man presented with a 5-month history of swallowing discomfort. Biopsy was taken under nasopharyngoscopy and histopathology revealed NPC. Lesions of the nasopharynx, oropharynx and tonsils, and enlargement lymph nodes of parotid gland, retroauricular and cervical regions were found by magnetic resonance imaging (MRI), which may be a synchronous, double primary tumor in which NPC and NPL co-exist. Pathology consultation confirmed that the biopsy specimen of nasopharynx was a collision tumor of NPC and MCL. Positron emission tomography–computed tomography (PET-CT) revealed thickening of the posterior wall of the nasopharynx, and NPC with lymphoma was considered. Enlargement of pharyngeal lymphatic ring and multiple lymph nodes with high metabolism were evaluated as lymphoma infiltration. The patient received two courses of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) followed by head and neck radiotherapy. At the time of this writing, he had remained alive without recurrence for 61 months since the initial treatment and was still undergoing follow-up.
Conclusions
Magnetic resonance imaging helps identify different components of collision tumors. Pathological examination helps to confirm the diagnosis. Histological examination reveals different components and PET-CT can help determine the extent of the lesion. Dose-adjusted chemotherapy combined with radiotherapy may have good therapeutic effects, but additional case studies are needed for confirmation.
Preparation and properties of nanocellulose- reinforced environmentally adaptable PAM/PVA semi- interpenetrating highly conductive ion-conducting hydrogel
Authors: Huang Xinmin , Wang Yaning , Tan Xiaobin , Yang Lianhe
Published: July 2023

In this work, a semi-interpenetrating network (IPN) hydrogel reinforced with cellulose nanocrystals (CNC) and containing lithium chloride (LiCl) and dimethyl sulfoxide (DMSO) is composed of cross-linked polyacrylamide (PAM) and linear polyethylene alcohol (PVA) chains, which had excellent anti-drying, anti-freezing, and ionic conductivity performance. The experimental results show that the ion-conducting hydrogel has excellent cyclic stretching performance. Under the tensile strain of 200%, the relative resistance of the PAM/PVA/CNC/LiCl hydrogel remained unchanged after 10 stretching cycles and returned to its original length. The water retention rate of PAM/PVA/CNC/LiCl hydrogel is close to 80% at 60 °C. In addition, even at -20 °C, the hydrogel still has good electrical conductivity and exhibits excellent anti-freezing performance. The ion-conducting hydrogel has excellent conductivity and anti-freezing and anti-drying properties and has potential application prospects in flexible wearable devices and sensors.
STK11 loss leads to YAP1-mediated transcriptional activation in human KRAS-driven lung adenocarcinoma cell lines
Authors: Seward David , Lenahan Sean , Sarausky Hailey , Deming Paula
Published: July 2023

Serine Threonine Kinase 11 (STK11) loss of function (LoF) correlates with anti-PD-1 therapy resistance in patients with KRAS-driven lung adenocarcinoma (LUAD). The molecular mechanisms governing this observation remain unclear and represent a critical outstanding question in the field of lung oncology. As an initial approach to understand this phenomenon, we knocked out STK11 in multiple KRAS-driven, STK11-competent human LUAD cell lines and performed whole transcriptome analyses to identify STK11-loss-dependent differential gene expression. Subsequent pathway enrichment studies highlighted activation of the HIPPO/YAP1 signaling axis, along with the induction of numerous tumor-intrinsic cytokines. To validate that YAP1-mediated transcriptional activation occurs in response to STK11 loss, we pursued YAP1 perturbation as a strategy to restore an STK11-competent gene expression profile in STK11-KO LUAD cell lines. Together, our data link STK11loss with YAP1-mediated transcriptional activation, including the upregulation of immune-evasion promoting cytokines IL-6, CXCL8 and CXCL2. Further, our results raise the intriguing possibility that YAP1 antagonism may represent a therapeutic approach to counter anti-PD-1 therapy resistance in STK11-null, KRAS-driven LUADs by modulating tumor-intrinsic gene expression to promote a “hot” tumor immune microenvironment.
FimH of uropathogenic Escherichia coli influenced the infection in prostate cells by the modulation of JAK/STAT signaling pathway
Authors: Ho Chen-Hsun , Huang Tzu-Wen , Fan Chia-Kwung , Liu Shih-Ping , Cheng Po-Ching
Published: July 2023

Background: The FimH expression may be a key factor affecting prostatitis caused by UPEC infection. Whether its regulation by the JAK/STAT pathway increases resistance to inflammation caused by infection with high FimH-expressing UPEC strains requires investigation.
Methods: The effect of FimH on the ability of knockout ΔFimH UPEC, FimHover -expressed UPEC, and wild-type strains to invade prostate cells and induce inflammation and the effects of different FimH levels on testosterone-treated UPEC and regulation of the JAK/STAT pathway were analyzed.
Results: Comparison of the three strains revealed the inhibitory effects of testosterone were more significant in the ΔFimH strain. Testosterone-pretreated ΔFimH UPEC showed weak inflammatory responses and JAK/STAT expression. FimHover UPEC better resisted the inhibitory effects of testosterone, which there was no significantly decreases except 20 μg/ml pretreated group in most JAK/STAT-related proteins. The effects of FimH showed a concentration-dependent response to testosterone, particularly to JAK1, STAT3, and pSTAT3, which also affected the subsequent expression of TLR4, IL-6, and IFN-γ. It has been suggested that regulation of the JAK1/STAT3 pathway may be associated with the effects of the FimH virulence factor on the inhibition of testosterone in UPEC infection.
Conclusion: The inhibitory effect of testosterone on UPEC infection in prostate epithelial cells was affected by the virulence factor FimH of UPEC, and reduced the production of inflammatory factors. The JAK/STAT pathway plays a key role in regulating UPEC infection and influences testosterone suppression responses in prostate cells. Our study provides a possible guideline for using testosterone to treat clinical recurrent UPEC infection and persistent prostatitis.
Skeletal muscle status and survival among patients with advanced biliary tract cancer
Authors: Takaoka Shinya , Hamada Tsuyoshi , Takahara Naminatsu , Saito Kei , Endo Go , Hakuta Ryunosuke , Ishida Kota , Ishigaki Kazunaga , Kanai Sachiko , Kurihara Kohei , Oyama Hiroki , Saito Tomotaka , Sato Tatsuya , Suzuki Tatsunori , Suzuki Yukari , Tange Shuichi , Tokito Yurie , Tateishi Ryosuke , Nakai Yousuke , Fujishiro Mitsuhiro
Published: July 2023

Background
Studies have demonstrated a prognostic role of sarcopenia (i.e., loss of skeletal muscle volume and functionality) in patients with various cancer types. In patients with biliary tract cancer, the quantity and quality of skeletal muscles and their serial changes have not been fully investigated in relation to survival outcomes.
Methods
We identified 386 patients with unresectable or recurrent biliary tract cancer and calculated skeletal muscle index (SMI) and skeletal muscle density (SMD) to estimate muscular quantity and quality, respectively, based on computed tomography images. Using the Cox regression model with adjustment for potential confounders, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for progression-free survival (PFS) and overall survival (OS) according to skeletal muscle status and its serial change.
Results
Compared to patients without sarcopenia, patients with sarcopenia had multivariable HRs of 1.56 (95% CI, 1.13–2.17; P = 0.008) and 1.23 (95% CI, 0.99–1.53; P = 0.059) for PFS and OS, respectively. SMD at baseline was associated with OS with a multivariable HR comparing the extreme quartiles of 1.54 (95% CI, 1.09–2.18; Ptrend = 0.010). A reduction in SMI rather than that in SMD was associated with OS. Progressive disease was a risk factor for reductions in SMI and SMD.
Conclusions
Skeletal muscle quantity and quality and their serial changes were associated with survival outcomes in patients with advanced biliary tract cancer. Our data highlight the importance of designing nutritional and physical interventions for improvements in skeletal muscle status in this population.
The relationship between COVID-19 event strength and job burnout among primary health care staff: The chain mediating effect of job stress and work engagement
Authors: Li Xinru , Song Yiwen , Hu Bingqin , Chen Yitong , Cui Peiyao , Liang Yifang , He Xin , Li Jinghua
Published: July 2023

Background
As a global pandemic, The Corona Virus Disease 2019 (COVID-19) has brought significant challenges to the primary health care (PHC) system. Health professionals are constantly affected by the pandemic's harmful impact on their mental health and are at significant risk of job burnout. Therefore, it is essential to gain a comprehensive understanding of how their burnout was affected. The study aimed to examine the relationship between COVID-19 event strength and job burnout among PHC providers and to explore the single mediating effect of job stress and work engagement and the chain mediating effect of these two variables on this relationship.
Methods
We used multilevel stratified convenience sampling to recruit participants from PHC institutions in Jilin Province, China. A total of 1148 medical professionals completed questionnaires regarding sociodemographic characteristics, COVID-19 event strength, job stress, work engagement, and job burnout. The chain mediation model was analysed using SPSS PROCESS 3.5 Macro Model 6.
Results
COVID-19 event strength not only positively predicted job burnout, but also indirectly influenced job burnout through the mediation of job stress and work engagement, thereby influencing job burnout through the "job stress → work engagement" chain.
Conclusions
This study extends the application of event systems theory and enriches the literature about how the COVID-19 pandemic impacted PHC medical staff job burnout. The findings derived from our study have critical implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.
Subgroups of depressive Symptoms determined by a Latent Class Analysis in a Chinese College Students Population during COVID-19
Authors: Luo Cong , Li Jiahong , Liu Lili , Huang Andi , Wang Xiayong , Chen Rongning , Zhao Jingbo
Published: July 2023

Background: The ongoing epidemic continues to exert a lasting impact on the physical and mental health of students. Therefore, it is crucial to identify the related risk factors and target populations with a high risk of mental health issues.
Method: A sample of 6309 participants from 6 colleges in Guangdong Province, China was recruited from June 10 to 18, 2021. Depressive symptoms were assessed using the Patient Health Questionnaire and risk factors were assessed using the Intolerance of Uncertainty (IU) scale and demographics. Data analysis consisted of chi-square test, latent class analysis, and Multinomial Logistic Regression.
Result: (1) Four latent subgroups were identified: “low-symptom group (2244, 35.57%),” “moderate-symptom group (1323, 20.97%),” “major-symptom with low-risk of suicide group (1128, 17.88%),” and “major-symptom with high-risk of suicide group (1614, 25.58%).” (2) Students with high IU were more likely to report severe suicidal ideation (OR=14.14, p<0.001,). (3) Although females were more likely to have depressive symptoms (OR=1.55, p<0.001,), but that of male may be server once they had depressive symptoms (OR=0.73, p<0.001,). (4) The students with severe depressive symptoms were likely to be non-exercise, uninfected area, unvaccinated and severer impact on family economy
Conclusion: Our findings offer valuable data support for identifying subgroups that are particularly susceptible to developing depressive symptoms during the epidemic. These results have important implications for mental health interventions and the formulation of public health policies.
The association between the red cell distribution width and mortality in elderly patients with non- traumatic coma: a retrospective observation study
Authors: Kim Dong Ki , Lee Ji Ho , Lee Dong Hun , Lee Byung Kook , Ko Sang Won
Published: July 2023

Background
Elevated red blood cell distribution width (RDW) can be associated with disease severity. However, studies on RDW for the prognosis of elderly patients with non-traumatic coma (NTC) are lacking. This study aimed to examine the relationship between RDW and prognoses in elderly patients with NTC.
Methods
This retrospective observational study included elderly patients (≥ 65 years) with NTC between January 2022 and December 2022. We measured RDW upon patient arrival to the emergency department (ED). We conducted a multivariate analysis using logistic regression of relevant covariates to predict in-hospital mortality. Survival curves based on 30-day mortality were designed using the Kaplan–Meier method. The primary outcome was in-hospital mortality, and the secondary outcome was 30-day mortality.
Results
A total of 689 patients were included in the study, and in-hospital mortality was 29.6% (n = 204). Our results found that the RDWs of non-survivors were significantly greater than those of survivors (14.6% vs 13.6%). Multivariable analysis showed that RDWs at ED arrival were independently associated with in-hospital mortality (odds ratio, 1.130; 95% confidence interval, 1.050–1.216; P < 0.001). The Kaplan–Meier curve indicated that the survival probability of patients with a low RDW was greater than those with a high RDW.
Conclusions
Having a high RDW at ED arrival was associated with in-hospital mortality in elderly patients with NTC.
Microwave combustion synthesis of La 1-x Gd x FeO 3 (x=0 to 0.25) nanoparticles: structural, magnetic, vibrational, morphology, and optical behavior
Authors: S Yuvaraj , A Roniboss , Kumar Anuj , Ubaidullah Mohd , R.S. RimalIsaac , M. Sundararajan , V Ravi , Prakesh Chander , Pandit Bidhan , N Senthilkumar , S. Sehgal Satbir
Published: July 2023

La1 − xGdxFeO3 (x = 0 to 0.25) nanoparticles are prepared by microwave combustion process (MCP) with L-alanine as a fuel. The synthesized samples are confirmed by different instrumental characterization for evaluating the nanostructured materials such as XRD, TEM, SAED, XPS, FE-SEM, EDX, FTIR, DRS-UV and VSManalysis.XRD and FT-IR are confirmed that lanthanum ferrite was orthorhombic structure with average crystallite size ranged ̴ 57.8 to 37.9 nm. The energy gap values were estimated using UV-vis spectra and it is in the range between 2.17 and 2.43 eV. The elements like Gd, La, Fe and O are present in EDX and XPS analysis. FE-SEM images reveal aggregated spherical morphology. VSM analysis are shows strong ferro magnetic behavior of La1−xGdxFeO3 nanoparticles. The Ms and Mr values are in the range between1.06 to 1.71and 1.94 to 6.53 emu/g for La1−xGdxFeO3 respectively.
Effects of matcha tea extract on cell viability and estrogen receptor β expression on MCF7 breast cancer cells
Authors: Keckstein Simon , Tilgener Constantin , jeschke udo , Hofmann Simone , Vilsmaier Theresa , Keilmann Lucia , Heidegger Helene , Kaltofen Till , Batz Falk , Mahner Sven , Schröder Lennard
Published: July 2023

Purpose:
In the following work, we investigated the effect of matcha green tea extract (MTE) on MCF-7 breast cancer cell viability and estrogen receptor beta expression (ERβ).
Methods:
MCF-7 cells were stimulated with MTE at concentrations of 5 and 10 µg/ml. Cell viability was assessed using a WST-1 assay after an incubation time of 72 h. ERβ was quantified at gene level by real-time polymerase chain reaction (PCR). A western blot (WB) was carried out for the qualitative assessment of the expression behavior of on a protein level.
Results:
The WST-1 test showed a significant inhibition of viability in MFC-7 cells after 72 h at 10 µg/ml. The WB demonstrated a significant quantitative decrease of ERβ at protein level with MTE concentrations of 10 µg/ml. In contrast the PCR did not result in significant downregulation of ERβ.
Conclusion:
MTE decreases the cell viability of MCF-7 cells and furthermore leads to a decrease of ERβ at protein level.
Niosomal Hesperidin Attenuates the M1/M2-Macrophage Polarization-Based Hepatotoxicity Followed Chlorpyrifos -Induced Toxicities
Authors: Sharifnia Mahsa , Eftekhari Zohre , Mortazavi Pejman
Published: July 2023

Purpose: The organophosphate pesticide chlorpyrifos (CPF) can cause developmental , neurological deficiencies , and mitochondria-mediated oxidative stress responses. In this study, the effect of niosomal hesperidin (Nio+Hesp) on the polarization of M1-M2 liver macrophages and the amount of inflammatory cells secretion in the brain, liver, and ovary tissues of CPF induced mice (3 mg/kg for 4 weeks; Intraperitoneally) was investigated.
Methods: Fourty C57 mice were divided into CPF, Sham, CPF+Hesp, and CPF+Nio+Hesp groups and treated carried out orally for 30 days. The activity of superoxide dismutase (SOD) and malondialdehyde (MDA), tissue changes, inflammation, and apoptosis in brain, liver, and ovary tissues, the number of ovarian germ cells , and M1-M2 liver macrophage polarization were evaluated by examining the expression of CD163and CD68 genes.
Results: Nio+Hesp prescription caused an increase in SOD and a decrease in MDA. Nio+Hesp decreased the amount of cell apoptosis in the liver, also reduced the expression of CD163 and CD68genes. Although there was a significant difference between Hesperidin and Nio+Hesp in the increase of Graafian follicles, corpus luteum, and peri-antral follicles, no substantial difference was observed in primary follicles in the uterus. Both Nio+Hesp and Hesp alleviated CPF-induced hepatotoxicity, however, Nio+Hesp was superior to Hesp in downregulation of the CD163 and CD68genes expression.
Conclusion: The ameliorative effects of HSP and Nio+Hesp may be at least in part due to their antioxidant and anti-inflammatory properties. By attenuating, Nio+Hesp may have therapeutic applications for reversing CPF-induced toxicity as an appropriate antioxidant effects.
Deep-learning-based automated detection and assistance in the diagnosis of early dental carious lesions
Authors: Portella Paula Dresch , de Oliveira Lucas Ferrari , Ferreira Mateus Felipe de Cássio , Dias Bruna Cristine , de Souza Juliana Feltrin , Assunção Luciana Reichert da Silva
Published: July 2023

Objective
To investigate the effectiveness of a convolutional neural network (CNN) in the detection of healthy teeth and early carious lesions on occlusal surfaces, and to assess the applicability of this deep-learning algorithm as an aid in the diagnosis of dental caries.
Materials and Methods
A total of 2,481 posterior teeth (2,459 permanent and 22 deciduous teeth) with varying stages of carious lesions were classified according to the International Caries Detection and Assessment System (ICDAS). After clinical evaluation, ICDAS 0 and 2 occlusal surfaces were photographed with a professional digital camera. VGG-19 was chosen as the CNN and the findings were compared with those of a reference examiner to evaluate its detection efficiency. To verify the effectiveness of the CNN as a diagnostic aid, three examiners (an undergraduate student (US), a newly graduated dental surgeon (ND), and a specialist in pediatric dentistry (SP) assessed the acquired images (Phase I). In Phase II, the examiners reassessed the same images using the CNN-generated algorithms.
Results
The training dataset consisted of 8,749 images, whereas the test dataset included 140 images. VGG-19 achieved an accuracy of 0.879, sensitivity of 0.827, precision of 0.949, and F1-score of 0.887. In Phase I, the accuracy rates for examiners US, ND, and SP were 0.543, 0.771, and 0.807, respectively. In Phase II, the accuracy rates improved to 0.679, 0.886, and 0.857 for the respective examiners. The number of correct answers was significantly higher in Phase II than in Phase I for all examiners (McNemar test;P < 0.05).
Conclusions
VGG-19 demonstrated satisfactory performance in the detection of early carious lesions and as a diagnostic aid.
Clinical relevance:
Automated detection of early carious lesions by deep-learning algorithms is an important aid in the early diagnosis of the disease, as it minimizes subjective assessments by different examiners, enabling quicker and more reliable clinical decision-making.
Cannabis use is associated with pain severity and interference among cancer survivors
Authors: Nugent Shannon M. , Latour Emile , Lim Jeong , Shannon Jackilen , Morasco Benjamin J.
Published: July 2023

Context: Cannabis use for symptom management among individuals with cancer is increasingly common. Objectives We sought to describe the 1) prevalence and characteristics of cannabis use, 2) perceived therapeutic benefits of cannabis use, and 3) examine how use of cannabis was associated with self-reported pain, mood, and general health outcomes among a representative sample of patients treated at NCI designated OHSU Knight Cancer Institute. Methods We conducted a population-based, cross-sectional survey developed in conjunction with 11 other NCI designated cancer centers and distributed to eligible individuals. The survey inquired about characteristics of cannabis use, perception of therapeutic benefits, pain, mood, and general health. Responses were population weighted. We examined the association of cannabis use with self-reported pain, mood, and general health using logistic regression controlling for relevant sociodemographic and clinical characteristics. Results 523 individuals were included in our analytic sample. 54% endorsed using cannabis at any time since their cancer diagnosis and 42% endorsed using cannabis during active treatment. The most endorsed reasons for use included: sleep disturbance (54.7%), pain (47.1%), and mood (42.6%). We found moderate pain was associated with more than a 2-fold (OR = 2.4 [95% CI = 1.3–4.6],p = 0.002) greater likelihood of self-reported cannabis use. Depressed mood or general health were not associated with cannabis use. Conclusions In a state with medical and recreational cannabis legislation, a high number of cancer survivors report cannabis use. Those with pain were more likely to use cannabis. Oncologists should be aware of this trend and assess use of cannabis when managing long-term symptoms of cancer and its treatments.
Fabrication of 3D Printed Hollow Spheres for QC and Feasibility for Use With xSPECT Bone
Authors: Lam Tuyet Oanh , Young Andy
Published: July 2023

Quantitative accuracy and constancy of Siemens xSPECT Bone quantitative reconstruction algorithm (xBone) can be monitored using activity-filled hollow spheres, which could be 3D printed (3DP-S) and increases accessibility to phantoms. One concern is that 3D prints can have air gaps in the walls which may pose issues for attenuation correction and xBone tissue zone mapping. This study assessed the feasibility of using 3DP-S with materials PLA, PETG and Resin as substitutes for commercial hollow spheres (C-S). Phantom preparation and acquisition parameters were based on the white paper. A Jaszczak phantom was fitted with six 99mTc- and contrast-filled 3DP-S. SPECT/CT acquisitions were performed on the Siemens Intevo T6 and reconstructed with xBone. Regions-of-interest for activity concentration measurements were drawn to the internal diameter of the spheres. PLA and PETG printed via filament freeform fabrication resulted in minute air gaps mainly at steep overhang however did not impact xBone zone maps. Activity concentration recovery of the 3DP-S were within +/-5% of C-S when sufficient projection angles are used. Resin printed via masked stereolithography experienced minor resin pooling and increased wall thickness – the smallest sphere was not usable. Resin printing achieved the best watertightness and transparency. PLA and PETG were most affordable but was labour intensive in construction. PLA performed best overall in print reproducibility and quantitative accuracy. Similarly printed hollow spheres can be used for quality control of xBone accuracy where C-S are not available. While 3D printing increases accessibility to phantoms, close oversight is required of printing conditions.
Construction and operation of an ophthalmic day-care ward in a general hospital
Authors: Cao Juan , Zhang Yeran , Huang Xiaoyun , Chen Dandan , Weng Jie , Yuan Songtao
Published: July 2023

Purpose
We aim to discuss the construction, operation, and prospects of ophthalmic day-care wards in general hospitals and to provide a reference for the management of ophthalmic day-care wards.
Methods
Nursing staff with clinical experience were arranged to participate in the construction of ophthalmic day-care ward, including the ward layout, staff training, and management. WeChat groups were set up to promote health awareness. Clinical information was collected from patients who had ophthalmic day surgeries at our hospital between January and December 2021. All patients had standard medical procedures for admission, treatment, and health education. The incidence of adverse events, age distribution, disease types, and reasons for canceling surgeries were analyzed to evaluate the operation of ophthalmic day-care wards.
Results
A total of 4,830 patients were admitted between January and December 2021. Cataract accounted for the largest proportion of disease types (89.4%). 61.45% of patients were aged between 61 and 80. No medical adverse events, such as information error, iatrogenic injury, equipment failure, and medication error occurred.
Conclusion
The keys to a well-functioning ophthalmic day ward are 1. management by nursing staff with adequate clinical experience; 2. emphasis on health awareness; 3. pre-operative preparation and assessment 4, standard medical procedures for admission, treatment, and health education. Day-care wards are high-quality and low-cost, which will benefit ophthalmic patients and be a useful addition to the medical field.
Lombard effect – is it a remedy for speech communication in noisy environments?
Authors: Korvel Gražina , Kąkol Krzysztof , Treigys Povilas , Kostek Bożena
Published: July 2023

The aim of this study is to address the question of whether the Lombard effect, either natural (an involuntary tendency to raise the uttered speech level in the presence of background noise) or synthetically created, is a remedy for speech communication in noise. To this end, a series of experiments to examine the interference of different noises in synthesizing the Lombard effect is performed. Several steps are proposed; first, a recording session is carried out to prepare a dataset of speech with and without the Lombard effect in a controlled environment. Then, we detect frequency changes at each time point on the 2D speech representation. Determining frequency tracks in a speech signal is performed using McAulay and Quartieri algorithm. To quantify the effect of noise on speech, containing the Lombard effect, an average formant track error is calculated as an objective image quality metric. Three image assessment measures, i.e., SSIM (Structural SIMilarity) index, RMSE (Root Mean Square Error), and dHash (Difference Hash), are employed for that purpose. Moreover, several spectral descriptors are analyzed in the context of Lombard speech and various types of noise to discuss their influence on speech. The investigations are concluded with an initial attempt at automatic noise profiling based on the method developed, followed by pitch modifications of neutral speech signal depending on the profiling result and frequency change trends obtained. An overlap-add synthesis in the STRAIGHT vocoder is used for synthesized speech.
In vitro replication system mediated by NIb of Potato virus Y
Authors: Fu Jiayu , Li Zichen , Liu Minjun , Geng Guowei
Published: July 2023

Potato virus Y (PVY) is a serious global virus. At present, PVY are mainly focused on strain analysis and protein interaction with host, but independent studies on PVY replication in vitro are still weak, the main problem is that there is no independent in vitro replication system for PVY. This study was focused on the creation of in vitro replication system mediated by NIb of PVY. The optimal expression concentration of MBP-NIb is 0.2 mM by the IPTG gradient experiment. Based on the solubility analysis, it is suggested that 37℃ is feasible and the soluble ratio of MBP-NIb is about 10%, which is enough for following affinity chromatography against MBP-tag. The purified MBP-NIb can specifically recognize the 3' terminal region of PVY plus or minus strand and perform in vitro replication. This is the first time that an in vitro replication system for PVY has been established. This in vitro replication system will facilitate the study of mechanism on PVY replication.