bluuebunny/crossref_metadata_2025 huggingface dataset:
Two-year incidence and risk factors of diabetic foot ulcer: second phase report of Ahvaz diabetic foot cohort (ADFC) study
Authors: Yazdanpanah Leila , Shahbazian Hajieh , Hesam Saeed , Ahmadi Behnam , Zamani Amir Mohammad
Published: April 2024

Aim/Introduction

This study was designed as the second phase of a prospective cohort study to evaluate the incidence and risk factors of diabetic foot ulcers (DFU).

Materials and methods

The study was conducted in a university hospital in Iran. Each participant was checked and followed up for two years in terms of developing newfound DFU as ultimate outcome. We investigated the variables using univariate analysis and then by backward elimination multiple logistic regression.

Results

We followed up 901 eligible patients with diabetes for two years. The mean age of the participants was 53.24 ± 11.46 years, and 58.53% of them were female. The two-year cumulative incidence of diabetic foot ulcer was 8% (95% CI 0.071, 0.089) [Incidence rate: 49.9 /1000 person-years]. However, the second-year incidence which was coincident with the COVID-19 pandemic was higher than the first-year incidence (4.18% and 1.8%, respectively). Based on our analysis, the following variables were the main risk factors for DFU incidence: former history of DFU or amputation [OR = 76.5, 95% CI(33.45,174.97), P value < 0.001], ill-fitting foot-wear [OR = 10.38, 95% CI(4.47,24.12), P value < 0.001], smoking [OR = 3.87,95%CI(1.28, 11.71),P value = 0.016], lack of preventive foot care [OR = 2.91%CI(1.02,8.29),P value = 0.045], and insufficient physical activity[OR = 2.25,95% CI(0.95,5.35),P value = 0.066].

Conclusion

Overall, the two-year cumulative incidence of diabetic foot ulcer was 8% [Incidence rate: 49.9 /1000 person-years]; however, the second-year incidence was higher than the first-year incidence which was coincident with the COVID-19 pandemic (4.18% and 1.8%, respectively). Independent risk factors of DFU occurrence were prior history of DFU or amputation, ill-fitting footwear, smoking, lack of preventive foot care, and insufficient physical activity.
Misconception between palliative care and euthanasia among Thai general practitioners: a cross-sectional study
Authors: Chutarattanakul Lalita , Jarusukthavorn Viriya , Dejkriengkraikul Nisachol , Oo Myo Zin , Tint Soe Sandi , Angkurawaranon Chaisiri , Wiwatkunupakarn Nutchar
Published: April 2024

Background

Palliative care lower medical expenses and enhances quality of life, but misconception with euthanasia delays timely care and makes inappropriate patient management.

Objective

To examine the magnitude of misconceptions between palliative care and euthanasia among Thai general practitioners, explore the association with knowledge, attitudes, and practical experience, and assess the association between misconception and confidence in practicing and referring patients to palliative care centers.

Methods

All 144 general practitioners who were going to start residency training at Maharaj Nakorn Chiang Mai Hospital in 2021 participated in this observational cross-sectional study. A chi-square test was utilized to examine the relationship between misconception and knowledge, attitude, practical experience, confidence to practice, and confidence to refer patients. Multivariable logistic regression was carried out while controlling for age, sex, knowledge, attitude, and experience to examine the relationship between misconception and confidence to practice and refer patients for palliative care. Statistical significance was defined at p < 0.05.

Results

About 41% of general physicians had misconceptions regarding palliative care and euthanasia. High knowledge was associated with a lower level of misconception (p = 0.01). The absence of misconceptions was weakly associated with a higher level of confidence in practicing palliative care, with an adjusted odds ratio of 1.51 (95% confidence interval 0.73 to 3.10, p = 0.07).

Conclusion

High misconception rates between palliative care and euthanasia among young Thai physicians might impact their confidence in delivering palliative care. Training initiatives for medical students and practitioners can mitigate misconceptions, fostering better palliative care utilization in Thailand.
Relationship between abnormal pelvic floor electromyography and obstetric factors in postpartum women: a cross-sectional study
Authors: Jiang Juan , Li Chun , Liu He-Yu , Zhu Zheng-Yan
Published: April 2024

Objective

To evaluate the surface electromyography (sEMG) of pelvic floor muscles (PFMs), compare between vaginal birth and cesarean section and correlate with maternity and obstetrics characteristics in primiparous 6–8 weeks postpartum.

Methods

PFMs surface electromyography screening data of primiparous postpartum women in our hospital at 6–8 weeks postpartum from 2018 to 2021 were selected and analyzed. The study collected data on delivery activities of 543 postpartum women totally.

Results

In general, the abnormal incidence of pelvic floor electromyography in postpartum women mainly occurred in slow muscle (type I fiber) stage and endurance testing stage. Compared to vaginal birth postpartum women, the incidence of abnormal pelvic floor electromyography in cesarean section postpartum women is lower. There were statistical differences in measurement values of pelvic floor electromyography in several different stages between cesarean section and vaginal birth (P < 0.005). Regarding the influence on pelvic floor electromyography, there were more influencing factors on vaginal birth postpartum women including age, height, weight, weight gain during pregnancy, gestational week, and first and second stage of labor than on cesarean section postpartum women whose influencing factors included age, weight gain during pregnancy, and newborn weight.

Conclusion

Effects on surface electromyography (sEMG) of pelvic floor muscles (PFMs) at 6–8 weeks postpartum differed based on the different modes of delivery. The high-risk obstetric factors closely related to abnormal surface electromyography (sEMG) of pelvic floor muscles (PFMs) were maternal age, height, weight, and second stage of labor.
The role of champions in the implementation of technology in healthcare services: a systematic mixed studies review
Authors: Pettersen Sissel , Eide Hilde , Berg Anita
Published: April 2024

Background

Champions play a critical role in implementing technology within healthcare services. While prior studies have explored the presence and characteristics of champions, this review delves into the experiences of healthcare personnel holding champion roles, as well as the experiences of healthcare personnel interacting with them. By synthesizing existing knowledge, this review aims to inform decisions regarding the inclusion of champions as a strategy in technology implementation and guide healthcare personnel in these roles.

Methods

A systematic mixed studies review, covering qualitative, quantitative, or mixed designs, was conducted from September 2022 to March 2023. The search spanned Medline, Embase, CINAHL, and Scopus, focusing on studies published from 2012 onwards. The review centered on health personnel serving as champions in technology implementation within healthcare services. Quality assessments utilized the Mixed Methods Appraisal Tool (MMAT).

Results

From 1629 screened studies, 23 were included. The champion role was often examined within the broader context of technology implementation. Limited studies explicitly explored experiences related to the champion role from both champions’ and health personnel’s perspectives. Champions emerged as promoters of technology, supporting its adoption. Success factors included anchoring and selection processes, champions’ expertise, and effective role performance.

Discussion

The specific tasks and responsibilities assigned to champions differed across reviewed studies, highlighting that the role of champion is a broad one, dependent on the technology being implemented and the site implementing it. Findings indicated a correlation between champion experiences and organizational characteristics. The role’s firm anchoring within the organization is crucial. Limited evidence suggests that volunteering, hiring newly graduated health personnel, and having multiple champions can facilitate technology implementation. Existing studies predominantly focused on client health records and hospitals, emphasizing the need for broader research across healthcare services.

Conclusions

With a clear mandate, dedicated time, and proper training, health personnel in champion roles can significantly contribute professional, technological, and personal competencies to facilitate technology adoption within healthcare services. The review finds that the concept of champions is a broad one and finds varied definitions of the champion role concept. This underscores the importance of describing organizational characteristics, and highlights areas for future research to enhance technology implementation strategies in different healthcare settings with support of a champion.
Can family doctor system improve health service utilization for patients with hypertension and diabetes in China? A difference-in-differences study
Authors: Zhang Luying , Zhang Peng , Chen Wen
Published: April 2024

Background

Family doctors, serving as gatekeepers, are the core of primary health care to meet basic health needs, provide accessible care, and improve attainable health. The study objective was to evaluate the impact of the family doctor system on health service utilization among patients with hypertension and diabetes in China.

Methods

Difference-in-Differences (DID) models are constructed to estimate the net effect of the family doctor system, based on the official health management records and medical insurance claim data of patients with hypertension and diabetes in an eastern city of China.

Results

The family doctor system significantly increases follow-up visits (hypertension patients coef. = 0.13, diabetes patients coef. = 0.08, bothp < 0.001) and outpatient visits (hypertension patients coef. = 0.08, diabetes patients coef. = 0.05, bothp < 0.001) among the contracted compared to the non-contracted. The proportion of outpatient visits in community health centers among the contracted significantly rose (hypertension patients coef. = 0.02, diabetes patients coef. = 0.04, bothp < 0.001) due to significantly more outpatient visits in community health centers and fewer in secondary and tertiary hospitals. It also significantly mitigates the increase in inpatient admissions among hypertension patients but not among diabetes patients.

Conclusions

The examined family doctor system strengthens primary care, both by increasing follow-up visits and outpatient visits and promoting a rationalized structure of outpatient utilization in China.
Advancing the concept of global oral health to strengthen actions for planetary health and One Health
Authors: Fisher Julian , Splieth Christian , Matanhire-Zihanzu Cleopatra , Glick Michael
Published: April 2024

Advancing the concept of global oral health can help tackle the triple planetary crises of climate change, nature and biodiversity loss, and pollution and waste. A model for oral and planetary health places more explicit focus on understanding the state of the Earth’s systems, changing environment in relation to planetary health boundaries and their impact on human well-being. This can facilitate a planet-centric critical thinking for equity in global oral health that contributes to UN 2030 Agenda for Sustainable Development.
Mesoporous silica coated spicules for photodynamic therapy of metastatic melanoma
Authors: Liang Xuejiao , Zhang Jialiang , Zhang Chi , Zhai Haojie , Yang Ping , Chen Ming
Published: April 2024

We report on the fabrication of mesoporous silicon dioxide coated Haliclona sp. spicules (mSHS) to enhance the delivery of the insoluble photosensitizer protoporphyrin IX (PpIX) into deep skin layers and mediate photodynamic therapy for metastatic melanoma in mice. The mSHS are dispersed sharp edged and rod-like micro-particles with a length of approximate 143.6 ± 6.4 μm and a specific surface area of 14.9 ± 3.4 m2/g. The mSHS can be topically applied to the skin, adapting to any desired skin area and lesion site. The insoluble PpIX were incorporated into the mesoporous silica coating layers of mSHS (mSHS@PpIX) with the maximum PpIX loading capacity of 120.3 ± 3.8 μg/mg. The mSHS@PpIX significantly enhanced the deposition of PpIX in the viable epidermis (5.1 ± 0.4 μg/cm2) and in the dermis (0.5 ± 0.2 μg/cm2), which was 154 ± 11-fold and 22 ± tenfold higher than those achieved by SHS, respectively. Topical delivery of PpIX using mSHS (mSHS@PpIX) completely eradicated the primary melanoma in mice in 10 days without recurrence or metastasis over 60 days. These results demonstrate that mSHS can be a promising topical drug delivery platform for the treatment of diverse cutaneous diseases, such as metastatic melanoma.

Graphic Abstract
The impact of incentive scheme on rural healthcare workforce availability: a case study of Kazakhstan
Authors: Jobalayeva Bagym , Khismetova Zaituna , Glushkova Natalya , Kozhekenova Zhanat , Abzaliyeva Akerke , Berikuly Duman , Semenova Yuliya
Published: April 2024

Background

During the 1990–2000, Kazakhstan experienced a decline in the number of healthcare professionals working in rural areas. Since 2009, the national government has been implementing financial incentives to encourage healthcare professionals to relocate to rural areas. This study aims to investigate the temporal and spatial patterns in the distribution of the rural healthcare workforce and evaluate the impact of this incentive scheme.

Methods

Interrupted Time Series Analysis using ARIMA models and Difference in Differences analyzes were conducted to examine the impact of the incentive scheme on the density of different categories of the healthcare workforce in rural Kazakhstan in the period from 2009 to 2020.

Results

There was a significant increase in the number of rural healthcare professionals from 2009 to 2020 in comparison to the period from 1998 to 2008. However, this increase was less pronounced in per capita terms. Moreover, a decline in the density of internists and pediatricians was observed. There is substantial variation in the density of rural nurses and physicians across different regions of Kazakhstan. The incentive scheme introduced in 2009 by the government of Kazakhstan included a one-time allowance and housing incentive. This scheme was found to have contributed insignificantly to the observed increase in the number of rural healthcare professionals.

Conclusion

Future research should be undertaken to examine the impact made by the incentive scheme on other medical subspecialties, particularly primary practitioners. Addressing the shortage of healthcare workers in rural areas is a complex issue that requires a multifaceted approach. Aside from financial incentives, other policies could be considered to increase relocation and improve the retention of healthcare professionals in rural areas.
Deciphering the virome of Chunkung (Cnidium officinale) showing dwarfism-like symptoms via a high-throughput sequencing analysis
Authors: Belete Mesele Tilahun , Kim Se Eun , Gudeta Workitu Firmosa , Igori Davaajargal , Kwon Jeong A. , Lee Su-Heon , Moon Jae Sun
Published: April 2024

Background

Viruses have notable effects on agroecosystems, wherein they can adversely affect plant health and cause problems (e.g., increased biosecurity risks and economic losses). However, our knowledge of their diversity and interactions with specific host plants in ecosystems remains limited. To enhance our understanding of the roles that viruses play in agroecosystems, comprehensive analyses of the viromes of a wide range of plants are essential. High-throughput sequencing (HTS) techniques are useful for conducting impartial and unbiased investigations of plant viromes, ultimately forming a basis for generating further biological and ecological insights. This study was conducted to thoroughly characterize the viral community dynamics in individual plants.

Results

An HTS-based virome analysis in conjunction with proximity sampling and a tripartite network analysis were performed to investigate the viral diversity in chunkung (Cnidium officinale) plants. We identified 61 distinct chunkung plant-associated viruses (27 DNA and 34 RNA viruses) from 21 known genera and 6 unclassified genera in 14 known viral families. Notably, 12 persistent viruses (7 DNA and 5 RNA viruses) were exclusive to dwarfed chunkung plants. The detection of viruses from the families Partitiviridae, Picobirnaviridae, and Spinareoviridae only in the dwarfed plants suggested that they may contribute to the observed dwarfism. The co-infection of chunkung by multiple viruses is indicative of a dynamic and interactive viral ecosystem with significant sequence variability and evidence of recombination.

Conclusions

We revealed the viral community involved in chunkung. Our findings suggest that chunkung serves as a significant reservoir for a variety of plant viruses. Moreover, the co-infection rate of individual plants was unexpectedly high. Future research will need to elucidate the mechanisms enabling several dozen viruses to co-exist in chunkung. Nevertheless, the important insights into the chunkung virome generated in this study may be relevant to developing effective plant viral disease management and control strategies.
HERC5 downregulation in non-small cell lung cancer is associated with altered energy metabolism and metastasis
Authors: Schneegans Svenja , Löptien Jana , Mojzisch Angelika , Loreth Desirée , Kretz Oliver , Raschdorf Christoph , Hanssen Annkathrin , Gocke Antonia , Siebels Bente , Gunasekaran Karthikeyan , Ding Yi , Oliveira-Ferrer Leticia , Brylka Laura , Schinke Thorsten , Schlüter Hartmut , Paatero Ilkka , Voß Hannah , Werner Stefan , Pantel Klaus , Wikman Harriet
Published: April 2024

Background

Metastasis is the leading cause of cancer-related death in non-small cell lung cancer (NSCLC) patients. We previously showed that low HERC5 expression predicts early tumor dissemination and a dismal prognosis in NSCLC patients. Here, we performed functional studies to unravel the mechanism underlying the “metastasis-suppressor” effect of HERC5, with a focus on mitochondrial metabolism pathways.

Methods

We assessed cell proliferation, colony formation potential, anchorage-independent growth, migration, and wound healing in NSCLC cell line models with HERC5 overexpression (OE) or knockout (KO). To study early tumor cell dissemination, we used these cell line models in zebrafish experiments and performed intracardial injections in nude mice. Mass spectrometry (MS) was used to analyze protein changes in whole-cell extracts. Furthermore, electron microscopy (EM) imaging, cellular respiration, glycolytic activity, and lactate production were used to investigate the relationships with mitochondrial energy metabolism pathways.

Results

Using different in vitro NSCLC cell line models, we showed that NSCLC cells with low HERC5 expression had increased malignant and invasive properties. Furthermore, two different in vivo models in zebrafish and a xenograft mouse model showed increased dissemination and metastasis formation (in particular in the brain). Functional enrichment clustering of MS data revealed an increase in mitochondrial proteins in vitro when HERC5 levels were high. Loss of HERC5 leads to an increased Warburg effect, leading to improved adaptation and survival under prolonged inhibition of oxidative phosphorylation.

Conclusions

Taken together, these results indicate that low HERC5 expression increases the metastatic potential of NSCLC in vitro and in vivo. Furthermore, HERC5-induced proteomic changes influence mitochondrial pathways, ultimately leading to alterations in energy metabolism and demonstrating its role as a new potential metastasis suppressor gene.
Chitin-mediated blockade of chitinase-like proteins reduces tumor immunosuppression, inhibits lymphatic metastasis and enhances anti-PD-1 efficacy in complementary TNBC models
Authors: Salembier Robbe , De Haes Caro , Bellemans Julie , Demeyere Kristel , Van Den Broeck Wim , Sanders Niek N. , Van Laere Steven , Lyons Traci R. , Meyer Evelyne , Steenbrugge Jonas
Published: April 2024

Background

Chitinase-like proteins (CLPs) play a key role in immunosuppression under inflammatory conditions such as cancer. CLPs are enzymatically inactive and become neutralized upon binding of their natural ligand chitin, potentially reducing CLP-driven immunosuppression. We investigated the efficacy of chitin treatment in the context of triple-negative breast cancer (TNBC) using complementary mouse models. We also evaluated the immunomodulatory influence of chitin on immune checkpoint blockade (ICB) and compared its efficacy as general CLP blocker with blockade of a single CLP, i.e. chitinase 3-like 1 (CHI3L1).

Methods

Female BALB/c mice were intraductally injected with luciferase-expressing 4T1 or 66cl4 cells and systemically treated with chitin in combination with or without anti-programmed death (PD)-1 ICB. For single CLP blockade, tumor-bearing mice were treated with anti-CHI3L1 antibodies. Metastatic progression was monitored through bioluminescence imaging. Immune cell changes in primary tumors and lymphoid organs (i.e. axillary lymph nodes and spleen) were investigated through flow cytometry, immunohistochemistry, cytokine profiling and RNA-sequencing. CHI3L1-stimulated RAW264.7 macrophages were subjected to 2D lymphatic endothelial cell adhesion and 3D lymphatic integration in vitro assays for studying macrophage-mediated lymphatic remodeling.

Results

Chitin significantly reduced primary tumor progression in the 4T1-based model by decreasing the high production of CLPs that originate from tumor-associated neutrophils (TANs) and Stat3 signaling, prominently affecting the CHI3L1 and CHI3L3 primary tumor levels. It reduced immunosuppressive cell types and increased anti-tumorigenic T-cells in primary tumors as well as axillary lymph nodes. Chitin also significantly reduced CHI3L3 primary tumor levels and immunosuppression in the 66cl4-based model. Compared to anti-CHI3L1, chitin enhanced primary tumor growth reduction and anti-tumorigenicity. Both treatments equally inhibited lymphatic adhesion and integration of macrophages, thereby hampering lymphatic tumor cell spreading. Upon ICB combination therapy, chitin alleviated anti-PD-1 resistance in both TNBC models, providing a significant add-on reduction in primary tumor and lung metastatic growth compared to chitin monotherapy. These add-on effects occurred through additional increase in CD8α+ T-cell infiltration and activation in primary tumor and lymphoid organs.

Conclusions

Chitin, as a general CLP blocker, reduces CLP production, enhances anti-tumor immunity as well as ICB responses, supporting its potential clinical relevance in immunosuppressed TNBC patients.
Evaluating and improving the representation of bacterial contents in long-read metagenome assemblies
Authors: Feng Xiaowen , Li Heng
Published: April 2024

Background

In the metagenomic assembly of a microbial community, abundant species are often thought to assemble well given their deeper sequencing coverage. This conjuncture is rarely tested or evaluated in practice. We often do not know how many abundant species are missing and do not have an approach to recover them.

Results

Here, we propose k-mer based and 16S RNA based methods to measure the completeness of metagenome assembly. We show that even with PacBio high-fidelity (HiFi) reads, abundant species are often not assembled, as high strain diversity may lead to fragmented contigs. We develop a novel reference-free algorithm to recover abundant metagenome-assembled genomes (MAGs) by identifying circular assembly subgraphs. Complemented with a reference-free genome binning heuristics based on dimension reduction, the proposed method rescues many abundant species that would be missing with existing methods and produces competitive results compared to those state-of-the-art binners in terms of total number of near-complete genome bins.

Conclusions

Our work emphasizes the importance of metagenome completeness, which has often been overlooked. Our algorithm generates more circular MAGs and moves a step closer to the complete representation of microbial communities.
Estimation of pop-up satellite archival tag initial surface position: applications for eastern Bering Sea crab research
Authors: Nault Andrew J. , Gaeuman William B. , Daly Benjamin J. , Vanek Vicki A.
Published: April 2024

Background

Climate change is reshaping Bering Sea crab distributions and recent population declines have elevated the urgency in understanding spatial dynamics in relation to management boundaries. While pop-up satellite archival tags (PSATs) can provide fishery-independent movement information, a high level of spatial resolution is needed to evaluate small-scale (i.e., 10 s of km) movements of crabs. Because PSATs drift at the surface prior to acquisition of a satellite-estimated location (via Argos), the accuracy of pop-up location (i.e., animal terminal position) estimates depends on the ability to accurately estimate drift error. We deployed PSATs (n = 36) on fixed-position moorings in Bristol Bay and Marmot Bay, Alaska to validate a new method to estimate tag pop-up location and an associated error ellipse that uses in situ drift data from surfaced tags to estimate drift error. Estimated pop-up location was compared to the location of tag surfacing (i.e., the tag’s fixed position) and to an alternative estimate (i.e., an early satellite-estimated location). Additional tags were deployed on mature male red king crab (Paralithodes camtschaticus) in Bristol Bay during 2020 (n = 84) and 2021 (n = 90) to compare estimates of tag drift error and crab displacement derived using the method.

Results

For red king crab tags with pop-up location estimates in 2020 (n = 79) and 2021 (n = 46), mean drift error was 9% and 44% of mean crab displacement, respectively. For fixed-position PSATs with pop-up location estimates (n = 27), mean distance between the estimated pop-up location and the tag’s fixed position was 2.0 km, representing a mean improvement in accuracy of 51% over alternative estimates. Corresponding error ellipse estimates either encompassed the tag’s fixed position (n = 11) or their boundaries were a mean distance of 1.3 km (n = 16) from the fixed position.

Conclusions

Our method improves pop-up location estimates for PSAT-tagged animals and is particularly well suited for crabs and other slow-moving benthic marine species. The improved estimates enhance PSAT utility for addressing management and ecological questions that require a fine spatial resolution, such as movement near management boundaries or defining essential habitat for important life history events.
NF1-Driven Rhabdomyosarcoma Phenotypes: A Comparative Clinical and Molecular Study of NF1-Mutant Rhabdomyosarcoma and NF1-Associated Malignant Triton Tumor
Authors: de Traux de Wardin Henry , Dermawan Josephine K. , Vanoli Fabio , Jiang Samuel C. , Singer Samuel , Chi Ping , Tap William , Wexler Leonard H. , Antonescu Cristina R.
Published: April 2024

PURPOSE

Alterations of the NF1 tumor suppressor gene is the second most frequent genetic event in embryonal rhabdomyosarcoma (ERMS), but its associations with clinicopathologic features, outcome, or coexisting molecular events are not well defined. Additionally, NF1 alterations, mostly in the setting of neurofibromatosis type I (NF1), drive the pathogenesis of most malignant peripheral nerve sheath tumor with divergent RMS differentiation (also known as malignant triton tumor [MTT]). Distinguishing between these entities can be challenging because of their pathologic overlap. This study aims to comprehensively analyze the clinicopathologic and molecular spectrum of NF1-mutant RMS compared with NF1-associated MTT for a better understanding of their pathogenesis.

METHODS

We investigated the clinicopathologic and molecular landscape of a cohort of 22 NF1-mutant RMS and a control group of 13 NF1-associated MTT. Cases were tested on a matched tumor-normal hybridization capture-based targeted DNA next-generation sequencing.

RESULTS

Among the RMS group, all except one were ERMS, with a median age of 17 years while for MTT the mean age was 39 years. Three MTTs were misdiagnosed as ERMS, having clinical impact in one. The most frequent coexisting alteration in ERMS was TP53 abnormality (36%), being mutually exclusive from NRAS mutations (14%). MTT showed coexisting CDKN2A/B and PRC2 complex alterations in 38% cases and loss of H3K27me3 expression. Patients with NF1-mutant RMS exhibited a 70% 5-year survival rate, in contrast to MTT with a 33% 5-year survival. All metastatic NF1-mutant ERMS were associated with TP53 alterations.

CONCLUSION

Patients with NF1-mutant ERMS lacking TP53 alterations may benefit from dose-reduction chemotherapy. On the basis of the diagnostic challenges and significant treatment and prognostic differences, molecular profiling of challenging tumors with rhabdomyoblastic differentiation is recommended.
Insulinemic and Inflammatory Dietary Patterns Show Enhanced Predictive Potential for Gestational Diabetes Mellitus Risk
Authors: Zu Ping , Wang Haixia , Zhang Lei , Bian Haoran , Bian Jingfeng , Jiang Nan , Luo Wei , Xu Min , Xu Jirong , Jiang Xiaomin , Tao Ruixue , Zhu Peng
Published: April 2024

Context

The putative association between pro-inflammatory and hyperinsulinemic dietary patterns and susceptibility to gestational diabetes mellitus (GDM) remains unclear.

Objective

We aimed to compare the risk associated with the Mediterranean diet, as well as insulinemic and pro-inflammatory dietary patterns, in relation to the occurrence of GDM, and evaluate their predictive value.

Methods

We prospectively followed 8495 women from the Maternal and Infant Health cohort in Hefei, China (2015-2021). Using a food frequency questionnaire, we calculated the empirical dietary inflammatory pattern (EDIP), the empirical dietary index for hyperinsulinemia (EDIH) score, and the Mediterranean diet (MD) score. GDM was diagnosed based on a 2-hour 75-gram oral glucose tolerance test conducted between 24 to 28 weeks of gestation. Logistic regression was used to estimate the risk of GDM, while receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of the empirical dietary index for GDM.

Results

Participants who followed hyperinsulinemic or pro-inflammatory dietary patterns to the greatest extent had a higher risk of developing GDM. The odds ratio (OR) for the highest quartile compared to the lowest quartile were 1.39 (95% CI, 1.30-1.49) for EDIH and 2.40 (95% CI, 1.88-3.01) for EDIP. The OR for the lowest quartile compared to the highest quartile was 1.33 (95% CI, 1.14-1.55) for MD. The ROC curve analysis indicated that the combination of EDIP and EDIH (AUC = 0.81; 95% CI, 0.78-0.82; P = .003) can effectively predict the occurrence of GDM.

Conclusion

Utilizing both empirical dietary indexes, EDIP and EDIH, might offer a potentially more effective approach in preventing GDM when compared to solely focusing on adherence to the MD pattern.
The BALB/c.mdx62 mouse exhibits a dystrophic muscle pathology and is a model of Duchenne muscular dystrophy
Authors: Swiderski Kristy , Chan Audrey S. , Herold Marco J. , Kueh Andrew J. , Chung Jin D. , Hardee Justin P. , Trieu Jennifer , Chee Annabel , Naim Timur , Gregorevic Paul , Lynch Gordon S.
Published: April 2024

Duchenne muscular dystrophy (DMD) is a devastating monogenic skeletal muscle-wasting disorder. Although many pharmacological and genetic interventions have been reported in preclinical studies, few have progressed to clinical trials with meaningful benefit. Identifying therapeutic potential can be limited by availability of suitable preclinical mouse models. More rigorous testing across models with varied background strains and mutations can identify treatments for clinical success. Here, we report the generation of a DMD mouse model with a CRISPR-induced deletion within exon 62 of the dystrophin gene (Dmd) and the first generated in BALB/c mice. Analysis of mice at 3, 6 and 12 months of age confirmed loss of expression of the dystrophin protein isoform Dp427 and resultant dystrophic pathology in limb muscles and the diaphragm, with evidence of centrally nucleated fibers, increased inflammatory markers and fibrosis, progressive decline in muscle function, and compromised trabecular bone development. The BALB/c.mdx62 mouse is a novel model of DMD with associated variations in the immune response and muscle phenotype, compared with those of existing models. It represents an important addition to the preclinical model toolbox for developing therapeutic strategies.
Lower Limb Joint Mechanics during Maximal Accelerative and Decelerative Running
Authors: FITZWILLIAM EMILY , STEVENTON-LORENZEN NIKOLAI , OPAR DAVID , SCHACHE ANTHONY G. , MANIAR NIRAV
Published: April 2024

Introduction

Maximal acceleration and deceleration tasks are frequently required in team sports, often occurring rapidly in response to external stimuli. Accelerating and decelerating can be associated with lower limb injuries; thus, knowledge of joint mechanics during these tasks can improve the understanding of both human high performance and injury mechanisms. The current study investigated the fundamental differences in lower limb joint mechanics when accelerating and decelerating by directly comparing the hip, knee, and ankle joint moments and work done between the two tasks.

Methods

Twenty participants performed maximal effort acceleration and deceleration trials, with three-dimensional marker trajectories and ground reaction forces collected simultaneously. Experimental data were combined with inverse dynamics analysis to compute joint moments and work.

Results

Net joint work for all lower limb joints was positive during acceleration and negative during deceleration. This occurred because of significantly greater positive work production from the ankle and hip during acceleration and significantly greater negative work production from all joints during deceleration. The largest contributions to positive work during acceleration came from the ankle, followed by the hip and knee joints, whereas the largest contributions to negative work during deceleration came from the knee and hip joints, followed by the ankle. Peak joint moments were significantly greater when decelerating compared with accelerating, except for the peak ankle plantarflexion and hip flexion moments, which were significantly greater when accelerating.

Conclusions

Our findings may help to guide training interventions, which aim to enhance the performance of acceleration and deceleration tasks, while also mitigating the associated injury risk.
Natura: do cálculo de externalidades à governança da sustentabilidade
Authors: Vieira Renata , Monzoni Mario
Published: April 2024

Atribuir valor monetário às externalidades sociais e ambientais dos negócios, assim como correlacioná-las diretamente à contabilidade tradicional, ainda constituem desafio relevante para as organizações que se propõem a gerir as próprias atividades de uma perspectiva mais sistêmica, ou integrada -- e a submeter sua atuação a uma análise igualmente ampla por seus públicos de interesse. Este trabalho aplicado, apresentado em formato de caso de ensino, narra o momento de implementação de uma metodologia de mensuração integrada de externalidades socioambientais pela Natura, fabricante brasileira de cosméticos. Depois de uma década de iniciativas fragmentadas de mensuração dos impactos ambientais, sociais e humanos decorrentes do negócio, a Natura lança seu primeiro Integrated Profit and Loss (o IP&L) em 2022. O roteiro para discussão proposto na seção de notas de ensino busca conduzir os estudantes à observação dos entraves e oportunidades que se apresentam à implementação e disseminação do IP&L nas rotinas gerenciais da Natura e, na esteira disso, intenta conduzir também à identificação dos fatores que favorecem ou dificultam a construção de modelos de valoração de impacto pelas empresas de modo geral. Em seguida, estimula reflexões sobre os diferenciais da companhia que protagoniza o caso, pioneira no desenvolvimento e na aplicação de modelos de valoração de externalidades ambientais e sociais.
The role of National Ethics Committees in the changing research environment
Authors: Mollaki Vasiliki , Karatzas Isidoros , Tsekeris Charalambos , Karkaletsis Vangelis
Published: April 2024

No abstract available.
Integrating perspectives from engineering ethics into the study of technology: A synthesis of research on critical cases
Authors: Konstantis Konstantinos , Tsakalakis Thomas
Published: April 2024

Ethics play a crucial role in the work of engineers, and therefore in everyone’s life, from the field of artificial intelligence ethics to the fields of environmental ethics and biomedical ethics. Analyzing critical technology case studies from the perspective of engineering ethics affords us the opportunity to understand if engineers acted ethically or not in a given situation, what they could have done otherwise, and what they should bear in mind for future case studies regarding ethics. In this article, at first, we draw upon primary and secondary sources in order to analyze two case studies that are of critical importance because, according to the engineers involved in them, it was likely they could have led to fatal accidents. Then, we offer engineering ethics perspectives into the studies. Studying engineering cases from an engineering ethics perspective is crucial for two reasons. First, engineers could have a more completed point of view regarding engineering ethics in order to understand how to act ethically during their work. Second, engineers and others (philosophers of technology, historians of technology, etc.), who analyze these cases in retrospect, could present a more adequate story that would be more useful for the engineers who are taught from it.
Το ανθρώπινο πρόσωπο και το μετανθρώπινο όραμα: Θεολογική προσέγγιση
Authors: Δουραμάνη Γεωργία
Published: April 2024

Η επιθυμία του ανθρώπου για μετεξέλιξή του σε ένα ον πιο προικισμένο προκειμένου να καλυτερεύσει τους όρους της ζωής του δεν είναι νέα, αλλά σύμφυτη με το είδος του. Αρωγοί στην πορεία του φιλοσοφία και θρησκεία, προσπαθώντας να δώσουν λύσεις στο διακαές αίτημα βελτίωσης της ανθρώπινης φύσης, από τη δική της θέση έκαστη. Φτάνοντας στην εποχή της Ύστερης -ή Ρευστής- Νεωτερικότητας ο άνθρωπος επιτυγχάνει να σπάσει τα δεσμά της παράδοσης, και στηριζόμενος στις δικές του δυνάμεις προωθεί το μοντέλο του ελεύθερου, αυτεξούσιου ανθρώπου.

            Στην εποχή της αλματώδους προόδου της Επιστήμης και της Τεχνολογίας, ο άνθρωπος επαναπροσδιορίζει την ταυτότητά του ως πρόσωπο και τη συνολική του σχέση με τον Θεό και το περιβάλλον. Παράλληλα, ο ολιστικός μετασχηματισμός των δομικών στοιχείων που αποτέλεσαν τα θεμέλια της νεωτερικότητας συνιστά χαρακτηριστικό της μετάβασης σε μια μετα-μοντέρνα εποχή, δημιουργώντας νέα ταυτότητα για τον άνθρωπο, αυτή του μετα-ανθρώπου, ο οποίος δεν αποτελεί πλέον ένα ουτοπιστικό όραμα, παρά δρομολογείται μέσω του Διανθρωπισμού και των διεπαφών.

            Στο πλαίσιο των νέων κοινωνικών μετασχηματισμών υπό το πρίσμα της τεχνολογικής προόδου, δημιουργείται προβληματισμός σχετικός με τη δυνατότητα διατήρησης της ταυτότητας του ανθρώπινου είδους ως «πρόσωπο» με τα χαρακτηριστικά του όντος-θεϊκού δημιουργήματος, βάσει της Πατερικής Διδασκαλίας, ή αν τελικά μετασχηματιστεί σε ναρκισσιστική, παντοδύναμη και αυτονομημένη ύπαρξη, απομακρυσμένη από την ανθρωπιά της.
The ethical and legal dilemmas of Telepsychiatry
Authors: Chatzi Maria
Published: April 2024

This paper was written in the framework of my internship at the National Commission for Bioethics and Technoethics of the Hellenic Republic. It constitutes an attempt at exploring the ethical and legal dilemmas of the medical practice of telepsychiatry. Telepsychiatry, as well as other forms of telemedicine, has become a prevalent way through which patients gain access to healthcare and with many research papers reporting on its effectiveness and advantages, telepsychiatry has gained a lot of proponents in the scientific and healthcare community. However, several questions regarding the ethical and legal nature of the practice remain unanswered and this can put patients and other users of telemental health services under risk for basic rights violations. In this paper, at first the scientific data supporting the use of telepsychiatry will be cited. In addition to that, there will be discussion of several ethical dilemmas that have been reported concerning the use of telemedicine in psychiatry during the past few years and there will be reference to the medical code of ethics. Following that, there will be reference to the existing legislation for telepsychiatry in Greece and the legal issues that can arise will be analyzed. In spite of the fact that the advantages and ethical pitfalls of telepsychiatry are common in many countries, the focus of this paper will be on Greece’s code of medical ethics and legislation due to the lack of relevant bibliography on the matter, even though telepsychiatry is widely used by Greek patients. Finally some suggestions will be made on what ought to be ameliorated in regards to the current conditions, so as to make sure telepsychiatry is in line with the basic principles of bioethics.
Christine M. Philliou, Turkey: A Past Against History
Authors: Lamprou Alexandros
Published: April 2024

Review of Christine M. Philliou, Turkey: A Past Against History, Oakland: University of California Press, 2021. 294 pp.
No Right to Family Life? Single Mothers and their Children in a “Mixed Economy of Welfare” in Switzerland, 1930s–1950s
Authors: Matter Sonja
Published: April 2024

In Switzerland single mothers, especially from the working class, were rarely able to support themselves and their children as a result of widespread discrimination against women in the labor market throughout the 20th century. Focusing on the case records of the social welfare of the city of Bern from the 1930s to 1950s, the article examines to what extent single mothers benefited from a ‘mixed economy of welfare’. The article points out that after the Second World War, social welfare measures were expanded with the introduction of widows’ and survivors’ insurance and the establishment of family allowances. While these new social insurance schemes undoubtedly brought improvements, the article shows that single mothers continued to experience practices of social exclusions. Especially, the combination of welfare dependency on the one hand, and guardianship measures on the other, often resulted in the out-of-home placement of the children of single mothers.
“I felt I should be there, all these people talking on my behalf without consulting me”
Authors: Earner-Byrne Lindsey
Published: April 2024

In the early 1970s, Cherish, the first support and advocacy group for unmarried mothers run by unmarried mothers, emerged into the mixed economy of welfare in the Irish Republic. The self-help aspect of the organisation was fundamental to its sociopolitical agenda to remove the stigma associated with unmarried motherhood and the legal status of illegitimacy, to secure welfare payments for this group and to reframe Irish understandings of what constituted a legitimate family. This article explores how Cherish reflected and contributed to a particular moment in Irish gender and welfare history, when notions of responsibility, the role of religion and the state were being redefined. It reveals how the organisation engaged with and reshaped the existing mixed economy of welfare by reframing understandings of expertise, challenging inherent moral biases, and broadening the concept of family.
Ioannis K. Hassiotis, Ο Οδυσσέας στις θάλασσες του Νότου: Η ελληνική παρουσία στις υπερπόντιες κτήσεις της Ισπανίας (16ος–17ος αι.) [Odysseus in the southern seas: The Greek presence in the Spanish overseas territories (16th–17th century)]
Authors: Sakkas Konstantinos
Published: April 2024

Review of Ioannis K. Hassiotis, Ο Οδυσσέας στις θάλασσες του Νότου: Η ελληνική παρουσία στις υπερπόντιες κτήσεις της Ισπανίας (16ος–17ος αι.). [Odysseus in the southern seas: The Greek presence in the Spanish overseas territories (16th–17th century)]. Thessaloniki: University Studio Press, 2022. 448 pp.
Application of ‘Readiness for Change’ concept within implementation of evidence-based mental health interventions globally: protocol for a scoping review
Authors: Dev Saloni , Shidhaye Rahul
Published: April 2024

Background Concerning the growing burden of mental illnesses globally, there has been an increased investment into the implementation of evidence-based mental health interventions (EBmhIs) in routine care settings. However, the uptake and implementation of these EBmhIs has faced challenges in the real-world context. Among the many barriers and facilitators of implementation of EBmhIs identified by implementation science frameworks, evidence on the role of readiness for change (RFC) remains sparse. RFC constitutes the willingness and perceived capacity of stakeholders across an organization to implement a new practice. Theoretically, RFC has been defined at organizational, group, and individual levels, however, its conceptualization and operationalization across all these levels have differed in studies on the implementation of EBmhIs. By conducting a scoping review, we aim to examine the literature on RFC within the implementation of EBmhIs. Methods This scoping review will be conducted following the PRISMA-ScR guidelines. Iterative review stages will include a systematic and comprehensive search through four electronic databases (PubMed, Web of Science, Embase, and PsycINFO), selecting studies, charting data, and synthesizing the results. English-language studies meeting the inclusion criteria will be screened independently by two reviewers. Discussion This review will synthesize knowledge on the conceptualization of RFC across organizational, group, and individual levels within the implementation of EBmhIs. In addition, it will identify how RFC has been measured in these studies and summarize the reported evidence on its impact on the implementation of EBmhIs. Conclusions This review will assist mental health researchers, implementation scientists, and mental health care providers to gain a better understanding of the state of research on RFC within the implementation of EBmhIs. Registration The final protocol was registered with the Open Science Framework on October 21, 2022 (https://osf.io/rs5n7).
The genome sequence of subterranean clover, Trifolium subterraneum L. (Fabaceae)
Authors: Christenhusz Maarten J. M. , Fay Michael F. , Leitch Ilia J. ,   Royal Botanic Gardens Kew Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Plant Genome Sizing collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: April 2024

We present a genome assembly from an individual Trifolium subterraneum (subterranean clover; Tracheophyta; Magnoliopsida; Fabales; Fabaceae). The genome sequence is 483.8 megabases in span. Most of the assembly is scaffolded into 8 chromosomal pseudomolecules. The mitochondrial and plastid genome assemblies have lengths of 309.28 kilobases and 144.76 kilobases in length, respectively.