bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of teaching, learning, and assessment of medical law on cognitive, affective and psychomotor skills of medical students: a systematic review
Authors: Abbasi Mahmoud , Shirazi Mandana , Torkmandi Hojjat , Homayoon Sanaz , Abdi Mohammad
Published: September 2023

Background

It is necessary to improve medical students’ legal cognitive, affective, and psychomotor skills to prevent further legal issues in the medical profession. Choosing the proper teaching and assessment methods is crucial in this matter. This study aimed to investigate the impact of teaching, learning, and assessment of medical law on the cognitive, affective, and psychomotor skills of medical students.

Methods

A systematic review was conducted in PubMed, Embass, and Web of Science databases, and Google Scholar search engine using MECIR and PRISMA, AMEE Guide 94 for 1980 to 2022.12.30. Nineteen articles met the inclusion criteria. MERSQI checklist was used to assess the quality of the articles, and URSEC (theoretical underpinning of the development, resources required, setting, educational methods employed, and content) used to assess the risk of educational bias.

Results

Internship courses called Medical Education Humanities and Society (MESH), clinical scenario design, seminars and small group discussions, web-based interactive training, legal training courses, PBL, and mind maps have been used to improve the medico-legal knowledge of medical students. MESH clerkship, simulation of a legal event, medico-legal advocacy program based on interdisciplinary education, group discussion, integration, and court-based learning used to improve student attitudes. Multidisciplinary training, small group discussions after the seminar, mock trial competition, and interdisciplinary education are used to teach psychomotor skills. All studies, except one on knowledge, reported positive effects of legal education on students’ knowledge, attitudes, and legal performance. Written assessments were used for cognitive and affective domains, while performance was assessed by OSCE, simulated court, and evaluation of patient referrals.

Conclusion

There are few studies to examine the cognitive, affective, and legal psychomotor skills of medical students. The texts have not yet fully explored the high level of affective and psychomotor domains, which is evidence of a gap in this sector. Recognizing that medico-legal problems are prevented through proper education and assessment, it is recommended that this area be considered a research priority and that effective educational policies are adopted.
Digital health literacy and digital engagement for people with severe mental ill health across the course of the COVID-19 pandemic in England
Authors: Spanakis P , Lorimer B , Newbronner E , Wadman R , Crosland S , Gilbody S , Johnston G , Walker L. , Peckham E
Published: September 2023

Background

An unprecedented acceleration in digital mental health services happened during the COVID-19 pandemic. However, people with severe mental ill health (SMI) might be at risk of digital exclusion, partly because of a lack of digital skills, such as digital health literacy. The study seeks to examine how the use of the Internet has changed during the pandemic for people with SMI, and explore digital exclusion, symptomatic/health related barriers to internet engagement, and digital health literacy.

Methods

Over the period from July 2020 to February 2022, n = 177 people with an SMI diagnosis (psychosis-spectrum disorder or bipolar affective disorder) in England completed three surveys providing sociodemographic information and answering questions regarding their health, use of the Internet, and digital health literacy.

Results

42.5% of participants reported experiences of digital exclusion. Cochrane-Q analysis showed that there was significantly more use of the Internet at the last two assessments (80.8%, and 82.2%) compared to that at the beginning of the pandemic (65.8%; ps < 0.001). Although 34.2% of participants reported that their digital skills had improved during the pandemic, 54.4% still rated their Internet knowledge as being fair or worse than fair. Concentration difficulties (62.6%) and depression (56.1%) were among the most frequently reported symptomatic barriers to use the Internet. The sample was found to have generally moderate levels of digital health literacy (M = 26.0, SD = 9.6). Multiple regression analysis showed that higher literacy was associated with having outstanding/good self-reported knowledge of the Internet (ES = 6.00; 95% CI: 3.18–8.82; p < .001), a diagnosis of bipolar disorder (compared to psychosis spectrum disorder – ES = 5.14; 95% CI: 2.47–7.81; p < .001), and being female (ES = 3.18; 95% CI: 0.59–5.76; p = .016).

Conclusions

These findings underline the need for training and support among people with SMI to increase digital skills, facilitate digital engagement, and reduce digital engagement, as well as offering non-digital engagement options to service users with SMI.
Novel homozygous frameshift variant in the ATCAY gene in an Iranian patient with Cayman cerebellar ataxia; expanding the neuroimaging and clinical features: a case report
Authors: Siavashani Elham Salehi , Ashrafi Mahmoud Reza , Ghabeli Homa , Heidari Morteza , Garshasbi Masoud
Published: September 2023

Background

Pathogenic variants in the ATCAY gene are associated with a rare autosomal recessive disorder called Cayman cerebellar ataxia. Affected individuals display psychomotor retardation, cerebellar dysfunction, nystagmus, intention tremor, ataxic gait and dysarthric in some cases.

Case presentation

Whole exome sequencing was performed for a 21-month-old girl suffering from developmental delay specifically in motor and language aspects, hypotonia, nystagmus, pes planus and strabismus. The detected variant in the patient was confirmed by family segregation analysis by Sanger sequencing in both of her parents. Previously three homozygous variants in the ATCAY gene (missense, splice site and frameshift deletion) have been reported in patients with Cayman cerebellar ataxia. Here we report the fourth homozygous variant and the second homozygous frameshift deletion in this gene to be associated with autosomal recessive Cayman cerebellar ataxia.

Conclusion

The identification of this novel homozygous frameshift deletion in the ATCAY gene expands our understanding of the genetic landscape underlying Cayman cerebellar ataxia. Furthermore, the occurrence of this variant in Iran, in addition to Pakistan, signifies the importance of considering genotypic and phenotypic factors beyond ethnicity when studying this disorder. These findings contribute to the ongoing efforts to unravel the molecular basis of Cayman cerebellar ataxia and improve diagnostic approaches and potential therapeutic interventions.
Eosinophil extracellular traps in asthma: implications for pathogenesis and therapy
Authors: Shen Kunlu , Zhang Mengyuan , Zhao Ruiheng , Li Yun , Li Chunxiao , Hou Xin , Sun Bingqing , Liu Bowen , Xiang Min , Lin Jiangtao
Published: September 2023

Asthma is a common, chronic inflammatory disease of the airways that affects millions of people worldwide and is associated with significant healthcare costs. Eosinophils, a type of immune cell, play a critical role in the development and progression of asthma. Eosinophil extracellular traps (EETs) are reticular structures composed of DNA, histones, and granulins that eosinophils form and release into the extracellular space as part of the innate immune response. EETs have a protective effect by limiting the migration of pathogens and antimicrobial activity to a controlled range. However, chronic inflammation can lead to the overproduction of EETs, which can trigger and exacerbate allergic asthma. In this review, we examine the role of EETs in asthma.
Application of MFI-5 in severe complications and unfavorable outcomes after radical resection of colorectal cancer
Authors: Huang Lihong , Li Zhifa , Jian Mengru , Wu Xiaobing , Chen Huixian , Qin Haifeng , Li Ziqiao , Song Shixi , Xie Yingjun , Chen Rong
Published: September 2023

Background

Frailty is considered a characteristic manifestation of physiological decline in multiple organ systems, which significantly increases the vulnerability of elderly individuals with colorectal cancer (CRC) and is associated with a poor prognosis. While studies have demonstrated that the 11-factor Modified Frailty Index (mFI-11) can effectively predict adverse outcomes following radical resection of CRC, there is a lack of research on the applicability of the 5-factor Modified Frailty Index (mFI-5) within this patient population.

Methods

In this retrospective analysis, we examined a cohort of CRC patients aged 65 years and above who had undergone radical resection. For each patient, we calculated their mFI-5 score, considering a score of ≥ 2 as an indication of frailty. We conducted univariate and multivariate analyses to assess the association between the mFI-5 and adverse outcomes as well as postoperative complications.

Results

Patients with an mFI-5 score ≥ 2 exhibited a significantly higher incidence of serious postoperative complications (53% vs. 30%; P = 0.001) and experienced a longer hospital stay [19.00 (15.00–24.50) vs. 17.00 (14.00–20.00); P < 0.05]. Notably, an mFI-5 score greater than 2 emerged as an independent risk factor for severe postoperative complications (odds ratio: 2.297; 95% confidence interval: 1.216 to 4.339; P = 0.01). Furthermore, the mFI-5 score displayed predictive capabilities for severe postoperative complications with an area under the receiver operating characteristic (ROC) curve of 0.629 (95% confidence interval: 0.551 to 0.707; P < 0.05).

Conclusion

The mFI-5 demonstrates a high level of sensitivity in predicting serious complications, prolonged hospital stays, and mortality following radical resection of colorectal carcinoma. As a practical clinical assessment tool, the mFI-5 enables the identification of high-risk patients and facilitates preoperative optimization.
Virtual embodiment for improving range of motion in patients with movement-related shoulder pain: an experimental study
Authors: Álvarez de la Campa Crespo Mercè , Donegan Tony , Amestoy-Alonso Beñat , Just Andrea , Combalía Andrés , Sanchez-Vives Maria V.
Published: September 2023

Background

Recent evidence supports the use of immersive virtual reality (VR) as a means of delivering bodily illusions that may have therapeutic potential for the treatment of musculoskeletal conditions. We wanted to investigate whether a single session of an embodiment-based immersive VR training program influences pain-free range of motion in patients with shoulder pain.

Methods

We designed a rehabilitation program based on developing ownership over a virtual body and then “exercising” the upper limb in immersive VR, while the real arm remains static. We then carried out a single-arm pre-post experiment in which 21 patients with movement-related musculoskeletal shoulder pain were exposed to the 15-min VR program and measured their active pain-free range of motion immediately before and afterwards.

Results

We found that shoulder abduction and hand-behind-back movements, but not shoulder flexion, were significantly and clinically improved post-intervention and that the level of improvement correlated with the level of embodiment. Following this one session, at 1-week follow-up the improvements were not maintained.

Conclusions

Virtual embodiment may be a useful therapeutic tool to help improve range of motion in patients with movement-related shoulder pain in the short term, which in turn could expedite rehabilitation and recovery in these conditions.
Hypoxia-induced TMTC3 expression in esophageal squamous cell carcinoma potentiates tumor angiogenesis through Rho GTPase/STAT3/VEGFA pathway
Authors: Yuan Hongyu , Zhao Zitong , Xu Jing , Zhang Ruiping , Ma Liying , Han Jing , Zhao Weihong , Guo Mingzhou , Song Yongmei
Published: September 2023

Background

Hypoxia is one of most typical features in the tumor microenvironment of solid tumor and an inducer of endoplasmic reticulum (ER) stress, and HIF-1α functions as a key transcription factor regulator to promote tumor angiogenesis in the adaptive response to hypoxia. Increasing evidence has suggested that hypoxia plays an important regulatory role of ER homeostasis. We previously identified TMTC3 as an ER stress mediator under nutrient-deficiency condition in esophageal squamous cell carcinoma (ESCC), but the molecular mechanism in hypoxia is still unclear.

Methods

RNA sequencing data of TMTC3 knockdown cells and TCGA database were analyzed to determine the association of TMTC3 and hypoxia. Moreover, ChIP assay and dual-luciferase reporter assay were performed to detect the interaction of HIF-1α and TMTC3 promoter. In vitro and in vivo assays were used to investigate the function of TMTC3 in tumor angiogenesis. The molecular mechanism was determined using co-immunoprecipitation assays, immunofluorescence assays and western blot. The TMTC3 inhibitor was identified by high-throughput screening of FDA-approved drugs. The combination of TMTC3 inhibitor and cisplatin was conducted to confirm the efficiency in vitro and in vivo.

Results

The expression of TMTC3 was remarkably increased under hypoxia and regulated by HIF-1α. Knockdown of TMTC3 inhibited the capability of tumor angiogenesis and ROS production in ESCC. Mechanistically, TMTC3 promoted the production of GTP through interacting with IMPDH2 Bateman domain. The activity of Rho GTPase/STAT3, regulated by cellular GTP levels, decreased in TMTC3 knockdown cells, whereas reversed by IMPDH2 overexpression. Additionally, TMTC3 regulated the expression of VEGFA through Rho GTPase/STAT3 pathway. Allopurinol inhibited the expression of TMTC3 and further reduced the phosphorylation and activation of STAT3 signaling pathway in a dose-dependent manner in ESCC. Additionally, the combination of allopurinol and cisplatin significantly inhibited the cell viability in vitro and tumor growth in vivo, comparing with single drug treatment, respectively.

Conclusions

Collectively, our study clarified the molecular mechanism of TMTC3 in regulating tumor angiogenesis and highlighted the potential therapeutic combination of TMTC3 inhibitor and cisplatin, which proposed a promising strategy for the treatment of ESCC.
Brain tissue oxygen monitoring in traumatic brain injury—part II: isolated and combined insults in relation to outcome
Authors: Svedung Wettervik Teodor , Beqiri Erta , Hånell Anders , Bögli Stefan Yu , Placek Michal , Guilfoyle Mathew R. , Helmy Adel , Lavinio Andrea , O’Leary Ronan , Hutchinson Peter J. , Smielewski Peter
Published: September 2023

Background

The primary aim was to explore the concept of isolated and combined threshold-insults for brain tissue oxygenation (pbtO2) in relation to outcome in traumatic brain injury (TBI).

Methods

A total of 239 TBI patients with data on clinical outcome (GOS) and intracranial pressure (ICP) and pbtO2 monitoring for at least 12 h, who had been treated at the neurocritical care unit, Addenbrooke’s Hospital, Cambridge, UK, between 2002 and 2022 were included. Outcome was dichotomised into favourable/unfavourable (GOS 4–5/1–3) and survival/mortality (GOS 2–5/1). PbtO2 was studied over the entire monitoring period. Thresholds were analysed in relation to outcome based on median and mean values, percentage of time and dose per hour below critical values and visualised as the combined insult intensity and duration.

Results

Median pbtO2 was slightly, but not significantly, associated with outcome. A pbtO2 threshold at 25 and 20 mmHg, respectively, yielded the highest x2 when dichotomised for favourable/unfavourable outcome and mortality/survival in chi-square analyses. A higher dose and higher percentage of time spent with pbtO2 below 25 mmHg as well as lower thresholds were associated with unfavourable outcome, but not mortality. In a combined insult intensity and duration analysis, there was a transition from favourable towards unfavourable outcome when pbtO2 went below 25–30 mmHg for 30 min and similar transitions occurred for shorter durations when the intensity was higher. Although these insults were rare, pbtO2 under 15 mmHg was more strongly associated with unfavourable outcome if, concurrently, ICP was above 20 mmHg, cerebral perfusion pressure below 60 mmHg, or pressure reactivity index above 0.30 than if these variables were not deranged. In a multiple logistic regression, a higher percentage of monitoring time with pbtO2 < 15 mmHg was associated with a higher rate of unfavourable outcome.

Conclusions

Low pbtO2, under 25 mmHg and particularly below 15 mmHg, for longer durations and in combination with disturbances in global cerebral physiological variables were associated with poor outcome and may indicate detrimental ischaemic hypoxia. Prospective trials are needed to determine if pbtO2-directed therapy is beneficial, at what individualised pbtO2 threshold therapies are warranted, and how this may depend on the presence/absence of concurrent cerebral physiological disturbances.
Decreasing consumption of sugar-sweetened beverages and Raising tap water consumption through Interventions based on Nutrition and sustainability for Kids: study protocol of the “DRINK” cluster randomised controlled trial
Authors: Castetbon Katia , Assakali Wassila , Thiébaut Isabelle , Desbouys Lucille
Published: September 2023

Background

Effectiveness of actions to reduce sugar-sweetened beverage (SB) consumption in children still needs to be improved. Furthermore, the growing concern about sustainable food systems encourages to develop sustainability-based interventions. The objective of this cluster randomised controlled trial is to evaluate the long-term effectiveness of nutrition- and environmental sustainability-based interventions on the reduction in SB intake and on the increase in tap water consumption in 3rd to 6th grade primary school children (8 to 11 years of age).

Methods

Forty-eight French-speaking Belgian primary schools (equivalent to around 3500 pupils involved in the evaluation) are randomised using a factorial plan: (i) control, (ii) nutrition-based intervention, (iii) sustainability-based intervention, and (iv) both. The interventions (encouragement of water breaks; provision of posters, leaflets, reusable cups, and glass bottles; website; meetings at school) were undertaken from February 2022 to June 2023. Evaluation includes questionnaires for the children and their parents on various determinants of dietary behaviour, a 4-day diary to collect information on the child’s beverage consumption, and audits at schools. The first evaluation was conducted in Spring 2021 before any intervention, with the two post-intervention evaluations being held in 2022 and 2023. The main quantitative judgement criterion will be the change over time in the mean SB consumption (in ml/day) in the intervention groups compared with the control group. Given the context of the research (school), the safety of the intervention, and the content of data collection, a consent was acknowledged as unnecessary by the Ethical Committee of the Faculty of Psychology (ULB; n°073/2021), but children and parents are explicitly informed of their right to refuse to fill in the questionnaires.

Discussion

Multicomponent interventions based on nutrition and on environmental sustainability, alone or mixed, will provide an original and topical insight into health promotion at school around dietary behaviours. The dissemination plan will enable to widely inform stakeholders, school staff, and families, in addition to the scientific community through the usual medium (articles, conferences), about the research findings in 2024–2025.

Trial registration

ISRCTN Registry ISRCTN99843102. Retrospectively registered on 25 May 2021
First report of the efficacy of a fluralaner-based pour-on product (Exzolt® 5%) against ectoparasites infesting cattle in Brazil
Authors: da Costa Alvimar José , de Souza Martins João Ricardo , de Almeida Borges Fernando , Vettorato Luis Fernando , Barufi Francisco Bonomi , de Oliveira Arriero Amaral Heitor , Abujamra Luara Carolina , de Castro Rodrigues Daniel , Zanetti Lopes Welber Daniel
Published: September 2023

Background

This study describes the effectiveness of a novel active pharmaceutical ingredient, fluralaner (isoxazoline class), against important ectoparasites infesting cattle in Brazil.

Methods

A total of 13 studies involving a 5% fluralaner-based pour-on formulation (Exzolt 5%; further referred to as Exzolt) were conducted. Specifically, the effectiveness of this formulation was studied against Rhipicephalus microplus (6 studies), Cochliomyia hominivorax larvae (4 studies), Dermatobia hominis larvae (1 study) and Haematobia irritans flies (2 studies).

Results

The therapeutic efficacy of Exzolt was found to exceed 98% at 4 days post treatment (DPT), while persistent efficacy (> 90% efficacy) against repeated infestations of R. microplus was observed for up to 79 DPT. In field studies, ≥ 98% therapeutic efficacy was demonstrated at all study sites by 7 DPT, and a persistent efficacy (> 90% efficacy) was observed for 42, 49 or 56 DPT. Exzolt prevented C. hominivorax eggs from developing to the larval stage, thus mitigating the development of myiasis in cattle naturally and artificially infested with this screworm. The efficacy of Exzolt against D. hominis larvae was 98% at 3 DPT, while persistent efficacy (> 90% effectiveness) was found to last for up to 70 DPT. Against H. irritans, Exzolt showed therapeutic efficacy (≥ 90%) within the first day of treatment at both study sites, while persistent efficacy (≥ 90%) was observed for 7 DPT at one site and for 21 DPT at the other site.

Conclusions

Overall, the results from these studies confirm that Exzolt is therapeutically efficacious against the most important ectoparasites infesting cattle in Brazil. The novel active pharmaceutical ingredient, fluralaner, provides a new treatment option for farmers to control cattle ectoparasites, especially where there is resistance to other chemical classes. In addition, an effective control of ectoparasites will improve overall cattle health and well-being as well as production.

Graphical Abstract
Borrelia persica infection in wild carnivores in Israel: molecular characterization and new potential reservoirs
Authors: Shwartz Dor , Nachum-Biala Yaarit , Oren Stephanie , Aharoni Kobi , Edery Nir , Moss Lior , King Roni , Lapid Roi , Straubinger Reinhard K. , Baneth Gad
Published: September 2023

Background

Borrelia persica causes tick-borne relapsing fever in Israel, the eastern Mediterranean basin, and Asia. Relapsing fever is associated with severe illness and potentially death in humans and animals. Since B. persica infection has rarely been described in wild animals, the aim of this study was to evaluate the prevalence of infection with B. persica in wild carnivores in Israel.

Methods

Spleen and blood clot samples from wild carnivores, which underwent necropsy, were tested for the presence of Borrelia DNA by real-time polymerase chain reaction (PCR). PCR products were sequenced, and the spirochete loads were quantified using a specific quantitative PCR (qPCR).

Results

A total of 140 samples from 74 wild carnivores were analyzed for the presence of Borrelia DNA. Six out of the 74 (8.1%) animals were found positive for B. persica by PCR and sequencing of the flagellin B gene, of which 4/74 (5.4%) were also positive by PCR for the glycerophosphodiester phosphodiesterase (glpQ) gene. Positive samples were obtained from three European badgers, and one striped hyena, golden jackal, and red fox each. All B. persica-positive animals were young males (P < 0.0001). Quantifiable results were obtained from 3/5 spleen and 4/5 blood samples. The spirochete loads in the blood were significantly higher than those found in the spleen (P = 0.034).

Conclusions

The prevalence of B. persica infection found in wild carnivores brought for necropsy was unexpectedly high, suggesting that this infection is widespread in some wild animal species in Israel. This is the first report of B. persica infection in the European badger and striped hyena. These carnivores have a wide geographical range of activity, and the results of this survey raise the possibility that they may serve as reservoir hosts for B. persica.

Graphical Abstract
Physical function and sex differences in radiographic axial spondyloarthritis: a cross-sectional analysis on Bath Ankylosing Spondylitis Functional Index
Authors: Hallström Magnus , Klingberg Eva , Deminger Anna , Rehnman Jeannette Beckman , Geijer Mats , Forsblad-d’Elia Helena
Published: September 2023

Background

Physical function is an important determinant of health-related quality of life in radiographic axial spondyloarthritis patients (r-axSpA). To improve the basis of effective healthcare efforts, we aimed to investigate which demographic and disease-related factors that influence Bath Ankylosing Spondylitis Functional Index (BASFI) in r-axSpA patients overall and stratified by sex. Furthermore, we sought to explore differences between sexes regarding separate BASFI questions and also to explore which factors that may contribute to these differences.

Methods

This observational cross-sectional study included patients fulfilling the modified New York criteria for Ankylosing Spondylitis. Patients were assessed with 66/68 joint count and Bath Ankylosing Spondylitis Metrology Index (BASMI) measurements. Lateral X-rays were performed for Modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-Reactive Protein (CRP), and BASFI were registered. Multivariable linear regression analyses were used to investigate which factors that associate with BASFI.

Results

A total of 353 r-axSpA patients were included, mean age 52.2 ± 12.7 years, 62.3% males. No significant sex difference was seen in BASFI scores (2.7 ± 2.0 in males vs 2.9 ± 2.1 in females). Age, body mass index, ASDAS-CRP, BASMI or mSASSS, fatigue, and tenderness were found to associate independently with BASFI in different models (R2 0.53–0.63). Investigation of separate BASFI questions revealed that the ability to look over shoulder was worse in males than females (mean 4.43 ± 3.37 vs 3.74 ± 3.06, p = 0.05) and most strongly correlated with mSASSS and BASMI among separate BASFI questions (r = 0.53, p < 0.001; r = 0.62, p < 0.001). The ability to climb stairs was worse in females than males (mean 2.49 ± 2.77 vs 1.54 ± 2.32, p < 0.001).

Conclusions

No difference between male and female r-axSpA patients was seen in BASFI despite significant sex differences in BASMI, mSASSS, and CRP levels. Our results underline the impact of fatigue and tenderness on BASFI. The ability to climb stairs without a handrail was scored worse among females compared to males. Furthermore, the ability to look over the shoulder was worse in males than females and closely related to spinal mobility and structural spinal changes.
A multi-omics study to investigate the progression of the Correa pathway in gastric mucosa in the context of cirrhosis
Authors: Ma Ruiguang , Li Qian , Yu Guoxian , Wang Jun , Li Yueyue , Xu Xinyan , Zhu Yiqing , Dong Min , Gao Yanjing , Li Lixiang , Li Zhen
Published: September 2023

Background

Patients with liver cirrhosis (LC) are prone to gastric mucosa damage. We investigated the alterations of gastric mucosa in LC patients and their possible mechanisms through multi-omics.

Results

We observed significant gastric mucosa microbial dysbiosis in LC subjects. Gastric mucosal microbiomes of LC patients contained a higher relative abundance of Streptococcus, Neisseria, Prevotella, Veillonella, and Porphyromonas, as well as a decreased abundance in Helicobacter and Achromobacter, than control subjects. The LC patients had higher levels of bile acids (BAs) and long-chain acylcarnitines (long-chain ACs) in serum. The gastric mucosal microbiomes were associated with serum levels of BAs and long-chain ACs. Transcriptome analyses of gastric mucosa revealed an upregulation of endothelial cell specific molecule 1, serpin family E member 1, mucin 2, caudal type homeobox 2, retinol binding protein 2, and defensin alpha 5 in LC group. Besides, the bile secretion signaling pathway was significantly upregulated in the LC group.

Conclusions

The alterations in the gastric mucosal microbiome and transcriptome of LC patients were identified. The impaired energy metabolism in gastric mucosal cells and bile acids might aggravate the inflammation of gastric mucosa and even exacerbate the Correa’s cascade process. The gastric mucosal cells might reduce bile acid toxicity by bile acid efflux and detoxification.

Trial registration: ChiCTR2100051070.
Convergent evolution and convergent loss in the grasping structures of immature earwigs and aphidlion-like larvae as demonstrated by about 100-million-year-old fossils
Authors: Haug Carolin , Haug Gideon T. , Kiesmüller Christine , Haug Joachim T.
Published: September 2023

Convergent evolution is a common phenomenon, independently leading to similar morphologies in different evolutionary lineages. Often similar functional demands drive convergent evolution. One example is the independent evolution of grasping structures in different lineages of Euarthropoda, though the exact morphology of these grasping structures varies significantly. In this study, we investigated grasping apparatuses with two movable counteracting structures as well as some related structures, exemplified by the stylets (compound structures of mouthparts) of aphidlion-like larvae (part of Neuroptera or lacewings) and the cerci of immature earwigs (Dermaptera). For the stylets of aphidlion-like larvae, studies have pointed to a significant loss in morphological diversity in the last 100 million years. We used quantitative morphology to evaluate if a similar process has also occurred in the cerci of earwigs. The cerci of extant immature earwigs exhibit two distinct types of morphologies in the modern fauna: elongated cerci divided into several ringlets with a feeler-type function, and pincer-like stout cerci. In some fossil immature earwigs, however, the cerci are generally elongated but undivided and roughly occupy the morphospace between those of the two modern cerci types; hence this fossil cerci morphology appears to have been lost. To some extent, a comparable loss is also found in certain lacewing larvae. Outgroup comparisons suggest that the morphologies no longer present today are in fact not ancestral, but instead specialised, hence their loss is possibly resulting from disruptive evolution in earwigs as well as lacewings. We discuss the possible functions of these specialised grasping structures.
Lung aeration estimated by chest electrical impedance tomography and lung ultrasound during extubation
Authors: Joussellin Vincent , Bonny Vincent , Spadaro Savino , Clerc Sébastien , Parfait Mélodie , Ferioli Martina , Sieye Antonin , Jalil Yorschua , Janiak Vincent , Pinna Andrea , Dres Martin
Published: September 2023

Background

This study hypothesized that patients with extubation failure exhibit a loss of lung aeration and heterogeneity in air distribution, which could be monitored by chest EIT and lung ultrasound. Patients at risk of extubation failure were included after a successful spontaneous breathing trial. Lung ultrasound [with calculation of lung ultrasound score (LUS)] and chest EIT [with calculation of the global inhomogeneity index, frontback center of ventilation (CoV), regional ventilation delay (RVD) and surface available for ventilation] were performed before extubation during pressure support ventilation (H0) and two hours after extubation during spontaneous breathing (H2). EIT was then repeated 6 h (H6) after extubation. EIT derived indices and LUS were compared between patients successfully extubated and patients with extubation failure.

Results

40 patients were included, of whom 12 (30%) failed extubation. Before extubation, when compared with patients with successful extubation, patients who failed extubation had a higher LUS (19 vs 10, p = 0.003) and a smaller surface available for ventilation (352 vs 406 pixels, p = 0.042). After extubation, GI index and LUS were higher in the extubation failure group, whereas the surface available for ventilation was lower. The RVD and the CoV were not different between groups.

Conclusion

Before extubation, a loss of lung aeration was observed in patients who developed extubation failure afterwards. After extubation, this loss of lung aeration persisted and was associated with regional lung ventilation heterogeneity.

Trial registration Clinical trials, NCT04180410, Registered 27 November 2019—prospectively registered, https://clinicaltrials.gov/ct2/show/NCT04180410.
The burden of vision loss in the Middle East and North Africa region, 1990–2019
Authors: Bahremani Erfan , Alizadeh Mahasti , Nejadghaderi Seyed Aria , Noori Maryam , Sullman Mark J M , Kolahi Ali-Asghar , Safiri Saeid
Published: September 2023

Background

The loss of vision is a substantial public health concern that has important implications for an individual’s quality of life. The primary objective of this research was to document the burden of vision loss in the Middle East and North Africa (MENA) region, spanning the years 1990–2019, by age group, sex, underlying cause and sociodemographic index (SDI).

Methods

Publicly available data concerning the burden of vision loss were acquired from the Global Burden of Disease study 2019. The data encompassed all 21 countries within the MENA region for the period spanning 1990 to 2019. The estimates were reported as raw counts and age-standardised rates per 100,000, accompanied by their corresponding 95% uncertainty intervals (UIs).

Results

In 2019, MENA had an age-standardised point prevalence of 7040.0 (95% UI: 6195.0, 8002.7) and an YLD rate of 314.5 (222.1, 427.6) per 100,000 for vision loss, which were 11.1% (-12.5, -9.7) and 24.3% (-27.6, -20.8) lower, respectively, than in 1990. In 2019, Afghanistan [469.6 (333.0, 632.8)] had the largest age-standardised YLD rate and Turkey [210.7 (145.3, 290.9)] had the lowest. All countries showed a decrease in the age-standardised point prevalence and YLD rate between 1990 and 2019, except for Oman, Afghanistan, and Yemen. Furthermore, in 2019 the largest number of prevalent cases and YLDs were found in the 65–69 age group. Also in 2019, the age-standardised YLD rates in MENA exceeded the global averages for most age groups, for both males and females. In 2019, refractive disorders were the most common types of vision loss among children, adolescents, and middle-age adults in MENA, while near vision loss and cataracts were the most common among older adults. Finally, the burden of vision loss had a slightly negatively association with SDI over the period 1990–2019.

Conclusion

Although the burden of vision loss has decreased over the last three decades, the prevalence remains high. These results underscore the importance of healthcare policymakers taking action to implement preventive measures, especially among the elderly and those living in low socioeconomic countries, to decrease the attributable burden in MENA.
What’s in my fuel tank? Insights into beliefs and preferences for e-fuels and biofuels
Authors: Linzenich Anika , Bongartz Dominik , Arning Katrin , Ziefle Martina
Published: September 2023

Background

Alternative fuels made from biomass or CO2 and water using renewable energy can reduce CO2 and pollutant emissions compared to fossil-based mobility and thus support a transition to a more sustainable transport. The adoption of alternative fuels in transport will ultimately depend on public acceptance and drivers’ willingness to use them. Little is known if and under which circumstances people would accept alternative fuels and which narratives and cognitive beliefs might underlie these usage intentions. Moreover, it is unclear if and how laypeople distinguish between different alternative fuel types in their perceptions, e.g., between fuels made from biomass (biofuels) and fuels produced using electricity (e-fuels). To address the research gap, this study empirically investigated laypeople’s beliefs and expectations towards alternative fuels and preferences for different fuel types. Understanding preferences for fuel types could help in steering public information, support managerial decisions and communication pathways, and promote the roll-out process of fuel innovations.

Results

Laypeople expected alternative fuels to be made using renewable feedstocks and to not contain gasoline or diesel. Whereas alternative fuels were believed to have advantages concerning environmental and toxic effects and safety compared to diesel and gasoline, they were associated with practical disadvantages for drivers. It was shown that although e-fuels and biofuels both fall under the definition of ”alternative fuels”, laypeople distinguish between them in evaluations of safety, costs, and resource competitiveness: E-fuels were preferred over biofuels and believed to have a lower competition for resources than biofuels. They were also evaluated to be more expensive and comparably less safe to use. Moreover, different adopter groups were identified for both fuels.

Conclusions

The study has highlighted both adoption drivers and barriers for alternative fuels: Reduced environmental impact could be an important positive factor. In contrast, drawbacks feared by laypeople regarding a low range and an expensive fuel price could be barriers for alternative fuel adoption because they reflect current technical challenges for these fuels. Thus, a more cost-efficient production and higher fuel efficiency should be considered in an acceptance-optimized alternative fuel production.
Association of niacin intake with constipation in adult: result from the National Health and Nutrition Examination
Authors: Huang Xiao , Zhao Liwen , Li Zhenyang , Gu Xiaodong , Li Mingzhe , Xiang Jianbin
Published: September 2023

Background

Although dietary intake is believed to be associated with constipation, there is currently a lack of research exploring the relationship between niacin intake and constipation. Therefore, the aim of this study is to investigate the association between niacin intake in adults and constipation using data from the National Health and Nutrition Examination Survey (NHANES).

Methods

This study included 5170 participants (aged ≥ 20 years) from the NHANES survey conducted between 2009 and 2010. Participants who reported experiencing constipation “always”, “most of the time”, or “sometimes” in the past 12 months were defined as constipation cases. The daily niacin intake was obtained from dietary recall and dietary supplement recalls of the patients. Weighted multivariate logistic regression analysis, restricted cubic spline regression, subgroup analysis, and interaction analysis were used to assess the correlation between niacin intake and constipation.

Results

After adjustment for covariates, the multivariate logistic regression model showed that low niacin intake was associated with a higher risk of constipation (Model 1: OR: 0.917, 95% CI 0.854–0.985, P = 0.023; Model 2: OR: 0.871, 95% CI 0.794–0.955, P = 0.01). After dividing niacin intake into four groups, a daily intake of 0–18 mg niacin was associated with a higher risk of constipation (Model 1: OR: 1.059, 95% CI 1.012–1.106, P = 0.019; Model 2: OR: 1.073, 95% CI 1.025–1.123, P = 0.013). The restricted cubic spline regression analysis also showed a non-linear relationship between niacin intake and the risk of constipation.

Conclusion

The findings of this study suggested that daily intake of 0–18 mg of niacin was associated with a higher risk of constipation compared to a daily intake of 18–27 mg of niacin.
The causal relationship between COVID-19 and seventeen common digestive diseases: a two-sample, multivariable Mendelian randomization study
Authors: Wang Zhiqi , Zhou Huanyu , Zhang Shurui , Wang Fei , Huang Haishan
Published: September 2023

Objectives

In clinical practice, digestive symptoms such as nausea, vomiting are frequently observed in COVID-19 patients. However, the causal relationship between COVID-19 and digestive diseases remains unclear.

Methods

We extracted single nucleotide polymorphisms associated with the severity of COVID-19 from summary data of genome-wide association studies. Summary statistics of common digestive diseases were primarily obtained from the UK Biobank study and the FinnGen study. Two-sample Mendelian randomization analyses were then conducted using the inverse variance-weighted (IVW), Mendelian randomization-Egger regression (MR Egger), weighted median estimation, weighted mode, and simple mode methods. IVW served as the primary analysis method, and Multivariable Mendelian randomization analysis was employed to explore the mediating effect of body mass index (BMI) and type 2 diabetes.

Results

MR analysis showed that a causal association between SARS-CoV-2 infection (OR = 1.09, 95% CI 1.01–1.18, P = 0.03), severe COVID-19 (OR = 1.02, 95% CI 1.00–1.04, P = 0.02), and COVID-19 hospitalization (OR = 1.04, 95% CI 1.01–1.06, P = 0.01) with gastroesophageal reflux disease (GERD). Mediation analysis indicated that body mass index (BMI) served as the primary mediating variable in the causal relationship between SARS-CoV-2 infection and GERD, with BMI mediating 36% (95% CI 20–53%) of the effect.

Conclusions

We found a causal relationship between SARS-CoV-2 infection and gastroesophageal reflux disease. Furthermore, we found that the causal relationship between SARS-CoV-2 infection and GERD is mainly mediated by BMI.
A scoping literature review of the associations between highly visual social media use and eating disorders and disordered eating: a changing landscape
Authors: Sharma Ashley , Vidal Carol
Published: September 2023

Background

Although the etiology of eating disorders (ED) and disorder eating (DE) is multifactorial, exposure to highly visual social media (HVSM) may be an important contributor to the onset or worsening of DE and ED symptoms. We aim to understand HVSM use, ED, and DE with a particular focus on gender differences, as well as details of engagement on “selfies” in adolescents and young adults (AYA) through a scoping review of the literature.

Methods

We conducted a literature search in Psycho ED, PubMed, MEDLINE of articles, including participants with DE/ED and users of HVSM, focused on AYA. Studies in which the study population did not include AYA, the SM platforms used did not include HVSM platforms, and the methodology to assess ED/HVSM use was not robust were excluded.

Results

We found a strong relationship between HVSM and ED and DE with existing gender differences related to the nature of engagement and preference of content. The literature also shows effects of the specific mechanisms of use of these platforms involving “selfie” preparation and posting. Existing research is limited and consists of mostly cross-sectional studies with no uniform methodology and with participant populations that are not well-defined.

Conclusions

The use of unregulated and profit-driven SM platforms can increase risk for ED. To use these HVSM platforms for positive influence, there is a need to have more transparency, and involvement of clinicians, researchers, and educators.

Public significance

Due to HVSM’s popularity among the AYA population, it is important to identify its effects on the development of DE and ED, as well as recognize any gender differences. Clinicians, parents, and other adults working with youth should be aware of HVSM’s impact on DE/ED, as described in this review.
The role of family communication patterns in intergenerational COVID-19 discussions and preventive behaviors: a social cognitive approach
Authors: Gong Wanqi , Jiang Li Crystal , Guo Qin , Shen Fei
Published: September 2023

Background

This study explores and compares the influences of family communication patterns (conversation orientation and conformity orientation) on family discussion and preventive behaviors for older parents and their adult children in the context of the early COVID-19 outbreak.

Methods

A total of 248 participants, including 117 parents and 131 adult children, participated in an online survey in February 2020. Participants reported family communication patterns, family discussions related to COVID-19, and their preventive behaviors.

Results

Conversation orientation was positively associated with information sharing and scientific discussion for older parents and adult children. Our results revealed the differential influences of conformity orientation on older parents and adult children. Conformity orientation was positively associated with scientific discussion for older parents but was not significantly associated with any form of family discussion reported by adult children. There was a significant interaction effect of conversation orientation and conformity orientation on disputed communication within the family, suggesting that conflicts may arise in COVID-related discussions when parents and adult children value conversation and conformity. Scientific discussion was found to mediate the relationships between family communication patterns and preventive behaviors. The effects of scientific discussions were stronger for older parents than for adult children.

Conclusions

Family communication patterns can be associated with preventive behaviors through different forms of family discussion about COVID-19. Conversation orientation is a strong facilitator for positive behavioral effects and scientific discussion is the most benign form of family health discussion. Health communication efforts should enhance the agency role of the family and motivate scientific discussion in health practices.
Pilot-scale continuous biogenic silica extraction from rice husk by one-pot alkali hydrothermal treatment and ball milling
Authors: Park Ji Yeon , Gu Yang Mo , Chun Jinyoung , Sang Byoung-In , Lee Jin Hyung
Published: September 2023

Background

Rice husk is the most silicon-rich renewable biomass and can be used as a raw material for producing silicon-based materials. With the increasing interest in utilizing rice husk as a renewable resource, the development of a robust silica extraction method is required. In this study, a one-pot alkali hydrothermal and ball-milling continuous silica extraction method was developed at the pilot scale.

Results

Three residence times (50, 100, and 150 min) were selected to compare the performance of the continuous extraction process depending on the residence time. The silica production was 4.09, 2.67, and 2.22 kg day−1 while the silica extraction yield was 52.8, 69.1, and 86.0% at resident times of 50, 100, and 150 min, respectively. The energy consumption for producing 1 kg of silica from rice husk was 51.6, 47.7, and 47.4 MJ kg−1 at resident times of 50, 100, and 150 min, respectively. The one-pot continuous silica extraction process was performed for 150 h to verify the stability of the process. During long-term operation, the process exhibited a constant solid content and stable silica extraction yield. The silicate solution obtained by the one-pot continuous process was successfully used to synthesize size-controlled spherical silica particles, which had a purity of 99.1 wt% and amorphous structure.

Conclusions

Overall, this study presents a novel continuous silica extraction method for the efficient recovery of silica from rice husk-based biorefineries.

Graphical abstract