bluuebunny/crossref_metadata_2025 huggingface dataset:
Bringing experiences of healthcare in custody into quality improvement
Authors: Murphy Yoko , Winzer Andrea , Ogilvie Linda , Mayoh Melanie , McLeod Katherine E.
Published: March 2024

Patient experience is an essential component of safe and high-quality healthcare, yet rarely examined in the context of carceral settings. This article describes a project undertaken by the Ontario Ministry of the Solicitor General to collect evidence and perspectives on how to bring patient experiences of healthcare services delivered in provincial correctional facilities into ongoing quality improvement work. We first conducted a scoping review and jurisdictional scan to learn from existing processes and experiences. We then engaged frontline healthcare providers delivering services in custody and people with recent experience of incarceration regarding priority measures and processes for data collection and mechanisms for implementing evidence-based change. This article describes methods used to engage stakeholders, including a survey and focus groups, as well as key lessons learned. This work is relevant to readers experiencing barriers to patient engagement, interested in collaborative research processes, and developing services for people who have experienced incarceration.
Effects of Tai-Chi on Quality of Life in People With Neurodegenerative Diseases. A systematic Review of Randomised Clinical Trials
Authors: Navas-Otero Alba , Pineda-Nogueras Alicia , Ortiz-Rubio Araceli , Calvache Mateo Andrés , Torres-Sánchez Irene , Carmen Valenza Marie , Granados-Santiago María
Published: March 2024

Objective

This systematic review aimed to evaluate the effects of Tai Chi on the health-related quality of life (HRQoL) of people with neurodegenerative diseases.

Data Source

This review followed the guidelines of the updated PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. A systematic search in five electronic databases (Medline via PubMed, Web of Science, Scopus, PEDro, and OTseeker) was performed.

Study Inclusion and Exclusion Criteria

Randomized control trials (RCTs) examining Tai Chi interventions to improve HRQoL in patients with neurodegenerative diseases published through March 2023 were included.

Data Extraction

Data were extracted from each study by two independent researchers into a data extraction form based on the Cochrane recommendations. Methodological quality and risk of bias were assessed.

Data Synthesis

A meta-analysis was performed using Review Manager 5.3 software.

Results

Of the 439 records that were screened, eight RCTs met the eligibility criteria. They assessed cognitive decline (n = 2) or Parkinson’s disease (n = 6). RCT comparison groups included active interventions or usual care. The duration of Tai Chi therapy ranged from 8 to 24 weeks. A sensitivity analysis using a fixed effect model indicated that Tai Chi therapy significantly increased HRQoL [ P < 001, SMD (95% CI) = .41 [.21, .60], I2 = 4%].

Conclusion

Tai Chi can effectively improve the HRQoL of people with neurodegenerative diseases, but the heterogeneity across intervention was relatively high. Further studies are needed as research into the benefits of Tai Chi in neurodegenerative disease rehabilitation is still limited.
Energy loss mechanism of a full tubular pump under reverse power generation conditions using entropy production theory
Authors: Shi Lijian , Chen Yiyu , Yu Xianlei , Han Yi , Chai Yao , Xue Muzi
Published: March 2024

This paper investigates the energy dissipation mechanism of the internal flow field of the full tubular pump during reverse power generation and pump conditions, utilizing CFD and model test methods to research the device’s hydraulic characteristics, internal flow field and entropy production. The results indicate that the reverse power generation and pump conditions’ performance curves have opposite trends. Under PRPG conditions, the flow uniformity and weighted average angle of the impeller inlet flow field are smaller and the inlet flow field is poor. The stator-rotor gap flow under PRPG conditions increases with the increase in total flow, the gap flow under the design flow is 2.88 L/s, and the torque is 7.35 N·m. Under the PRPG condition, the turbulent and wall entropy production ratio increases gradually with the flow increase. Under the design flow rate, the entropy production rate of the impeller is 55.07%, and the entropy production rate of the impeller is the largest among the components under different flow rates. The entropy production of the outlet channel rises significantly with the flow rate. The research results of this paper provide a theoretical basis for the distribution of energy loss in reverse power generation of the full tubular pump.
Specificity and sensitivity of an indirect fluorescent antibody test to detect antibodies against bovine viral diarrhea virus
Authors: Karakida Naoya , Murakami Momoko , Takeda Yohei , Ogawa Haruko , Imai Kunitoshi
Published: March 2024

Since being reported in 1979 and 2006, indirect fluorescent antibody (IFA) tests have not been reported to detect bovine viral diarrhea virus (BVDV) antibodies to our knowledge. Thus, we re-evaluated the efficacy and usefulness of IFA tests for BVDV serology. We tested 4 combinations of 2 antibody conjugates (fluorescein isothiocyanate [FITC]-conjugated rabbit IgG anti-bovine IgG; rabbit IgG F(ab')2 fragment anti-bovine IgG [F(ab')2 FITC-IgG]) and 2 washing solutions (PBS; carbonate-bicarbonate–buffered saline [CBBS]) to evaluate the specificity of an IFA test for BVDV. We compared the sensitivity of the optimal combination with virus neutralization (VN) tests and an ELISA, and compared IFA with VN titers against different genotype (subgenotype) strains. For the F(ab')2 FITC-IgG/CBBS combination, only 1 of the 156 (0.6%) 4-fold diluted cattle sera resulted in a nonspecific reaction; other combinations led to a much higher incidence (22.9–37.2%). For the F(ab')2 FITC-IgG/CBBS combination, IFA detection rates were identical (36 of 59) for BVDV1 and BVDV2 genotypes, and IFA titers against them were strongly correlated ( r = 0.99). The antibody-detection rates of the IFA tests were almost identical to those of VN tests and the ELISA (κ: 0.96 and 0.89, respectively). The IFA titers against 4 strains (BVDV1a, BVDV1j, BVDV2a, and an unidentified strain) were similar, 1,024 to ≥4,096, although the VN titers were different. Thus, our IFA tests were specific and sensitive, and more useful than VN tests given that the IFA tests could evaluate the immune status of cattle using a representative strain, regardless of genotype (subgenotype).
Application of nonlinear system identification and feature extraction in fault diagnosis of the cracked cantilever beam
Authors: Liu Yang , Liang Haiying , Feng Kunpeng , Zhao Chencheng
Published: March 2024

The cantilever beam structure is extensively applied in civil, transportation, and mechanical fields. It is generally prone to structural damage like cracks arising from material defects, operation conditions, and environmental factors. Cracks in a cantilever beam generally induce nonlinear behavior, potentially compromising structural durability and even posing threats to production safety. The present study primarily focuses on online and quantitative fault diagnosis of cracks in the cantilever beam. A simulation model is established for the cantilever beam with varying cracks, where responses corresponding to excitation signals are collected. A Nonlinear Autoregressive with Exogenous inputs (NARX) model for the cantilever beam is identified, and Nonlinear Output Frequency Response Functions weighted contribution rate (WNOFRFs) are evaluated from the established NARX model. A WNOFRFs-associated index is extracted to quantify the severity of breathing cracks. Simulation results indicate that this approach can online diagnose and quantify the severity of crack faults to a certain extent. The applicability of this approach is further verified through experiments on a cracked cantilever beam.
Simulation and design model for reinforced concrete slabs with lacing systems
Authors: Ali Al-Tameemi Saif Khudhair , Al-hasany Ehab G , Mohammad Hussein Kareem , Jabir Hussain A , Ibrahim Teghreed H , Allawi Abbas A , El-Zohairy Ayman
Published: March 2024

Lacing reinforcement plays a critical role in the design and performance of reinforced concrete (RC) slabs by distributing the applied loads more evenly across the slab, ensuring that no specific area of the slab is overloaded. In this study, nine slabs, divided into three groups according to the investigated parameters, were meticulously designed and evaluated to study the interplay between the lacing reinforcement and other key parameters. Each slab was crafted for simple support and was subjected to both static and repeated two-point load tests. The lacing reinforcement had an angle of 45° with various tension and lacing steel. The repeated-tested specimens with lacing reinforcement experienced smaller ductility than those of similar static-tested specimens, where the reduction in ductility factor ranged between 8.4% and 22.3% for all specimens. Additionally, the tested slabs were analyzed numerically using the ABAQUS software package. The validated FE test program was used to study the effect of varying the lacing reinforcement ratio, the compressive strength of concrete, and the material types of the tension and lacing reinforcements. The lacing reinforcement becomes more effective in increasing the slab capacity when using the higher compressive strength of concrete.
Effect of strengthening by carbon fiber reinforced polymer sheets on the flexural behavior of reinforced self-compacting concrete beams under repeated loads
Authors: Abbas AL-Khafaji Ali Ghanim , Muhammed Sabah Hashim , Jadooe Awad , Abdulredha Muhammad
Published: March 2024

This study investigates the effect of strengthening self-compacted concrete (SCC) beams using CFRP sheets on flexural behaviour subjected to repeated loads. During the experiment, six rectangular reinforced SCC beams were evaluated; two were reference beams without strengthening, while the remaining four were strengthened with CFRP sheets. The beam’s length, depth, and width are 2100 mm, 300 mm, and 200 mm, respectively. A monotonic load was applied to one of the reference beams, while repeated loads were applied to the remaining (compression cyclic loads). The main parameters studied in this experimental work were the type of loading (monotonic and repeated), the positions of strengthening and the dimensions of CFRP sheets. The flexural behaviour of these beams was investigated through experimental examination by recording the ultimate load and maximum deflection. Meanwhile, the cracks’ pattern and failure modes were observed. The findings of the present study demonstrated that the limited cycles of repeated loads have marginal effect on the flexural behaviour of the beams. This results in an ultimate load reduction of no more than 11%. It was also noted that SCC beams strengthened using CFRP sheets subjected to repeated loads significantly affected the flexural behaviour of these beams. Consequently, the ultimate load of the strengthened beams was improved by up to 18%. Besides, the maximum deflection of the strengthened SCC beams was reduced by 45% compared to those without strengthening. Using strengthening throughout the beams’ entire width and length that are subjected to repeated loads improved their ultimate load to surpass that of non-strengthened beams under monotonic loads by as much as 7%.
Generativity as a heuristic for impact-driven scholars addressing grand challenges
Authors: Luederitz Christopher , Etzion Dror
Published: March 2024

In this contribution, we theorize generativity as a heuristic for impact-driven management scholars seeking to address grand challenges through research. We use generativity to connote the engagement of diverse actors in pluralistic inquiry to create conditions for future flourishing. Our theorization applies a pragmatist worldview and builds on insights from the multidisciplinary literature on generativity to envisage researchers as agents of care, collective learning, and transformative change. We synthesize four tenets for researchers seeking both academic and real-world impact. These tenets can support researchers addressing grand challenges by guiding their efforts to diversify inputs, distribute agency, conduct experiments, and pursue prospective impacts. We illustrate generativity in action by drawing on our experience in a transdisciplinary research project on small- and medium-sized enterprises taking climate action in Canada. We show how the four tenets foster generativity to promote an inclusive understanding of grand challenges and a bias toward action, thereby providing an optimistic stance toward addressing issues of social concern.
Co-expression of interleukin (IL)-17RA and IL-36γ in the hypothalamic paraventricular nucleus of the stress-induced hypertension rats
Authors: Zhang Hong , Ding Tingyu , Zhang Wenying , Wu Changhao , Chen Yupin , Jiang Jinjin , Sun Jihu , Wu Qin
Published: March 2024

Objectives: The up-regulation of proinflammatory cytokines in the hypothalamic paraventricular nucleus (PVN) is well demonstrated to be involved in the development of neurogenic hypertension, including stress-induced hypertension (SIH). IL-17A has been found to be increased in the PVN of several hypertensive animal models and has been shown to play a key role in the development of hypertension. Although IL-36γ was found to be expressed in spinal neurons, its role in hypertension remains elusive. Here, we investigated the co-expression of IL-17 receptor A (IL-17RA) and IL-36γ in the PVN cells of SIH rats. Methods: The electric foot shock combined with buzzer noise stressors were used to make hypertensive rat model. The immunochemical staining or immunofluorescence staining was used to reveal cells as requested. The Western blot was used to detect the related protein levels. Results and Conclusion: In the PVN of the SIH rats, the number of CD3+CD4+ T cells was significantly increased by the immunochemical staining. Additionally, the protein levels of RORγt and IL-17A were significantly upregulated by Western blot, confirming the infiltration of CD4+ T cells and differentiation into Th17 cells in the PVN of SIH rats. Immunofluorescence staining revealed abundant expression of IL-17RA in PVN neurons, with relatively less expression in astrocytes or microglia. Furthermore, IL-36γ positive cells and protein expression of IL-36R were significantly increased. Notably, this study demonstrates for the first time that most IL-36γ cells were strongly colocalized with IL-17RA positive cells in the PVN of SIH rats, and the colocalized cells were significantly higher in SIH rats. This suggests that IL-17A secreted by infiltrated Th17 cells may stimulate PVN neurons to produce IL-36γ via IL-17RA, indicating that the combination of IL-17 and IL-36γ might produce strong pro-inflammatory effects in the PVN of SIH rats.
Does Spinal Cord Type Predict Intraoperative Neuro-Monitoring Alerts in Scoliosis Correction Surgery? A Systematic Review and Meta-Analysis of Operative and Radiologic Predictors
Authors: Al-Naseem Abdulrahman O. , Al-Naseem Abdulaziz O. , Cawley Derek T. , Aoude Ahmed , Catanzano Anthony A. , Abd-El-Barr Muhammad M. , Sharma Aman , Shafafy Roozbeh
Published: March 2024

Study Design

Systematic literature review and meta-analysis.

Objectives

Predicting patient risk of intraoperative neuromonitoring (IONM) alerts preoperatively can aid patient counselling and surgical planning. Sielatycki et al established an axial-MRI-based spinal cord classification system to predict risk of IONM alerts in scoliosis correction surgery. We aim to systematically review the literature on operative and radiologic factors associated with IONM alerts, including a novel spinal cord classification.

Methods

A systematic review and meta-analysis was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines. A literature search identifying all observational studies comparing patients with and without IONM alerts was conducted. Suitable studies were included. Patient demographics, radiological measures and operative factors were collected.

Results

11 studies were included including 3040 patients. Relative to type 3 cords, type 1 (OR = .03, CI = .01-.08, P < .00001), type 2 (OR = .08, CI = .03, P <.00001) and all non-type 3 cords (OR = .05, CI = .02-.16, P < .00001) were associated with significantly lower odds of IONM alerts. Significant radiographic measures for IONM alerts included coronal Cobb angle (MD = 10.66, CI = 5.77-15.56, P < .00001), sagittal Cobb angle (MD = 9.27, CI = 3.28-14.73, P = .0009), sagittal deformity angle ratio (SDAR) (MD = 2.76, CI = 1.57-3.96, P < .00001) and total deformity angle ratio (TDAR) (MD = 3.44, CI = 2.27-4.462, P < .00001). Clinically, estimated blood loss (MD = 274.13, CI = −240.03-788.28, P = .30), operation duration (MD = 50.79, CI = 20.58-81.00, P = .0010), number of levels fused (MD = .92, CI = .43-1.41, P = .0002) and number of vertebral levels resected (MD = .43, CI = .01-.84, P = .05) were significantly greater in IONM alert patients.

Conclusions

This study highlights the relationship of operative and radiologic factors with IONM alerts.
How to write a “results section” in biomedical scientific research papers?: Critical review
Authors: Habtu Yitagesu , Deressa Wakgari
Published: March 2024

Introduction

The “Results section” is a vital organ of a scientific paper, the main reason why readers come and read to find new information in the paper. However, writing the “Results section” demands a rigorous process that discourages many researchers, leaving their work unpublished and uncommunicated in reputable journals. Therefore, this review aims to describe the content, structure, and key standards of writing the “results section” and suggest practical recommendations to reduce common errors in writing the “results section” of manuscripts.

Methods

We searched the literature using search terms in the PubMed database. We also traditionally searched for literature from “Google Scholars”, “Google”, and “Websites”. We narrated and summarized finding sections as the content, structure, writing and presenting of data, logical flow of, and advised on the writing of the “results section” of the scientific paper.

Result

The review suggests guidelines for writing the content and organization, techniques of tabular, and graphical presentation of data in the “results section”. The review also suggests experiences on how to effectively present data in numbers such as percentages, statistical measures such as p-values, and other advanced forms of statistics, Finally, the review recommends relevant points to keep language brevity and logical flow in writing the “results section” of a scientific paper.

Conclusions

Writing a result section of a scientific paper requires practice and it must be concisely written, logically structured, and supported by a good journal-specific standard to be published.
EBV+ nodal T/NK-cell lymphoma associated with clonal hematopoiesis and structural variations of the viral genome
Authors: Kato Seiichi , Hamada Motoharu , Okamoto Akinao , Yamashita Daisuke , Miyoshi Hiroaki , Arai Haruto , Satou Akira , Gion Yuka , Sato Yasuharu , Tsuyuki Yuta , Miyata-Takata Tomoko , Takata Katsuyoshi , Asano Naoko , Takahashi Emiko , Ohshima Koichi , Tomita Akihiro , Hosoda Waki , Nakamura Shigeo , Okuno Yusuke
Published: March 2024

Epstein-Barr virus (EBV)-positive (EBV+) nodal T- and natural killer (NK)-cell lymphoma is a peripheral T-cell lymphoma (EBV+ nPTCL) that presents as a primary nodal disease with T-cell phenotype and EBV-harboring tumor cells. To date, the genetic aspect of EBV+ nPTCL has not been fully investigated. In this study, whole-exome and/or whole-genome sequencing was performed on 22 cases of EBV+ nPTCL. TET2 (68%) and DNMT3A (32%) were observed to be the most frequently mutated genes whose presence was associated with poor overall survival (P = .004). The RHOA p.Gly17Val mutation was identified in 2 patients who had TET2 and/or DNMT3A mutations. In 4 patients with TET2/DNMT3A alterations, blood cell–rich tissues (the bone marrow [BM] or spleen) were available as paired normal samples. Of 4 cases, 3 had at least 1 identical TET2/DNMT3A mutation in the BM or spleen. Additionally, the whole part of the EBV genome was sequenced and structural variations (SVs) were found frequent among the EBV genomes (63%). The most frequently identified type of SV was deletion. In 1 patient, 4 pieces of human chromosome 9, including programmed death-ligand 1 gene (PD-L1) were identified to be tandemly incorporated into the EBV genome. The 3′ untranslated region of PD-L1 was truncated, causing a high-level of PD-L1 protein expression. Overall, the frequent TET2 and DNMT3A mutations in EBV+ nPTCL seem to be closely associated with clonal hematopoiesis and, together with the EBV genome deletions, may contribute to the pathogenesis of this intractable lymphoma.
Insight into telomere regulation: road to discovery and intervention in plasma drug-protein targets
Authors: Ding Kaixi , Zhangwang Juejue , Lei Ming , Xiong Chunping
Published: March 2024

Background

Telomere length is a critical metric linked to aging, health, and disease. Currently, the exploration of target proteins related to telomere length is usually limited to the context of aging and specific diseases, which limits the discovery of more relevant drug targets. This study integrated large-scale plasma cis-pQTLs data and telomere length GWAS datasets. We used Mendelian randomization(MR) to identify drug target proteins for telomere length, providing essential clues for future precision therapy and targeted drug development.

Methods

Using plasma cis-pQTLs data from a previous GWAS study (3,606 Pqtls associated with 2,656 proteins) and a GWAS dataset of telomere length (sample size: 472,174; GWAS ID: ieu-b-4879) from UK Biobank, using MR, external validation, and reverse causality testing, we identified essential drug target proteins for telomere length. We also performed co-localization, Phenome-wide association studies and enrichment analysis, protein-protein interaction network construction, search for existing intervening drugs, and potential drug/compound prediction for these critical targets to strengthen and expand our findings.

Results

After Bonferron correction (p < 0.05/734), RPN1 (OR: 0.96; 95%CI: (0.95, 0.97)), GDI2 (OR: 0.94; 95%CI: (0.92, 0.96)), NT5C (OR: 0.97; 95%CI: (0.95, 0.98)) had a significant negative causal association with telomere length; TYRO3 (OR: 1.11; 95%CI: (1.09, 1.15)) had a significant positive causal association with telomere length. GDI2 shared the same genetic variants with telomere length (coloc.abf-PPH 4 > 0.8).

Conclusion

Genetically determined plasma RPN1, GDI2, NT5C, and TYRO3 have significant causal effects on telomere length and can potentially be drug targets. Further exploration of the role and mechanism of these proteins/genes in regulating telomere length is needed.
Exogenous betaine enhances salt tolerance of Glycyrrhiza uralensis through multiple pathways
Authors: Dong Xinping , Ma Xiaomei , Zhao Zhilong , Ma Miao
Published: March 2024

Background

Glycyrrhiza uralensis Fisch., a valuable medicinal plant, shows contrasting salt tolerance between seedlings and perennial individuals, and salt tolerance at seedling stage is very weak. Understanding this difference is crucial for optimizing cultivation practices and maximizing the plant’s economic potential. Salt stress resistance at the seedling stage is the key to the cultivation of the plant using salinized land. This study investigated the physiological mechanism of the application of glycine betaine (0, 10, 20, 40, 80 mM) to seedling stages of G. uralensis under salt stress (160 mM NaCl).

Results

G. uralensis seedlings’ growth was severely inhibited under NaCl stress conditions, but the addition of GB effectively mitigated its effects, with 20 mM GB had showing most significant alleviating effect. The application of 20 mM GB under NaCl stress conditions significantly increased total root length (80.38%), total root surface area (93.28%), and total root volume (175.61%), and significantly increased the GB content in its roots, stems, and leaves by 36.88%, 107.05%, and 21.63%, respectively. The activity of betaine aldehyde dehydrogenase 2 (BADH2) was increased by 74.10%, 249.38%, and 150.60%, respectively. The 20 mM GB-addition treatment significantly increased content of osmoregulatory substances (the contents of soluble protein, soluble sugar and proline increased by 7.05%, 70.52% and 661.06% in roots, and also increased by 30.74%, 47.11% and 26.88% in leaves, respectively.). Furthermore, it markedly enhanced the activity of antioxidant enzymes and the content of antioxidants (SOD, CAT, POD, APX and activities and ASA contents were elevated by 59.55%, 413.07%, 225.91%, 300.00% and 73.33% in the root, and increased by 877.51%, 359.89%, 199.15%, 144.35%, and 108.11% in leaves, respectively.), and obviously promoted salt secretion capacity of the leaves, which especially promoted the secretion of Na+ (1.37 times).

Conclusions

In summary, the exogenous addition of GB significantly enhances the salt tolerance of G. uralensis seedlings, promoting osmoregulatory substances, antioxidant enzyme activities, excess salt discharge especially the significant promotion of the secretion of Na+Future studies should aim to elucidate the molecular mechanisms that operate when GB regulates saline stress tolerance.
NnARF17 and NnARF18 from lotus promote root formation and modulate stress tolerance in transgenic Arabidopsis thaliana
Authors: Libao Cheng , Shiting Liang , Chen Zhao , Shuyan Li
Published: March 2024

Auxin response factors (ARFs) play a crucial role in regulating gene expression within the auxin signal transduction pathway, particularly during adventitious root (AR) formation. In this investigation, we identified full-length sequences for ARF17 and ARF18, encompassing 1,800 and 2,055 bp, encoding 599 and 684 amino acid residues, respectively. Despite exhibiting low sequence homology, the ARF17- and ARF18-encoded proteins displayed significant structural similarity and shared identical motifs. Phylogenetic analysis revealed close relationships between NnARF17 and VvARF17, as well as NnARF18 and BvARF18. Both ARF17 and ARF18 demonstrated responsiveness to exogenous indole-3-acetic acid (IAA), ethephon, and sucrose, exhibiting organ-specific expression patterns. Beyond their role in promoting root development, these ARFs enhanced stem growth and conferred drought tolerance while mitigating waterlogging stress in transgenic Arabidopsis plants. RNA sequencing data indicated upregulation of 51 and 75 genes in ARF17 and ARF18 transgenic plants, respectively, including five and three genes associated with hormone metabolism and responses. Further analysis of transgenic plants revealed a significant decrease in IAA content, accompanied by a marked increase in abscisic acid content under normal growth conditions. Additionally, lotus seedlings treated with IAA exhibited elevated levels of polyphenol oxidase, IAA oxidase, and peroxidase. The consistent modulation of IAA content in both lotus and transgenic plants highlights the pivotal role of IAA in AR formation in lotus seedlings.
Transcriptomics and metabolomics reveal the underlying mechanism of drought treatment on anthocyanin accumulation in postharvest blood orange fruit
Authors: Liu Hongbin , Jin Yan , Huang Le , Miao Chouyu , Tang Jiayi , Zhang Huimin , Yin Haojie , Lu Xiaopeng , Li Na , Dai Suming , Gentile Alessandra , Zhang Ling , Sheng Ling
Published: March 2024

Background

Anthocyanins are the most important compounds for nutritional quality and economic values of blood orange. However, there are few reports on the pre-harvest treatment accelerating the accumulation of anthocyanins in postharvest blood orange fruit. Here, we performed a comparative transcriptome and metabolomics analysis to elucidate the underlying mechanism involved in seasonal drought (SD) treatment during the fruit expansion stage on anthocyanin accumulation in postharvest ‘Tarocco’ blood orange fruit.

Results

Our results showed that SD treatment slowed down the fruit enlargement and increased the sugar accumulation during the fruit development and maturation period. Obviously, under SD treatment, the accumulation of anthocyanin in blood orange fruit during postharvest storage was significantly accelerated and markedly higher than that in CK. Meanwhile, the total flavonoids and phenols content and antioxidant activity in SD treatment fruits were also sensibly increased during postharvest storage. Based on metabolome analysis, we found that substrates required for anthocyanin biosynthesis, such as amino acids and their derivatives, and phenolic acids, had significantly accumulated and were higher in SD treated mature fruits compared with that of CK. Furthermore, according to the results of the transcriptome data and weighted gene coexpression correlation network analysis (WGCNA) analysis, phenylalanine ammonia-lyase (PAL3) was considered a key structural gene. The qRT-PCR analysis verified that the PAL3 was highly expressed in SD treated postharvest stored fruits, and was significantly positively correlated with the anthocyanin content. Moreover, we found that other structural genes in the anthocyanin biosynthesis pathway were also upregulated under SD treatment, as evidenced by transcriptome data and qRT-PCR analysis.

Conclusions

The findings suggest that SD treatment promotes the accumulation of substrates necessary for anthocyanin biosynthesis during the fruit ripening process, and activates the expression of anthocyanin biosynthesis pathway genes during the postharvest storage period. This is especially true for PAL3, which co-contributed to the rapid accumulation of anthocyanin. The present study provides a theoretical basis for the postharvest quality control and water-saving utilization of blood orange fruit.
The relationship between preoperative blood pressure during anesthetic examinations and pre-intubation blood pressure
Authors: Koibuchi Ikuya , Kadoi Yuji , Asou Chizu , Saito Shigeru
Published: March 2024

Background

There have been few reports showing the relationship between blood pressure (BP) measured at clinics preoperatively and BP measured before anesthetic intubation/induction. The purpose of this study was to examine the relationship between BP measured at different times and settings preoperatively and BP measured before intubation/induction.

Methods

A total of 182 patients who underwent general anesthesia between March 2021 and April 2022 in a university hospital were examined. In addition to self-reported BP asked on an anesthetic examination sheet completed by each patient, BPs were measured three times, before, during, and after preoperative examination by the anesthesiologist. The derived parameter was compared with BP measured before intubation at the time of general anesthesia induction.

Results

The systolic BP in the intra-examination period had the most significant correlation with pre-intubation systolic BP (r = 0.5230, p < 0.0001, 95% CI = 0.4050 to 0.6238). On Bland–Altman analysis, the intra-examination systolic BP seemed to be similar and showed better agreement with pre-intubation systolic BP than other measured BPs, with a mean bias of 2.2 mmHg and the narrowest 95% limits of agreement (-33.7 to + 38.1 mmHg).

Conclusions

The preoperative systolic BP value measured during the examination by the anesthesiologist was found to be closely related to pre-intubation systolic BP measured in the operating room. Higher BP during the preoperative examination may be a result of anxiety-induced stress or white-coat hypertension. Measuring BP during the anesthesiologist’s examination may be useful for predicting hypertension in the pre-intubation period.
Prognostic value of metabolic syndrome in patients with heart failure and malnutrition
Authors: Zhang Xuehe , Shan Chunfang , Hu Kaixuan , Fang Binbin , Zhang Zhiyang , Xie Qian , Liu Chang , An Xin , Yang Yining , Li Xiaomei
Published: March 2024

Background

Malnutrition is severely associated with worst prognosis of patients with heart failure (HF). Malnourished patients with the metabolic syndrome (MS) can result in a double burden of malnutrition. We aimed to investigate the impact of the MS on clinical outcomes in malnourished HF patients.

Methods

We examined 529 HF patients at risk of malnutrition with a mean age of (66 ± 10) years and 78% (415) were male. Nutritional status defined primarily by the prognostic nutritional index (PNI), with PNI < 40 being defined as malnutrition. The follow-up endpoint was cardiovascular death or all-cause death.

Results

During the 36-month follow-up, survival rates for cardiovascular and all-cause death were significantly lower in the MS group than in the non-MS group (log-rank P < 0.01). Multivariate Cox proportional hazards regression models showed that MS was independently associated with cardiovascular death (HR:1.759, 95%CI:1.351–2.291, p < 0.001) and all-cause death (HR:1.326, 95%CI:1.041–1.689, p = 0.022) in malnourished patients with HF. MS significantly increased the predictive value of cardiovascular death (AUC:0.669, 95%CI:0.623–0.715, p < 0.001) and all-cause death (AUC:0.636, 95%CI:0.585–0.687, p < 0.001) on the basis of established risk factors. The predictive effect of MS on cardiovascular death was independent of sex, age, functional class and left ventricular ejection fraction.

Conclusions

In malnourished patients with HF, MS is an independent risk factor for cardiovascular and all-cause mortality. MS significantly enhance the predictive value for clinical events in patients.
Causality of the gut microbiome and atherosclerosis-related lipids: a bidirectional Mendelian Randomization study
Authors: Teng Da , Jia Wenjuan , Wang Wenlong , Liao Lanlan , Xu Bowen , Gong Lei , Dong Haibin , Zhong Lin , Yang Jun
Published: March 2024

Aims

Recent studies have indicated an association between intestinal flora and lipids. However, observational studies cannot indicate causality. In this study, we aimed to investigate the potentially causal relationships between the intestinal flora and blood lipids.

Methods

We performed a bidirectional two-sample Mendelian Randomization (MR) analysis to investigate the causal relationship between intestinal flora and blood lipids. Summary statistics of genome-wide association studies (GWASs) for the 211 intestinal flora and blood lipid traits (n = 5) were obtained from public datasets. Five recognized MR methods were applied to assess the causal relationship with lipids, among which, the inverse-variance weighted (IVW) regression was used as the primary MR method. A series of sensitivity analyses were performed to test the robustness of the causal estimates.

Results

The results indicated a potential causal association between 19 intestinal flora and dyslipidemia in humans. GenusRuminococcaceae,Christensenellaceae, Parasutterella, Terrisporobacter, Parabacteroides,Class Erysipelotrichia, Family Erysipelotrichaceae, and order Erysipelotrichales were associated with higher dyslipidemia, whereas genusOscillospira, Peptococcus, Ruminococcaceae UCG010, Ruminococcaceae UCG011, Dorea,and Family Desulfovibrionaceae were associated with lower dyslipidemia. After using the Bonferroni method for multiple testing correction, Only Desulfovibrionaceae [Estimate = -0.0418, 95% confidence interval [CI]: 0.9362–0.9826,P = 0.0007] exhibited stable and significant negative associations with ApoB levels. The inverse MR analysis did not find a significant causal effect of lipids on the intestinal flora. Additionally, no significant heterogeneity or horizontal pleiotropy for IVs was observed in the analysis.

Conclusion

The study suggested a causal relationship between intestinal flora and dyslipidemia. These findings will provide a meaningful reference to discover dyslipidemia for intervention to address the problems in the clinic.
Characteristics of the most severely ill and injured patients in a Norwegian helicopter emergency medical service: a retrospective cohort study
Authors: Ringen Eirik , Haugland Helge , Brede Jostein Rødseth
Published: March 2024

Background

Physician-staffed helicopter emergency medical services (HEMS) are dispatched to a variety of incidents, ranging from less serious to life-threatening. The skillset of a physician may be important to provide appropriate care for the most critically ill and severely injured patients. A better understanding of these patients may therefore be important to optimize dispatch criteria, training, and equipment setups for HEMS units.

The aim of this study was to describe the characteristics of patients with the national advisory committee on aeronautics (NACA) score 5 and 6, primarily by diagnostic group and interventions performed.

Methods

Retrospective cohort study on aggregated data from the HEMS-base in Trondheim, Norway. All patients with NACA score 5 and 6 in the 10-year period from 2013 to 2022 were included. Patients with return of spontaneous circulation (ROSC) after successful cardiopulmonary resuscitation were described separately from non-cardiac arrest patients.

Results

Out of 9546 patient encounters, 2598 patients were included, with 1640 in the NACA 5 and 958 in NACA 6 group. Patient age was median 63 (interquartile range 45–74) and 64% of the patients were male. Post-ROSC patients accounted for 24% of patients. Of the non-cardiac arrest patients, the most frequent aetiology was trauma (16%), cardiac (15%), neurologic (14%) and respiratory (11%). The most common physician-requiring advanced interventions were general anaesthesia (22%), intubation (21%), invasive blood pressure monitoring (21%) and ventilator treatment (18%). The mean number of advanced interventions per mission were consistent during the study period (1,78, SD 0,25).

Conclusion

Twenty-seven percent of all HEMS dispatches were to NACA 5 and 6 patients. Twenty-four percent of these were post-ROSC patients. Sixty-three percent of all patients received at least one advanced physician-requiring intervention and the average number of interventions were consistent during the last 10 years. Hence, the competence a physician-staffed HEMS resource provide is utilized in a high number of critically ill and injured patients.
Power calculation for detecting interaction effect in cross-sectional stepped-wedge cluster randomized trials: an important tool for disparity research
Authors: Yang Chen , Berkalieva Asem , Mazumdar Madhu , Kwon Deukwoo
Published: March 2024

Background

The stepped-wedge cluster randomized trial (SW-CRT) design has become popular in healthcare research. It is an appealing alternative to traditional cluster randomized trials (CRTs) since the burden of logistical issues and ethical problems can be reduced. Several approaches for sample size determination for the overall treatment effect in the SW-CRT have been proposed. However, in certain situations we are interested in examining the heterogeneity in treatment effect (HTE) between groups instead. This is equivalent to testing the interaction effect. An important example includes the aim to reduce racial disparities through healthcare delivery interventions, where the focus is the interaction between the intervention and race. Sample size determination and power calculation for detecting an interaction effect between the intervention status variable and a key covariate in the SW-CRT study has not been proposed yet for binary outcomes.

Methods

We utilize the generalized estimating equation (GEE) method for detecting the heterogeneity in treatment effect (HTE). The variance of the estimated interaction effect is approximated based on the GEE method for the marginal models. The power is calculated based on the two-sided Wald test. The Kauermann and Carroll (KC) and the Mancl and DeRouen (MD) methods along with GEE (GEE-KC and GEE-MD) are considered as bias-correction methods.

Results

Among three approaches, GEE has the largest simulated power and GEE-MD has the smallest simulated power. Given cluster size of 120, GEE has over 80% statistical power. When we have a balanced binary covariate (50%), simulated power increases compared to an unbalanced binary covariate (30%). With intermediate effect size of HTE, only cluster sizes of 100 and 120 have more than 80% power using GEE for both correlation structures. With large effect size of HTE, when cluster size is at least 60, all three approaches have more than 80% power. When we compare an increase in cluster size and increase in the number of clusters based on simulated power, the latter has a slight gain in power. When the cluster size changes from 20 to 40 with 20 clusters, power increases from 53.1% to 82.1% for GEE; 50.6% to 79.7% for GEE-KC; and 48.1% to 77.1% for GEE-MD. When the number of clusters changes from 20 to 40 with cluster size of 20, power increases from 53.1% to 82.1% for GEE; 50.6% to 81% for GEE-KC; and 48.1% to 79.8% for GEE-MD.

Conclusions

We propose three approaches for cluster size determination given the number of clusters for detecting the interaction effect in SW-CRT. GEE and GEE-KC have reasonable operating characteristics for both intermediate and large effect size of HTE.
Evaluation of deprescription by general practitioners in elderly people with different levels of dependence: cross-sectional study
Authors: Coelho Tânia , Rosendo Inês , Seiça Cardoso Carlos
Published: March 2024

Background

Polypharmacy is easily achieved in elderly patients with multimorbidity and it is associated with a higher risk of potentially inappropriate medication use and worse health outcomes. Studies have shown that deprescription is safe, however, some barriers have been identified. The aim of this study was to analyse Portuguese General Practitioners (GP) deprescription’s attitudes using clinical vignettes.

Methods

Cross-sectional study using an online survey with 3 sections: demographic and professional characterization; two clinical vignettes with an elderly patient with multimorbidity and polypharmacy in which the dependency level varies; barriers and factors influencing deprescription. Frequencies, means, and standard deviations were calculated to describe the GPs. Analysis of the deprescription attitude, globally and for each drug, for each clinical vignette applying the McNeemar’s test.

Results

A sample of 396 GP was obtained with a mean age of 38 years, most of them female. A statistically significant difference (p < 0.01) was observed in deprescribing according to the patient dependency level, with more GPs (80.4% versus 75.3%) deprescribing in the most dependent patient. A statistically significant difference was found for all drugs except for antihypertensive drugs. All medications were deprescribed more often in dependent patients except for anti-dementia drugs. More than 70% of the participants considered life expectancy and quality of life as “very important” factors for deprescription and more than 90% classified the existence of guidelines and the risks and benefits of medication as “very important” or “important”. In the open question, the factors most reported by the GP were those related to the patient (52,9%).

Conclusions

This is the largest study on this topic carried out in Portugal using clinical vignettes, with a representative sample of Portuguese GP. The level of dependence significatively influenced the deprescription attitude of Portuguese GPs. The majority of the GPs classified the quality of life, life expectancies, potential negative effects and the existence of guidelines as “very important” or “important” while deprescribing. It is important to develop and test deprescribing in real life studies to analyze if these attitudes are the same in daily practice.
Exploring the impact of information and communication technologies on loneliness and social isolation in community-dwelling older adults: a scoping review of reviews
Authors: Gunnes Mari , Løe Ida-Camilla , Kalseth Jorid
Published: March 2024

Background

Recognizing the escalating public health concerns of loneliness and social isolation in aging populations, this study seeks to comprehensively explore the potential of information and communication technology (ICT)-based interventions to address these issues among older adults. This scoping review of reviews aims to map and synthesize existing evidence on the effectiveness and scope of ICT interventions targeting loneliness and social isolation in community-dwelling older adults, elucidating types of technology, impacts, facilitators, barriers, and research gaps.

Methods

Following the Joanna Briggs Institute framework, we systematically searched eight diverse databases identifying relevant published reviews. We included English-written, peer-reviewed reviews of all types, with no limits regarding time of publication about ICTs targeting loneliness and/or social isolation for community-dwelling older adults. Eligible reviews were analysed and summarized, offering a holistic narrative of the reported types of ICTs and their impact, the identified facilitators and barriers influencing the implementation and adoption of ICT interventions, and the research gaps identified in the literature.

Results

The review included 39 publications published between 2012 and 2024, spanning systematic, scoping, and reviews of reviews. Various ICTs were reported, primarily social media virtual communities, followed by video-mediated friendly visits, conversational agents, social robots, exergames and online gameplay. Predominantly positive impacts on mitigating social isolation and loneliness were evident for these ICTs, although methodological diversity and contradictory findings complicated definite conclusions. Facilitators and barriers encompassed individual competencies, access and usage, and intervention design and implementation. Research gaps involved targeting specific subgroups, exploring innovative technologies, incorporating diverse study designs, improving research methodologies, and addressing usability and accessibility. Future research should focus on identifying elderly individuals who can benefit the most from ICT use, exploring novel technologies, using a wider range of study designs, and enhancing usability and accessibility considerations.

Conclusions

This review sheds light on the diverse range of ICTs, their impact, and the facilitators and barriers associated with their use. Future investigations should prioritize refining outcome measures, addressing gender differences, and enhancing the usability and accessibility of interventions. The involvement of older adults in the design process and the exploration of technological training interventions hold promise in overcoming barriers.