bluuebunny/crossref_metadata_2025 huggingface dataset:
A brief exposure to toluene vapor alters the intrinsic excitability of D2 medium spiny neurons in the rat ventral striatum
Authors: Okas Michael , Kastner Abigail , Gioia Dominic , Woodward John J.
Published: August 2023

Although volatile organic solvents such as toluene are used for commercial and industrial uses, they are often voluntarily inhaled for their intoxicating and euphoric effects. Research into the effects of inhalants such as toluene on brain function have revealed actions on a variety of ligand-gated and voltage-activated ion channels involved in regulating neuronal excitability. Previous work from this laboratory has also shown that brief exposures to toluene vapor induce changes in the intrinsic excitability and synaptic transmission of neurons within the medial prefrontal cortex and ventral tegmental area that vary depending on projection target. In the present study, we recorded current-evoked spiking of medium spiny neurons (MSNs) in the nucleus accumbens (NAc) core and shell in adolescent rats exposed to an intoxicating concentration of toluene vapor. Compared to air controls, firing of NAc core MSNs in Sprague–Dawley rats was not altered 24 h after exposure to 10,500 ppm toluene vapor while spiking of NAc shell MSNs was enhanced at low current steps but reduced at higher current steps. When the rheobase current was used to putatively identify MSN subtypes, both “D1-like” and “D2-like” MSNs within the NAc shell but not core showed toluene-induced changes in firing. As toluene may itself have altered the rheobase resulting in misclassification of neuron subtype, we conducted additional studies using adolescent D2-Cre rats infused with a Cre-dependent mCherry reporter virus. Following toluene vapor exposure, spiking of NAc shell D2+ MSNs was enhanced at low current steps but inhibited at higher currents as compared to air controls while there were no differences in the firing of NAc shell D2- MSNs. The toluene-induced change in NAc D2+ shell MSN firing was accompanied by alterations in membrane resistance, rheobase, action potential rise time and height with no changes noted in D2- MSNs. Overall, these data add to a growing literature showing that brief exposures to intoxicating concentrations of toluene vapor causes selective alterations in the excitability of neurons within the addiction neurocircuitry that vary depending on sub-region, cell-type and projection target.
The neurological and non-neurological roles of the primary microcephaly-associated protein ASPM
Authors: Wu Xingxuan , Li Zheng , Wang Zhao-Qi , Xu Xingzhi
Published: August 2023

Primary microcephaly (MCPH), is a neurological disorder characterized by small brain size that results in numerous developmental problems, including intellectual disability, motor and speech delays, and seizures. Hitherto, over 30 MCPH causing genes (MCPHs) have been identified. Among these MCPHs, MCPH5, which encodes abnormal spindle-like microcephaly-associated protein (ASPM), is the most frequently mutated gene. ASPM regulates mitotic events, cell proliferation, replication stress response, DNA repair, and tumorigenesis. Moreover, using a data mining approach, we have confirmed that high levels of expression of ASPM correlate with poor prognosis in several types of tumors. Here, we summarize the neurological and non-neurological functions of ASPM and provide insight into its implications for the diagnosis and treatment of MCPH and cancer.
Effect of intravenous vitamin C on adult septic patients: a systematic review and meta-analysis
Authors: Liang Huoyan , Mu Qingqing , Sun Wenju , Liu Liming , Qiu Simin , Xu Zili , Cui Yuqing , Yan Yan , Sun Tongwen
Published: August 2023

Background

An increasing number of studies indicate that vitamin C (VC) reduces the mortality of adult septic patients, while some articles suggest otherwise. We performed this systematic review and meta-analysis to resolve the discrepancies in reported results concerning the efficacy of VC in septic patients.

Methods

We comprehensively searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled trials for randomized controlled trials (RCTs) evaluating the efficacy of intravenous VC (IVVC) on adult septic patients published from inception to November 28, 2022. The quality of outcomes for eligible studies was assessed using the Recommendations Assessment, Development, and Evaluation methodology. The results were analyzed using the pooled mean difference (MD) or risk ratio (RR) and 95% confidence intervals (CIs).

Results

Twenty-two studies (3,570 adult septic patients) were included. IVVC treatment did not improve 28-day mortality compared to the control group (RR, 0.92; 95% CI, 0.81–1.04; I2 = 26%; evidence risk, moderate). IVVC monotherapy decreased mortality (RR, 0.69; 95% CI, 0.52–0.93; I2 = 57%), whereas combination therapy did not affect mortality (RR, 1.03; 95% CI, 0.90–1.17; I2 =0%). IVVC had a trend to decrease the mortality of septic patients (RR, 0.83; 95% CI, 0.69–1.00; I2 = 33%) but did not affect septic shock patients (RR, 1.01; 95% CI, 0.85–1.21; I2 = 18%). IVVC reduced the duration of vasopressor use (MD, −8.45; 95% CI, −15.43 to −1.47; evidence risk, very low) but did not influence the incidence of AKI, ICU length of stay, duration of mechanical ventilation.

Conclusions

IVVC treatment did not improve the 28-day mortality in septic patients. Subgroup analysis indicated that VC had a trend to decrease the 28-day mortality in patients with sepsis but not septic shock. IVVC monotherapy, rather than combination therapy, decreased the 28-day mortality in septic patients. The findings imply that Hydrocortisone, Ascorbic acid, Thiamine (HAT) combination therapy is not superior to IVVC monotherapy for septic patients. These findings warrant further confirmation in future studies, which should also investigate the mechanisms underlying the enhanced efficacy of IVVC monotherapy in septic patients.

Systematic review registration

https://inplasy.com/.
Stereotactic body radiation therapy for the treatment of lymph node metastases: a retrospective mono-institutional study in a large cohort of patients
Authors: Caivano Donatella , Bonome Paolo , Pezzulla Donato , Rotondi Margherita , Sigillo Riccardo Carlo , De Sanctis Vitaliana , Valeriani Maurizio , Osti Mattia Falchetto
Published: August 2023

Introduction

Lymph node metastases (NMs) are a common site of tumor spread that can occur at different times of the disease. Stereotactic body radiation therapy (SBRT) can be a therapeutic option for the treatment of NMs in the setting of oligometastatic disease (OMD). The aim of this study was to evaluate as primary end points the local control (LC) and secondary end points the locoregional nodal control (LRNC), distant nodal control (DNC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS), and concurrently to assess the predictive factors of response.

Methods

This is a retrospective study that analyzes a group of patients treated with SBRT on NMs from different primary tumors, with a of maximum five metastasis. Treated lesions were divided into four groups: oligometastatics, oligorecurrents, oligoprogressives, and oligopersistents.

Results

From 2007 to 2021, 229 NMs were treated in 174 patients with different primary tumor. The schedule most represented was 30 Gy in five fractions. The LC was obtained in 90% of NMs treated by SBRT with rates at 1, 3, and 5 years of 93%, 86%, and 86%, respectively. The LRNC was reached in 84% of cases with rates at 1, 3, and 5 years of 88%, 83%, and 77%, respectively. The DNC was obtained in 87% of cases with rates at 1, 3, and 5 years of 92%, 82%, and 78%, respectively. The DMFS was obtained in 38% of cases with rates at 1, 3, and 5 years of 57%, 40%, and 30%, respectively. The rate of PFS were 44%, 23%, and 13% at 1, 3, and 5 years, respectively. The rates at 1, 3, and 5 years of OS were 78%, 48%, and 36%, respectively.

Conclusion

SBRT is an option for the treatment of NMS, with high rates of LC, improving survival, and with a good safety and tolerance. Tumor volume, tumor burden, lesion site, and doses can be predictive factors of response; however, multi-institutional studies with a greater number of patients could be helpful to better select patients and understand the right integrations between ablative treatment and systemic therapies.
A review on lymphocyte radiosensitivity and its impact on radiotherapy
Authors: Paganetti Harald
Published: August 2023

It is well known that radiation therapy causes lymphopenia in patients and that this is correlated with a negative outcome. The mechanism is not well understood because radiation can have both immunostimulatory and immunosuppressive effects. How tumor dose conformation, dose fractionation, and selective lymph node irradiation in radiation therapy does affect lymphopenia and immune response is an active area of research. In addition, understanding the impact of radiation on the immune system is important for the design and interpretation of clinical trials combining radiation with immune checkpoint inhibitors, both in terms of radiation dose and treatment schedules. Although only a few percent of the total lymphocyte population are circulating, it has been speculated that their increased radiosensitivity may contribute to, or even be the primary cause of, lymphopenia. This review summarizes published data on lymphocyte radiosensitivity based on human, small animal, and in vitro studies. The data indicate differences in radiosensitivity among lymphocyte subpopulations that affect their relative contribution and thus the dynamics of the immune response. In general, B cells appear to be more radiosensitive than T cells and NK cells appear to be the most resistant. However, the reported dose-response data suggest that in the context of lymphopenia in patients, aspects other than cell death must also be considered. Not only absolute lymphocyte counts, but also lymphocyte diversity and activity are likely to be affected by radiation. Taken together, the reviewed data suggest that it is unlikely that radiation-induced cell death in lymphocytes is the sole factor in radiation-induced lymphopenia.
The integrated stress response in cancer progression: a force for plasticity and resistance
Authors: Lines Caleb L. , McGrath Morgan J. , Dorwart Tanis , Conn Crystal S.
Published: August 2023

During their quest for growth, adaptation, and survival, cancer cells create a favorable environment through the manipulation of normal cellular mechanisms. They increase anabolic processes, including protein synthesis, to facilitate uncontrolled proliferation and deplete the tumor microenvironment of resources. As a dynamic adaptation to the self-imposed oncogenic stress, cancer cells promptly hijack translational control to alter gene expression. Rewiring the cellular proteome shifts the phenotypic balance between growth and adaptation to promote therapeutic resistance and cancer cell survival. The integrated stress response (ISR) is a key translational program activated by oncogenic stress that is utilized to fine-tune protein synthesis and adjust to environmental barriers. Here, we focus on the role of ISR signaling for driving cancer progression. We highlight mechanisms of regulation for distinct mRNA translation downstream of the ISR, expand on oncogenic signaling utilizing the ISR in response to environmental stresses, and pinpoint the impact this has for cancer cell plasticity during resistance to therapy. There is an ongoing need for innovative drug targets in cancer treatment, and modulating ISR activity may provide a unique avenue for clinical benefit.
The global/local (limited to some regions) effect of cesarean delivery on the risk of pediatric allergic rhinitis: a systematic review and meta-analysis
Authors: He Xingyi , Zhang Shipeng , Wu Jiamin , Fu Qinwei , Zhang Qinxiu , Peng Wenyu
Published: August 2023

Background

Allergic rhinitis is a chronic and refractory disease that can be affected by a variety of factors. Studies have shown an association between cesarean section and the risk of pediatric allergic rhinitis.

Methods

The PubMed, Springer, Embase, Cochrane Library, and Web of Science databases were searched to retrieve all studies published from January 2000 to November 2022, focusing on the relationship between cesarean section and the risk of pediatric allergic rhinitis. A meta-analysis was conducted to find a correlation between cesarean section and the risk of pediatric allergic rhinitis. A subgroup analysis was performed, considering the region and family history of allergy, after adjusting for confounding factors. Pooled odds ratios (ORs) were calculated, publication bias was assessed using a funnel plot, and heterogeneity between study-specific relative risks was taken into account.

Results

The results showed that cesarean section was significantly associated with an increased risk of pediatric allergic rhinitis (OR: 1.27, 95% CI: 1.20–1.35). Subgroup analysis stratified by region indicated that cesarean section increased the risk of pediatric allergic rhinitis, with the highest increase in South America (OR: 1.67, 95% CI: 1.10–2.52) and the lowest in Europe (OR: 1.13, 95% CI: 1.02–1.25). The results of the subgroup analysis stratified by family history of allergy indicate that family history of allergy was not associated with the risk of pediatric allergic rhinitis.

Conclusion

An association exists between cesarean section as the mode of delivery and the increased risk of pediatric allergic rhinitis, and cesarean section is a risk factor for allergic rhinitis.
Jianpi Yangzheng Xiaozheng decoction alleviates gastric cancer progression via suppressing exosomal PD-L1
Authors: Chen Yanzhen , Liu Jiayun , Chen Yuxuan , Zhang Ruijuan , Tao Jialei , Chen Xu , Wang Haidan , Sun Qingmin , Wu Jian , Liu Shenlin
Published: August 2023

Jianpi Yangzheng Xiaozheng decoction (JPYZXZ) is an empirical traditional Chinese medicine formula that has been reported to significantly prolong the survival of patients with advanced gastric cancer (GC). However, its underlying mechanism have not been fully elucidated. The present work aims to explore the possible mechanism of JPYZXZ on regulating GC progression. We firstly confirmed the inhibitory effect of JPYZXZ in GC MKN74 cells and 615-strain mice, which was possibly mediated with IL-6/JAK2/STAT3 pathway dependent PD-L1 expression. Moreover, we showed that JPYZXZ diminished the expression levels of GC-derived exosomal PD-L1 in MFC murine cells and xenograft GC model, as well as stage IIA-IIIB GC patients. We further found that in different types of tumor-infiltrating immune cells, PD-L1 expression was most positively correlated with myeloid-derived suppressor cells (MDSCs) in GC in the TISIDB database. We isolated exosomes derived from supernatants of MFC cells and co-cultured with bone marrow cells derived from C57BL/6 mice, and further revealed that the expansion of MDSCs was mediated by GC-derived exosomal PD-L1. Meanwhile, our results indicated that JPYZXZ inhibited the delivery of exosomal PD-L1 from GC cells to bone marrow cells, thereby alleviating exosomal PD-L1-induced differentiation and expansion of MDSCs in the tumor microenvironment. This led to a decrease in the levels of several immunosuppressive factors, including iNOS, Arg-1, TGF-β, IL-10, and IL-6, in 615-strain mice. Moreover, clinical data also revealed a significant positive relationship between exosomal PD-L1 and polymorphonuclear MDSCs under the JPYZXZ treatment in stage IIA-IIIB GC patients. In conclusion, our study confirmed that exosomal PD-L1 could be a key factor in controlling MDSCs differentiation in GC. JPYZXZ alleviated GC progression via suppressing exosomal PD-L1 mediated expansion of MDSCs, thereby remodeling the immunosuppressive tumor microenvironment, which provided the experimental evidence for the clinical application of JPYZXZ in the treatment of GC via PD-L1.
Cost-utility analysis of using paliperidone palmitate in schizophrenia in China
Authors: Luo Rui , Lu He , Li Hengfen
Published: August 2023

Objective: Long-acting injections (LAIs) of paliperidone palmitate have been shown to improve medication adherence and relieve psychotic symptoms. However, the specific cost-utility analysis of these LAIs in schizophrenia in China remains unclear.

Methods: A multi-state Markov model was constructed to simulate the economic outcomes of patients with schizophrenia in China who received paliperidone palmitate 1-month formulation (PP1M), paliperidone palmitate 3-month formulation (PP3M), and paliperidone extended-release (ER). A cost-utility analysis was conducted, mostly derived from published literature and clinical databases. All costs and utilities were discounted at a rate of 5% per annum. The primary outcome measure was the incremental cost-effectiveness ratios (ICERs). A series of sensitivity analyses were also applied.

Results: After 20 years, compared to ER, using PP1M resulted in an increased discounted cost from $36,252.59 to $43,207.28. This increased cost was associated with a gain in quality-adjusted life years (QALYs) from 8.60 to 9.45. As a result, the ICER for PP1M was estimated to be $8,247.46/QALY, which was lower than the willingness-to-pay (WTP) threshold of $12,756.55/QALY. When using PP3M instead of ER, the incremental cost was $768.81 and the incremental utility was 0.88 QALYs, projecting an ICER of $873.13/QALY, which was also lower than the WTP threshold of $12,756.55/QALY. The univariate sensitivity analysis showed that the costs of PP1M, PP3M, and ER had the greatest impact on ICERs. The probability sensitivity analysis (PSA) revealed that when the WTP thresholds were $12,756.55/QALY, the probability of PP1M and PP3M being cost-effective was 59.2% and 66.0%, respectively.

Conclusion: From the Chinese healthcare system perspective, PP3M and PP1M are both more cost-effective compared to ER, and PP3M has notable cost-utility advantages over PP1M.
Varietal responses of root characteristics to low nitrogen application explain the differing nitrogen uptake and grain yield in two rice varieties
Authors: Liu Lei , Cui Kehui , Qi Xiaoli , Wu Yu , Huang Jianliang , Peng Shaobing
Published: August 2023

Rice root characteristics are tightly associated with high-efficient nitrogen uptake. To understand the relationship of root plastic responses with nitrogen uptake when reducing nitrogen application for green rice production, a hydroponic experiment and a soil pot experiment were conducted under high (HN) and low (LN) nitrogen applications, using two rice (Oryza sativa L.) varieties, NK57 and YD6, three nitrogen absorption traits (total nitrogen accumulation, net NH4+ influx on root surface, nitrogen uptake via apoplasmic pathway) and root characteristics were investigated. In comparison with HN, LN significantly reduced nitrogen absorption and grain yield in both varieties. Concomitantly, there was a decrease in total root length, root surface area, root number, root volume, and root cortical area under LN, while single root length, root aerenchyma area, and root lignin content increased. The expression of OsAMT1;1 and OsAMT1;2 down-regulated in both varieties. The findings revealed that YD6 had smaller reduction degree for the three nitrogen absorption traits and grain yield, accompanied by smaller reduction degree in total root length, root surface area, root cortical area, and expression of the two genes under LN. These root characteristics were significantly and positively correlated with the three nitrogen absorption traits and grain yield, especially under LN. These results indicate that a large root system, lower reduction degree in several root characters, and high expression of OsAMT genes in YD6 explains its high nitrogen accumulation and grain yield under reduced nitrogen application. The study may provide rationale for developing varieties with low nitrogen fertilizer requirements for enabling green rice production.
Cultural differences in explicit and implicit support provision and underlying motivations for self-esteem, closeness, and relational concerns
Authors: Tanaka Rina , Zheng Shaofeng , Ishii Keiko
Published: August 2023

This research explores how culture influences the motivations underlying explicit (emotional and instrumental) and implicit (companionship and attentiveness) support provision. Two studies (N = 1,106) compared the responses of European Americans and Japanese individuals to a close other’s stressful event. The results showed that European Americans were more likely than Japanese to provide explicit support and more motivated to increase the close other’s self-esteem and feeling of closeness. Conversely, Japanese individuals were more likely to provide attentiveness support, motivated by concern for an entire group and a friend. These findings support the motivation as a mediator hypothesis. On the other hand, the culture as a moderator hypothesis applied to the association between concern for an entire group motivation and implicit support provision. Specifically, concern for an entire group motivation predicted companionship support provision only in Japanese, while it predicted attentiveness support provision mainly in European Americans.
Exploring the relationships among art therapy students’ burnout, practicum stress, and teacher support
Authors: Jue Juliet , Kim Tae-Eun
Published: August 2023

Introduction

This study examines how teacher support and practicum stress affect art therapy graduate students’ burnout.

Methods

A total of 125 master’s and doctoral students from art therapy graduate schools in Korea participated in the study. We conducted a correlation analysis and multiple regression analysis to explore the relationship between the variables.

Results

The correlation analysis results showed that burnout, practicum stress, and social support are significantly interrelated. The regression analysis results indicated that practicum stress increases burnout while social support decreases it. When we used the sub-factors of social support as independent variables, we found that professor support rather than the support of colleagues or family significantly reduced burnout. When we divided the perceived teacher support into emotional support and academic support, our analysis identified that academic support was more important than emotional support to reduce students’ burnout.

Conclusion

Art therapy students’ practicum stress can cause psychological burnout, while teacher support—especially academic support—can lower the possibility of experiencing such burnout.
Application of machine learning for risky sexual behavior interventions among factory workers in China
Authors: Zhang Fang , Zhu Shiben , Chen Siyu , Hao Ziyu , Fang Yuan , Zou Huachun , Cai Yong , Cao Bolin , Zhang Kechun , Cao He , Chen Yaqi , Hu Tian , Wang Zixin
Published: August 2023

Introduction

Assessing the likelihood of engaging in high-risk sexual behavior can assist in delivering tailored educational interventions. The objective of this study was to identify the most effective algorithm and assess high-risk sexual behaviors within the last six months through the utilization of machine-learning models.

Methods

The survey conducted in the Longhua District CDC, Shenzhen, involved 2023 participants who were employees of 16 different factories. The data was collected through questionnaires administered between October 2019 and November 2019. We evaluated the model's overall predictive classification performance using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. All analyses were performed using the open-source Python version 3.9.12.

Results

About a quarter of the factory workers had engaged in risky sexual behavior in the past 6 months. Most of them were Han Chinese (84.53%), hukou in foreign provinces (85.12%), or rural areas (83.19%), with junior high school education (55.37%), personal monthly income between RMB3,000 (US$417.54) and RMB4,999 (US$695.76; 64.71%), and were workers (80.67%). The random forest model (RF) outperformed all other models in assessing risky sexual behavior in the past 6 months and provided acceptable performance (accuracy 78%; sensitivity 11%; specificity 98%; PPV 63%; ROC 84%).

Discussion

Machine learning has aided in evaluating risky sexual behavior within the last six months. Our assessment models can be integrated into government or public health departments to guide sexual health promotion and follow-up services.
Machine learning-based cognitive load prediction model for AR-HUD to improve OSH of professional drivers
Authors: Teng Jian , Wan Fucheng , Kong Yiquan , Kim Ju-Kyoung
Published: August 2023

Motivation

Augmented reality head-up display (AR-HUD) interface design takes on critical significance in enhancing driving safety and user experience among professional drivers. However, optimizing the above-mentioned interfaces poses challenges, innovative methods are urgently required to enhance performance and reduce cognitive load.

Description

A novel method was proposed, combining the IVPM method with a GA to optimize AR-HUD interfaces. Leveraging machine learning, the IVPM-GA method was adopted to predict cognitive load and iteratively optimize the interface design.

Results

Experimental results confirmed the superiority of IVPM-GA over the conventional BP-GA method. Optimized AR-HUD interfaces using IVPM-GA significantly enhanced the driving performance, and user experience was enhanced since 80% of participants rated the IVPM-GA interface as visually comfortable and less distracting.

Conclusion

In this study, an innovative method was presented to optimize AR-HUD interfaces by integrating IVPM with a GA. IVPM-GA effectively reduced cognitive load, enhanced driving performance, and improved user experience for professional drivers. The above-described findings stress the significance of using machine learning and optimization techniques in AR-HUD interface design, with the aim of enhancing driver safety and occupational health. The study confirmed the practical implications of machine learning optimization algorithms for designing AR-HUD interfaces with reduced cognitive load and improved occupational safety and health (OSH) for professional drivers.
Case report: Effect of Hb E heterozygosity on HbA1c value by the Tosoh HLC-723G11
Authors: Gao Wei , Li Wenyu , Zheng Qian , Jiang Nenggang , Tang Huairong
Published: August 2023

Objective

We report the effect of Hb E heterozygosity on HbA1c value by the Tosoh HLC-723G11.

Case report

A 45 years-old Chinese woman presented with an abnormally low HbA1c level of 3.7% (3.9%–6.1%) in a health examination. Fasting blood glucose was normal. Blood routine examination and serum bilirubin were in the normal range. HbA1c was determined by Tosoh HLC-723G11. There was an abnormal peak between A1c and A0 on the chromatogram. Hemoglobin electrophoresis indicated that the Hb E zone accounted for 25.1%. The β-thalassemia-related genes (mutant type) were βE M/N, and the related gene CD26 (A > G) was mutated. OGTT indicated prediabetes.

Conclusion

Hb E heterozygosity may reduce HbA1c value with abnormal chromatograms, as determined by a Tosoh HLC G11 analyzer. The Tosoh HLC G11 analyzer can well identify Hb E variation. In this case, further blood glucose-related tests should be performed to avoid missed diagnoses. However, a large sample size is needed to confirm this conclusion.
Prevalence and factors of COVID-19 vaccine refusal among solid cancer patients in China: an application of the health belief model
Authors: Xie Zhaomin , Lau Joseph Tak-Fai , Liang Yuanke , Ouyang Qiaolei , Chen Junjia , Lin Si , Yao Kaitao , Hu Xuanyin , Lin Haoyu , Yu Yanqiu , Zeng De
Published: August 2023

Introduction

It is essential to protect cancer patients from contracting COVID-19 through vaccination. A majority of cancer patients are recommended by international health authorities to take up the vaccines. COVID-19 vaccine refusal among cancer patients during the pandemic period is under-researched. This study investigated factors of vaccine refusal based on the Health Belief Model (HBM).

Methods

A cross-sectional study was conducted among female breast cancer patients, male/female thyroid cancer patients, and gynecological cancer patients in Shantou, China from April to August 2022 (n = 1,115). Multinomial logistic regression analysis adjusted for socio-demographics was conducted to test factors of COVID-19. Adjusted odds ratios of the two models comparing vaccine refusal vs. “vaccine non-refusal” and vaccine refusal vs. ever-vaccination were derived and presented.

Results

Of all the participants, the prevalence of vaccine refusal, “vaccine non-refusal,” and ever-vaccination was 25.9, 22.2, and 51.8%, respectively. In both multinomial logistic regression models, significant factors of vaccine refusal included socio-demographics (age, education level, employment status, monthly household income, cancer type, duration since cancer diagnosis, current treatment status) and some vaccine-related HBM (perceived benefits, perceived barriers, cue to action, and self-efficacy). Perceived severity of COVID-19 was significant only in the vaccine refusal vs. ever-vaccination model. In neither model, perceived susceptibility to contract COVID-19 was statistically significant.

Conclusion

About ¼ of the participants expressed vaccine refusal. Interventions are warranted. Future longitudinal studies are needed to verify this study’s findings. Pilot interventions should also be launched to test effectiveness of interventions modifying the significant HBM factors found in this study.
Public knowledge, attitudes, and practices during the first wave of COVID-19 in Indonesia
Authors: Sinuraya Rano K. , Wulandari Chalisma , Amalia Riezki , Puspitasari Irma M.
Published: August 2023

Background

The COVID-19 pandemic became a global emergency, and it is vital to understand the knowledge, attitudes, and practices of populations regarding this disease to prevent its spread.

Objective

The study aimed to investigate the knowledge, attitudes, and practices of the Indonesian public toward COVID-19.

Methods

An observational study was conducted in Indonesia between November 2020 and January 2021. The study employed a validated questionnaire with 391 respondents to the survey. A comparative analysis was performed to assess the mean differences in respondents’ characteristics in terms of their knowledge, attitude, and practice scores. Furthermore, regression analysis was used to investigate those factors associated with the good practice of health protocols during the COVID-19 pandemic.

Results

The findings showed significant differences in the average knowledge scores across gender, geographical location, and educational attainment. Furthermore, significant differences in practices were identified in terms of gender and educational attainment. The findings of the study indicate that the participants demonstrated a significant awareness of COVID-19, as evidenced by their high mean knowledge score of 17.83 ± 1.74 out of a possible total score of 22 points. The results indicate that the respondents exhibited a positive attitude toward COVID-19 prevention measures, as evidenced by an attitude score of 26.95 ± 3.14 out of a possible total score of 30 points. Additionally, the mean score for good practice in health protocols aimed at reducing COVID-19 infection was found to be high (4.23 ± 0.96) at 5 points. This suggests that the study participants had already adopted effective measures to comply with the recommended health guidelines. The results of the regression analysis indicated that gender, level of education, and knowledge were statistically significant predictors for adherence to health protocols during the COVID-19 pandemic (p < 0.05).

Conclusion

The aforementioned results offer significant perspectives into the populace’s comprehension, disposition, and conduct regarding COVID-19 in Indonesia. These insights could potentially contribute to the formulation of efficacious measures aimed at curtailing transmission of the virus.
Prediction of mental effort derived from an automated vocal biomarker using machine learning in a large-scale remote sample
Authors: Taptiklis Nick , Su Merina , Barnett Jennifer H. , Skirrow Caroline , Kroll Jasmin , Cormack Francesca
Published: August 2023

Introduction

Biomarkers of mental effort may help to identify subtle cognitive impairments in the absence of task performance deficits. Here, we aim to detect mental effort on a verbal task, using automated voice analysis and machine learning.

Methods

Audio data from the digit span backwards task were recorded and scored with automated speech recognition using the online platform NeuroVocalixTM, yielding usable data from 2,764 healthy adults (1,022 male, 1,742 female; mean age 31.4 years). Acoustic features were aggregated across each trial and normalized within each subject. Cognitive load was dichotomized for each trial by categorizing trials at >0.6 of each participants' maximum span as “high load.” Data were divided into training (60%), test (20%), and validate (20%) datasets, each containing different participants. Training and test data were used in model building and hyper-parameter tuning. Five classification models (Logistic Regression, Naive Bayes, Support Vector Machine, Random Forest, and Gradient Boosting) were trained to predict cognitive load (“high” vs. “low”) based on acoustic features. Analyses were limited to correct responses. The model was evaluated using the validation dataset, across all span lengths and within the subset of trials with a four-digit span. Classifier discriminant power was examined with Receiver Operating Curve (ROC) analysis.

Results

Participants reached a mean span of 6.34 out of 8 items (SD = 1.38). The Gradient Boosting classifier provided the best performing model on test data (AUC = 0.98) and showed excellent discriminant power for cognitive load on the validation dataset, across all span lengths (AUC = 0.99), and for four-digit only utterances (AUC = 0.95).

Discussion

A sensitive biomarker of mental effort can be derived from vocal acoustic features in remotely administered verbal cognitive tests. The use-case of this biomarker for improving sensitivity of cognitive tests to subtle pathology now needs to be examined.
The impact of bariatric surgery on breathing-related polysomnography parameters—Updated systematic review and meta-analysis
Authors: Mashaqi Saif , Rihawi Anas , Rangan Pooja , Ho Katherine , Khokhar Mateen , Helmick Sonia , Ashouri Yazan , Combs Daniel , Ghaderi Iman , Parthasarathy Sairam
Published: August 2023

Introduction

We conducted this systematic review and meta-analysis (SRMA) to evaluate the impact of bariatric surgery on obstructive sleep apnea (OSA) as represented by the following polysomnography (PSG) parameters: apnea-hypopnea index (AHI), oxygen desaturation index (ODI), mean oxygen desaturation (mean SpO2), total sleep time spent with SpO2 < 90% (T-90), and the nadir of oxygen saturation (L SpO2).

Methods

A comprehensive search of the literature was conducted in Ovid MEDLINE, Embase, and Scopus databases from inception to March 31, 2023. Only articles written in English were reviewed. The analysis of all outcomes was performed using a random-effects model. We included 30 studies (two randomized controlled trials and 28 observational studies) in the final quantitative synthesis with a total of 1,369 patients.

Results

We concluded that bariatric surgery (regardless of the type) was associated with reduction in AHI [MD 23.2 events/h (95%CI 19.7, 26.8)], ODI [MD 26.8 events/h (95%CI 21.6, 32.1)], mean SpO2 [MD−1.94% (95%CI −2.5, −1.4)], T-90 [MD 7.5min (95%CI 5.0, 10.0)], and L SpO2 [MD 9.0% (95%CI −11.8, −6.3)].

Conclusion

Our SRMA results are updates to previously published results and continue to support the positive impact of bariatric surgery on OSA and sleep-related hypoxia.
Managed grazing and agroecological transformation in the Midwestern United States
Authors: Lowe Erin B. , Fochesatto Ana , Rissman Adena R.
Published: August 2023

A growing number of intergovernmental agencies, policymakers, scholars, and farmers are calling to transform the dominant food system so that it better supports farmers, communities, and the environment. The goal of this paper is to identify which actions that support managed livestock grazing and graziers can also promote agroecological transformation in the Midwestern U.S. We conducted 128 semi-structured interviews and 3 participatory workshops with farmers, civil society, and agricultural industry professionals focused on visions for the future and actions that could support managed grazing. We then applied a political agroecology framework to assess the transformative potential of specific actions. Action categories with high transformative potential include addressing industry consolidation and inequities in the distribution of land and capital; providing social supports for farm owners and workers; and shifting the social norms that support the dominant food system. Specific actions within these categories include supporting cooperative models of farming, marketing, and resource-sharing; providing healthcare, living wages, and retirement to farmers; supporting farmer-to-farmer networks; modifying crop insurance and anti-trust legislation; addressing farmland access and consolidation; expanding public education on agroecology; and enacting policies that dismantle and repair colonial and racial violence. The workshops revealed that a disproportionate share of attention within the Midwest sustainable agriculture movement is currently focused on strategies that support sustainable farming practices such as education and conservation assistance but do little to address governance structures that maintain the power of the current agricultural system. While these efforts are important, workshop participants and interviewees concluded that more systemic change is needed to build a food system that works better for people, communities, and the environment.
Right tracheal sleeve pneumonectomy with VV-ECMO assistance for non-small cell lung cancer through anterior thoracotomy: a single centre experience
Authors: Marziali Valentina , Mangiameli Giuseppe , Crepaldi Alessandro , Piccioni Federico , Costantini Elena , Citterio Enrico , Borbone Alessandro , Cariboni Umberto
Published: August 2023

For a long time, non-small cell lung cancer (NSCLC) arising less than 2 cm distal to the carina has been usually considered unresectable and incurable with a radical or extended resection because of surgical technical difficulty and airway management. Recently, the introduction of more advanced surgical techniques, often including the use of extracorporeal life support (ECLS), has allowed us to extend the limits of conventional surgery, increasing the rate of complete surgical resection. ECLS also overcomes the limitation of conventional ventilation during complex tracheo-bronchial reconstruction, avoiding the presence of disturbing lines or tubes that obstruct the operative field during a challenging surgery. In this article, we share our experience in performing right tracheal sleeve pneumonectomy with veno-venous extracorporeal membrane oxygenation (VV-ECMO) in three cases by anterior right thoracotomy, reporting our tips and tricks.
Between Autonomy and Paternalism: Attitudes of Nursing Personnel Towards Jehovah’s Witnesses’ Refusal of Blood Transfusion
Authors: Domaradzki Jan , Głodowska Katarzyna , Jabkowski Piotr
Published: August 2023

Objectives: The study describes the attitudes of Polish nursing personnel towards Jehovah’s Witnesses’ (JWs’) refusal to receive blood and blood products.

Methods: We developed an online survey assessing nurses’ knowledge and attitudes towards JWs’ refusal of blood transfusion in a life-threatening condition. It also examined nurses’ attitudes towards ethical and legal issues associated with JWs’ refusal of blood transfusions. These questions were explored using a sample of 202 Polish nurses.

Results: Nurses’ knowledge of JWs’ stance towards blood transfusions is inadequate and they tended to be ill-disposed towards JWs’ refusal of blood transfusions. Although most nurses respected adult JW patients’ autonomy and supported their right to refuse blood, in the case of JW children they are guided by paternalism. Nurses’ attitudes were affected by whether they had children, whether they declared themselves religious, their level of education and prior experience with patients who had refused a blood transfusion.

Conclusion: Since most nurses felt unprepared to care for JW patients, this study reveals an urgent need to train nurses in transcultural nursing and increase nurses’ cultural competencies, and that this should be incorporated into medical curricula.
Germplasm Diversification in Citrus Orchards in a Mesothermal Climate in Brazil
Authors: Napoleão Gabriel Maluf , Leonel Sarita , Souza Jackson Mirellys Azevedo , Leonel Magali , Martins Rafaelly Calsavara , Cardoso Caroline Pardine , Tecchio Marco Antonio , Filho Jaime Duarte
Published: August 2023

The limited scion-rootstock combinations used in sweet orange orchards in Brazil reduce the commercial potential of citrus and lead to greater susceptibility to pests and diseases. Aiming to provide germplasm diversification, the research evaluated the Folha Murcha (FM) and Charmute de Brotas (CB) orange trees grafted onto ‘Rangpur’ lime (RL) and ‘Swingle’ citrumelo (SC) rootstocks. The study was conducted in the southern center of the state of São Paulo, in the subtropical region of southeastern Brazil. The grafted trees were planted in September 2016. The field experiment was conducted over two seasons. The combinations were evaluated based on the duration in days and degree-days of the phenological intervals, growth and yield performance, alternate bearing, fruit ripening, and quality. The trees of the two scion cultivars grafted onto RL had the shortest crop cycle, the earliest fruit ripening, and the largest canopy volume. SC produced fewer alternate bearings with greater production efficiency. The CB/SC combination produced fruits with a better color index, higher total soluble solids content, and a higher technological index. This assessment can be useful in planning orchards for dual-purpose markets, such as table fruit and the juice industry.
Use of Spirulina platensis and Curcuma longa as Nutraceuticals in Poultry
Authors: Bondar Adrian , Horodincu Loredana , Solcan Gheorghe , Solcan Carmen
Published: August 2023

Since the banning of antibiotics in animal feeds (2006), there has been an increase in the number of studies looking for alternatives to stimulate the gut immune system. The main objective of our review article is to underline the nutraceutical properties of Curcuma longa and Spirulina platensis in the broiler chicken industry, and the experimental data were obtained by analyzing literature sources. Spirulina platensis is widely recognized as a valuable protein source, containing approximately 55–70% protein, 25% carbohydrates, essential amino acids, and 18% fatty acids. It is also rich in various vitamins like thiamin, riboflavin, pyridoxine, vitamin B12, vitamin C, gamma-linolenic acid, phycocyanins, tocopherols, chlorophyll, beta-carotenes, carotenoids, exhibiting positive effects on growth performance, gut integrity, and immunity. The anti-inflammatory effect of spirulina supplementation at different levels showed a decrease in caspase-3 and the TNF-α immunolabeling index; a reduction in IL-1β, IL-2 and IFN-γ; and an increase in the expression of the anti-inflammatory cytokine IL-4. Spirulina inhibits the synthesis of cytokines IL-1, IL-6, and TNF-gamma in addition to the activities of inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) enzymes. Turmeric also positively influences the growth, egg production, and overall health of chickens. Curcumin, the most potent component of turmeric, possesses additional pharmacological activities, including hepatoprotective, immunostimulant, and anticancer effects. Its immunomodulatory properties greatly enhance the immune system response, acting as a natural antibiotic against pathogens and decreasing levels of proinflammatory interleukins IL-1β, IL-6, IL-2, IL-18, and TNF-α.
Wheat Farmers’ Perception of Constraints and Their Adaptive Capacity to Changing Demands in Egypt
Authors: Abdalla Ahmed , Stellmacher Till , Becker Mathias
Published: August 2023

Most of the approximately 105 million Egyptians depend on wheat in the form of baladi bread for their daily diet. Millions of smallholders along the River Nile have produced wheat for millennia; however, in more recent history, the wheat demand and supply ratio has dramatically changed. The first wheat imports in Egyptian history were in 1966. Today, domestic production meets only half of the wheat consumption, and Egypt has become the largest wheat importer in the world. Before the Russia–Ukraine war, 85% of the wheat imports to Egypt came from Russia and Ukraine. The war and the associated disruption of the wheat supply chains has put Egypt on the top list of so-called “developing countries highly threatened by food crises”. Against this backdrop, we analyzed decision-making factors and perceptions of wheat-producing smallholders in the Nile River Delta, the wheat basket of Egypt. The study draws on nine months of empirical fieldwork in the Nile River Delta. We employed a mixed approach to data collection, combining interviews and focus group discussions with smallholders, experts, and agriculture extension agents with transect walks and field observations. In total, 246 randomly selected wheat-growing smallholders were interviewed in four divisions in the Nile River Delta. Our findings show that the production of wheat by smallholders is highly influenced by system-immanent factors, such as subsistence need for home consumption and the presence and intensity of animal husbandry, as well as by external factors, such as the domestic prices for wheat determined by the government in each season and the time of the declaration of these prices. These factors affect smallholders’ decisions to increase or decrease their wheat cultivation area. However, the study also showed that the factors influencing farmers’ decisions to grow wheat or implement innovative practices vary across different areas within the same region. Smallholders struggle with poor access to fundamental production factors and are discontented with the low provision of extension and support services as well as poor market structures. These constraints act as disincentives for smallholders to produce (more) wheat. They need to be addressed and eliminated to increase domestic production and to reduce Egypt’s dependency on expensive and unreliable wheat imports.