bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Associated Risk Factors of Urinary Incontinence in Sexually Active Women in Ecuador
Authors: Zeas-Puga Ana Lucía , Méndez-Sacta Viviana , Vega Crespo Bernardo , Samijn Bieke , Hervé François , Martínez-Merinero Patricia , Pecos-Martín Daniel
Published: November 2024

Background/Objectives: Urinary incontinence (UI) significantly affects women’s health worldwide, but its specific prevalence in Ecuador is not well documented. This research aimed to determine the prevalence of urinary incontinence among sexually active women in the Cuenca canton and the factors associated with its presence. Methods: A descriptive cross-sectional study was conducted from August 2023 to January 2024 involving 460 women aged 30 years or older attending public health centers in Cuenca, Ecuador. The ICIQ-SF questionnaire was used to assess the presence and severity of UI and its impact on quality of life, along with a data collection form. Results: The findings revealed that UI is prevalent in a population that often lacks timely diagnosis, further obscuring the true extent of the issue. The results demonstrated that sociodemographic, gyneco-obstetric, and urological factors significantly influenced the risk of developing this condition. Conclusions: This study demonstrated a high prevalence of UI among women in Cuenca, Ecuador, with a notable impact on quality of life. The aforementioned factors predispose to the development of this condition, highlighting the need for preventive and rehabilitative interventions, as well as appropriate policies to address UI as a public health issue.
Workload Is Associated with Anxiety and Insomnia Symptoms in an Italian Nationally Representative Sample of Public Health Medical Residents: The PHRASI Cross-Sectional Study
Authors: Catalini Alessandro , Stacchini Lorenzo , Minutolo Giuseppa , Ancona Angela , Caminiti Marta , Cosma Claudia , Gallinoro Veronica , De Nicolò Valentina , Cedrone Fabrizio , Barbadoro Pamela , Gianfredi Vincenza
Published: November 2024

Background/Objectives: Mental health disorders pose a substantial challenge for healthcare workers, particularly in the post-COVID-19 era. Public health medical residents (PHRs) played a pivotal role during the pandemic and were significantly affected by the heavy workload. This study aims to uncover potential associations between workload characteristics and symptoms of anxiety and insomnia in Italian PHRs based on data collected in 2022 through the Public Health Residents’ Anonymous Survey in Italy (PHRASI) study. Methods: A total of 379 residents completed the self-administered questionnaire comprising the Generalized Anxiety Disorder-2 (GAD-2), and the Insomnia Severity Index (ISI). Results: While 36% PHRs reported anxiety symptoms (GAD-2 ≥ 3), 12% reported moderate-to-severe insomnia symptoms (ISI ≥ 15). The multivariate logistic regressions showed that a high work–life interference was associated with the presence of anxiety and insomnia symptoms, while attending two or more simultaneous traineeships was associated with insomnia symptoms. A high workload perceived was positively associated with both the mental health outcomes considered, while the perception of work environment manageability was negatively associated with them. Conclusions: These findings underscore the significant role of the workload in influencing the mental health status of PHRs and emphasize the importance of fostering a supportive work environment that prioritizes mental well-being
Tonic Cold Pain Temporal Summation and Translesional Cold Pressor Test-Induced Pronociception in Spinal Cord Injury: Association with Spontaneous and Below-Level Neuropathic Pain
Authors: Ríos-León Marta , Demertzis Elena , Palazón-García Ramiro , Taylor Julian
Published: November 2024

Background/Objectives: Although increased nociceptive excitability and deficient endogenous pain modulation are considered key features of pronociception and central sensitization, their contribution to neuropathic pain (NP) characteristics in SCI is unclear. The aim of this study was to characterize tonic cold perception and endogenous pain modulation in individuals with and without SCI-NP, considering the stage and severity of SCI and, secondarily, NP phenotype. Methods: Temporal summation of pain (TSP) and neuropathic features were assessed using the numerical rating scale (NRS) and Douleur Neuropathique 4 screening questionnaire (DN4) during the tonic cold pressor test (CPT, 12 °C 60 s) applied to the dominant hand and foot. CPT-induced pronociception was assessed as change in algometer pressure pain thresholds (PPTs) measured at the V2, C6, and L4 dermatomes. Results: A total of 72 individuals were recruited (age-sex-matched noninjured, n = 24; SCI-NP, n = 24; SCI-noNP, n = 24 [AIS A: n = 12, AIS B-D: n = 12; subacute SCI: n = 12, chronic SCI: n = 12]). TSP in response to the foot CPT was higher in subacute compared to chronic incomplete SCI-NP, while TSP to the hand CPT was significantly higher in chronic compared to the subacute complete SCI-NP group. Evoked pain intensity during the hand CPT correlated with duration of below-level SCI-NP. The hand CPT induced widespread pronociception (lower PPT), which correlated with 7-day non-evoked (spontaneous) pain intensity in individuals with incomplete SCI-NP. Individuals with below-level NP, but not at-level NP, showed higher TSP during the foot CPT and greater hand CPT-induced L4 dermatome pronociception. Conclusions: Collectively, measurements of above and below-level temporal summation of pain and translesional-induced pronociception in the SCI-NP group highlight the role of these mechanisms in widespread central sensitization, spontaneous pain intensity, and spinothalamic tract hyperexcitability, especially in individuals diagnosed with below-level NP.
Assessing the Performance of Chatbots on the Taiwan Psychiatry Licensing Examination Using the Rasch Model
Authors: Chang Yu , Su Chu-Yun , Liu Yi-Chun
Published: November 2024

Background/Objectives: The potential and limitations of chatbots in medical education and clinical decision support, particularly in specialized fields like psychiatry, remain unknown. By using the Rasch model, our study aimed to evaluate the performance of various state-of-the-art chatbots on psychiatry licensing exam questions to explore their strengths and weaknesses. Methods: We assessed the performance of 22 leading chatbots, selected based on LMArena benchmark rankings, using 100 multiple-choice questions from the 2024 Taiwan psychiatry licensing examination, a nationally standardized test required for psychiatric licensure in Taiwan. Chatbot responses were scored for correctness, and we used the Rasch model to evaluate chatbot ability. Results: Chatbots released after February 2024 passed the exam, with ChatGPT-o1-preview achieving the highest score of 85. ChatGPT-o1-preview showed a statistically significant superiority in ability (p < 0.001), with a 1.92 logits improvement compared to the passing threshold. It demonstrated strengths in complex psychiatric problems and ethical understanding, yet it presented limitations in up-to-date legal updates and specialized psychiatry knowledge, such as recent amendments to the Mental Health Act, psychopharmacology, and advanced neuroimaging. Conclusions: Chatbot technology could be a valuable tool for medical education and clinical decision support in psychiatry, and as technology continues to advance, these models are likely to play an increasingly integral role in psychiatric practice.
The Battle Within: A Qualitative Meta-Synthesis of the Experience of the Eating Disorder Voice
Authors: Tragantzopoulou Panagiota , Mouratidis Christos , Paitaridou Konstantina , Giannouli Vaitsa
Published: November 2024

Background/Objectives: Individuals with eating disorders frequently describe encountering a highly critical internal voice that fixates on their eating habits, body shape, and weight. While existing literature acknowledges the significant impact of this eating disorder voice on affected individuals and its influence on treatment trajectories, research in this area remains limited. This study aimed to comprehensively examine and synthesize qualitative data concerning the experience of the eating disorder voice, with the goal of deepening our understanding of its fundamental characteristics and informing more effective approaches to assessment, treatment, and support in clinical settings. Methods: A systematic search was conducted across six databases for studies presenting qualitative findings relevant to the eating disorder voice. Fifteen studies were included, and their findings were reviewed and synthesized. Results: Results revealed that the eating disorder voice is often perceived by individuals as both protective and comforting, yet also controlling and intrusive, often seen as a force more powerful than themselves. Participants described a constant struggle to manage this internal criticism by differentiating themselves from the voice, with the fear of separation from the voice posing a significant challenge. Conclusions: This study underscores the complex nature of the EDV and its profound impact on individuals with eating disorders.
Effects of Long-Term Nitrogen Fertilization and Application Methods on Fruit Yield, Plant Nutrition, and Soil Chemical Properties in Highbush Blueberries
Authors: Jayasinghege Charitha P. A. , Bineng Carine , Messiga Aimé J.
Published: November 2024

Nitrogen (N) fertilizer is routinely applied in highbush blueberry (Vaccinium corymbosum L.) production. The recommended N fertilizer rate increases as the plants mature, and is usually determined based on regional growing conditions. However, the effects of N fertilizer rates and application methods over the long term remain poorly understood. In this study, ammonium sulfate was applied as an N source at the recommended rate (100%), which corresponds to a maximum of 155 kg N ha−1 for plants older than eight years, along with higher rates at 150% and 200% of the recommended level, as well as a control treatment of no N. Treatments were applied to the blueberry cultivar ‘Duke’ as either broadcast (BROAD) or fertigation (FERT), and impacts were analyzed after 12 and 13 years of treatment. In the 14th year, the 100% N rate was uniformly applied as BROAD across all plants to separate the effects of different N rates from those caused by long-term soil condition changes. The BROAD treatment at the 100% N rate achieved the highest yield, and the FERT treatment at 200% resulted in the lowest yield in the 12th year, suggesting that excessive N rates can reduce fruit yield. However, no significant yield differences were observed in the 13th year. Higher N rates were associated with reduced titratable acidity in fruits and fewer flower buds. The soil pH declined across all N treatments, with the FERT at 200% showing the most significant reduction. All N treatments generally increased soil electrical conductivity (EC). High N rates also decreased plant accumulation of magnesium, calcium, and copper, with the latter reaching deficiency levels. These findings emphasize the importance of adhering to recommended N application rates and adjusting soil pH and EC to mitigate the adverse effects of prolonged N treatments.
In Vitro Initiation, Regeneration, and Characterization of Plants Derived from Mature Tetraploid Floral Explants of Date Palm (Phoenix dactylifera L.)
Authors: Othmani Ahmed , Sellemi Amel , Jemni Monia , Kadri Karim , Leus Leen , Werbrouck Stefaan P. O.
Published: November 2024

A stable tetraploid date palm mutant with the potential for increased fruit size was recovered from a sectorial di-tetraploid chimera via the in vitro culture of flower explants. Callus was induced using 2,4-D, followed by shoot regeneration on a medium containing NAA and BAP and rooting with IBA. Regenerated plantlets, confirmed as tetraploid via flow cytometry, were acclimatized and grown for six years. The leaves of tetraploids exhibited significantly wider petiole bases, thicker rachis and spines, broader leaflets, and a more intense green leaf color compared to diploids. However, leaf length, spine count, and overall leaf number were reduced. This is the first report of successful tetraploid recovery from a chimeric date palm, demonstrating the potential of this technique to generate novel germplasm and highlighting the phenotypic differences associated with tetraploidy in this species.
Research Overview and Development of Impatiens L.: A Bibliometric Analysis (1987–2023)
Authors: Chen Yuan , Zhu Jiarui , Wang Ling , Ning Peng , Huang Weixia , Zou Zhuoran
Published: November 2024

Impatiens L. plants have a variety of flower colors, abundant flowers, and unique flower types, which have high ornamental and medicinal value. This paper utilized CiteSpace (version 6.2.R4) and VOSviewer (version 1.6.20) software to analyze documents related to Impatiens L. research from 1987 to 2023, sourced from the Web of Science database (WOS) and the China National Knowledge Infrastructure (CNKI). Bibliometric analyses were conducted to explore the literature potential of Impatiens L. research, revealing publication volume, discipline distribution, major research institutions and researchers, research hotspots, and research trends. The results indicated a consistent increase in articles published on Impatiens L., with the United States, China, and India as the primary research countries. The research direction predominantly focused on plant science, ecology, and horticulture, with universities and research institutes being the main contributors. The Chinese Academy of Sciences and Florida State University were identified as having the most published articles and a strong influence. Research on Impatiens L. primarily focused on investigating new species, phenotypic plasticity, biodiversity, and systematic classification. Future efforts should emphasize the investigation and protection of Impatiens L. resources, conduct in-depth research on the plant’s active components, innovate breeding technology, and explore the biological characteristics and ecological role of Impatiens L. through interdisciplinary collaboration.
Circular Pear Production Using Compost Fertilization: Influence on Tree Growth and Nitrogen Leaf Concentration
Authors: Butcaru Ana Cornelia , Mihai Cosmin Alexandru , Moț Andrei , Gogoț Ruxandra , Hoza Dorel , Stănică Florin
Published: November 2024

The circular economy with compost fertilization is included in the sustainable orchard paradigm, creating a holistic production ecosystem. Modern orchards are mostly intensive and super-intensive, requiring different rootstocks. This research presents the response to compost fertilization of two specific pear rootstocks (quince ‘CTS 212’ and ‘Farold® 40’) and own-rooted trees, analyzing six resistant cultivars in a circular production system. The dynamic of nitrogen and carbon concentration in leaves, soil respiration coefficient, the evolution of the fruit maturity stage in the field, and some biometric parameters such as trunk cross-section area, the annual vegetative growth, and fruiting shoots annual number were analyzed. The results highlighted that compost fertilization led to increased leaf nitrogen concentration over the first two years while carbon concentration remained relatively stable. Rootstock and compost fertilization influenced the fruit maturity dynamic, but a single pattern was not identified. Quince, as pear rootstock, expressed a higher sensitivity to compost application; the biometric parameters, such as trunk cross-section area, and almost all cultivars’ annual vegetative growth were higher than the controls’. Positive output can lead to future model upscaling in farms and households.
Altered Photoprotective Mechanisms and Pigment Synthesis in Torreya grandis with Leaf Color Mutations: An Integrated Transcriptome and Photosynthesis Analysis
Authors: Chen Yujia , Wang Lei , Zhang Jing , Chen Yilu , Jin Songheng
Published: November 2024

Torreya grandis is a widely cultivated fruit species in China that is valued for its significant economic and agricultural importance. The molecular mechanisms underlying pigment formation and photosynthetic performance in Torreya leaf color mutants remain to be fully elucidated. In this study, we performed transcriptome sequencing and measured photosynthetic performance indicators to compare mutant and normal green leaves. The research results indicate that the identified Torreya mutant differs from previously reported mutants, exhibiting a weakened photoprotection mechanism and a significant reduction in carotenoid content of approximately 33%. Photosynthetic indicators, including the potential maximum photosynthetic capacity (Fv/Fm) and electron transport efficiency (Ψo, φEo), decreased significantly by 32%, 52%, and 49%, respectively. While the quantum yield for energy dissipation (φDo) increased by 31%, this increase was not statistically significant, which may further reduce PSII activity. A transcriptome analysis revealed that the up-regulation of chlorophyll degradation-related genes—HCAR and NOL—accelerates chlorophyll breakdown in the Torreya mutant. The down-regulation of carotenoid biosynthesis genes, such as LCY1 and ZEP, is strongly associated with compromised photoprotective mechanisms and the reduced stability of Photosystem II. Additionally, the reduced expression of the photoprotective gene psbS weakened the mutant’s tolerance to photoinhibition, increasing its susceptibility to photodamage. These changes in gene expression accelerate chlorophyll degradation and reduce carotenoid synthesis, which may be the primary cause of the yellowing in Torreya. Meanwhile, the weakening of photoprotective mechanisms further impairs photosynthetic efficiency, limiting the growth and adaptability of the mutants. This study emphasizes the crucial roles of photosynthetic pigments and photosystem structures in regulating the yellowing phenotype and the environmental adaptability of Torreya. It also provides important insights into the genetic regulation of leaf color in relation to photosynthesis and breeding.
Sustainable Practices for Arid Climates: Evaluating Combined Mulches with Biostimulant in Combating Soil Salinity and Cowpea Cultivation
Authors: Saber Esraa A. , Elbagory Mohssen , Abdel-Kader Nasser I. , Ahmed Mohamed E. , Abd El-Rahman Lamyaa A. , Khalifa Tamer H. , Omara Alaa El-Dein
Published: November 2024

Salinity and water security are significant challenges in arid climates, necessitating effective practices to enhance crop productivity in these stressful environments. To address this, a study was conducted during the summer seasons of 2022 and 2023 using a randomized, completely block setup with three replications. The research assessed the effects of different mulch materials, unmulched (bare soil), white plastic, rice straw, and sawdust, combined with biostimulant foliar applications (control, bulk chitosan at 250 mg/L, and two concentrations of chitosan nanoparticles at 125 mg/L and 62.5 mg/L) on physiochemical and biological properties of salt-affected soil, as well as on the growth and yield of cowpeas. The findings of this study indicate that different mulch materials exert distinct effects based on their type. For instance, white plastic mulch with chitosan nanoparticles at a concentration of 62.5 mg/L markedly decreased soil salinity (by 10.80% and 14.64%) and ESP (by 6.93% and 6.80%). In contrast, white plastic mulch paired with a control foliar application significantly increased the soil moisture content (by 23.93% and 27.63%) compared to un-mulched soil. The combination of organic mulches and biostimulant foliar treatments significantly enhanced soil health by increasing the pH, organic carbon, nutrient content, and beneficial bacteria while reducing the bulk density and suppressing harmful fungi. Biostimulant foliar treatments have a modest affected soil property. Additionally, this study highlights that integrating specific mulching materials with biostimulant foliar treatments can significantly improve cowpea’s vegetative growth, yield, and nutrient content. This suggests that combining mulches and biostimulants may provide a sustainable solution for enhancing cowpea production in saline environments.
Evaluation of Five Asian Lily Cultivars in Chongqing Province China and Effects of Exogenous Substances on the Heat Resistance
Authors: Bai Ningyu , Song Yangjing , Li Yu , Tan Lijun , Li Jing , Luo Lan , Sui Shunzhao , Liu Daofeng
Published: November 2024

Lily is one of the world’s important ornamental flowers. Potted Asiatic lily is a further selected dwarf cultivar suitable for indoor or garden planting. However, there is a lack of relevant research on the cultivation adaptability of potted Asiatic lilies cultivars in the Chongqing region which in the southwest of China. This study selected five potted Asiatic lily cultivars, and the phenological period, stem and leaf characteristics, and flowering traits were assessed through statistical observation. The Asiatic lily ‘Tiny Ghost’ and ‘Tiny Double You’ are well-suited for both spring and autumn planting in Chongqing, while ‘Sugar Love’ and ‘Curitiba’ are best planted in the spring. The ‘Tiny Diamond’ is more appropriate for autumn planting due to its low tolerance to high temperature. The application of exogenous substances, including calcium chloride (CaCl2), potassium fulvic acid (PFA) and melatonin (MT), can mitigate the detrimental effects of high-temperature stress on ‘Tiny Diamond’ by regulating photosynthesis, antioxidant systems, and osmotic substance content. A comprehensive evaluation using the membership function showed that the effect of exogenous CaCl2 treatment is the best, followed by exogenous PFA treatment. CaCl2 acts as a positive regulator of heat stress tolerance in Asian lilies, with potential applications in Asian lily cultivation. This study provides reference for cultivation and application of Asian lily varieties in Chongqing region, and also laid the foundation for further research on the mechanism of exogenous substances alleviating heat stress in lilies.
Optimizing Basil Seed Vigor Evaluations: An Automatic Approach Using Computer Vision-Based Technique
Authors: Altizani-Júnior Júlio César , Cicero Silvio Moure , de Lima Cristina Batista , Alves Rafael Mateus , Gomes-Junior Francisco Guilhien
Published: November 2024

The short cultivation cycle and high essential oil content of basil plants render them a valuable raw material source for diverse industries. However, large-scale production is hindered by the lack of specific protocols to assess seed vigor; thus, a consistent supply of high-quality seeds that meet consumer demands cannot be ensured. This study investigated the effectiveness of an automated system for seedling analysis as a tool for evaluating basil seed vigor and compared it to traditional tests. For this purpose, seeds from eight commercial lots were evaluated in two separate trials spaced six months apart using the following tests: germination, first germination count, saturated salt accelerated aging, primary root emergence, mean germination time, seedling emergence, seedling emergence speed index, and computerized seedling image analysis. The parameters provided by the system allowed us to clearly and objectively classify the basil seed lots based on vigor, and the results were strongly and significantly correlated with the findings of traditional vigor tests, particularly between the vigor index and seedling length. Digital analysis of four-day-old seedlings proved to be a fast and efficient technique for evaluating basil seed vigor and has the potential for use in automating the data collection and analysis process.
Plant Responses and Adaptations to Salt Stress: A Review
Authors: Liu Cuiyu , Jiang Xibing , Yuan Zhaohe
Published: November 2024

Salinity poses a significant environmental challenge, limiting plant growth and development. To cultivate salt-tolerant plants, it is crucial to understand the physiological, biochemical, and molecular responses and adaptations to salt stress, as well as to explore natural genetic resources linked to salt tolerance. In this review, we provide a detailed overview of the mechanisms behind morphological and physiological responses triggered by salt stress, including salt damage to plants, the disturbance of cell osmotic potentials and ion homeostasis, lipid peroxidation, and the suppression of photosynthesis and growth. We also describe the physiological mechanisms that confer salt tolerance in plants, such as osmotic adjustments, reactive oxygen species (ROS) scavenging, photosynthetic responses, phytohormone regulation, and ion regulation. Additionally, we summarize the salt-stress sensing and signaling pathways, gene regulatory networks, as well as salt-tolerance mechanisms in plants. The key pathways involved in salt-stress signal perception and transduction, including Ca2+-dependent protein kinase (CDPK) cascades, the salt overly sensitive (SOS) pathway, and the abscisic acid (ABA) pathway, are discussed, along with relevant salt-stress-responsive genes and transcription factors. In the end, the important issues and challenges related to salt tolerance for future research are addressed. Overall, this review aims to provide essential insights for the future cultivation and breeding of crops and fruits.
Enhancing Groundwater Recharge Through Nature-Based Solutions: Benefits and Barriers
Authors: Kebede Mahlet M. , Kumar Mukesh , Mekonnen Mesfin M. , Clement T. Prabhakar
Published: November 2024

Nature-based solutions (NbSs) for water involve using or mimicking natural processes to contribute to the improved management of water. Although NbSs are gaining a significant amount of scientific attention, to ensure their wide usage for enhancing groundwater recharge, there is a need for clear documentation outlining their benefits and barriers. In this study, a systematic literature review was carried out to evaluate the application of NbSs for managing groundwater recharge. First, NbS approaches were classified into two broad groups: managed aquifer recharge (MAR) and ancillary recharge methods (ARMs). MAR includes all activities that intentionally enhance the recharge of an aquifer for later recovery, while ARMs include all the remaining NbSs wherein recharge enhancement is a secondary goal. In 50 out of 61 reviewed studies, MAR was reported to be successful in increasing recharge. However, in the remaining studies, reductions in recharge rates were reported. Most of the NbSs that failed to improve groundwater recharge were from the ARMs group. This group had little consensus among studies regarding the effectiveness of NbSs on groundwater recharge. In this study, we also identified opportunities and challenges, such as gaps in our knowledge of NbSs’ effectiveness, their assessment in long-term, cost–benefit analysis and scalability. Addressing these challenges will further enhance the efficiency of NbSs, which indeed is a promising alternative for enhancing groundwater resources.
The Ripple Framework: Co-Producing Social, Cultural, and Economic Value in Care Through a Generative and Relational Approach
Authors: Soares Luis , Kettley Sarah
Published: November 2024

Work has been undertaken in the healthcare sector to explore ways of co-producing design responses with different communities and organisations. However, we lack empirical analysis of how design thinking can help tackle complexity. To assist the Healthier Working Lives programme, we curated the Ripple Framework to develop trust and attempt to address the challenges of complexity in residential care. Through a generative design process, data were used to collaboratively define bespoke co-design pathways with 31 participants from six Scottish care providers over ten months. Thematic, content, and matrix analyses produced insights to inform vignettes illustrating how design responded to complex social care sector needs, with a particular focus on the fulfilment and flourishing of the care workforce. Drawing on our empirical material and using the Design Research Value Model, we illustrate how we have developed social, cultural, and economic value in care through co-design, enabling an opportunity to test the novel methodology.
Alcohol Use and Abuse Among Family Caregivers of People Living with Dementia in the United States: A Scoping Review
Authors: Hazzan Afeez A. , Sniatecki Jessica L. , Metz Gary , Williams Jamia
Published: November 2024

The population of the United States is rapidly aging due to a number of factors, such as lower fertility rates and increases in life expectancy. Globally, dementia is a leading cause of disability among older adults, affecting approximately 50 million people. Family caregivers, who often have to sacrifice their health and well-being, provide most of the care needed by older adults living with dementia. Further, alcohol is one of the most commonly used substances in the United States. Considering the stress and unfavorable health outcomes that are associated with caring for a loved one with dementia, it is important to understand the prevalence of alcohol use and abuse among family caregivers. In this study, Arksey and O’Malley’s five-stage approach for a scoping review is used to examine the nature and scope of a body of research related to alcohol use and abuse among family caregivers of people living with dementia in the United States. Overall, the results show a paucity of research on the prevalence and implications of alcohol use among family caregivers. The identified studies suggest that family caregivers may be less likely to misuse alcohol than non-caregivers. However, additional population-wide studies are needed.
Using YouTube Comments Data to Explore Postpartum Depression in Social Media: An Infodemiology Study
Authors: Virani Anila , Nagra Bhupinder , O’Mahony Joyce , Bacsu Juanita , Ghatore Jasjot Kaur , Panda Sourajita
Published: November 2024

Background: Postpartum depression (PPD) is a prevalent mental health issue profoundly impacting both parents and their families. This study examines YouTube comments to identify common public discourse and prevalent themes surrounding PPD. Methods: We analyzed 4915 comments from 33 YouTube videos to provide a comprehensive picture of PPD-related discourse on social media. We analyzed data using engagement metrics and Braun and Clarke’s thematic analysis. Results: The engagement metrics indicated that public discourse is primarily focused on the stigma associated with PPD in men and celebrities, with related videos receiving significant attention and high engagement metrics score. Thematic analysis revealed two themes: (1) perspectives of stigmatized, stigmatizer and people in between; and (2) adaptation despite adversity. Conclusion: This study provides key insights into public discourse on PPD. It highlights the importance of family and community support and advocates for a healthcare system capable of addressing the needs of stigmatized populations. A significant finding of this study is the call for action to raise awareness and debunk myths about PPD. Misconceptions worsen stigma and deter help-seeking by affected individuals. Awareness initiatives are crucial to enhance public understanding of PPD symptoms, its impact on individuals and families, and the importance of parental mental health.
Exploring Managers’ Insights on Integrating Mental Health into Tuberculosis and HIV Care in the Free State Province, South Africa
Authors: Heunis Christo , Kigozi-Male Gladys
Published: November 2024

The integration of mental health (MH) services into tuberculosis (TB) and HIV care remains a significant challenge in South Africa’s Free State province. This study seeks to understand the perspectives of public health programme managers on the barriers to such integration and to identify potential strategies to overcome these challenges. Data were collected between February and October 2021 using qualitative methods including four individual semi-structured interviews and two focus group discussions with a total of 15 managers responsible for the MH, primary healthcare, TB, and HIV programmes. Thematic data analysis was guided by an adapted version of the World Health Organization’s “building blocks” framework encompassing “service delivery”, “workforce”, “health information”, “essential medicines”, “financing”, and “leadership/governance”. Additionally, the analysis underscored the crucial role of “people”, acknowledging their significant contributions as both caregivers and recipients of care. Managers highlighted significant concerns regarding the insufficient integration of MH services, identifying structural barriers such as inadequate MH management structures and staff training, as well as social barriers, notably stigma and a lack of family treatment adherence support. Conversely, they recognised strong management structures, integrated screening, and social interventions, including family involvement, as key facilitators of successful MH integration. The findings emphasise the need for a whole-system approach that addresses all building blocks while prioritising the role of “people” in overcoming challenges with integrating MH services into TB and HIV care.
Extracellular ATP Contributes to Barrier Function and Inflammation in Atopic Dermatitis: Potential for Topical Treatment of Atopic Dermatitis by Targeting Extracellular ATP
Authors: Yamamura Kazuhiko , Ohno Fumitaka , Yotsumoto Shu , Sato Yuki , Kimura Nanae , Nishio Kiichiro , Inoue Keiichi , Ichiki Toshio , Kuba-Fuyuno Yoko , Fujishima Kei , Ito Takamichi , Kido-Nakahara Makiko , Tsuji Gaku , Nakahara Takeshi
Published: November 2024

Atopic dermatitis (AD) is characterized by chronic inflammation, barrier dysfunction, and pruritus, exacerbated by external stimuli, such as scratching. This study investigates the role of extracellular adenosine triphosphate (ATP) in the pathophysiology of AD and assesses the therapeutic potential of clodronate, an ATP release inhibitor. Our research demonstrates that extracellular ATP impairs skin barrier function by reducing the filaggrin expression in the keratinocytes, a critical protein for barrier integrity. Furthermore, ATP release, triggered by IL-4 and mechanical stimuli, amplifies inflammation by promoting cytokine and chemokine production by the immune cells. Clodronate, by inhibiting ATP release, restores the filaggrin levels in the keratinocytes, reduces TARC production in the dendritic cells, and alleviates AD symptoms in a mouse model. These findings suggest that targeting extracellular ATP could offer a novel therapeutic approach to improving skin barrier function and reducing inflammation in AD. Future studies should explore the long-term efficacy and safety of ATP-targeted therapies in clinical settings.
Hyperhomocysteinemia and Disease—Is 10 μmol/L a Suitable New Threshold Limit?
Authors: Marroncini Giada , Martinelli Serena , Menchetti Sara , Bombardiere Francesco , Martelli Francesco Saverio
Published: November 2024

Hyperhomocysteinemia (HHcy) is a medical condition characterized by an abnormally high level of homocysteine (Hcy) in the blood. Homocysteine is a toxic sulfur-containing amino acid that is produced during the metabolism of methionine. Under normal circumstances, Hcy is recycled back to methionine via the remethylation pathway, through the action of various enzymes and vitamins, particularly folic acid (vitamin B9) and B12 used when intracellular methionine levels are low, thus restoring the necessary levels to correctly maintain active protein synthesis. A second pathway, used in cases of intracellular methionine excess, (the trans-sulfuration pathway) is the one that recycles Hcy into cysteine (a precursor of glutathione), first passing through cystathionine (via the enzyme cystathionine beta-synthase), a reaction that requires vitamin B6 in its active form. HHcy has been identified as a risk factor for a variety of disorders, including cardiovascular diseases, multiple sclerosis, diabetes, Alzheimer’s and Parkinson’s diseases, osteoporosis and cancer. However, it remains unclear whether the slightly elevated concentration of Hcy (Hcy 7–10 μmol/L) is a causative factor or simply a marker of these pathologies. In human plasma, the concentration of Hcy ([Hcy]) is classified as mild (15 to 30 μmol/L), moderate (30 to 100 μmol/L), and severe (greater than 100 μmol/L). Interestingly, many laboratories continue to consider 25 μmol/L as normal. This review seeks to examine the controversial literature regarding the normal range of HHcy and emphasizes that even a [Hcy] level of 10 μmol/L may contribute to the development of several diseases, aiming to discuss whether it would be appropriate to lower the threshold of HHcy normal values.
Up-Regulated Expression of Thioredoxin-Interacting Protein (TXNIP) in Mesenchymal Stem Cells Associated with Severe Aplastic Anemia in Children
Authors: Peng Ying-Hsuan , Li Chang-Wei , Wu Kang-Hsi , Li Ju-Pi , Yang Shun-Fa , Chao Yu-Hua
Published: November 2024

The pathogenic mechanisms of severe aplastic anemia (SAA) in children are not completely elucidated. The insufficiency of the bone marrow microenvironment, in which mesenchymal stem cells (MSCs) are an important element, can be a potential factor associated with hematopoietic impairment in SAA. In the present study, we compared bone marrow MSCs from five children with SAA and five controls. We found a higher intensity of senescence-associated β-galactosidase activity in SAA MSCs, indicating the increased senescence in these cells. Further RNA sequencing analysis identified a distinctive profile of transcriptomes in SAA MSCs. After conducting a survey of the differentially expressed genes, we found that the up-regulated expression of TXNIP may compromise the proliferative potential of MSCs and probably relate to the pathogenesis of SAA. These results were validated by qPCR. To explore the molecular mechanism involving aberrant TXNIP regulation in SAA MSCs, the expression levels of IGF-1 and IGFBP-1 were measured. A significant increase in IGFBP-1 expression was noted in SAA MSCs despite the wide range of IGF-1 expressions. Accordingly, we postulated a novel pathogenic mechanism of SAA: a compensated increase in the expression of IGF-1 in MSCs to down-regulate TXNIP expression in the face of SAA, which is offset by the up-regulated expression of IGFBP-1.
Silencing Multiple Crustacean Hyperglycaemic Hormone-Encoding Genes in the Redclaw Crayfish Cherax quadricarinatus Induces Faster Molt Rates with Anomalies
Authors: Black Nickolis , Banks Thomas M. , Glendinning Susan , Chowdhury Gourab , Mykles Donald L. , Ventura Tomer
Published: November 2024

RNA interference (RNAi)-based biotechnology has been previously implemented in decapod crustaceans. Unlike traditional RNAi methodologies that investigate single gene silencing, we employed a multigene silencing approach in decapods based on chimeric double-stranded RNA (dsRNA) molecules coined ‘gene blocks’. Two dsRNA constructs, each targeting three genes of the crustacean hyperglycaemic hormone (CHH) superfamily of neuropeptides, were produced: Type II construct targeting Cq-Molt-inhibiting hormone 1 (MIH1), Cq-MIH-like 1 (MIHL1), and Cq-MIHL2 isoforms and Type I construct targeting Cq-ion transport peptide (Cq-ITP; a putative hybrid of CHH and MIH) and Cq-CHH and Cq-CHH-like (CHHL) isoforms. Both constructs were injected into juvenile redclaw crayfish, Cherax quadricarinatus, to determine the effects of multigene knockdown on molting and developmental processes. A 20-Hydroxyecdysone (20E) enzyme-linked immunosorbent assay (ELISA) and glucose assay were used to determine the effects of RNAi on molting and hemolymph glycemic activities, respectively. Multigene silencing reduced the intermolt interval by 23%. Statistically significant elevated 20E was recorded in treated intermolt individuals, consistent with the reduced intermolt interval as well as unique and abnormal phenotypes related to the molting process, which indicates a shift in 20E-induced cascade. There was no effect of RNAi treatment on hemolymph glucose level or molt increment. Through multigene silencing and subsequent annotation of gene networks, gene blocks may provide a tailored approach to investigate complex polygenic traits with RNAi in a more efficient and scalable manner.
Assessing Urinary Para-Hydroxyphenylacetic Acid as a Biomarker Candidate in Neuroendocrine Neoplasms
Authors: de Falco Renato , Costantini Susan , Russo Luigi , Giannascoli Denise , Minopoli Anita , Clemente Ottavia , Tafuto Salvatore , Vitagliano Carlo , Di Gennaro Elena , Budillon Alfredo , Cavalcanti Ernesta
Published: November 2024

The management of neuroendocrine neoplasms (NENs) involves the measurement of serum chromogranin A (s-CGA), serum neuro-specific enolase (s-NSE), and urinary 5-hydroxindolacetic acid (5-HIAA). Urinary para-hydroxyphenylacetic acid (u-pHPAA), a metabolite of tyrosine, has been proposed as a potential biomarker for these diseases. This study aims to evaluate the effectiveness of u-pHPAA and tyrosine as biomarkers. We measured the levels of s-CgA, s-NSE, u-5-HIAA, u-pHPAA, and tyrosine in blood or 24 h urine samples collected at baseline (T0) and after 1 year of follow-up (T1) from a limited cohort of patients enrolled at Istituto Nazionale Tumori-IRCCS-Fondazione “G. Pascale”. Biomarker values were normalized using the ratios between T1 and T0 values (T1/T0 parameters). The T1/T0 ratios for s-CgA and u-pHPAA were significantly associated with the outcome of death (p = 0.044 and p = 0.022, respectively). An ROC curve analysis demonstrated outstanding performances for these biomarkers (AUC = 0.958 and AUC = 1.00, respectively) and the Kaplan–Meier survival analysis showed significant Log-rank test results (p = 0.001 and p < 0.001, respectively). Additionally, T0 serum tyrosine correlated with the outcome of death (p = 0.044), with the ROC curve showing good performance (AUC = 0.958) and the Kaplan–Meier analysis yielding significant Log-rank test results (p = 0.007). Our study confirms the role of s-CgA in the management of NEN patients and highlights the potential roles of u-pHPAA and serum tyrosine as biomarkers. Further research is needed to validate our findings in larger populations.
Differential Dynamics and Roles of FKBP51 Isoforms and Their Implications for Targeted Therapies
Authors: Martinelli Silvia , Hafner Kathrin , Koedel Maik , Knauer-Arloth Janine , Gassen Nils C. , Binder Elisabeth B.
Published: November 2024

The expression of FKBP5, and its resulting protein FKBP51, is strongly induced by glucocorticoids. Numerous studies have explored their involvement in a plethora of cellular processes and diseases. There is, however, a lack of knowledge on the role of the different RNA splicing variants and the two protein isoforms, one missing functional C-terminal motifs. In this study, we use in vitro models (HeLa and Jurkat cells) as well as peripheral blood cells of a human cohort (N = 26 male healthy controls) to show that the two expressed variants are both dynamically upregulated following dexamethasone, with significantly earlier increases (starting 1–2 h after stimulation) in the short isoform both in vitro and in vivo. Protein degradation assays in vitro showed a reduced half-life (4 h vs. 8 h) of the shorter isoform. Only the shorter isoform showed a subnuclear cellular localization. The two isoforms also differed in their effects on known downstream cellular pathways, including glucocorticoid receptor function, macroautophagy, immune activation, and DNA methylation regulation. The results shed light on the difference between the two variants and highlight the importance of differential analyses in future studies with implications for targeted drug design.
Microsomal Prostaglandin E Synthase-1 Controls Colonic Prostaglandin E2 Production and Exerts a Protective Effect on Colitis Induced by Trinitrobenzene Sulfonic Acid in Mice
Authors: Kojima Fumiaki , Hioki Yuka , Sekiya Hiroki , Kashiwagi Hitoshi , Iizuka Yoshiko , Eto Kei , Maehana Shotaro , Kawakami Fumitaka , Kubo Makoto , Ishibashi Hitoshi , Ichikawa Takafumi
Published: November 2024

Microsomal prostaglandin E synthase-1 (mPGES-1) is an isozyme of the prostaglandin (PG) E synthase that acts downstream of cyclooxygenase and catalyzes the conversion of PGH2 to PGE2. The impact of genetic deletion of mPGES-1 on the development of 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis, a well-established model of inflammatory bowel disease (IBD), was investigated in this study. After administration of TNBS, mice deficient in mPGES-1 (mPGES-1−/− mice) showed more severe colitis than did wild-type (WT) mice. Histological examination revealed that mPGES-1−/− mice had markedly exacerbated symptoms of colitis. mPGES-1 expression was detectable in the colons of WT mice at both the mRNA and protein levels. Lack of mPGES-1 resulted in marked reduction of colonic PGE2 production. Our study also showed a significant increase in colonic expression of interleukin-17A (IL-17A), as well as interferon γ (IFNγ) and tumor necrosis factor α, during colitis in mPGES-1−/− mice compared with that in WT mice. Furthermore, loss of mPGES-1 increased the populations of IL-17A-producing T-helper (Th) 17 and IFNγ-producing Th1 cells in mesenteric lymph nodes. These results suggest that mPGES-1 is the main enzyme responsible for colonic PGE2 production and deficiency of mPGES-1 facilitates the development of colitis and T-cell-mediated immunity. mPGES-1 might, therefore, impact T-cell-related immune response associated with IBD.
The Role of TNF Receptor-Associated Factor 5 in the Formation of Germinal Centers by B Cells During the Primary Phase of the Immune Response in Mice
Authors: Hikosaka-Kuniishi Mari , Iwata Chieri , Ozawa Yusuke , Ogawara Sayaka , Wakaizumi Tomomi , Itaya Riho , Sunakawa Ren , Sato Ayaka , Nagai Hodaka , Morita Masashi , So Takanori
Published: November 2024

TNF receptor-associated factors (TRAFs) function as intracellular adaptor proteins utilized by members of the TNF receptor superfamily, such as CD40. Among the TRAF family proteins, TRAF5 has been identified as a potential regulator of CD40. However, it remains unclear whether TRAF5 regulates the generation of germinal center (GC) B cells and antigen-specific antibody production in the T-dependent (TD) immune response. TRAF5-deficient (Traf5−/−) and TRAF5-sufficient (Traf5+/+) mice were immunized in the footpad with 2,4,6-trinitrophenol-conjugated keyhole limpet hemocyanin (TNP-KLH) and complete Freund’s adjuvant (CFA). We found that GC B cell generation and antigen-specific IgM and IgG1 production were significantly impaired in Traf5−/− mice compared to Traf5+/+ mice. The expression levels of CD40-target genes Fas and Lta, which are involved in GC formation, were significantly decreased in B220+ cells isolated from immunized Traf5−/− mice. Traf5−/− B cells showed decreased antibody production, proliferation, and induction of CD40-target genes Tnfaip3, Tnfsf4, and Cd80 in response to agonistic Fc-CD40L protein in vitro. Furthermore, administration of TNP-KLH and Fc-CD40L to Traf5−/− mice resulted in a severe loss of GC B cell development. These results highlight the crucial role of TRAF5 in driving CD40-mediated TD immune response in vivo.