bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracellular vesicles—a new player in the development of urinary bladder cancer
Authors: Kasiński Damian , Szeliski Kamil , Drewa Tomasz , Pokrywczyńska Marta
Published: January 2025

Bladder cancer was the 10th most commonly diagnosed cancer worldwide in 2020. Extracellular vesicles (EVs) are nano-sized membranous structures secreted by all types of cells into the extracellular space. EVs can transport proteins, lipids, or nucleic acids to specific target cells. What brings more attention and potential implications is the fact that cancer cells secrete more EVs than non-malignant cells. EVs are widely studied for their role in cancer development. This publication summarizes the impact of EVs secreted by urinary bladder cancer cells on urinary bladder cancer development and metastasis. EVs isolated from urinary bladder cancer cells affect other lower-grade cancer cells or normal cells by inducing different metabolic pathways (transforming growth factor β/Smads pathway; phosphoinositide 3-kinase/Akt pathway) that promote epithelial–mesenchymal transition. The cargo carried by EVs can also induce angiogenesis, another critical element in the development of bladder cancer, and modulate the immune system response in a tumor-beneficial manner. In summary, the transfer of substances produced by tumor cells via EVs to the environment influences many stages of tumor progression. An in-depth understanding of the role EVs play in the development of urinary bladder cancer is crucial for the development of future anticancer therapies.
Exploring the Bioactive Constituents, Antibacterial, Antioxidant Potentialities of Aloe officinalis Forssk Flower
Authors: Menachery Santhosh Joseph , Moni Sivakumar S. , Khardali Amani , Elmobark Mohamed Eltaib , Alam Mohammad Firoz , Ali Albarqi Ali Ahmed , Abdallah Hana F. , Daws Dalia , Moochikkal Remesh , Areshyi Razan Willie , Sofyani Hissah Ali
Published: January 2025

Objectives

The aim of this study is to analyze the chemical composition of Aloe officinalis Forssk and to investigate its potential medicinal use, especially as a natural antibacterial agent.

Methods

The red flowers of Aloe officinalis Forssk were collected from Al Kadimi, Jazan province, Saudi Arabia, and processed into a methanolic extract (MEAOF) by maceration. The extract was comprehensively analyzed by GC-MS, LC-MS, FT-IR, and NMR spectroscopy. The antioxidant activity of MEAOF was evaluated using the DPPH assay, while its antibacterial potential against various human pathogenic bacteria was investigated using the agar well diffusion method.

Results

The analyzes identified several bioactive compounds in MEAOF, including stearic acid, palmitic acid, 9,12-octadecadienoic acid (Z, Z) and dasycarpidan-1-methanol acetate. MEAOF exhibited significant antibacterial activity against both Gram-positive and Gram-negative bacteria. In addition, MEAOF demonstrated an antioxidant scavenging capacity of 87.96%.

Conclusion

The study confirms the significant therapeutic potential of the flowers of Aloe officinalis Forssk and emphasizes their strong antibacterial and antioxidant properties. These results support the use of extracts from the flowers of Aloe officinalis Forssk in the development of new drugs to combat antibiotic resistance and reduce oxidative stress and underline their value for medical applications.
Gairan Land Questions in Marathwada: Observations from a Village Study
Authors: Bansode Nageshwar
Published: January 2025

This article examines the land issues faced by Dalits in this region, specifically focusing on the gairan land questions in Marathwada. The article brings out three key aspects of gairan land in the context of a resettled village: First, the gairan land movement and Dalits’ role in Marathwada; second, the legal implications and challenges associated with gairan occupation in the newly resettled village; and third, the economic outcomes for the gairan occupants who have settled in the new village. The analysis is based on both qualitative and quantitative evidence gathered through interviews and focus group discussions conducted in the village.
The New Politics of Education and the Pursuit of a Diverse Democracy
Authors: Kahne Joseph , Rogers John , Kwako Alexander
Published: January 2025

The increasingly partisan politics of education make it vital to conceptualize why and to empirically assess how current partisan pressures threaten public schools’ efforts to educate toward a diverse democracy. We examine these dynamics, drawing on a survey of a large and diverse sample of high school principals, weighted to reflect national demographics, conducted in summer 2022. We find that high schools in purple contexts are particularly likely to experience parent and community pushback related to education toward a diverse democracy and that schools in purple and red communities are less likely to provide support for this priority. By mapping this terrain, the study informs our understanding of the new partisan politics of education, priorities for future research, and, ultimately, directions for strategic action on the part of key stakeholders.
Two views of Anglophone Southeast Asia: The Heinemann Writing in Asia series and Skoob Pacifica
Authors: Ang Ann
Published: January 2025

This article surveys two important early publishers of writing from Southeast Asia with a regional reach and presents a case for understanding transnational connections based on publishing and writerly networks. Founded by Leon Comber in 1966, the Heinemann Writing Asia series emerged amidst a decolonizing Southeast Asia, publishing authors from Singapore, Malaysia, Indonesia, the Philippines, and Thailand. Besides being an important publication outlet for local writers without access to metropolitan publishing houses, the series arguably provided a regional outlet for works that fall outside the political rhetoric of national consolidation, while canonizing others from established literary traditions. The second half of the paper examines Skoob Pacifica, a London-based publishing imprint active between 1992 and 1994, paying specific attention to the two anthologies titled S. E. Asia Writes Back! and The Pen is Mightier than the Sword. The press was the first to position Southeast Asian writers and the region in opposition to the imperial metropole, in line with the rise of postcolonial studies in the Anglo-American academy. Significantly, Skoob Pacifica mirrors the earlier linguistic and geographical formation of the Heinemann series as a reflection of colonial linguistic legacies. By examining the affordances and limitations of Anglophone Southeast Asia through a materialist lens in the broader context of post independence and the Cold War, this essay makes a methodological case for understanding the region as a literary unit through its publishing networks.
Introduction to a How I Treat series on iron overload in hematologic disorders
Authors: Coates Thomas D.
Published: January 2025

It has long been recognized that iron overload is toxic and that diagnosis and management of iron overload in patients with hematological disorders are complex and can be disease-specific. Associate Editor Thomas D. Coates presents a series that aims to deconvolute iron overload and provide advice on management. An overarching theme is that the magnitude and duration of exposure to reactive non–transferrin-bound iron, increased by ineffective erythropoiesis, transfusion, or upregulated iron absorption, determine tissue damage. Understanding this biology in a specific disease setting guides management. Coates reviews iron overload in transfusion-dependent hemoglobinopathies; Angelucci contributes insights on treating iron overload before, during, and after stem cell transplantation through discussion of 5 cases; and Leitch and Buckstein share their wisdom on treating iron overload in patients with myelodysplastic syndromes, outlining their approach in several common clinical scenarios.
Clinical Significance of Respiratory Bacteria and Mycobacteria Isolates in Adult Bronchiectasis in Taiwan
Authors: Chang Chia-Ling , Sheu Chau-Chyun , Wang Ping-Huai , Hsieh Meng-heng , Hsu Wu-Huei , Chen Ming-Tsung , Ou Wei-Fan , Wei Yu-Feng , Yang Tsung-Ming , Lan Chou-Chin , Wang Cheng-Yi , Lin Chih-Bin , Lin Ming-Shian , Wang Yao-Tung , Lin Ching-Hsiung , Liu Shih-Feng , Cheng Meng-Hsuan , Chen Yen-Fu , Cheng Wen-Chien , Peng Chung-Kan , Chan Ming-Cheng , Chen Ching-Yi , Jao Lun-Yu , Wang Ya-Hui , Chen Chi-Jui , Chen Shih-Pin , Tsai Yi-Hsuan , Cheng Shih-Lung , Lin Horng-Chyuan , Chien Jung-Yien , Wang Hao-Chien
Published: January 2025

Background

The clinical impact of bacterial and mycobacterial isolates on bronchiectasis remains uncertain.

Materials and methods

Patients with bronchiectasis at 16 hospitals in Taiwan were recruited with a 1-year follow-up. The patients were classified into six groups: Group 1,Pseudomonas aeruginosa; Group 2,Klebsiella pneumoniae; Group 3, Other bacteria; Group 4, Non-tuberculous mycobacteria (NTM); Group 5, Daily sputum without bacterial or NTM colonization; and Group 6, Dry bronchiectasis.

Results

A total of 1416 patients (mean age, 67 years; males, 43%) were included. The mean modified Reiff score was 5 (range: 1–18). Fifty-nine percent (829 patients) had sputum, whereas the remaining did not. The proportions of bacteria and NTM cultured from sputum within one year of observation were 27% (381/1416) and 15% (202/1416), respectively. The most common bacterial isolate wasP. aeruginosa(13%), followed byK. pneumoniae(7%). Twenty-six percent of the patients experienced severe exacerbations at least once within the year. The one-year all-cause mortality rate was 3%. Patients with sputum exhibited a higher rate of severe exacerbations compared to that in patients with dry bronchiectasis, regardless of the presence of bacteria or NTM (p<0·001). Patients with bacterial colonization had a higher mortality rate (p<0·001). Further, the highest mortality rate was observed among those withK. pneumoniaecolonization (hazard ratio [HR]: 8.39, 95% confidence interval [95% CI]: 2.39–29.49), followed by individuals colonized with other bacteria (HR: 8.04, 95% CI: 2.36–27.38) andP. aeruginosa(HR: 7.83, 95% CI: 2.45–25.03). Additionally, old age was an independent risk factor (HR, 2.72; 95% CI: 1.19–6.18).

Conclusion

K. pneumoniaewas more frequently isolated from patients with bronchiectasis in Taiwan, compared with Western countries and was associated with unfavorable clinical outcomes.
Long-Term Exercise Capacity in Paediatric Cystic Fibrosis: A Modern Era Perspective
Authors: Gaupmann René , Stöger Laura , Schmidthaler Klara , Pauger Bianca , Mersi Brigitte , Graf Alexandra , Szépfalusi Zsolt , Renner Sabine , Dehlink Eleonora , Gruber Saskia
Published: January 2025

Background

Maintaining good cardiopulmonary fitness is crucial for global health in Cystic Fibrosis (CF), but there is limited knowledge about the longitudinal evolution of fitness measures at young ages, particularly with recent therapeutic advances. We investigated trends in exercise test outcomes in young people with CF (PwCF) and how they are influenced by elexacaftor/tezacaftor/ivacaftor (ETI) and the COVID-19 pandemic.

Methods

70 young PwCF (12 to 20 years) were included in this retrospective observational single-centre study. We reviewed 177 symptom-limited surveillance cardiopulmonary exercise tests (CPET) conducted on a cycle ergometer between 2010 and 2024. Longitudinal trends in peak oxygen uptake (VO2peak), maximal workload, and ventilation were analysed using linear mixed models, separately for periods before and after the COVID-19 pandemic onset and ETI introduction.

Results

In ETI-naïve PwCF, VO2peakwas lower, and the increase from 12 to 20 years was smaller than predicted by validated reference data (p<0.001). Forty PwCF started ETI during the observational period with 46/103 tests performed under ETI (median therapy duration 1.6 years, range: 0.4–3.9). After ETI introduction, VO2peakimproved significantly, while ventilation and maximal workload were not relevantly affected. ETI approval coincided with the COVID-19 pandemic, during which a steeper decline of VO2peakin ETI-naïve PwCF was observed. However, this potential confounder did not significantly impact the overall longitudinal improvement in VO2peaktrajectory following ETI introduction (p<0.05).

Conclusion

The longitudinal trend in VO2peakprogression from adolescence to young adulthood is impaired in PwCF, but the initiation of ETI can have a positive impact on this trajectory.
Pandemic-disordered sleep: longer illness, more fatigue, but little SARS-CoV-2 effect
Authors: Proctor Simon , Cheetham Nathan J. , Brown Julia R. B. , Bowyer Vicky , Toson Barbara , Harvey Nicholas R. , Leschziner Guy , Joseph Desaline , Hammers Alexander , Sudre Carole H. , Steves Claire J , Mukherjee Sutapa , Duncan Emma L
Published: January 2025

The COVID-19 pandemic disturbed sleep globally in both infected and uninfected individuals. Prolonged symptoms (particularly fatigue) after SARS-CoV-2 infection (post-COVID syndrome [PCS]) remains a health issue. Whether there is a relationship between PCS and sleep disturbance is largely unknown, with most studies lacking uninfected controls. We assessed sleep behaviours in a large UK cohort, analysing sleep disruption, fatigue, SARS-CoV-2 infection, and symptom duration.

Methods

UK adults previously recruited from the KCL-ZOE COVID Symptom Study to the COVID Symptom Study Biobank, with prospective symptom logging and SARS-CoV-2 testing, were invited to complete online validated questionnaires for sleep (Pittsburgh Sleep Quality Index, Sleep Condition Indicator, STOP-Bang, Epworth Sleepiness Scale), fatigue (Chalder Fatigue Scale), and mental health (GAD-2, PDH2). Data were analysed considering SARS-CoV-2 infection, symptom duration, and co-morbidities including mental health.

Results

Questionnaires were completed by 3833 of 8355 participants (2089 infected, 1721 uninfected, 23 unknown). Individuals with longer (versusshorter) symptom duration had poorer sleep scores for multiple questionnaires; but SARS-CoV-2 infection had no independent effect on sleep. However, previously infected (versusuninfected) individuals had greater fatigue, over a year since infection. Longer symptom duration, poorer sleep scores, and greater fatigue were also associated with higher contemporaneous levels of anxiety and depression; however, an independent effect of prior SARS-CoV-2 infection on fatigue remained after adjustment. Higher body mass index, greater age, and prior co-morbidities independently worsened sleep scores also.

Conclusions

Sleep disturbance contributes to long symptoms, irrespective of SARS-CoV-2 infection. Proven sleep interventions may help individuals with post-pandemic fatigue, including PCS.
Psychosocial working conditions and violence prevention climate in German emergency departments – a cross-sectional study
Authors: Reißmann Sonja , Guliani Mannat , Wirth Tanja , Groneberg David A. , Harth Volker , Mache Stefanie
Published: January 2025

Background

Emergency departments (EDs) are high pressure work environments with several psychosocial job demands, e.g., violence, and job resources, e.g., colleague support. So far, the perceptions of working conditions have been compared between doctors and nurses, but there is limited knowledge regarding their respective supervisors. In addition, the violence prevention climate has not been assessed in German EDs before. Thus, the current study focuses on differences in the perceptions of working conditions and the violence prevention climate between the groups of doctor-supervisors, doctor-employees, nurse-supervisors, and nurse-employees within the ED. Further analyses regarding the association between social relations and pressure for unsafe practices are performed, including the moderating role of belonging to one of the aforementioned groups.

Methods

A cross-sectional online survey was carried out among N = 370 participants, who were doctors or nurses from German EDs. The Questionnaire for Psychosocial Risk Assessment (QPRA) and the Violence Prevention Climate Scale (VPCS) were applied. Kruskal-Wallis tests were performed for group comparisons, followed by a hierarchical multiple linear regression model and moderation analyses.

Results

Statistically significant differences between the groups were found for eight out of 13 variables. The highest number of significant pairwise comparisons was found between the groups of doctor-supervisors and nurse-employees. High job demands regarding work intensity and work interruptions became apparent across all groups. Nurse-employees reported the highest social and emotional demands as well as the highest pressure for unsafe practices regarding violence prevention, significantly differing from the other groups on these variables. The variables of supervisor support and social stressors were found to be significantly predictive of pressure for unsafe practices. Furthermore, there was no moderating effect of belonging to one of the above-mentioned groups in the relationships between variables of social relations and pressure for unsafe practices.

Conclusions

Differences found in the current study can help tailor preventive measures according to the needs of distinct professions and positions in order to improve working conditions and the violence prevention climate in EDs. Furthermore, supervisor support should be strengthened while social stressors should be resolved in order to decrease pressure for unsafe practices regarding violence prevention.
Diagnostic value of interferon-γ release assay in patients with COPD complicated with pulmonary tuberculosis
Authors: Rong Yanxiao , Wang Haibin , Su Yuanyuan , Wang Qian , Sun Xuepei , Wang Wei
Published: January 2025

Background

The common diagnostic methods for tuberculosis have been showing reduced sensitivity among chronic obstructive pulmonary disease patients. This study was conducted to evaluate and analyse the diagnostic value of an interferon-γ release assay in COPD patients complicated with pulmonary tuberculosis.

Methods

A nested case-control study was conducted on 123 COPD patients hospitalized at the Fifth Hospital of Shijiazhuang, Hebei Province, from January 2019 to June 2021. Thirty-one patients with active pulmonary tuberculosis complicated with COPD composed the observation group (Group A), 31 patients with nonactive pulmonary tuberculosis complicated with COPD composed the COPD control group (Group B), and 31 patients with active pulmonary tuberculosis not complicated with COPD composed the non-COPD control group (Group C). An interferon-γ release assay, a purified protein derivative of tuberculin (PPD) test, an anti-tuberculosis antibody test, a test of Mycobacterium tuberculosis by sputum smear microscopy and a test of Mycobacterium tuberculosis by PCR method were used to test patients in each group. The positive detection rates generated from the five test methods were compared and analysed.

Results

In COPD patients complicated with active pulmonary tuberculosis, the differences in the percentage of patients with positive interferon-γ release between the PPD test, anti-tuberculosis antibody test, Mycobacterium tuberculosis by sputum smear microscopy and PCR test results were statistically significant.

Conclusion

In patients with COPD complicated with active pulmonary tuberculosis, the percentage of patients who were positive according to the interferon-γ release assay was higher than that according to the sputum smear microscopy, PCR detection of Mycobacterium tuberculosis in sputum specimen, and detection of anti-tuberculosis antibodies. COPD-related complications did not affect the T-SPOT; the greater the T-SPOT value was, the greater the likelihood of active TB. For patients who are T-SPOT positive but clinically considered to have inactive tuberculosis, regular follow-ups should be performed to observe changes in the patient’s condition.
Ramadan during pregnancy and the role of dietary intake for neonatal health in Kaduna, Northwestern Nigeria: a cross-sectional study
Authors: Kana Musa Abubakar , Usman Bilkisu , Mohammed-Durosinlorun Amina , Ahmed Jennifer , Abubakar Hassana Habiba , Abdulmalik Yakub , Pradella Fabienne
Published: January 2025

Background

Ramadan during pregnancy is associated with adverse offspring health outcomes. Recent evidence from Europe indicates that maternal diet during non-fasting hours might alleviate these effects. This study describes fasting, diet, and sleep habits among pregnant Muslims in Kaduna, Nigeria, and assesses impacts on neonatal health in this setting.

Methods

Between July 2023 and February 2024, we conducted 1814 interviews with women whose pregnancy overlapped with Ramadan 2023 in Kaduna, northwestern Nigeria (cross-sectional study). We used a structured questionnaire to collect data on fasting, diet and sleep during Ramadan, as well as maternal socio-demographic characteristics. In the analyses of birth outcomes, 1370 mother-newborn pairs were included. We performed multivariate regression analyses to evaluate associations between fasting and birth weight and gestational duration, as well as the interaction of fasting with maternal dietary intake and sleep patterns.

Results

More than 80% of the study participants fasted during pregnancy. Women who fasted had infants with lower birth weights than non-fasting participants (-90.38 g, 95% CI: -173.64 g to -6.12 g). No independent associations were detected between reduced sleep and food intake, and birth weight. Fasting was not associated with gestational duration. Negative effects of fasting on birth weight were consistently concentrated among participants who reduced their dietary or fluid intake during Ramadan.

Conclusions

Dietary intake during non-fasting hours might mitigate potential adverse effects of Ramadan fasting on birth weight. With more than 25% of the global population adhering to Islam, this study highlights the need for additional research on Ramadan during pregnancy across different settings.
Sex-based disparities in the association between uric acid levels and anxiety: a cross-sectional analysis of nationwide data in Korea
Authors: Park Soohyun , Kim Joo O. , Park Gyu Nam , Oh Jae Won , Lee San
Published: January 2025

Background

Uric acid has antioxidant properties, and several studies have suggested its neuroprotective effects. Despite reports of increased oxidative damage and decreased antioxidants in anxiety disorders, findings remain inconclusive. This study investigated the association between serum uric acid levels and anxiety symptoms, stratified by sex, using nationwide data from South Korea.

Methods

Data were derived from the Korea National Health and Nutrition Examination Survey, which included 2,228 males and 2,805 females. Presence of anxiety symptoms was defined as a Generalized Anxiety Disorder 7-item scale (GAD-7) score of ≥ 10. Study participants were categorized into three groups based on serum uric acid levels: 1 (lowest) to 3 (highest). Multivariable logistic regression analyzed the association between uric acid levels and anxiety symptoms, stratified by sex.

Results

Compared to reference group 2, females in group 1 had increased anxiety symptoms (odds ratio (OR) 2.28, 95% confidence interval (CI) 1.48–3.49). When anxiety symptoms were defined as a GAD-7 score of ≥ 5, females in groups 1 (OR 1.68, 95% CI 1.30–2.16) and 3 (OR 1.35, 95% CI 1.04–1.74) both showed more anxiety symptoms than group 2, with a U-shaped relationship between uric acid levels and anxiety symptoms. In males, uric acid levels weren't significantly linked to anxiety symptoms.

Conclusions

This study indicates that low serum uric acid levels are associated with a higher prevalence of anxiety symptoms only in females, suggesting involvement of oxidative stress in anxiety disorders and its sex-based variation.
Challenges and possibilities when doing research on active school travel interventions in a school setting - a non-randomized pilot study assessing feasibility of an evaluation design
Authors: Andersson Mathias , Tseli Elena , Lindqvist Anna-Karin , Rutberg Stina , Palstam Annie
Published: January 2025

Background

A wide range of school interventions have been launched to increase childrens’ physical activity. Evaluation of the effectiveness of interventions requires suitable study designs and feasible quantitative evaluations relating to the school setting. The purpose of this study was to assess the evaluation design and methods for data collection, in order to make decisions about approaching forthcoming studies of the effectiveness of active school travel (AST) interventions.

Methods

Children from four Swedish schools in fifth grade (11–12 years old) participated in this non-randomized pilot study, two schools received an AST intervention and two schools were controls. The school-based AST intervention Sustainable Innovation for Children Transporting Actively (SICTA) was conducted by teachers in the classroom setting during four weeks. To assess feasibility of the evaluation design and methods for data collection a combination of quantitative and qualitative methods were applied, using participation- and response rates, a feasibility questionnaire and focus group interviews.

Results

Out of 25 potential schools, four schools accepted participation with explicit allocation requests preventing randomization. Out of 181 children, 107 children (59%) accepted participation. A total of 82% of the participating children reported active travel before the AST intervention, and 80% found reporting of daily school travels in the web-based survey to be easy. The children were in general positive about participating in the study and the methods for data collection were considered easy for the participating children to conduct and to blend well with usual school activities. There was an imbalance in reporting rates between intervention and control schools as well as a decrease in reporting rates during the study period.

Conclusions

Our results highlight the complexity and challenges in conducting controlled research among school children. Although children were positive about participation and found reporting to be easy, our results invoke the need to use alternative research designs and recruitment strategies that also attract children using non-active modes of travel when evaluating AST interventions in school contexts.

Trial registration

The study is registered 2023/11/02 with Researchweb, the Swedish Register for Research with registration number 281,543. The registration can be reached via this link: https://www.researchweb.org/is/sverige/project/281543.
Short dentin etching with universal adhesives: effect on bond strength and gingival margin adaptation
Authors: Ismail Hoda Saleh , Soliman Hanan Ahmed Nabil
Published: January 2025

Background

Short dentin etching, a relatively recent technique, aims to improve resin-dentin bonding by preserving hydroxyapatite crystals within the collagen spaces. This study explores short dentin etching’s potential in mitigating over-etching issues in deep proximal dentin/cementum margins, an aspect not previously investigated. This study evaluates the microtensile bond strength (μTBS) and marginal adaptation of two universal adhesives using different etch-and-rinse strategies (15-second and 3-second etching) and self-etch strategies, both immediate and post-thermal cycling and mechanical loading.

Methods

Eighty-four molars underwent μTBS testing, categorized by the universal adhesive type (Tetric Uni and Prime&Bond Uni) (n = 42) and adhesive strategy (n = 14) with half tested after 24 h and the rest post aging. Forty-two molars received occluso-mesial preparations with proximal margins in dentin/cementum and were restored accordingly. Scanning electron microscope (SEM) examination of epoxy replicas for the restoration/gingival dentin interfaces was conducted after 24 h and aging. Dentin etching patterns were assessed using SEM. A three-way ANOVA evaluated μTBS data, while a two-way ANOVA and paired sample t-test analyzed marginal adaptation data (significance level is α = 0.05).

Results

Adhesive type, strategy, and aging significantly influenced μTBS. After aging, Tetric Uni subgroups displayed higher bond strength compared to Prime&Bond Uni subgroups. Marginal adaptation was unaffected by adhesive type or strategy, although aging reduced bond strength and adaptation for both adhesives.

Conclusions

The etch-and-rinse protocol yielded higher μTBS results for the HEMA-free isopropanol-based adhesive (Prime&Bond Uni). Marginal integrity was similar for both adhesives. The 3-second and 15-second etching times produced consistent results in all tests and for both adhesives.

Clinical significance

The adhesive protocol for bonding universal adhesives to dentin is contingent on the adhesive composition.
Rehabilitation success and related costs following stroke in a regional hospital: a retrospective analysis based on the Australian National Subacute and Non-Acute Patient (AN-SNAP) classification
Authors: He Fan , Mnatzaganian George , Njovu Michael , Rutherford David , Alexander Tara , Blackberry Irene
Published: January 2025

Background

Evidence is limited on the factors influencing successful stroke rehabilitation in regional contexts. Additionally, the relationship between rehabilitation costs following acute stroke, based on Australian National Subacute and Non-Acute Patient (AN-SNAP) casemix classification, and rehabilitation success remains unclear.

Objective

This retrospective cohort study investigated the factors contributing to improved functional outcomes following stroke rehabilitation in an Australian regional hospital, also evaluating the respective average daily and total payments.

Methods

Stroke patients’ admission records, during 2010–2020, were linked with rehabilitation registry data. Rehabilitation success was defined as relative functional gain (RFG) ≥ 0.5 and Functional Independence Measure (FIM) efficiency ≥ 1. Multivariate mixed effects logistical regressions modelled the sociodemographic and medical (i.e., comorbidities and stroke type) predictors of rehabilitation success, while logarithms of average daily and total rehabilitation payments were modelled using robust regressions.

Results

Of 582 included patients, 315 (54.1%) achieved RFG ≥ 0.5 and 258 (52.2%) achieved FIM efficiency ≥ 1. A longer delay in starting rehabilitation was associated with a lower likelihood of achieving RFG success [Odds Ratio (OR): 0.85, 95% confidence interval (CI): 0.78–0.93, P < 0.001] and FIM efficiency success (OR: 0.89, 95% CI: 0.82–0.97, P = 0.010). A higher FIM score at admission was associated with decreased odds of FIM efficiency success (OR: 0.35, 95% CI: 0.20–0.60, P < 0.001). The average daily and total rehabilitation payments for inpatients were $AU1,255 (median) [interquartile range (IQR): 1,040, 1,771] and $AU28,363 (median) (IQR: 18,822, 41,815), respectively. FIM efficiency success was positively associated with the average daily payment (Beta: 0.25, 95% CI: 0.20–0.30, P < 0.001), but negatively correlated with the total payment (Beta: -0.18, 95% CI: -0.24–0.13, P < 0.001). No significant associations were found between RFG success and these payments.

Conclusion

This study identifies key factors affecting stroke rehabilitation outcomes in a regional Australian setting. Delays in starting rehabilitation were linked to lower success rates, underscoring the importance of timely intervention. While higher average daily costs were associated with better FIM efficiency, total costs did not correlate with relative functional gains. These findings may inform rehabilitation practices and may influence future funding strategies for rehabilitation services.
Socioeconomic Inequity in Access to Medical and Long-Term Care Among Older People
Authors: Okamoto Shohei , Yamada Atsuhiro , Kobayashi Erika , Liang Jersey
Published: January 2025

Background

Ensuring equitable access to medical and long-term care (LTC) is critical to enable older people to maintain their health and well-being even after they undergo a decline in their intrinsic capacity.

Methods

We used data from five waves of the National Survey of the Japanese Elderly, conducted between 2002 and 2021, to assess gradients in access to medical care and LTC by income and education among Japanese individuals aged 60 years and above. Specifically, we assessed self-reported unmet needs for medical care and LTC, and public LTC use, and estimated the concentration indices (CI) to evaluate the degree of inequality and inequity. We standardised public LTC use by need and non-need variables. We analysed data derived from up to 1,775 person-wave observations from 1,370 individuals.

Findings

The pooled incidence across waves of forgone medical care, self-reported unmet support for activities of daily living (ADL) or instrumental ADL (IADL), and those not certified for LTC services even with ADL or IADL limitations were 4.6%, 15.5%, and 62.5%, respectively. Public LTC use demonstrated pro-higher education and pro-rich distribution, whereas the gaps decreased for need-predicted use. Based on the CI estimates, no explicit inequality was found for forgone medical care. However, we observed inequity in standardised LTC use across education, indicating pro-higher education inequality, particularly among women and those aged ≥ 80 years.

Conclusion

Improving the understanding of available resources and strengthening the functions of health centres and communities are required to detect the needs of citizens and facilitate their access to necessary care.
Satisfied with the worst health outcomes or unsatisfied with the best: explaining the divergence between good patient-reported outcomes and low satisfaction and vice versa among knee arthroplasty patients – a retrospective cohort study
Authors: Schöner Lukas , Steinbeck Viktoria , Busse Reinhard , Marques Carlos J.
Published: January 2025

Objectives

Total knee arthroplasty (TKA) is an effective treatment for patients with end-stage knee osteoarthritis but some patients exhibit a discrepancy between patient-reported outcomes (PROs) and patient satisfaction (PS). This study aims to identify predictors for patients reporting unfavorable PROs but high PS and vice versa.

Materials and methods

This retrospective cohort study categorized patients from nine German hospitals into four groups based on (i) whether they achieved a minimal clinically important difference (MCID) in knee functionality, measured with a joint-specific PRO from admission to 12-month post-surgery; and (ii) whether they were satisfied at 12 months post-surgery. The groups were (A) Satisfied Achievers (satisfied, MCID reached), (B) Dissatisfied Achievers (not satisfied, MCID reached), (C) Satisfied Non-Achievers (satisfied, MCID not reached) and (D) Dissatisfied Non-Achievers (not satisfied, MCID not reached). Exploratory analyses were performed to understand differences between the four groups using chi-squared tests and ANOVA. Multinomial logistic regression models were conducted to identify predictors for the allocation of patients in groups.

Results

A total of 1546 knee arthroplasty patients with a mean age of 65.9 years, 54.1% female, were included. 1146 (74.1%) patients were Satisfied Achievers, 131 (8.5%) were Dissatisfied Achievers, 141 (9.1%) were Satisfied Non-Achievers, and 128 (8.3%) Dissatisfied Non-Achievers. The results showed that higher improvements in health-related quality of life, pain and fatigue symptoms significantly decreased the likelihood of being a Dissatisfied Achiever and a Satisfied Non-Achiever. Comorbidities of blood circulation, chronic back pain or diabetes increased the likelihood of being a Dissatisfied Achiever, while depression decreased the likelihood of being a Satisfied Non-Achiever.

Conclusion

Addressing individual health concerns, e.g. through expectation management, and assessing alternative treatment options might improve satisfaction in line with functional improvements. A closer evaluation at which physical impairment level surgery is beneficial could help to improve the care of Satisfied Non-Achievers.
Menopause mysteries: the exosome-inflammation connection
Authors: Sultania Aarushi , Brahadeeswaran Subhashini , Kolasseri Aparna Eledath , Jayanthi Sivaraman , Tamizhselvi Ramasamy
Published: January 2025

Extracellular vesicles, or exosomes, are produced by every type of cell and contain metabolites, proteins, lipids, and nucleic acids. Their role in health and disease is to influence different aspects of cell biology and to act as intermediaries between cells. Follicular fluid exosomes or extracellular vesicles (FF-EVs) secreted by ovarian granulosa cells are critical mediators of ovary growth and maturation. The movement and proteins of these exosomes are crucial in the regulation of cellular communication and the aging of cells, a process termed inflammaging. Menopause, a natural progression in the aging of females, is often accompanied by numerous negative symptoms and health issues. It can also act as a precursor to more severe health problems, including neurological, cardiovascular, and metabolic diseases, as well as gynecological cancers. Researchers have discovered pathways that reveal the diverse effects of exosome-driven cellular communication and oocyte development in the follicular fluid. It also explores the complex functions of FF exosomal proteins in the pathologies associated with menopause.

Graphical Abstract
Quantitative valve motion assessment in adolescents using point-of-care ultrasound: short communication
Authors: Riera Antonio , Chen Lei , Wright Donald S. , Leviter Julie I.
Published: January 2025

E-point septal separation (EPSS) and tricuspid annular plane systolic excursion (TAPSE) are M-mode measures of left and right ventricular systolic function, with limited pediatric point-of-care ultrasound (POCUS) research. We conducted a cross-sectional study in a pediatric emergency department, enrolling 12–17-year-olds without cardiopulmonary complaints. Exclusion criteria included abnormal vital signs, fever, altered mental status, or psychiatric illness. POCUS faculty performed the measurements, while blinded to pediatric echocardiography reference values. Data was analyzed using unpaired t-tests and Pearson’s correlation. Correlations with age, height, weight, body mass index, and heart rate were examined. Twenty subjects were enrolled. The mean EPSS was 2.5 mm (SD 1.9 mm), and the mean TAPSE was 2.6 cm (SD 0.4 cm), aligning with pediatric echocardiography reference values. No significant correlations were found between EPSS or TAPSE and anthropometric data.
Mesenchymal stromal cells-derived extracellular vesicles in cartilage regeneration: potential and limitations
Authors: Piñeiro-Ramil María , Gómez-Seoane Iván , Rodríguez-Cendal Ana Isabel , Fuentes-Boquete Isaac , Díaz-Prado Silvia
Published: January 2025

Background

Articular cartilage injuries can lead to pain, stiffness, and reduced mobility, and may eventually progress to osteoarthritis (OA). Despite substantial research efforts, effective therapies capable of regenerating cartilage are still lacking. Mesenchymal stromal cells (MSCs) are known for their differentiation and immunomodulatory capabilities, yet challenges such as limited survival post-injection and inconsistent therapeutic outcomes hinder their clinical application. Recent evidence suggests that the beneficial effects of MSCs are largely mediated by their secreted small extracellular vesicles (sEVs), which have been shown to promote tissue repair and reduce inflammation. MSC-derived sEVs have shown promise in mitigating cartilage degradation and chondrocyte apoptosis, positioning them as a promising alternative to MSC-based therapies for OA treatment. This review explores the potential and limitations of MSC-derived sEVs in cartilage regeneration.

Main text

This systematic review was conducted following PRISMA guidelines, with a comprehensive search of the Web of Science and Scopus databases for studies published between 2019 and 2024. A total of 223 records were identified, of which 132 articles were assessed for eligibility based on general selection criteria. After full-text screening, 60 articles were initially selected, comprising 58 in vitro studies and 40 in vivo studies. Following further exclusion based on specific criteria, 33 in vitro and 28 in vivo studies from a total of 47 scientific papers were included in the final qualitative synthesis. Most studies indicate that MSC-derived sEVs enhance chondrocyte proliferation, improve cartilage extracellular matrix composition, and reduce matrix-degrading enzymes and inflammation, thereby delaying OA progression.

Conclusion

A growing body of evidence supports the use of MSC-derived sEVs as a therapeutic tool for preventing OA progression, with most studies reporting beneficial effects on cartilage structure and function. However, challenges remain in optimizing and standardizing sEVs isolation, dosage, and delivery methods for clinical application. Further research is necessary to elucidate the mechanisms underlying sEVs-mediated cartilage regeneration and to facilitate their translation into effective OA therapies.
Deciphering mechanical cues in the microenvironment: from non-malignant settings to tumor progression
Authors: Zhu Yicheng , Chen Jiaoshun , Chen Chen , Tang Rong , Xu Jin , Shi Si , Yu Xianjun
Published: January 2025

The tumor microenvironment functions as a dynamic and intricate ecosystem, comprising a diverse array of cellular and non-cellular components that precisely orchestrate pivotal tumor behaviors, including invasion, metastasis, and drug resistance. While unraveling the intricate interplay between the tumor microenvironment and tumor behaviors represents a tremendous challenge, recent research illuminates a crucial biological phenomenon known as cellular mechanotransduction. Within the microenvironment, mechanical cues like tensile stress, shear stress, and stiffness play a pivotal role by activating mechanosensitive effectors such as PIEZO proteins, integrins, and Yes-associated protein. This activation initiates cascades of intrinsic signaling pathways, effectively linking the physical properties of tissues to their physiological and pathophysiological processes like morphogenesis, regeneration, and immunity. This mechanistic insight offers a novel perspective on how the mechanical cues within the tumor microenvironment impact tumor behaviors. While the intricacies of the mechanical tumor microenvironment are yet to be fully elucidated, it exhibits distinct physical attributes from non-malignant tissues, including elevated solid stresses, interstitial hypertension, augmented matrix stiffness, and enhanced viscoelasticity. These traits exert notable influences on tumor progression and treatment responses, enriching our comprehension of the multifaceted nature of the microenvironment. Through this innovative review, we aim to provide a new lens to decipher the mechanical attributes within the tumor microenvironment from non-malignant contexts, broadening our knowledge on how these factors promote or inhibit tumor behaviors, and thus offering valuable insights to identify potential targets for anti-tumor strategies.
Prediction models for the complication incidence and survival rate of dental implants—a systematic review and critical appraisal
Authors: Zhu Yuanxi , Du Mi , Li Ping , Lu Hongye , Li An , Xu Shulan
Published: January 2025

Purpose

This systematic review aims to assess the performance, methodological quality and reporting transparency in prediction models for the dental implant’s complications and survival rates.

Methods

A literature search was conducted in PubMed, Web of Science, and Embase databases. Peer-reviewed studies that developed prediction models for dental implant’s complications and survival rate were included. Two reviewers independently evaluated the risk of bias and reporting quality using the PROBAST and TRIPOD guidelines. The performance of the models were also compared in this study. The review followed the PRISMA guidelines and was registered with PROSPERO (CRD42019122274).

Results

The initial screening yielded 1769 publications, from which 14 studies featuring 43 models were selected. Four of the 14 studies predicted peri-implantitis as the most common outcome. Three studies predicted the marginal bone loss, two predicted suppuration of peri-implant tissue. The remaining five models predicted the implant loss, osseointergration or other complication. Common predictors included implant position, length, patient age, and a history of periodontitis. Sixteen models showed good to excellent discrimination (AUROC >0.8), but only three had undergone external validation. A significant number of models lacked model presentation. Most studies had a high or unclear risk of bias, primarily due to methodological limitation. The included studies conformed to 18–27 TRIPOD checklist items.

Conclusions

The current prediction models for dental implant complications and survival rate have limited methodological quality and external validity. There is a need for enhanced reliability, generalizability, and clinical applicability in future models.
A comprehensive in silico analysis of structural and functional impacts of natural nonsynonymous SNPs in the ALDH2_HUMAN gene
Authors: Mahmood Janlou Mehr Ali
Published: January 2025

Background

nsSNPs result in amino acid substitutions in coding regions that contribute significantly to the structural diversity of proteins in human populations and can affect protein function by altering solubility or stability. Mitochondrial aldehyde dehydrogenase 2 (ALDH2) is a key enzyme involved in the metabolism of acetaldehyde to acetate through a coenzyme-dependent mechanism. Acetaldehyde exhibits a toxic effect, highlighting the necessity of ALDH2’s proper functioning to protect against diseases associated with aldehyde toxicity. ALDH2 has three natural variants: E487K, E479K, and E320V. Consequently, it seems necessary to investigate the underlying molecular basis of the effect of each of these mutations on enzyme structure and function.

Results

Employing molecular docking and scoring functions of NAD+ at the prosthetic site of ALDH2 indicate that only E487K significantly reduces binding affinity and has a higher inhibition constant. Furthermore, performing microsecond-timescale molecular dynamics simulations revealed that only the E487K mutation elevated the conformational instability and induced less compactness of the ALDH2. To compare the results, four distinct SNP predictors were employed. The outcomes generated by these tools were noteworthy and corroborated the results obtained from the molecular docking and dynamics simulations, indicating that only the E487K variant was identified as a deleterious mutation.

Conclusions

This study revealed that among three natural variants of ALDH2, only the E487K significantly reduces the interaction between NAD+ and ALDH2 due to structural instability in the enzyme, disrupting critical interactions with Cys302 and Glu268 required for enzyme activity. The exploration of the dynamic behavior of the dominant negative mutant in this investigation will contribute essential knowledge toward the potential restoration of its function.
Nem sempre mais é melhor
Authors: Belo Neuza
Published: January 2025

A Loja Caraúba, especializada em acessórios femininos, está passando por um período de instabilidade financeira, caracterizado por um déficit de capital de giro. A chegada de uma nova sócia impulsiona a necessidade de reorganizar os processos financeiros da empresa e buscar soluções para a falta de liquidez. Através da análise das propostas apresentadas por Manoela, o caso convida os alunos a mergulhar no universo da gestão financeira, avaliando as diversas alternativas de financiamento disponíveis no mercado. Ao simular a tomada de decisão em um contexto empresarial real, o estudo proporciona aos alunos a oportunidade de aplicar os conhecimentos teóricos adquiridos em cursos de administração e MBA, desenvolvendo habilidades práticas para a gestão eficaz do capital de giro e a otimização do custo de capital.